Cody Tatum
274-9479
Pathology, 1902, 2015, Summer Semester
Death Certificate Assignment
Due 7/13/2015
Death Certificate #1 Name of deceased: George Jefferson Walker
Age: 64
Date of Birth: May 4, 1947
Date of Death: December 16, 2011
Cause of death: Hypertensive Heart disease
1. Etiology – Hypertensive heart disease is associated with high blood pressure related to the heart's arteries and muscles. Blood is transported to the heart by coronary arteries. High blood pressure causes blood vessels to become narrow which can cause the blood flow to the heart to slow and even stop. Sometimes blood clots form and get stuck in the narrowed arteries and put the person at serious risk of a heart attack. Poor blood circulation can
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Statins used to treat high blood pressure such as Zocor, Lipitor and other drugs to treat Parkinson's disease can cause rhabdomyolysis. 2. Symptoms (at least four)- There are several symptoms of rhabdomyolysis such as red or dark colored urine. Muscle fatigue, stiffness and aching are also common symptoms along with joint pain, seizures and unintended weight gain largely due to fluid buildup. Along with the red or dark colored urine another symptom is decreased urine output.
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3. Diagnosis - Doctors can look and feel the bigger muscles in the patient's body to determine if there is any tenderness in the area or if muscle tissue has died. Urine and blood tests are used to confirm the diagnosis by checking creatine kinase, myoglobin levels, calcium levels, potassium and creatine kinase isoenzymes. Lastly if it is suspected to be a genetic disease a test called the “forearm ischemis test” can be used. This test takes blood from a vein in the forearm and then a blood pressure cuff is placed on the forearm and tightened and another sample of blood is taken. If there are differences in the two samples it could indicate a genetic
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Diagnosis – Pulmonary embolisms are diagnosed through several ways; x-rays of the chest are done to get a good picture of the lungs, MRIs are done to produce images that are more detailed than x-rays, blood tests are sometimes conducted to check for a natural clot dissolving substance in the blood, venography’s are performed to get x-ray images of the veins in the lungs. CT scans are done to get cross-sectional views of the lungs. Duplex Venous Ultrasound are performed by using radio waves to check the flow of blood and to see if there are any clots existing in the legs. The most effective way of diagnosing a pulmonary embolism is through a pulmonary angiography, this is when the doctor makes an incision and inserts tools into the veins of the lungs and then puts a dye though the veins to detect any blockages.
4. Treatment – For the larger and more life threatening clots, most often surgeries are the only option to get them removed. For smaller blood clots, blood thinners and clot dissolvers are used to break up the clots in the lungs.
5. Prognosis – The prognosis of a pulmonary embolism can range from very good to very bad. Some pulmonary embolisms are so severe that death occurs in seconds to minutes. For others, after surgery or clot busting drugs, patients are usually put on blood thinners to reduce the risk of having another pulmonary embolism that could potentially be fatal. People who survive the embolism and immediately get treated usually have a good outlook, but
There are many ways to treat this condition. Treatment can depend on the size, location, and stage of the tumor. Often, more than one type of treatment is used. Treatment may include:
Although there are myriad causes of Rhabdomyolysis, the most common causes include the usage of alcohol or illicit drugs, extreme muscle strain, especially in someone who is an untrained athlete, a crush injury (e.g. auto accident, fall, or building collapse), long-lasting muscle compression, and/or the use of drugs (e.g. corticosteroids or statins, especially when given in high doses). (Muscal, 2013).
We review air embolism in the context of interventional radiology, although air embolism can also occur with barotrauma, lung biopsies and during surgical procedures, most notably neurosurgery and cardiothoracic surgery. In the former, patients may be operated on in the upright position,
Diagnosing the disease can be relatively simple, but this depends on accurate patient history and ones ability to recognize varied clinical signs and then perform diagnostic procedures. These diagnostic procedures may include antigen testing, x-rays, ultrasonography, angiography, a complete blood count, the Knott’s or Filter test, and in the worst case necropsy.
During inspection of the heart assessment observe abnormal finding. Inspect the jugular vein and the carotid artery. Note pallor or cyanotic skin color, temperature, turgor, texture, and clubbing of finger. Observe for swelling, edema and ulceration. Clubbing is a sign of chronic hypoxia caused by a lengthy cardiovascular or respiratory. Poor cardiac output and tissue perfusion is noted by cyanosis and pallor. For dark-skinned, inspect his mucous membranes for pallor. Decreases or absent of pulse with cool, pale, and shiny skin, and hair loss to the area, and the patient may have pain in the legs and feet may indicate arterial insufficiency. Ulcerations typically occur in the area around the toes, and the foot usually turns deep red when dependent
A pulmonary embolism occurs when a clot breaks off somewhere in the body and travels to the lungs causing a blockage (2016). If a pulmonary embolism is caught early enough, it can be treated with medications known as “clot busters.” If the pulmonary embolism is not found early enough, it can lead to a severe complication of damaging the lungs or even death (2016). People who have blood clots or who have blood clots in the past are always at future risk for developing a pulmonary embolism.
Rhabdomyolysis is a condition that results when muscle cells break down and release substances into the blood that can damage the kidneys. It happens because of damage to the muscles that move bones (skeletal muscle). When you damage this type of muscle, substances inside muscle cells are released into your blood. This includes a certain protein called myoglobin.
Rhabdomyolysis is rare. The muscle tissue breaks down and releases myoglobin in the blood. This can damage the kidneys. Some symptoms include dark urine, muscle aches, and weakness. Fewer than two hundred thousand cases
Treatment – The treatment for pulmonary fibrosis is a lung transplant, however in some patients there may be a response to administration of corticosteroids or other immune suppressing agents (Pulmonary Fibrosis, 2014). “Current therapies for pulmonary arterial hypertension have been adopted on the basis of short-term trials with exercise capacity as the primary end point”(Pulido et al., 2013, p. 809).
○ Electrocardiogram (ECG). This is an electrical tracing of the heart’s rhythm. It may show abnormal heartbeats.
Pulmonary embolism (PE) accounts for up to 30,000 deaths each year. (Beckman, 2014). It has been estimated that nearly one-third of deaths stemming from pulmonary embolism occur within the first hour. (Muckart, 2010). It can prove to be extremely difficult to diagnose pulmonary embolism due to the wide range of symptoms and presentations, or lack there of. (Muckart, 2010; Tarbox & Swaroop, 2013). Some patients with acute pulmonary embolism, possibly as many as 50%, are completely asymptomatic. (Muckart, 2010). Although the clinical presentation can vary dramatically, some of the main symptoms include tachycardia, sub-sternal chest pain, dyspnea, hypoxemia, hypotension and even possibly shock. (Tarbox & Swaroop, 2013). There are several risk factors attributed to PE, including but not limited to, recent immobilization, previous myocardial infarction or cerebral vascular accident, prior surgery or recent trauma. (Tarbox & Swaroop, 2013). Initial symptoms primarily present with severe respiratory distress, but the main adverse effects of PE effect the cardiovascular system due to the fact that the embolus causes an occlusion in the pulmonary vasculature. (Muckart, 2010). The obstruction within the pulmonary artery vastly increases vascular resistance, which results in right ventricular failure; therefore the left ventricular preload is minimized and cardiac output collapses. (Muckart, 2010).
Specific blood tests also can be an accurate diagnostic tool. A kidney biopsy can also provide accurate results. Chest x-ray, ultrasound, and electrocardiogram can be effectively used (Stevens, 2009).
Surgery normally consists either of saphenofemoral ligation (where a cut is made at the top of the groin above the main varicose vein) or short saphenous ligation, with or without stripping, and phlebectomies (removal of the vein). Alternatively, varicose veins can be treated by sclerotherapy, an injection treatment which shrinks the blood vessel, although this has been associated with a high recurrence rate.
Direct injuries include: extreme muscle strains and tears from prolonged physical activity, crush injuries, burns, overconsumption and use of drugs and alcohol, and ingestion of venomous agents from poisonous species. In adults, the most common causes of rhabdomyolysis are immobility, drug and alcohol abuse, and trauma (Torres, Helmstetter, Kaye, & Kaye, 2015). Additionally, indirect causes can include: exposure to extreme temperatures, bacterial and viral infections, genetic and autoimmune disorders, and chemical imbalances within the body (Criddle, 2003). Children are more likely to suffer from rhabdomyolysis because of indirect causes (Torres et al.,
Pulmonary embolism is defined as an obstruction of any pulmonary vessel This obstruction can form as a result of a clot or emboli. Essentially, the clot originates from a small distant vessel that rapidly migrates to the pulmonary system. Which in turn result in serious complications and/or symptoms that lead to mortality. Both men and women are equally affected by similar causative factors as well present with similar manifestations. Numerous causes and risk factors have been identified, with such evidence health care professionals and researchers alike have narrowed the gap to establishing accurate diagnostic practices. Clinical manifestations that are present, such as a simple cough to a severe symptom such as hypotension are problematic