Path 93: Forensic Pathology 1
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29 terms
Terms | Definitions |
|---|---|
 ME death investigation jurisdiction | violent, suspicious/unusual/unnatural, undiagnosed public health threat, unattended, unexplained coma, during therapeutic procedure -> inmates and bodies to be made unavailable for study (transport out of state, cremation, burial at sea) |
| Sexual Assault Response Team (SART) | physician, law enforcement, victim advocate, criminalist (lab technician), attorney |
| Medical exam for sexual assault | explain who you are, ask who/what/where/when, medical history, last menstrual period, birth control, last consensual intercourse, post assault hygiene (shower, clothing), acts committed (victim, assailant), ejaculation (location) -> do colposcopy, look at clothing and skin |
| Clothing exam for sexual assault | modesty, list/photography, collection -> have nurse present |
| Skin exam for sexual assault | trauma, trace evidence, alternative light source (Wood's light -> blue light), alopecia (hair pulled out), bite marks, nail clippings, suction ecchymoses |
| First specimens | swabs = oral, anal, vaginal, skin -> sperm, prostate secretions (PSA), DNA |
| Second specimens | gonorrhea, syphilis, Chlamydia, trichomonas, HSV, HPV, Hepatitis, HIV |
| Victim reference standards | buccal swab (DNA -> nuclear is best), saliva, pulled hair samples (known source), penile specimen, blood (drugs; pregnancy) |
| Lead poisoning | basophilic stippling in RBCs -> ribosomal aggregation |
| Dose related drugs/chemical injuries | alcohol, lead, tricyclic antidepressants, acetaminophen |
| Metabolic conversion by chemicals | ethylene glycol |
| Fast/slow metabolizers | depends on phenotypes -> Sertraline/Desipramine, Provigil/Depakote |
| Adverse reactions to drugs | beta blockers, ASA |
| Anaphylaxis | penicillin (IgE) |
| Disease transmission | HIV, hepatitis |
| Carbon Monoxide poisoning | Cherry red liver mortis -> blood settles in the gravity dependent regions (typically purple in normal people) -> can be caused by automobiles, house fires -> look at the trachea to look for inhaled products of combustion -> causes asphyxia (displaces O2 from Hb, impairs O2 release to tissue, inhibits cellular respiration |
| CO acute clinical presentation at 10-12% saturation | flu-like symptoms |
| CO acute clinical presentation at 20-30% saturation | headache: N/V confusion |
| CO acute clinical presentation >50% saturation | Syncope, coma, convulsions, respiratory paralysis, death |
| Ethanol | acute effects -> vasodilation, CNS depression, diuresis, fatty liver (Microvesicular change is reversible), trauma; Chronic effects -> cirrhosis, pancreatitis, dilated cardiomyopathy, Korsakoff Syndrome, oral and esophageal cancer; |
| Fetal alcohol syndrome | mental retardation, growth retardation, mid-facial hypoplasia, hypertelorism (wide eyes) |
| Methanol (wood alcohol -> breaks down to formaldehyde, formic acid) | metabolic acidosis -> 10cc can cause blindness, 200cc causes death |
| Isopropyl alcohol | acetone, CNS depression |
| Ethylene glycol (anti-freeze) | confusion/agitation, high anion gap, seizures, coma, renal failure -> 100cc causes death -> breaks down into glycolic acid which combines with calcium to make calcium oxalate crystals (lights up under polarized light) which deposits in kidney |
| Prescription drug abuse | hydrocodone, oxycodone, methadone |
| Cocaine (also meth) | sympathomimetic, vasoconstrictive, hypertensive -> acute intoxication = agitated delirium, dilated pupils, seizures and coma, chest pain -> lots of vasoconstrictive effects; chronic = DCM, pulmonary fibrosis, renal failure, movement disorders, infectious disease, intracerebral hemorrhage, flat smooth brain (from cerebral edema) |
| HTN | blood gets into the media -> can compress the coronary artery -> caused by acute hemorrhage due to vasoconstriction |
| Heroin (diacetylmorphine) -> 6-acetylmorphine to morphine | pinpoint pupils, CNS depression, pulmonary HTN, TB, hepatitis, HIV, Pneumocystis pneumonia |
| IV drugs | needle tracks or skin popping -> can get fibrosis in the lungs due to talcum powder mixed in -> forms a granuloma; can get bacterial endocarditis (staph) |
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