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Pathology > Hi - Post-Mortem > Flashcards

Hi - Post-Mortem Flashcards

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1
Q

describe the practical steps of a post mortem

A
  1. external examination
  2. incision from adams apple to pelvis
  3. remove ribs
  4. dissect out lungs and heart together
  5. dissect out bowel
  6. dissect out liver, stomach, pancreas, spleen
  7. dissect out kidneys, internal genitalia, ureters
  8. inspect bones for fractures, tumours
  9. assess each organ one by one
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2
Q

how can the length of time from death to post mortem affect the body

A

decomposition, decolouration, rigor mortis, temp/humidity changes, maggots, liquifactor necrosis of brain

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3
Q

why do previous heart surgeries make post mortem difficult

A

adhesions / fibrosis

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4
Q

how would pericarditis be seen in post mortem

A

adhesions

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5
Q

what is being observed in the heart at PM

A

muscle damage
valves
artery grafts
patent vessels inc coronaries
ventricles / lumen
size - hypertrophy

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6
Q

what % of body weight should the heart be in M and Fs

A

0.4% M
0.35% F

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7
Q

describe the processes that occur to the heart due to HF

A

hypertrophy
dilatation and thinning
baggy heart
end stage

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8
Q

what does a pale heart represent

A

ischaemia

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9
Q

what does a nutmeg liver indicated

A

back pressure on liver due to RHF

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10
Q

major cause of RHF

A

LHF

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11
Q

describe the steps in post MI rupture

A

MI –> fibrosis –> digestion of myocardium –> rupture

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12
Q

when would a post MI rupture happen

A

5 days post MI

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13
Q

causes of valve vegetations

A

infective endocarditis –> IVDU / dental
GI polyps
rheumatic fever

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14
Q

what is rheumatic fever

A

cross reactivity with strep sore throat

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15
Q

what valve is affected in rheumatic fever

A

mitral

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16
Q

how does a post mortem blood clot differ from an ante mortem blood clot at PM

A

PM = gelatinous
AM = vessel shape, solid, red to grey stripey colour change, valve impressions

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17
Q

what is the cause of black pigment commonly seen in the lungs

A

soot from industrialisation

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18
Q

what does frothy / bubbly fluid in lungs represent

A

pulmonary oedema

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19
Q

what is being observed in the lungs

A

parenchyma - tumours, pus, fluid
hilar - size
pleura - smooth/inflammed
airways
BVs - clots

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20
Q

thick, white, fibrotic outer covering of the lung. dx?

A

mesothelioma

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21
Q

what is the lag period of exposure in mesothelioma

A

20 years

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22
Q

what is mesothelioma

A

malignancy of pleura due to asbestos

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23
Q

what does a tumour look like at PM

A

white / creamy and invasive. like stilton

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24
Q

where does lung cancer met to

A

liver, brain, bone

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25
what colour is a normal lung at PM
grey
26
what does a white lung at PM indicate
pneumonia
27
what do lung mets look like at PM
large white/brown circles MANY of them
28
lumps of consolidation seen in lung at PM. Dx?
bronchopneumonia
29
little white dots all over lung at PM. Dx?
miliary TB
30
who gets miliary TB
homeless / IVDU pre TB Tx
31
what does miliary TB look like
disseminated carcinoma
32
where is the appendix
end of the caecum
33
what does foecal peritonitis indicate on PM
perforation of bowel
34
what are outpouchings of the bowel mucosa called
diverticuli
35
what pathology can happen at stomach sphincter
H pylori peptic ulcers
36
what 2 common pancreatic pathologies can and can't be visualised at PM
cancer CAN DM CAN'T - microscopic
37
what does a cut spleen look like
meaty
38
what does white dots on spleen indicate
infarction
39
what causes an enlarged spleen
malaria leukaemia
40
what causes a small spleen & why
sickle cell - autoinfarcts
41
what is looked at in the gall bladder
stones ? bright green bile present ? blockages ?
42
white balls all through liver. Dx?
mets
43
what would primary cancer look like in the liver
cirrhotic liver single nodule
44
florid fluffy area in colon. dx?
adenocarcinoma
45
where does bowel Ca metastasise to
liver / lung
46
what can cause a hole in the stomach
H Pylori ulcer - if in peptic area malignant - if elsewhere
47
where do cancers met to commonly
liver lung brain bone
48
which 2 cancers commonly met to bone
breast prostate
49
what is the consequence of a diverticuli rupture
peritonitis fistulae perforation
50
very bloody omental fat. Dx?
AAA rupture
51
why do you slice through the omental fat on PM?
look for bleeds / cancer
52
name the cancer of kidney collecting system
transitional cell SCC
53
name the cancer of kidney parenchyma
renal cell carcinoma
54
which kidney stones are found in collecting ducts
staghorn calculi
55
how easy should it be to remove capsule off kidney in healthy PM?
VERY easy
56
nodular, pock marked kidney with capsule hard to remove from kidney. Dx?
HTN
57
contrast kidney cyst from PCKD
PCKD is whole kidney replaced by cysts benign cysts filled with turbid fluid is not uncommon
58
bubbly looking kidney removed to make way for transplant. Dx?
PCKD
59
where do emboli come from that block renal artery
AF / infection that is throwing off clots
60
name a common gynae cancer
adenocarcinoma
61
does gynae cancer present late / early / single site / multi site
late presentation multi areas affected
62
when would an ectopic burst the fallopian tube (wks)
8-11 weeks
63
consequence of a fallopian ectopic
burst fallopian tube --> haemorrhage --> high fatality
64
what type of cancer is in the testes
NOT carcinoma yolk sac, semianoma, germ cell
65
PC of testicular cancer
20-30 year old man large testes
66
prognosis of testicular cancer
good as caught early - massive testicle is hard to ignore
67
apperance of testicular cancer on PM
looks like cheese ball
68
why is it not always possible to do PM on brain
decomposes very quickly after death - liquid factor necrosis so liquefies
69
PC of extradural haemorrhage
whack on the side of the head temporal bleed causes brief LOC lucid interval then rapid decline & death
70
what is a risk of extradural haemorrhage
coning due to raised ICP
71
2 main causes of SAH
ruptured berry aneurysm !!! trauma
72
PC of SAH
sudden worst headache of their life - hit round the head with a baseball bat can be small bleed (subclinical) --> fine --> HUGE bleed
73
age peak of SAH
40
74
what does haemorrhage look like PM
black
75
pale, irregular, discoloured "cream cheese" area of brain on PM. Dx?
tumour
76
what key definition is lost in brain tumour on PM
loss of white / grey matter definition
77
most common brain ca
mets
78
most aggressive brain ca
GBM
79
very black area on brain PM. Dx? & why is it so dark
melanoma mets - makes melanin so is dark
80
how do you write a death certificate
1a immediate cause of death 1b condition leading to 1a 1c condition leading to 1b 2 other present conditions not related to death
81
what is a very classic old people death certificate after stroke
1a LRTI 1b stroke
82
why would a death be referred to the coroner
suspicious circumstances around death or murder sudden death unknown cause of death Dr not seen pt 28 days before they died if person had their liberties removed
83
what group of conditions are not liked on death certificates
"failures" eg heart failure - need underlying cause
84
suitable alternative to cardiac failure on death certificates
MI / sepsis / aortic disease
85
is old age acceptable as a 1a cause of death
YES
86
is AKI / pulmonary oedema as 1a causes of death ok
NO - they are failures
87
list common causes of sudden unexpected death in the community
main 2: illicit drug use trauma related to alcohol other common ones: stroke MI rupture AAA
88
do you need consent for PMs?
hopsital PMs - YES coroner PMs - NO
89
what is looked at in the gall bladder
stones ? bright green bile present ? blockages ?

Pathology (87 decks)

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