# data[].attributes.body
link-https://docs.google.com/a/lammersvilleusd.net/document/d/1UuvDbIdFcSAxr3Mn2SPauG4Vhj78ITuFqG9MCRy3I80/edit?usp=sharing

# data[].attributes.body
link-https://docs.google.com/a/lammersvilleusd.net/document/d/1cIMJEnY59RVSyXYHHLFbujmhfnAgLGQpPRR7Uj2Q5gc/edit?usp=sharing

# data[].attributes.body
link-https://docs.google.com/a/lammersvilleusd.net/document/d/1Gr1cDl_4KBZTqKPc5Ec2OKePbFsu4s0KZwXbqkUN-iI/edit?usp=sharing

# data[].attributes.body
his is a partial autopsy of Anna Garcia.  Main points are below
Laboratory Results: Toxicology
Preliminary  Blood Results:
small amounts of acetylsalicylic acid (aspirin) are there
Head and Neck:
Injury to  right temple, including an open wound where during death bruising is clearly seen
Trunk:
Abdomen is swollen
Extremities
Extremities (limbs) are symmetrical and seem fine. Her ankles are swollen and signs of edema are present
Fingernails show considerable graying, which means low oxygen.
The right proximal humerus (top of the upper arm bone) and the left distal tibia (lower leg) shows signs of a recent from break
Inflammations shown on red injection sites on left thigh
Injuries:
Wound in the right temple, 2 cm in length, and 5 mm in depth at the center, area around seems bruised, some bleeding is shown
Bruise on right elbow, 2 cm in diameter
Physical Examination Results:
Skin is pale and seem like shes been through of oxygen deprivation
Fingernails and toenails are blue/grey in color
There is of vomit in the oral cavity
Physical trauma to the head, the wound shows that she might have had a fall against a hard object, light bleeding shows lack of blood flow
Edema of ankles are clearly seen

# data[].attributes.body
This medial history document  was recorded when Anna Garcia was 14 years old. These are the main points that can help us find out her cause of her death.
Case History
Recently, it was reported that she was experiencing fatigue, excessive thirst and the use of a bathroom, the inability of completing everyday activities without feeling tired, and she lost 10 pounds
Anna Garcia's family has a history of high cholesterol and heart disease
Physical Exam
no sign of edema but experience slight tingling sensations in her feet
Laboratory Analysis
Routine urinalysis shows glucose in urine

# data[].attributes.body
https://docs.google.com/a/lammersvilleusd.net/document/d/1VxIxJIfxK_4MKZYlmbG30S2oJFD4qLcifh2KzlOy15Y/edit?usp=sharing
Anna was diagnosed with Sickle cell Anemia and Splenic sequestration at the age of 14 months

# data[].attributes.body
link-https://docs.google.com/a/lammersvilleusd.net/document/d/1pbe3QKKAQIV2D0mcT6fnvgZirwP63mxHLhVPPgPCTuo/edit?usp=sharing

Toxicology reports show low levels of hematocrit levels., at 33.33%, suggesting she is anemic
Microscopic analysis of her blood shows sickle shaped blood cells
External Examination shows blue/grey nails
Possible causes of death: She could have died from complications of diabetes, such as a stroke which can explain the blue/grey color in her nails.

# data[].attributes.body
link-
https://docs.google.com/a/lammersvilleusd.net/document/d/1n0tn_1cJxrcxuzqkoLcpempDpYbs6NL7mhKtwMdpD2M/edit?usp=sharing
continued-
The results of the urinalysis test show that she was positive for a bacterial infection
The results of the Gross Morphology test indicate that the bacteria present was large, wavy, raised and red/pink in color
The results of the Gram Stain test indicate that the bacteria present was stained negative and was bacillus in shape
The results of the Gram Stain Morphology test indicate that the bacteria was Serratia Marcescens
Diagnosed with urinary tract infection by the serratia marcesens bacteria

# data[].attributes.body
1. Atherosclerosis- To start, I think Anna could have died from atherosclerosis because atherosclerosis is when build up of fats,cholesterol,and other substances on the artery walls. It is possible that the artery can get fully clogged therefore stopping all blood flow to your organs and tissues.I think this could have been the her cause of death because she had an unhealthy diet which could lead to plaque build up in the arteries and it is common in diabetes patients. That would cause a stroke or it could cause an artery to burst triggering a blood clot.

2. ketoacidosis - This could be the cause of Anna's death because she has type 2 diabetes and it is very common for people with type 2 diabetes to develop ketoacidous . Because people with type 2 diabetes cant produce enough insulin and the conditions of ketoacidosis occur when your body doesn't produce enough/accept insulin, And when this happens your liver will start to turn glycogen into glucose and release it into the bloodstream, and it begins to use fat for energy, and the higher your blood glucose levels, The more fat is used and the more keystones are formed(keytones are acids that cause kidney damage).

3. (untreated) kidney failure- This could have killed her because if you have kidney failure, then there is going to be a lots of water and chemical waste in your blood and this can kill you if you dont get your kidney treated/replaced.Since she has type 2 diabetes than keytones may be produced and if to many keystones are produced than you kidneys and other organs in your body can get damaged

4. Anna could have died because of Serratia Marcescens because it  could have caused a UTI and the UTI could have led to sepsis and she could have died from septic shock  .

5. Hypoxia can also be the cause, because sickle cell cannot carry enough oxygen to regulate the body.

6. I think that Anna Garcia could have died from acute chest syndrome. Because of a couple of reasons. First of all, acute chest syndrome is the leading cause of death for sickle cell patients. And Anna Garcia did have sickle cell anemia according to the 3.1.1 Autopsy report. Also, she was found with signs of oxygen deprivation. This shows signs of acute chest syndrome because people with acute chest syndrome have shortness of breath and many breathing problems.

7.Anna could have died from sepsis. I can say she could have died from sepsis because she had UTI (Urinary Tract Infection). One of the complications from untreated UTI is sepsis. I know she had UTI because of the diagnosis made in the 5.1.1 Medical History. The bacteria Serratia Marcescens led to her diagnosis of UTI.  The bacteria could have triggered the body´s defence mechanism and make it fight against it self. This could have caused the spleenic sequenstration when the sickle cells got stuck in her spleen, resulting it to enlarge. .

8. Splenic Sequestration-
In Autopsy report 1.3, it states that Annas abdomen was distended(swollen).this could have been caused by complications of Sickle cell disease. Splenic sequestration happens when a lot of sickled red blood cells become trapped in the spleen. The spleen can enlarge, get damaged, and not work as it should. You can die from this because if your spleen cant function properly then it cant supply your body with white blood cells, and if your body doesnt have acess to white blood cells than it cant battle any disease.So she could have died from other disease that she could n0t fight off due to shortage of white blood cells.

9.Stroke-
In medical history 4.3.1 It said that Anna had very high LDL levels. Safe LDL levels are 100-129mg/dl and her LDL level was 243 mg/dl,which is extremely high .LDL (aka bad cholesterol) transports cholesterol particles throughout your body. LDL cholesterol builds up in the walls of your arteries, making them hard and narrow,since she has very high LDL that leads me to believe that she died from a stroke because of the amount plaque that is clogging her arteries. There Is also evidence that Anna has left ventricular hypertrophy in Anna’s heart. This is a very serious condition in which the left ventricle of the heart become thicker. This can cause person to have a stroke, congestive heart failure, coronary heart disease, and sudden cardiac death.

# data[].attributes.body
Blood:

No evidence of alcohol

No evidence of non-prescription drugs or overdose of prescription drugs

Blood glucose – 280mg/dL

A1C – 11 percent

Urine

No evidence of non-prescription drugs or overdose of prescription drugs

Microalbumin test reveals significant protein in the urine Ketones in urine

Explanation of Results:

Internal Examination

Head and Neck:

Lens of the right eye appears cloudy. Blood vessels in both eyes are swollen. Abnormal blood vessels are present on the left retina. Vision was most likely compromised.

Examination of the oral cavity revealed significant plaque buildup on the teeth as well as severely receding gums. 4-5 unfilled dental cavities were visible.

Trunk

Left kidney appears pale and shows the beginning signs of necrosis. Right kidney appears normal.

# data[].attributes.body
Saturday – August 11, 2012

Breakfast

2 egg whites, scrambled, no butter

2 slices thick turkey bacon

1 slice whole wheat toast with 1 pat butter

1 cup coffee with artificial sweetener and 1 tbsp. light coffee creamer

Lunch

1 12oz can Sprite

1 turkey sandwich (2 slices whole wheat bread, 3 slices turkey lunch meat, 1 slice cheddar cheese, ½  tbsp. mayonnaise)

16 fat-free tortilla chips with salsa

Snack

1/4 cup dry roasted peanuts

1 small apple

Dinner

½ cup apple juice

6 ounces salmon filet

1 cup brown rice cooked with salt and butter

1 cup steamed broccoli

Dessert

½ cup sugar free lemon gel

Sunday – August 12, 2012

Breakfast

1 cup Cheerios

½ cup skim milk

½ cup blueberries

Lunch

1 cup low-fat strawberry yogurt

6 Ritz crackers

1 cup canned, low-sodium vegetable soup

1 12oz can cola

Snack

1 single serving bag potato chips

Dinner

2 slices thick crust pepperoni pizza (14” pizza)

2 cups tossed salad

4 tbsp. Caesar dressing

Dessert

1 cup vanilla ice cream with ½ cup mini marshmallows

5 Oreo cookies

Monday – August 13, 2012

Breakfast

1 cup whole milk

1 biscuit

# data[].attributes.body
Blood:

No evidence of alcohol.

No evidence of non-prescription drugs or overdose of prescription drugs.

Blood glucose level 280 mg/dL (normal range 70-125 mg/dL)

Stomach Contents:

No evidence of toxins or poisons

125 mL of partially digested food present

Internal Examination

Gastrointestinal System:

The mucosa and wall of the esophagus are intact and gray-pink, without lesions or injuries. The gastric (stomach) mucosa is intact and pink without injury. The mucosa of the three parts of the small intestine, the duodenum, the jejunum, and the ileum, and the mucosa of the large intestine, the colon and rectum, appears normal. Approximately 125 ml of partially digested semisolid food is found in the stomach.

Analysis of stomach contents:

Anna's stomach contents contained foods that caused her to have a high blood sugar level when she died.Over all, WE found that Anna had an unbalanced diet of carbs, proteins, and lipids.

# data[].attributes.body
Medical history analysis
As you can see Anna's medical history includes a history of heart disease and high cholesterol in her family.When Anna was a kid she was diagnosed with sickle cell disease which is basically when a group of disorders cause your red cells to break down.Anna has recently been feeling very thirsty, she said that no matter how much she drinks she still cant quench her thirst. Anna has been losing weight recently, she has lost about 10 pounds.

# data[].attributes.body
Laboratory Results:

Toxicology:

Preliminary  Blood Results:

No evidence of alcohol – BAC (% by volume), 0.015.

Trace amounts of acetylsalicylic acid present.

No evidence of overdose of non-prescription or prescription drugs.

External Examination

General Appearance:

The body is that of a well-developed, well-nourished adult Hispanic female who
appears to be her stated age of 38. Body height is 64 inches and body weight is 165 lbs. No evidence of post-mortem tampering is present and rigor mortis is generalized.

Clothing and Valuables:

The body is admitted to the morgue clothed and within a body bag. One ring is present on the right ring finger. Clothes are not torn but are stained with blood. A small amount of vomit is present on the shoulder area of the blouse.

Head and Neck:

The head is normally shaped with medium length, black hair. There is an injury to the right temple, including an open wound where pre-mortem bruising is evident. Neck shows no sign of injury.

Trunk:

The chest and torso are an appropriate size; no visible sign of trauma. Abdomen is distended.

Extremities:

The extremities are symmetrical and without abnormalities. The ankles are swollen and signs of edema are positive with moderate fluid accumulation. The fingernails show substantial graying, indicative of low oxygen. The right proximal humerus shows signs of a recently healed break, as does the left distal tibia. Inflamed, red injection sites on left thigh.

Injuries:

A head wound at the right temple, 2 cm in length, and 5 mm in depth at the center. Surrounding area bruised, limited bleeding evident. No skull fracture.

Right elbow bruise, 2 cm in diameter, limited contusion.

No other visible injuries.

Physical Examination Results:

Generalized pallor and evidence of oxygen deprivation.

Fingernails and toenails blue/gray color.

Evidence of vomit in oral cavity.

Blunt trauma to the head, wound indicative of a fall against a solid object, light bleeding suggesting lack of blood flow.

Edema of ankles visible.

Manner of Death: _________naturaul causes_________