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Flashcards in Forensic Pathology Deck (26)
1

When should a forensic autopsy be performed?

  • when we cannot exclude the possibility of crime
  • when there is a possibility of malpractice
  • to identify a body

2

Name the four aims of a forensic autopsy

  • to examine unnatural and suspected unnatural death cases
  • to detect, confirm or rule out criminal deaths
  • to determine the cause of death
  • to document and interprete other medical findings relevant to the police investigation

3

Define "cause of death"

The disease or injury that produces the physiological disruption inside the body resulting in death

4

Define "mechanism of death"

The physiological derangement that results in death

5

Define "manner of death"

How the death came about

6

Name the five types of manners of death

  • natural
  • accident
  • suicide
  • homicide
  • undetermined

7

Name some characteristics of sudden death

  • deaths from natural causes which can be sudden, unexpected, clinically unexplained or otherwise obscure
  • it can be also defined as a death case within 1 hour or the onset of symptoms
  • there is no unnatural element in their causation
  • approx 50% of cases are caused by sudden, natural death

8

How can sudden deaths be subdivided?

  • according to the mechanism of death
  • according to age
  • according to organs involved

9

Name some mechanisms of death

  • hemorrhage, hypovolemic shock
  • infection/sepsis
  • ischaemia/hypoxia
  • acidosis
  • alkalosis
  • arrythmia (asystole, ventricular fibrillation)
  • respiratory depression and paralysis
  • cardiac tamponade

10

Which organ system is most often involved in natural sudden death?

cardiovascular (56%)

followed by respiratory (16%), CNS and malignancies (both 8%)

11

What is coronary atherosclerosis?

The major cause of sudden cardiac death

  • basic mechanisms:
    • stenosis
    • occlusion
  • complications
    • ulcerated plaques
    • haemorrhage in the plaque
    • coronary thrombosis

12

Acute myocardial infarction (AMI)

  • mostly caused by atherosclerosis or its complications
  • mostly located in the left ventricle
  • types
    • laminar infarct
    • regional or focal infarct

13

Macroscopic changes after acute myocardial infarction AMi

  • under the first day - nothing
  • days 1-3 - demarcated and turns yellow; tigroid appearance (red streaks from breakdown of myocytes and hemorrhages)
  • few days till few weeks - area becomes fragile and softer (myomalacia)
  • from ca 3 weeks - the center becomes gelatinous and grey
  • after circa 3 months - widespread fibrosis

14

Early microscopic changes of AMI

contraction bands

15

late (18-24 hours) microscopic changes after AMI

  • Eosinophilia
  • oedema
  • variable cellular infiltration
  • after 1 weeks - new capillaries and fibroblasts are appearing

16

Causes for hypertrophy of the heart

  • hypertonia
  • valvular heart disease (aortic stenosis)
  • cardiomyopathy
  • (obesity)

17

Name five cardiovascular causes of sudden death

  • myocarditis, endocarditis
  • rupture of aneurysm
    • aortic
    • cerebral
  • pulmonary thrombo-embolism
  • anatomic anomalies
  • functional disorders

18

Name six functional disorders that may be cardiovascular causes of sudden death

  • low-output state due to sepsis
  • surgically repaired congenital heart defects
  • coronary artery spasm
  • vagal inhibition
  • spontaneous ventricular fibrillation
  • hereditary or acquired predisposition to arrythmia

19

Respiratory causes of sudden death

  • asthma
  • pneumonia
  • pneumothorax
  • tumour
  • epiglottitis
  • respirator hemorrhages
  • functional disorders

20

Abdominal causes of sudden death

  • bleeding in the alimentary tract
    • esophageal varices
    • mallory weiss syndrome
    • gastric and duodenal ulcers
    • carcinoma of the stomach
  • mesenteric thrombosis and infarction
  • acute pancreatitis
  • strangulated intestines, hernia
  • peritonitis (perforations)
  • tumour
  • vascular malformation
  • cirrhosis

spelic rupture

21

Genitourinary causes of sudden death

  • pyelonephritis
  • ruptured ectopic pregnancy
  • induced abortions
  • amniotic embolism

22

Endocrine causes of sudden death

  • adrenal hemorrhage
  • pheochromocytoma
  • hyper- and hypothyroidism
  • pituitary inufficiency
  • diabetic ketoacidosis

23

CNS causes of sudden death

  • cererovascular accident
  • ecephalomyelitis, meningitis, brain abscess
  • tumour
  • functional disorder (exclusion diagnosis)

24

Which organs/organ systems are the most common primary sources of infections resulting in sepsis?

lungs, abdomen, urnary tract

25

Name changes in three organs that are specific for chronic alcoholism

  • liver
    • fatty changes, cirrhosis
  • heart
    • alcoholic cardiomyopathy
  • brain
    • alcoholic cerebral degeneration

26

Name risk factors for SIDS
(sudden infant death syndrome)

  • maternal smoking
  • stomach sleeping
  • co-sleeping
  • overheating
  • prematourity and low birth weight
  • poor prenatal care
  • mothers younger than 20 years of age