ABMDI Scientific Knowledge Questions and Answers 100% correct

ABMDI Scientific Knowledge Questions and Answers 100% correct Cause of Death The disease, injury, or combination of conditions that leads to the death of the individual Manner of Death A classification of death based on how the cause of death was brought into play, with the typical options being natural, accident, suicide, homicide, or undetermined Cause of Death Statement (Part I) Immediate cause of death Intermediary cause of death Underlying cause of death Immediate Cause of Death The condition that was last to occur, immediately resulted in the death, and was the result of the underlying cause of death Intermediary Cause of Death A condition that was caused by the underlying cause of death and resulted in the immediate cause of death or another intermediary cause of death Underlying Cause of Death The condition (disease or injury) that started the downhill course of events leading to death Cause of Death Statement (Part II) Other significant conditions Other Significant Conditions Usually consist of co-existing co-morbid conditions or additional complications of the underlying cause of death, which were less important than those listed in Part I Terminal Events Final common pathways of death and include such things as cardiopulmonary arrest, asystole, ventricular fibrillation, respiratory arrest, and electromechanical dissociation (typically, these should not be listed on a death certificate because they are so common and non-specific) Nonspecific Anatomic Processes (NAP's) Consist of anatomic findings and include such things as pneumonia and cirrhosis, each of which has multiple underlying causes, and which may be reported on the death certificate using specific guidelines Nonspecific Physiologic Derangements (NPD's) Nonanatomical findings and include such things as hyperkalemia and hypoglycemia, each of which has multiple possible underlying causes, and which may be reported on the death certificate using specific guidelines An individual had insulin dependent diabetes mellitus. He recently obtained cerebral artery arteriosclerosis which caused him to be in a bedridden state from a previous stroke. Because he was bedridden, he obtained infected decubitus ulcers that caused him to obtain systemic sepsis and died. How should the death certificate be written? Part I: a. Systemic sepsis b. Due to: Infected decubitus ulcers c. Due to: Bedridden state from previous stroke d. Due to: Cerebral artery arteriosclerosis Part II: OSC: Insulin dependent diabetes mellitus An individual was a chronic alcoholic who obtained cirrhosis of the liver. He then had ruptured esophageal varices and died. How should the death certificate be written? Part I: a. Ruptured esophageal varices b. Due to: Cirrhosis of the liver c. Due to: Chronic alcoholism d. Due to: Part II: OSC: An individual obtained metastatic carcinoma of the prostate and died. How should the death certificate be written? Part I: a. Metastatic carcinoma of prostate b. Due to: c. Due to: d: Due to: Part II: OSC: An individual had a past medical history of cryptococcal myocarditis. He recently acquired immune deficiency syndrome and obtained pneumocystis carinii pneumonia and died. How should the death certificate be written? Part I: a. Pneumocystis carinii pneumonia b. Due to: Acquired immune deficiency syndrome c. Due to: d. Due to: Part II: OSC: Cryptococcal myocarditis (The myocarditis contributed to the death but did not result in the conditions shown in Part I) An individual was involved in a traffic accident. He was the driver of the vehicle, lost control, went left of the center and was struck head on by a sports utility vehicle. He obtained blunt force trauma of thorax and had an atlanto-occipital dislocation and died. How should the death certificate be written? Part I: a. Atlanto-occipital dislocation b. Due to: Blunt force trauma of the head c. Due to: Collision of motor vehicles d. Due to: Part II: OSC: Blunt force trauma of thorax Manner of Death: Accident How Injury Occurred: Driver of car. Lost control. Went left of center. Struck head-on by sports utility vehicle Algor Mortis Cooling of the body Variables Affecting Algor Mortis: Temperature of body at TOD Environmental temperature Habitus (fat serves as an insulator) Amount of clothing/bedding Rigor Mortis Stiffening of the body Cause of Rigor Mortis: Continued consumption of adenosine triphosphate (ATP) by muscles after death, without concurrent production of ATP Where do you usually first notice rigor mortis? Small muscle groups, then larger groups What accelerates rigor mortis? Any exertion, depleting ATP prior to death (strenuous physical activity, drowning, hyperthermia, certain drugs and poisons) What delays rigor mortis? Cold, diminished musculature Timeline of Rigor Mortis: Begins: 2-4 hours Full: 6-12 hours Gone: Onset of decomposition Livor Mortis Pooling/settling of the blood due to gravity Can livor mortis happen premortem? Yes, it can be premortem in the setting of severe heart failure Timeline of Livor Mortis: Begins: 0.5-2 hours Maximum: 8-12 hours Fixed: 12-18 hours When do you see tardieu spots in livor mortis? When small vessels rupture (18-24 hours), coalescing petechia-like areas "Cherry-Red" Lividity Carbon Monoxied Cyanide Fluoroacetate Cold Temperatures Green Lividity Hydrogen Sulfide What accelerates the fixation of lividity? Heat Sepsis Heart Failure What delays the fixation of lividity? Internal/External Hemorrhage Cold Decomposition Caused by a combination of putrefaction and autolysis; depending on circumstances, one or the other may be the dominant factor Autolysis Digestion of cells and tissues due to intrinsic enzymes and proteins Putrefaction Tissue breakdown as the result of bacterial action Early Decomposition (24-36 Hours) Rigor passes, lividity is fixed Green discoloration to abdomen Marbling Minor purging/Foul-smelling fluid Drying of fingertips/lips Moderate Decomposition (48-72 Hours) Bloating Green-black discoloration of head/neck Significant purging of fluids Skin slippage Protrusion of tongue and distension of ocular globes by gas Advanced Decomposition (>4-5 Days) Hot/Dry Climates: Mummification Cold/Wet Climates: Adipocere Weeks-Months Decomposition Skeletization Accelerants of Decomposition: Antemortem sepsis/infection Hot environment Hyperthermia Obesity Heavy clothing/bedding Decelerants of Decomposition: Refrigeration Cold environment Exposure to cool surfaces Air conditioning Hypoterhmia Embalming Cardiovascular System Most common system involved in sudden, unexpected, natural death in adults Coronary Artery Disease Most often coronary atherosclerotic stenosis Hypertensive Cardiovascular Disease Concentric left ventricular hypertrophy with cariomegaly Cardiomyopathies Primary diseases of myocardium Valvular Disease Aortic Stenosis Myxoid degeneration of mitral valve Myocardial Inflammatory Disease Myocarditis