CASE :
A dead body was lying on the
autopsy table. Fine odourless froth was found dripping from mouth and nostrils.
Internally, lungs were pale, large and filling chest cavity.
(a) What is your diagnosis?
-
Death by drowning.
(b) Describe hypostasis in such case.
-
Pale in colour, located in the head, neck, shoulders and
upper limbs as the body is usually suspended in an oblique position with the
head lower down.
(c) What is the differential diagnosis of froth?
-
Froth of putrefaction: coarse, foul-smelling and bloody.
(d) What are other changes in the lungs and heart of such case?
-
Lungs :
·
Froth oozes from cut surface
·
Sub-pleural petechial haemorrhages are almost absent in
drowning
·
Impressions of the ribs on the lateral surfaces of the lungs
-
Heart :
·
Dilated and engorged with fluid blood, especially the left
side
·
Subpericardial haemorrhage
TRUE OR FALSE
(a) Gastric lavage is indicated in treatment of phenol toxicity
:
True,
to decrease absorption of phenol as phenol has a systemic effect.
(b) The colour is blue in these two conditions : lips in
drowning and subconjunctival bruise after 3 days :
False,
subconjunctival bruises retain their bright red colour until they are
completely absorbed due to plenty oxygenation either through rich oxygen supply
of the conjunctiva or direct air exposure.
(c) Scalp wound can cause intracranial infection :
True,
due to spread of infection via emissary veins.
MCQs
(1) Exit wound in firearm injuries show :
(a)
Everted edges
(b)
Collar of contusion
(c)
Burnt skin
(d)
Tattooing
(2) Atropine toxicity is never accompanied with :
(a)
Tachycardia
(b)
Dry air passages
(c)
Hypothermia
(d)
Euphoria
(3) All may cause the triad of classic opioid toxidrome, except
:
(a)
Carbolic acid
(b)
Morphine
(c)
Hyoscine
(d)
Organophosphorous compounds
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