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manner of death: accidental
internal injury
stomach was distended red injection sites on let thigh a couple of healed brakes

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age:38
race: Hispanic
weight:165 lbs.

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allergic reaction
suffocation
head injury

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face down in the entry of her home

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the blood splatter indicates she was hit on the way down at level height with the broken table found at the crime scene. she was most likely hit by the table on the corner were the blood was found

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This is a test to see how fast glucose leaves the blood in order to diagnose diabetes. Anna's GTT showed that she did not return to homeostasis therefore she had diabetes.

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Alex and Anna divorced in the previous year and he quickly remarried. and now is expecting a child. him and his new wife are experiencing financial issues. he was last found at Anna's house the night before she died to pick up some paperwork.

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Anna's neighbor they where previously in a relationship before Anna's death.

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matches Anna Garcia

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the footprints located in Anna's house matched her shoes.

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the unknown substance found in pill form was aspirin

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a 12 point match matches Alex Garcia

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matches both Anna and Alex's bloods

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wheat bread
apple yogurt
rice
turkey
salmon
eggs peanuts
mayo
milk
butter
cheese

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This test measures your insulin levels after intake of glucose. The results of this test will reveal whether a patient is type 1 diabetic or type 2 diabetic. the test for Anna showed that her Insulin levels didn't change meaning that her pancreas wasn't producing insulin which means that she was type 1 diabetic

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general background on biology of diabetes

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general background on biology of diabetes

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Diabetes is a disease that occurs when you blood sugar, is too high. Blood glucose is your main source of energy and comes from the food you eat. Insulin is a hormone made by the pancreas, helps glucose from food get into your cells to be used for energy.

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DNA is obtained from the patient's blood or saliva, the section of DNA containing the LDL receptor gene is then amplified by the polymerase chain reaction

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Toxicology: There was no alcohol found in blood, evidence of statins, blood glucose 280 mg/dL ( the normal range is 70-125 mg/dL
External Examination: X-ray images, lungs are normal
Internal Examination: Cardiovascular system problem, mitral valve does not close properly, has a stent and also appears that she has atherosclerosis.

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basic recommendations of a diabetic diet

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basic recommendations of a diabetic diet

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Diabetics meals starts with eating a well-balanced diet that includes carbohydrates, protein, and fat.

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Anna's frequent exercise thirst and urination 

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Anna's frequent exercise thirst and urination 

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The reason for her frequent thirst and urination is from her diabetes. this is from osmosis. In the case of diabetes, the solvent is water, and the solute of interest is glucose.  Diabetics have high blood glucose, and, since it is not absorbed by the cells of the body, it eventually goes to the kidney.

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Blood:
- no evidence of alcohol
- no evidence of non prescription drugs or overdose of prescription drugs
- Blood glucose level 280 mg/dL
- AIC - 11%

Urine:
- no evidence of non prescription drugs or overdose of
- Micro albumin test reveals significant  protein in urine
- Ketones in urine

Analysis:
It appears that Anna had diabetic complications. The trace of Ketones in the urine indicate that Anna's body cells were not getting glucose so the cells began to burn fat instead. And

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Atherosclerosis effect on body and how it is related to cholesterol 

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Atherosclerosis effect on body and how it is related to cholesterol 

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Changes in the walls of large arteries consisting of lipid deposits on the artery walls.

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Positive

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on a hot day in august Anna pushed herself too hard in a soccer game. she soon felt dizzy and clammy. she felt weak and her vision was blurry but she kept playing. she soon passed out and the ambulance arrived.  She had a brief seizure in the ambulance.

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Anna went on vacation with her friends to an all-inclusive resort. Even though she checked her blood sugar frequently, there were times she forgot to bring her supplies with her down to the beach. she had started to eat sugary desert and drinking some wine. She noticed that she had to go to the bathroom quite often, but she just assumed that was due to the alcohol. On the third day of the trip Anna felt like she was getting the flu. Anna took more insulin, but her friends took her to the doctor just to be sure she was OK. Luckily, Anna was given IV fluids and sent home after a few hours.

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At a wedding, Anna knew she would be consuming more food than she normally ate. She took extra insulin before she got there so she did not have to worry about injections during the reception.Unfortunately, the ceremony went longer than expected and she began to feel a bit dizzy. She immediately drank a juice box that was in her purse and she soon felt back to normal. She stopped to check her blood sugar before the reception just to be sure.

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Anna has a family history of early heart disease and uncontrolled hypertension.
Physical Exam: she is tachycardia, has a resting heart rate of 90-105, has no sign of edema where they have swelling in their feet.
Cardiac Testing: During her treadmill test she has drastic changes in her heart rate. She has premature PVC's.

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aerobic training increases mitochondrial density, insulin sensitivity, oxidative enzymes, compliance and reactivity of blood vessels, lung function, immune function, and cardiac output. Diabetes is an independent risk factor for low muscular strength so resistance exercises can help to build strength. flexibility and balance exercises are likely important for older adults with diabetes. Limited joint mobility is frequently present in older people with diabetes. Lifestyle changes that will benefit someone with diabetes include a healthier diet, a positive routine consisting of exercise.

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Function of coronary arteries and the purpose of an angiogram 

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Function of coronary arteries and the purpose of an angiogram 

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the function of the coronary arteries is to allow blood to flow and the purpose of angiograms is to see the flow of blood in the coronary arteries

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A genetic blood disease due to the presence of an abnormal form of hemoglobin, hemoglobin S. Hemoglobin is the molecule in red blood cells that transports oxygen from the lungs to the farthest areas of the body. Anemia is a condition that develops when your blood lacks enough healthy red blood cells or hemoglobin.

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Explain at least two possible treatment options to open blocked blood vessels 

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Explain at least two possible treatment options to open blocked blood vessels 

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Angioplasty

Stent insertion

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Treatment and symptoms of high blood pressure 

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Treatment and symptoms of high blood pressure 

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Eating a healthier diet that contains less salt , exercising regularly, also taking medication can help your blood pressure lower.
High blood pressure doesn have any symptoms but if not treated they can cause heart diseases and strokes

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With high blood pressure, sickle cell anemia, and diabetes, she needed a pacemaker because of all the work the heart has been in.

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Complete Blood Count- no abnormalities in red blood cells, white blood cells, or platelets
Total Cholesterol - 389 mg/dL
LDL - 243 mg/dL HDL - 60 mg/dL
Triglycerides - 145 mg/dL
Fasting blood sugar - 85 mg/dL
Hemoglobin A1C - 7.1%

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The results of the urinalysis test indicate positive for bacterial infection. Further tests need to be performed to identify the type of bacteria.

Administration of pain medication containing Phenazopyridine Hydrochloride

Administration of antibiotics

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How will ACE inhibitors help Anna's blood pressure?

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How will ACE inhibitors help Anna's blood pressure?

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ACE inhibitors lower your blood pressure by reducing angiotensin II in your body. Angiotensin is a hormone that acts on the central nervous system to regulate blood pressure. This lets your blood vessels to relax and widen, making it easier for blood to flow through.

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Explain why PVCs, ventricular tachycardia, and ST elevation

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Explain why PVCs, ventricular tachycardia, and ST elevation

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PVC: where the lower chambers (ventricles) of the heart occur earlier than usual due to the abnormal electrical activity of the ventricles
Ventricular tachycardia: aka v-tach, is a very fast heart rhythm that begins in the ventricles, it is a pulse that is more than 100 beats per minute with at least three abnormal heartbeats in a row. It is cause by the malfunction in the heart's electrical system.
ST elevation: myocardial infractions, refers to the finding on a electrocardiogram where the trace in the ST segment is abnormally high above the baseline

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Diary Entries Symptoms and treatment options

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Diary Entries Symptoms and treatment options

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Age 10:  Her symptoms included pain in chest and legs, fever, and  hardness of breath. Treatment includes rest, medication, warm bath, and physical therapy.
Age 17: symptoms consisted of acute chest  syndrome, difficulty breathing, nausea,  fatigue hair loss, and yellow eyes. Treatment options for this are medications such as hydroxyurea.
Age 22: symptoms were a vascular necrosis, bone dying, and blocked arteries. Options for treatment consist of arthritis medications, physical therapy, and hip replacement.
Age 31: the only symptom present was stress. Treatment options included meeting with a genetic counselor in the aid of knowing genetic possibilities.

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Mutations in the HBB gene cause sickle cell disease. Hemoglobin consists of four protein subunits, typically, two subunits called alpha-globin and two subunits called beta-globin. The HBB gene provides instructions for making beta-globin.

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Sickle cell disease (SCD) is a-genetic condition that is present at birth. It is inherited when a child receives two sickle cell genes—one from each parent. A person with SCD can pass the disease on to his or her children.