THE POSTMORTEM EXAMINATION (Autopsy)

Question 1

Who said “We must turn to nature itself, to the observations of the body in health and disease, to learn the truth”

Answer 1

Hippocrates

Question 2

Considered the ultimate medical audit

Answer 2

Autopsy

Question 3

What are the five different rulings for manner of death?

Answer 3

SHAUN
- Suicide
- Homicide
- Accident
- Undetermined
- Natural

Question 4

T/F: in a case where suspicious circumstances surround the death, a medical examiner or coroner can order an autopsy without consent from next of kin

Answer 4

True

Question 5

T/F: Everyone receives an autopsy upon death

Answer 5

False

Question 6

In the 44 B.C. The first recorded autopsy occurs when ______ examines ________’s body
after his assassination.

Answer 6

Antistius; Julius Caesar

Question 7

Which among the 23 stab wounds of Julius Caesar was proven fatal?

Answer 7

one wound to the chest that ruptured Caesar’s aorta

Question 8

Who wrote “Hsi Yüan Lu, or The Washing Away of Wrongs”

Answer 8

Song Ci

Question 9

an instruction manual on how to conduct medico-legal investigations, examine corpses, and determine the time and cause of death. Other forward-thinking forensic issues were illustrated, such as poisoning, decomposition, wounds from various weapons, strangulation, and fake wounds.

Answer 9

Hsi Yüan Lu, or The Washing Away of Wrongs by Song Ci

Question 10

Conducted the first-known legal autopsy in 1302 where the death was investigated explicitly to determine if there was fault (what is referred to as a medico-legal autopsy)

Answer 10

Bartolomeo de Varignana

Question 11

Bartolomeo da Varignana was influenced by what book?

Answer 11

The Washing Away of Wrongs

Question 12

T/F: Bartolomeo da Varignana utilized his observations through a microscope

Answer 12

False; his observations were limited by the power of the human eye and his tools

Question 13

Throughout the renaissance, anatomy teachers and students in medical school would congregate in an operating theater and watch a cadaver be opened by a ______

Answer 13

Lay dissector

Question 14

T/F: Throughout the Renaissance, anatomy teachers and students in medical schools did not perform dissections themselves.

Answer 14

True

Question 15

performed a number of “autopsies,” dissecting corpses and observing the anatomy unseen by the naked eye.

Answer 15

Leonardo da Vinci and Michelangelo

Question 16

realized the importance of the microscope when conducting pathological research to uncover minute details.

Answer 16

Rudolf Virchow

Question 17

Through his examinations, he characterized a case of leukemia, and his resulting report is one of the earliest formal reports on this cancer.

Answer 17

Rudolf Virchow

Question 18

T/F: Wherever Scientific medicine of high quality is practiced, postmortem examinations are performed

Answer 18

True

Question 19

Also known as “Autopsy”

Answer 19

Postmortem examination

Question 20

Autopsies are helpful for physicians who challenge their ______

Answer 20

Diagnosis

Question 21

Considered as the first pathologist

Answer 21

Rudolf Virchow

Question 22

Most popular field where autopsies are done

Answer 22

Criminal law

Question 23

What are the 3 steps in preparation before the postmortem examination

Answer 23

Step 1 - Administrative preparations

Step 2 - Preparation of the autopsy room

Step 3 - Confirmation of decedent identity

Question 24

This is where we obtain and confirm consent for autopsy, review clinical records, and contact clinical team and staff pathologist

Answer 24

Step 1- Administrative preparations

Question 25

This is when we set up of dissection instruments and tools, Lay out swabs, media, etc. for any ancillary studies to be performed, prepare photographic equipment, assemble personal protective equipment

Answer 25

Step 2 - Preparation of the autopsy room

Question 26

This is the most important step in the autopsy procedure, where identifiers on the body must be confirmed and matched with the autopsy consent form, and also confirm any limitations or restrictions to the autopsy at this time

Answer 26

Step 3 - Confirmation of decedent identity

Question 27

Has jurisdiction in medicolegal cases, and may authorize the pathologist to proceed with an autopsy.

Answer 27

Medicolegal examiner or the coroner

Question 28

What are the 2 types of autopsies

Answer 28

Medical Autopsy Non-medical autopsy

Question 29

This type of autopsy is largely medicolegal and mainly used for forensics

Answer 29

Non-medical autopsy

Question 30

It is the death of an organism, cessation of circulation and respiration (1960s), and criteria for the pronouncement of death

Answer 30

Somatic Death

Question 31

If there in any medicolegal angle of death, the jurisdiction lies with which government agencies?

Answer 31

PNP and NBI

Question 32

What are the criteria for brain death? (4)

Answer 32

1. Coma and Cerebral unresponsiveness 2. Apnea 3. Absent cephalic (brainstem) reflexes 4. Electrocerebral silence

Question 33

Criteria for brain death should be present for how long after onset of coma and apnea?

Answer 33

30 minutes to at least 6 hours

Question 34

Order of consent for autopsy

Answer 34

1. Spouse 2. Adult children 3. Adult grandchildren 4. Parents 5. Brother/Sister 6. Nephew 7. Grandparents 8. Uncle/Aunt 9. Cousin 10. Stepchildren

Question 35

T/F: If autopsy is not required by law, it can be done even without the next of kin giving permission

Answer 35

False; CANNOT be done until the next of kin gives permission

Question 36

T/F: Consent form must be signed in the presence of a witness

Answer 36

True

Question 37

Autopsy in which all body cavities are examined (including the head / brain)

Answer 37

Complete

Question 38

Type of autopsy which may exclude the head / brain.

Answer 38

Limited (Partial)

Question 39

Type of autopsy where specific organs only are examined.

Answer 39

Selective

Question 40

An autopsy is usually carried out within how long after the death of a person?

Answer 40

48 hours

Question 41

T/F: Coronial autopsies are ordered by the state coroner, whereas hospital based autopsies may be performed at the request of the family of the deceased.

Answer 41

True

Question 42

This part of an autopsy indicates the gross findings

Answer 42

Death certificate

Question 43

Irreversible cessation of circulatory and respiratory functions or Irreversible cessation of all functions of the entire brain, including the brainstem

Answer 43

Death

Question 44

RA as amended by Republic Act No. 7885, organ and tissue donations from donors who have been declared brain dead has been allowed.

Answer 44

REPUBLIC ACT 7170 OR ORGAN DONATION ACT OF 1991

Question 45

How many copies of medical certifications of death are given and to whom.

Answer 45

3 1- Relatives 1 - City health office 1 - Funeral home

Question 46

is the final disease, injury, or complication directly causing death.

Answer 46

Immediate cause of death

Question 47

It precedes death as a consequence of an underlying cause or causes.

Answer 47

Immediate cause of death

Question 48

The condition(s) that led to or precipitated the immediate cause of death, as recorded on a death certificate.

Answer 48

Antecedent cause of death

Question 49

Other intervening cause (or causes) of death occurring between the underlying and immediate causes

Answer 49

Antecedent cause of death

Question 50

Defined for public health and legal purposes as “the disease or injury that initiated the train of events leading to death.”

Answer 50

Underlying (Proximate) cause of death

Question 51

The circumstances of the accident or violence which produced the fatal injury.

Answer 51

Underlying (Proximate) cause of death

Question 52

It is the most important entry in the certificate since mortality statistics is based on this.

Answer 52

Underlying (Proximate) Cause of Death

Question 53

Immediate/Antecedent/Underlying: Congestive Heart Failure

Answer 53

Immediate

Question 54

Immediate/Antecedent/Underlying: Myocardial Ischemia caused by coronary artery

Answer 54

Antecedent

Question 55

Immediate/Antecedent/Underlying: Coronary arterial atherosclerosis

Answer 55

Underlying

Question 56

Immediate/Antecedent/Underlying: Hypovolemic shock

Answer 56

Immediate

Question 57

Immediate/Antecedent/Underlying: Multiple fractures

Answer 57

Antecedent

Question 58

Immediate/Antecedent/Underlying: Pedestrian hit by a truck

Answer 58

Underlying

Question 59

Immediate/Antecedent/Underlying: Lobar pneumonia

Answer 59

Immediate

Question 60

Immediate/Antecedent/Underlying: High output cardiac failure due to anemia

Answer 60

Antecedent

Question 61

Immediate/Antecedent/Underlying: Thalassemia

Answer 61

Underlying

Question 62

Death resulting from disease

Answer 62

Natural

Question 63

Death as a result of environmental influence

Answer 63

Accidental

Question 64

Death intentionally self-inflicted

Answer 64

Suicide

Question 65

Death resulting from the deliberate action of another person

Answer 65

Homicide

Question 66

Unknown cause of death

Answer 66

Intermediate or undetermined

Question 67

Death without the intention to kill

Answer 67

Homicide

Question 68

Refers to a continuum of changes that occur in a dead body following death; these changes include livor mortis, rigor mortis, decomposition, and taphonomy.

Answer 68

Post-mortem changes

Question 69

First demonstrable change after death is cooling of the body.

Answer 69

Algor Mortis

Question 70

the body cools at ___ in 50% of cases

Answer 70

1.5°F/hr

Question 71

At room temp, the body cools to which temperature at the 1st hour?

Answer 71

2 to 2.5 deg F/hr

Question 72

At room temp, the body cools to which temperature at the next 12 hours?

Answer 72

1.5 to 2 degrees F/hr

Question 73

At room temp, the body cools to which temperature at the next 12-18 hrs?

Answer 73

1 deg F/hr

Question 74

Rigidity of the body due to hardening of the skeletal muscles caused by a series of physiochemical events after death

Answer 74

Rigor mortis

Question 75

Rigor mortis is the lack of ATP regeneration and increased acidity result in the formation of locking-chemical bridges between ____ and ____

Answer 75

Actin and myosin

Question 76

Rigor mortis sets within how many hours after death?

Answer 76

2 hours

Question 77

Rigor mortis is complete and fully fixed after approx. how many hours?

Answer 77

6-12 hours

Question 78

Rigor mortis dissipates after approximately how many hours?

Answer 78

36-48 hours

Question 79

Fixed rigor mortis of the upper extremities wherein the arms are suspended against gravity, indicating they were previously held in that position while rigor was fixing.

Answer 79

Antigravitational rigor mortis

Question 80

Blood supply gravitates to the skin vessels, which becomes toneless and dilate after circulation ceases.

Answer 80

Livor mortis

Question 81

Evident as deep purple-red discoloration in the skin and internal organs.

Answer 81

Livor mortis

Question 82

Other term for livor mortis

Answer 82

Postmortem (lividity) hypostasis

Question 83

Livor mortis can be mistaken for?

Answer 83

Hematoma

Question 84

Occurs in gravity-dependent areas of the body that come into contact with firm surfaces

Answer 84

Blanching

Question 85

Livor mortis is spared in these areas due to localized pressure preventing blood from entering the skin

Answer 85

Gravity-dependent areas (i.e. floor, tight clothing)

Question 86

Livor mortis becomes evident as early as how many minutes/hours after death?

Answer 86

20 minutes

Question 87

Livor mortis is fully evident within how many hours?

Answer 87

4 hours

Question 88

Livor mortis is fixed in aporox. how many hours?

Answer 88

8-12 hours

Question 89

What is observed during livor mortis?

Answer 89

Tardien spots aka: Tardieu petechiae, Tardieu spots

Question 90

2 Techniques of Autopsy

Answer 90

Cutting of bones to expose the cavities 1. Sawing of the skull 2. Cutting of the sternal plate

Question 91

It is a straight line incision extending from the chin to the symphysis pubis

Answer 91

I shaped incision

Question 92

This type of incision starts near the acromian process and progresses downwards towards the xiphoid process. The incision is then extended til the symphysis pubis. Also, a similar incision is made on the opposite side of the body.

Answer 92

Y shaped incision

Question 93

A Y shaped incision is made from the suprasternal notch to symphysis pubis. It extends from the suprasternal notch over the clavicle to its center on both sides and lasses upwards over the neck, behind the ear

Answer 93

Modified Y shaped

Question 94

T/F: For a woman, the Y-incision is curved around the bottom of the breasts before meeting at the breast bone.

Answer 94

True

Question 95

What is the order of examination according to Virchow’s technique?

Answer 95

Head > Thoracic (Cervical) > Abdominal Organs

Question 96

Material/Record (Non-Forensic autopsy records) Wet tissue

Answer 96

3 months after final report

Question 97

Material/Record (Non-Forensic autopsy records) Paraffin blocks

Answer 97

10 years

Question 98

Material/Record (Non-Forensic autopsy records) Slides

Answer 98

10 years

Question 99

Material/Record (Non-Forensic autopsy records) Reports

Answer 99

10 years

Question 100

subpleural spots of ecchymosis that follow the death of a newborn child by strangulation or suffocation

Answer 100

Tardieu’s ecchymoses

Question 101

is pink to purple discoloration of the skin from blood pooling in dependent areas of the body.

Answer 101

Lividity

Question 102

are purple to black spots on the skin that can develop along with lividity, from the rupture of capillaries.

Answer 102

Tardieu spots

Question 103

horizontal linear scleral blackening along the equator of the globe of the eye

Answer 103

Tache noir de la sclerotique

Question 104

T/F: tache noir is often initially black in appearance and over time becomes red

Answer 104

False; initially red —> black

Question 105

Multiple percutaneous needle biopsies after death

Answer 105

Blind biopsies

Question 106

extensive organ sampling or removal via a limited incision

Answer 106

Mini-autopsy