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Two treatments to open blocked blood vessels

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Two treatments to open blocked blood vessels

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Angioplasty and Stent Insertion are two procedures to open a blocked vessel. For Angioplasty the doctor threads a thin tube through a blood vessel in the arm or groin up to the involved site in the artery. The tube has a tiny balloon on the end. When the tube is in place, the doctor inflates the balloon to push the plaque outward against the wall of the artery. This widens the artery and restores blood flow. The second procedure, Stent Insertion, is when a stent is inserted into the clogged artery with a balloon catheter. The balloon is inflated and the stent expands and locks in place. This holds the artery open and allows blood to flow more freely.

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Test Preformed:

Urinalysis

Gross Examination of Colony Morphology

Gram Staining

Biochemical Test

Test Results:
The results of Urinalysis test indicate: Positive for bacterial infection. Further test need to preformed to identify the type of bacteria.
The results of the Gross Examination of Colony Morphology test indicate: Size of colonies-small, margins-wary, elevation-raised, color-red. Serratia Marcesens.
The results of Gram Staining test indicate: The gram staining process indicates that Anna's sample was gram negative.
The results of the Biochemical test indicate: Indote test- negative, unease-negative, mobility-positive, H2S-negative.
Type of Bacteria Present: Serratia Marcescens.

Diagnosis: Anna Garcia's death was possibly an affect of multiple things. Anna had diabetes and sickle cell anemia and a bacterial infection, Serratia Marcescens. Anna could have possibly been getting up for aspirin to stop pain in her body caused by diabetes when her legs gave out when standing up. Anna could have hit her head on the table and when she hit the floor it could have started up her respiratory track infection. Anna wouldn't have been able to pick herself off the floor due to her legs and eventually died.
Treatment:

Administration for pain medication containing Phenazopyridine Hydrochloride

Administration of antibiotics

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Urinalysis-used to detect and manage a wide range of disorders, such as urinary tract infections, kidney disease and diabetes. A urinalysis involves checking the appearance, concentration and content of urine.

Microscopic exam-doctor looks at drops of your urine under a microscope for abnormalities in your red or white blood cells, which may be signs of infections, kidney disease, bladder cancer, or a blood disorder, infectious bacteria or yeasts ect.

Dipstick test-doctor inserts a chemically treated plastic stick into your sample. The stick changes color based on the presence of certain substances. This helps doctor look for blood, protein, changes in pH levels or acidity, sugars, ect. High pH levels can indicate urinary tract or kidney issues and any presence of sugar can indicate diabetes.

Visual exam-doctor examines the sample for abnormalities, such as, clouded appearance, which can indicate an infection, abnormal odors, reddish or brownish appearance.

Gross Examination of Colony Morphology- one of the first steps in characterizing and identifying a bacterial culture. Colony morphology is a way scientists can identify bacteria. An individual colony of bacteria is spread directly onto nutrient agar and grows in a Petri dish. Colonies differ in their shape, size, color and texture.
Four basic categories of colony morphology:

Color

Margins- Smooth or Wavy.

Elevation- Flat, Raised or Convex.

Size- Small or Large.

Gram Staining-a process by which the cell wall structure of bacteria is determined using a series of reagents. This is considered a differential stain as the differences in bacteria are discovered. Bacteria are either Gram positive (they stain purple) or Gram negative (they stain pink/red). Gram negative bacteria are generally considered to be more dangerous as they have an additional membrane outside of their cell wall that is an endotoxin.

1. Heat fix slide so that bacterial cells are fixed to the slide.

2. Flood the slide with crystal violet dye. Gram positive bacteria has a thick peptidoglycan layer. Gram negative has a thin layer.

3. Rinse crystal violet dye off with water.

4. Flood the slide with iodine. Iodine ions penetrates the cell wall and binds with crystal violet dye.

5. Rise iodine off with water.

6. Decolorize slide with alcohol. Alcohol in Gram positive causes water to leave, crystal violet dye and iodine are blocked from leaving cell wall. Alcohol in Gram negative dissolves outer membrane therefore crystal violet dye can leave.

7. Rinse alcohol off with water.

8. Flood slide with Safranin dye. In Gram positive Safranin dye penetrates cell, but doesn’t change color. In Gram negative Safranin dye penetrates cell and dyes bacteria red/pink.

Biochemical Test- For this test we followed the Gram Negative Identification Flowcharts and use the biochemical test results documented in the data table to determine the bacterial species infecting Anna Garcia.

Data Table:

Ornithine Decarboxylase Test- Positive
Citrate Test-Positive
VP test-Positive
Oxidase Test-Negative
Lysine Decarboxylase Test-Positive
H ₂ S Test-Negative
Pigmentation-Red
Glucose Fermentation Test-Positive
Lactose Fermentation-Negative
Indole Test-Negative
Urease Test-Negative
Nitrate Reduction-Positive
Arabinose Test-Negative
Motility Test-Positive
Gelatin Hydrolysis-Positive
Catalase Test-Positive

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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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Coronary Arteries supply blood to the heart muscle. Like all the other tissues in the body the heart needs oxygen-rich blood to function. For the heart oxygen-depleted blood must be carried away. An angiogram is an X-ray for your heart. This X-ray looks for abnormalities in the heart muscle or heart valves and to see if the coronary arteries are narrowed or blocked.

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Atherosclerosis effect on the body and how it relates to cholesterol

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Atherosclerosis effect on the body and how it relates to cholesterol

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Atherosclerosis is the hardening of the arteries. Plaque builds up in your arteries over time and this may develop heart disease. Plaque builds up the coronary arteries and may distort the flow of oxygen rich blood to your heart muscle. This can cause chest pain called angina. Your arteries can become clogged from high cholesterol.

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Carlos: ff not affected
Anna: Ff Affected
Eric: ff not affected
Jason: Ff Affected
Erin: FF Affected
Maria: Ff Affected
Juanita: Ff Affected

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To detect the FH mutation, 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 (PCR). The amplified DNA is analyzed to see if there is a mutation. To analyze the DNA, investigators use restriction enzymes to cut the DNA in specific places. By examining the sizes of the DNA fragments obtained after exposing the DNA to the restriction enzymes, it is possible to detect mutations or changes in the DNA. This detection is possible because of Restriction Fragment Length Polymorphism or RFLP

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PVC's Ventricular tachycardia, and  ST elevation explained

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PVC's Ventricular tachycardia, and  ST elevation explained

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:PVC is abnormal heartbeats in one of the lower two chambers of the heart.
:Ventricular tachycardia is the when the lower two chambers of the heart beat very quickly.
:ST elevations refers to a finding on an electrocardiogram wherein the trace in the ST segment is abnormally high above the baseline

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Symptoms and Treatment of High Blood Pressure 

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Symptoms and Treatment of High Blood Pressure 

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-Symptoms
High blood pressure often has no symptoms. Over time, if untreated, it can cause health conditions, such as heart disease and stroke.

-Treatment
Eating a healthier diet with less salt, exercising regularly, and taking medications can help lower blood pressure.

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Physical Exam

Patient is tachycardic; average resting heart rate ranged from 90-105 over the course of the day.

Patient shows no signs of edema (swelling) in her feet or lower legs, although she does mention an occasional tingling sensation in her right calf.

Blood pressure values averaged 142/85 over the course of the workup.

Slight heart murmur detected.

Waist Circumference – 33 inches

Cardiac Testing

Patient completed a treadmill stress test. The patient experienced drastic increases in blood pressure as well as a few premature ventricular contractions (PVCs) on EKG during the exam. One run of ventricular tachycardia was noted. Additional monitoring using a Holter monitor is suggested given these abnormalities and the noted mitral regurgitation (see below). The patient was only able to walk for 8 minutes before the test was concluded – max speed 3.5 mph at an elevation of 2%, and max blood pressure of 190/110.

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The reason Anna needed a Pacemaker was because she had a blood clot in the heart which made the heart beat she had change. the pacemaker would make the rhythm of her heart stay on track.

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Anna's cholesterol test results: Full cholesterol panel
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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how ACE inhibitor will help Anna's blood pressure

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how ACE inhibitor will help Anna's blood pressure

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ACE inhibitors will help Anna's blood pressure because the drug lowers blood pressure by making the blood vessels relax

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Toxicology

1. Blood

No evidence of alcohol.

Evidence of statins, equivalent to 40mg/day. NOTE: A prescription bottle for Vasotec, an ACE inhibitor, was found at the scene, although there is no evidence of this drug in the blood. The decedent most likely had not taken this medication for at least 3-4 days.

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

2. External Examination

The following X-ray image was obtained of the heart and lungs before internal examination. Lungs appear normal with no infiltrates.

3. Cardiovascular System

Examination of the heart revealed concentric left ventricular hypertrophy. There is also evidence of mild mitral valve prolapse (this means that the mitral valve does not close properly).

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Sickle Cell Disease is a point mutation, when one nucleotide in a codon sequence. Sickle Cell Disease is a disorder in which red blood cells form an abnormal crescent shape. The disease is a genetic disorder caused by inheriting a mutated gene that codes for the protein hemoglobin. In SCD the codon for amino acid 6 is changed from glutamic acid codon (GAG) to a valine codon (GTG).

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Soda: positive for glucose and negative for starch,protein, and lipids
Yogurt: positive for glucose, and protein and negative for starch and lipids
Chips: positive for glucose,starch, and lipids negative for protein

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Symptoms and Diagnoses for Anna at age 16, 25, and 29

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Symptoms and Diagnoses for Anna at age 16, 25, and 29

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At age 16 Anna was experiencing symptoms of being dizzy, trembling, clammy, and blurry vision. She had passed out and had a seizure. She was diagnosed with Hypoglycemia.
At age 25 Anna was having symptoms of being thirsty, often bathroom breaks, being disoriented, and speaking incoherently. She was then diagnosed with Hyperglycemia.
At age 29 Anna was experiencing symptoms of being a little dizzy then back to normal. She was then diagnosed as unaffected.

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-Patient was given Infant Tylenol to relieve fever.
-Patient is running a fever, is extremely lethargic, experiencing breathing problems, and appears to be in a lot of pain
-Patient’s breathing is abnormal. Respiratory rate is slightly elevated, and patient seems to be short of breath.
-Pale skin, nails, and lips
-Patient does not have any hernias. Patient has not had much of an appetite for the last couple of days. Patient has a bright red diaper rash on bottom, and mother said she has been experiencing diarrhea for two days.
-Pulse is 175 bpm. Heart rate is rapid and above normal range.
-Positive for sickle cell anemia
-Splenic sequestration (sickling in the splenic vein resulting in collection of a large amount of blood in the spleen, causing the spleen to be enlarged).

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Reason for Anna's excessive thirst and frequent urination

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Reason for Anna's excessive thirst and frequent urination

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People who are diabetic have high levels of sugar or glucose in their blood. Glucose will absorb  all the water in a diabetic and it will make them thirsty. If they were to drink water the drinking water will also be absorbed. This continuous cycle is the reason diabetics are always thirsty. Since they are thirsty they have the need to drink more water causing them to use the restroom more often than normal.

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Sickle Cell- a disorder that cause red blood cells to become misshapen and break down and occasional blood clots.

Anemia- not enough healthy blood cells

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Age 10
Symptoms- Extreme pain in chest and legs. Fever.
Benefits Associated w/Treatment- Physical therapy legs hurt less. Whirlpool, Transcranial Doppler-Ultrasound, and Pain Medication
Risks associated w/Treatment- Pain Medication made her sleepy.
Biomedical Professionals Involved- Physical Therapist.
Lifestyle Concerns- Missed a lot of school, missed friends birthdays, can't hang out with friends.
Age 17
Symptoms- Many pain crises, thin hair, yellowish eyes.
Benefits Associated w/Treatment- Hydroxyurea- Live longer and have fewer pain episodes, less likely to get acute chest syndrome.
Risks associated w/Treatment- Hydroxyurea- makes her nauseous and tired, probably making her hair fall out. Her child may have birth defects if she had one while taking Hydroxyurea.
Biomedical Professionals Involved- Personal physician.
Lifestyle Concerns- Can't do the same things as her friends, can't go on ski trip because of the high altitude, the cold and it will act up the bone problem in her hip.
Age 22
Symptoms- Pain, arascular necrosis in hip worsens.
Benefits Associated w/Treatment- Arthritis medication, Physical therapy, Hip replacement: easier on Anna and she can get around better.
Risks associated w/Treatment- Hip replacement: Needs to get a new one in 10 yrs, recovery and rehabilitation take a while.
Biomedical Professionals Involved- Physical Therapist, Orthopedist
Lifestyle Concerns- Can't enjoy college like her friends and other normal Seniors.
Age 31
Symptoms- Stress
Benefits Associated w/Treatment- Pre-implantation Genetics: ability to chose the embryos that are genetically free of sickle cell.
Risks associated w/Treatment- Unethical
Biomedical Professionals Involved- Genetic councilor, hematologist
Lifestyle Concerns- Constant worrying about future children genes, affecting marriage, possible pregnancy could put her at greater risk of stroke and mess up her artificial hip.

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basic recommendations of a diabetic diet

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basic recommendations of a diabetic diet

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particularly more non starchy vegetables, fruits (in moderation), healthy fats, and lean proteins — while consuming fewer sugar-laden products and processed foods. Both diets also often call for reducing carbs and calories, while encouraging more physical activity.

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a medical diagnostic procedure during which insulin is injected into a patient's vein, after which blood glucose is measured at regular intervals, tells a person what type of diabetes you have.
Anna's Results:
She is a type 1 diabetic

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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.

BLOOD
Blood glucose level 280 mg/dL.

URINE
Ketones in urine.

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General background on the biology of diabetes 

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General background on the biology of diabetes 

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

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The Analysis shows that Anna had eaten food awhile before she had passed as they found half digested food in her stomach

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Healthy Carbohydrates, Fiber-Rich foods, and Heart-Healthy fish are main foods that a diabetic should include in their diet. Foods to avoid would include Saturated Fats, Trans Fats, Cholesterol, and Sodium.

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A test of the body’s ability to metabolize glucose that involves the administration of a measured dose of glucose to the fasting stomach and the determination of blood glucose levels in the blood or urine at intervals thereafter and that is used especially to detect diabetes.
Anna's Results:
Anna is diabetic

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The fingerprint found at the crime scene belongs to Alex Garcia because Alex matches the fingerprint found at the Crime Scene.

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It was concluded that the hair at the crime scene was Anna Garcia's since the two strands match each other

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There was a unknown substance found at the crime scene was Acetylsalicylic Acid (Aspiin)

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The blood found at the crime scene did match both Anna Garcia and her ex-husband, Alex Garcia who have type B blood. However, in later tests, results showed that it was Anna Garcia's blood found at the crime scene.

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The results prove that Anne was hit while she was going down because the blood drops circumference was smaller than tested higher above.

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The tread in the shoes prints at the crime scene matched Anna´s shoes that she was wearing.

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1. vomit
2. Phone
3. footprints
4. light
5. blood
6. syringe
7. pills
8. red nail polish
9. half empty orange juice
10. opened book
11. tv remote
12. victim
13. broken table
14. plant

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Alex and Anna were married
Lucy and Anna had a business
Doug and Anna we seeing each other but Anna ended it in the recent weeks
Erica is Alex's current wife

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Anna Garcia
Age: 38
Sex: Female
Race: Hispanic
Weight: 165 lbs.

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Lucy killed her trying to take control over the business.

Erica killed her because she wanted Anna completely out of Alex's life.

Alex killed her to get the insurance money and to get rid of Anna all together.

Doug killed her because he was very angry that Anna broke up with him.

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Anytown, USA
August 14, 2018
The front entrance hall in Anna's house

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Lucy Leffingwell
Doug Green
Erica Piedmont
Alex Garcia

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Anna died at 7:00 A

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Decedent's Name: Anna Garcia
Date and Time or Autopsy: August 15 11:00 am
Performed By: Dr. Jane King
General Information: 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, No evidence of post-mortem tampering is present and rigor mortis is generalized.
Clothing and valuables: Clothes are stained with blood but not ripped. A small amount of vomit is present on the shoulder area of her blouse.
Extremities: The extremities are symmetrial and without abnormalities. The ankles are swollen, 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 recently healed break, as does the left distal tibia. Inflamed, red injection sites on left thigh.
Trunk: Chest and torso are appropriate size, no trauma, and abdomen is distended.
Head and Neck: head injury on the right temple, including an open wound where pre-mortem bruising is evident.