Pathology Flashcards
What is the main difference in the components of a forensic as opposed to a hospital autopsy?
Forensic includes scene investigation
What is the difference in hospital and forensic autopsies in requiring a permit?
Required for hospital autopsies
Not required for forensic
What is the main purpose of the hospital autopsy as opposed no forensic?
Hospital - document natural disease processes, answer clinician’s questions
Forensic - determine cause and manner of death, document traumatic injury, and report important natural disease, identification
What is the confidentiality of a hospital vs forensic autopsy?
Hospital - confidential
Forensic - public record
Is toxicology obtained in an autopsy?
Hospital - rarely
Forensic - always
What components does a permit require?
Permission of legal next of kin
Signature of non-physician witness
What is the order of legal next of kin?
Spouse Adult child Legal guardian of minor Father or mother Next of kin (specify relationship) Person assuming custody for burial
What are the criteria for classification as a medical examiners case?
Death within 24 hrs of hospital admission
Any death in police custody
Death of child under 6
Stillbirth when maternal drug use suspected
Death during or following medical procedure (usually w/i 24 hrs but depends on case)
Any death involving trauma - no time limitations
Suspicious or unexpected or unexplained deaths
Any death without physician in attendance (unwitnessed deaths)
Death occurring at a workplace
What is the definition of the cause of death?
Condition, defect, injury, or process that initiated patients demise
Doesn’t matter now long ago the change occurred
Includes part I - “due to” list and part II - contributing factors
What is the manner of death?
Five different ones on checklist - determined by event that initiated death
Natural, suicide, homicide, accident, and undetermined
Only ME or coroner can sign death certificate for anything other than natural
What is the mechanism of death?
Physiological derangement by which death resulted
What are the four main techniques of organ removal?
Virchow - organ by organ, most common
Leutelle - en-bloc resection where everything removed together and subsequently dissected
Rokitansky - in situ dissection combined with biopsies
Ghon - distinct block organs - thoracic, abdominal, genitourinary
What are the benefits/utilities of the autopsy?
Examination of disease process
Answer clinicians questions
Detect infectious processes previously unknown
Identify diseases that might be hereditary
Answer questions regarding etiology of disease process
Teaching and education
Protect physicians from lawsuits
Study clinical therapies or treatment and its effectiveness
Quality management for hospital
Obtain tissue for research, education, and study
What are the limitations of the autopsy?
Good at finding structural defects but not functional
Limited in evaluation of electrolyte abnormalities, endocrinopathies, and some infectious diseases
Looks at single point in time - cant follow evolution of disease
What is the definition of SIDS?
Sudden unexpected death of an infant between one month and one year of age, with onset of fatal episode apparently occurring during sleep, that remains unexplained after thorough death scene investigation, including autopsy and review of history and circumstances of death
What is the triple risk model of SIDS?
A vulnerable infant
External stressors (such as prone sleep position, hyperthermia, minor infection, smoke inhalation, drugs, disease or injury of unknown significance)
Critical developmental period in homeostatic control
Combo of factors might trigger cute cardiovascular collapse and sudden death
