Case 1

Carton, Daly & Ramani: Clinical Pathology - Case Studies
1. Case 1
2. Case 2
3. Case 3
4. Case 4
5. Case 5
6. Case 6
7. Case 7
8. Case 8
9. Case 9
10. Case 10

Case 1

Image: ruptured abdominal aortic aneurysm

This is an image of a ruptured abdominal aortic aneurysm found at post-mortem of a 65-year-old. The patient had suddenly developed severe abdominal pain and collapsed. On arrival in hospital the patient was in severe shock, rapidly deteriorated, and died. The cause of death was not known.

Question 1

Which of the following statements about this patient are true? (Tick all those that apply)

	a)	The aneurysm was likely to have been more than 6 cm.
	b)	The patient is more likely to be female than male.
	c)	The underlying cause of the aneurysm is atherosclerosis.
	d)	The patient is also likely to have berry aneurysms of the intracranial arteries.
Correct. Aneurysms over 6 cm diameter have a high risk of rupturing, and hence this is the cut off for considering elective repair of aortic aneurysms. Aortic aneurysms are more common in men than women. The underlying cause is atherosclerosis. There is no association with berry aneurysms, which are thought to be due to congenital weaknesses in the muscle layer of the intracranial arteries. Page reference: 81 Incorrect. Aneurysms over 6 cm diameter have a high risk of rupturing, and hence this is the cut off for considering elective repair of aortic aneurysms. Aortic aneurysms are more common in men than women. The underlying cause is atherosclerosis. There is no association with berry aneurysms, which are thought to be due to congenital weaknesses in the muscle layer of the intracranial arteries. Page reference: 81 Your answer has been saved.

Question 2

Which of the following statements about shock are true? (Tick all those that apply)

	a)	Shock refers to a generalized reduction in blood flow to tissues.
	b)	The typical clinical findings are hypotension and bradycardia.
	c)	Prolonged shock risks the development of chronic renal failure.
	d)	Septic shock is an example of distributive shock.
Correct. Shock is a generalized reduction in blood flow to all tissues. The typical clinical signs are hypotension and tachycardia. The danger of prolonged shock is failure of multiple organs, including the development of acute renal failure. Septic shock is the commonest cause of distributive shock. Page reference: 68-70 Incorrect. Shock is a generalized reduction in blood flow to all tissues. The typical clinical signs are hypotension and tachycardia. The danger of prolonged shock is failure of multiple organs, including the development of acute renal failure. Septic shock is the commonest cause of distributive shock. Page reference: 68-70 Your answer has been saved.

Question 3

Which of the following statements regarding the post-mortem are true? (Tick all those that apply)

	a)	This case needs to be referred to the Coroner.
	b)	Consent from the relatives is required.
	c)	The doctors can fill out the death certificate as they knew the cause of death.
	d)	The post-mortem examination is performed by mortuary technicians.
Correct. As this patient has died within 24 hours of arriving in hospital, the case must be referred to the Coroner. Consent from the relatives is not required for a Coroner's post-mortem, although they will be counselled and given information by the Coroner's office. A death certificate is not filled out by the doctors if the death is referred to the Coroner, even if the cause of death is known. The post-mortem examination is performed by medically qualified pathologists with assistance from mortuary technicians. Page reference: 537-540 Incorrect. As this patient has died within 24 hours of arriving in hospital, the case must be referred to the Coroner. Consent from the relatives is not required for a Coroner's post-mortem, although they will be counselled and given information by the Coroner's office. A death certificate is not filled out by the doctors if the death is referred to the Coroner, even if the cause of death is known. The post-mortem examination is performed by medically qualified pathologists with assistance from mortuary technicians. Page reference: 537-540 Your answer has been saved.

Carton, Daly & Ramani: Clinical Pathology - Case Studies

Table of Contents

Case 1

Question 1

Question 2

Question 3