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FIP > 34. Natural Deaths > Flashcards

34. Natural Deaths Flashcards

1
Q

For what time frame is a death considered ‘sudden’?

A

From within an hour to 24 hours after the onset of illness

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2
Q

What is acute coronary syndrome?

A

Any group of symptoms compatible with acute myocardial ischaemia

  • unstable angina
  • MI with or without ST segment elevation
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3
Q

What are the complications associated with acute coronary syndrome?

A

Atheroma and thrombosis
Acute MI
Ischaemic heart disease
Arrhythmias

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4
Q

What size heart is a male is considered a reason for sudden death?

A

> 500g

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5
Q

What size heart in a female is considered evidence for a sudden cardiac death?

A

> 400g

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6
Q

What is a cardiomyopathy?

A

Heart is structurally or functionallly abnormal, in a way that is not explained by CAD, high BP, valve failure or congenital defects

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7
Q

What is the most common cause of sudden death?

A

Hypertrophic cardiomyopathy

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8
Q

What age group is hypertrophic cardiomyopathy present in?

A

30-40s

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9
Q

What are the signs of hypertrophic cardiomyopathy histiologically?

A

Interstitial fibrosis

Disorganised, branching and hypertrophic myocytes

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10
Q

What conditions can hypertrophic cardiomyopathy develop secondary to?

A

Hypertension
Amyloid
Glycogen storage disorders
Genetic syndromes

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11
Q

What are the types of cardiomyopathy?

A

Hypertrophic
Dilated
Restrictive
Arrythmogenic RV dysplasia

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12
Q

What are the causes of dilated cardiomyopathy?

A 
Genetic
Alcohol
Drugs
Viral
May be end stage presentation of other types of heart disease
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13
Q

What is the least common type of cardiomyopathy?

A

Restrictive

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14
Q

What might restrictive cardiomyopathy be secondary to?

A

Lupus
Amyloid
Sarcoid

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15
Q

How does arrhythmogenic RV dysplasia appear histiologically?

A

Fibrosis and fat +/- inflammation

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16
Q

What can prevent fatal arrythmias in RV dysplasia?

A

Defibrillator

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17
Q

What are the causes of myocarditis?

A 
Infection
Hypersensitivity
Toxic
Giant cell
Sarcoidosis
18
Q

What does hypertensive heart disease present as?

A

Acute LV failure or arrhythmias

19
Q

Name 2 possible valvular heart diseases

A

Floppy mitral valve

Aortic valve stenosis

20
Q

Name a physiological cause of sudden cardiac death

A

Wolff-Parkinson-white syndrome

21
Q

What is Wolff-Parkinson-White syndrome?

A

On an ECG appears as a short PR interval, showing an abnormal pathway between atria and ventricles
May develop arrythmias

22
Q

Name 3 ion channelopathies

A

Long QT syndrome
Brugada syndrome
CPVT

23
Q

What type of drug can trigger long QT syndrome?

A

Antipsychotics

24
Q

What is the pathology of long QT syndrome?

A

Na+ channel mutations means it takes longer to polarise

Syncope, seizures and sudden cardiac death

25
Q

What gene is mutated in long QT syndrome?

A

SCN5A

26
Q

What is brugada syndrome?

A

Na+ channel mutation caused by loss of SCN5A function

Also known as unexpected natural death syndrome in southeast asia

27
Q

What ion channel is affected in CPVT?

A

Ca++

28
Q

What are the symptoms of SADS?

A 
Abnormal heart rhythm
Fast HR that comes and goes when resting
Breathlessness on effort
chest pain
dizziness
Fainting and black outs
29
Q

What investigations should be done if SADS is part of the differential?

A

Family history

ECG and echo

30
Q

Who does spontaneous coronary artery dissection most commonly happen in?

A

Post partum and older females

31
Q

Which artery is most commonly involved in spontaneous coronary artery dissection?

A

LAD

32
Q

What is a bridging artery?

A

Main coronary artery is embedded in ventricular muscle, shuts off when muscle contracts

33
Q

What is the difference between SUDI and SIDS?

A

SUDI= Sudden Unexpected Death in Infants, describes any sudden death in a child younger than 1
SIDS means no cause has been found for SUDI after extensive investigation

34
Q

What is SUDC?

A

Sudden Unexpected Death in Childhood

child older than one year, in their sleep

35
Q

Give 2 vascular causes of SD

A

Aortic dissection

Rupture of aortic aneurysm

36
Q

Give 4 causes of CNS SD

A

Epilepsy
Subarachnoid haemorrhage
Intra-cerebral haemorrhage
Any disease with associated hydrocephalus

37
Q

What could a sudden death in a psych patient be caused by?

A

Neuroleptic malignant syndrome

38
Q

What are causes for sudden respiratory death?

A 
Epiglottitis
Spontaneous pneumothorax of newborn
PE
Asthma, COPD, pneumonia
Haemoptosis
39
Q

What are causes for sudden GI death?

A

Inflammatory
Haematemesis
Ischaemia and infarction
Carcinoma

40
Q

What are causes for sudden death within 6 weeks after pregnancy?

A 
Haemorrhage
Infection
Amniotic fluid embolism
Ruptured ectopic pregnancy
Eclampsia

FIP (36 decks)

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