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Exam (elaborations)

MMSC 230 Quiz 2 (All Correct)

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What is an autopsy actually doing? correct answers - Looking for cause and manner of death - It's different in the hospital autopsy -Opportunity to recognize missed diagnosis - Opportunity for teaching and learning Major Discrepancies (Class I) correct answers Discrepancies in major diagnoses. Knowledge of diagnosis before death would have led to changes in management that could have prolonged survival or cured the patient (e.g., pulmonary infarction treated as pneumonia, fungal pneumonia treated as bacteriaL infection). Major Discrepancies (Class II) correct answers Discrepancies in major diagnoses whose detection before death would not have changed survival even with correct treatment (e.g., biventricular cardiac insufficiency due to severe aortic stenosis with missed pulmonary emboli, correctly treated bacterial sepsis with multiorgan failure because of unrecognised postoperative cervical osteomyelitis in a patient with rheumatoid arthritis). No treatment available at the time (e.g. cytomegalovirus infection up to the early eighties). Minor Discrepancies (Class III) correct answers Discrepancies in minor diagnoses not directly related to cause of death, but with symptoms that should have been treated or would have eventually affected prognosis (e.g., pulmonary carcinoma in a patient with ruptured infrarenal aortic aneurysm). Minor Discrepancies (Class IV) correct answers Discrepancies in minor occult diagnoses (non-diagnosable) but with possible epidemiological or genetic importance (e.g., symptom less gallstones, goitre). Non Discrepancy (Class V) correct answers Non-discrepant diagnoses. Non-Classifiable Cases (Class VI) correct answers Patients died immediately after admission with no diagnostic procedures, or refused any diagnostic procedures or treatment. Necropsy was unsatisfactory with no clear findings and no diagnosis could be established after review of clinical and necropsy data. Why Have Autopsies Decreased Over Time? correct answers - Better medical understanding of many diseases - More advanced testing leads to better premortem diagnosis - Fewer in-hospital pathologists doing autopsy - Hospital cost-$$$$$$$

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