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Anna was taking some aspirin with a glass of something, and fell, hitting her head on the table.

Anna was taking some aspirin and was struck behind the head and fell, hitting her head on the table

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Went to the doctor recently

Stopped talking her prescription recently

Complaining about pain her lower back near her

Type 1 diabetic

Has Severe Sickle Cell Anemia

Received treatment:

Intravenous hydration

Administration of pain medication

Red Blood Cell transfusion

Administration of antibiotics to prevent infection

Tachycardia - average resting heart rate is 90-105

No signs of edema

Hypertension

Blood Pressure averages to 142/85

Stage 1

During treadmill stress test, Anna was only able to walk for 8 minutes - max speed 3.5 mph at an elevation of 2% and a max blood pressure at 190/110

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%

Slight heart murmur detected

Blockage in the left anterior descending coronary artery.

Left ventricle is slightly enlarged, still within normal limits, and a Slight mitral valve regurgitation noted.

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Preliminary Blood Results:

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

Trace amounts of acetylsalicylic acid present

No evidence of overdoes of non-prescription or prescription drugs

General Appearance:
The body is well-developed, well-nourished adult Hispanic female who appears to be state age 38. Body height is 64 inches and body weight is 165 pounds. No evidence of pot-mortem tamperong 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 os 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.

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:

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

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

Cardiovascular Systems:
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)

Extremities:
The extremities are symmetrical and without abnormalities. The ankles are swollen ad 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.
Injuries:
A head wound at the right temple, 2 cm in length, and 5mm in depth at the center. The surrounding area is bruised, limited bleeding evident. No skull fracture.
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.

Toxicology:
1. Blood

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

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

Blood glucose - 280mg/dL

A1C - 11%

2. Stomach Contents

No evidence of toxins or poisons

125 mL of partially digested food present

3. Urine

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

Microalbumin test reveals significant protein in the urine

Ketones in urine

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, ad the ileum, and the mucosa of the three parts of the colon and rectum, appears normal. Approximately 125 ml  of partially digested semisolid food is found in the stomach.

Anna Garcia Food Diary

Saturday -- August 11, 2012
- Breakfast

2 egg whites, scrambled, no butter

2 slices thick turkey bacon

1 slice whole wheat toast with 1 oat 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, 1'2 tbsp. mayonnaise)

16 fate-free tortilla chips with salsa

- Snack

1/4 cup dry roasted peanuts

1 small apple

- Dinner

1/2 cup of apple juice

6 ounces salmon filet

1 cup brown rice cooked with salt and butter

1 cup steamed broccoli

- Dessert

1/2 cup sugar free lemon gelatin

Sunday -- August 12, 2012
- Breakfast

1 cup of Cheerios

1/2 cup of skim milk

1/2 cup blueberries

- Lunch

1 cup low-fat strawberry yogurt

6 Ritz crackers

1 cup canned, low-sodium vegetable soup

1 12oz can cola

- Dinner

2 slices thick crust pepperoni pizza (14" pizza)

2 cups tossed salad

4 tbsp. Caesar dressing

- Dessert

1 cup vanilla ice cream with 1/2 cup mini marshmallows

Monday -- August 13, 2012
- Breakfast

1 cup whole milk

1 buscui

** Note that Anna's last entry was unfinished

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Things found at the crime scene:

White pills (Aspirin)

Cup sideways on the ground with unknown liquid spilled out of it

Syringe (unknown substance inside)

Vomit (unknown contents)

Fallen table with blood

Foot print belonging to Anna Garcia

Finger print belonging to Alex Garcia

Blood belonging to Anna Garcia

Blood droplets indicating it fell from the owner at around 120cm

Hair belonging to Anna Garcia

Facts about the murder:

911 call came in at 9:45 by neighbor, Doug

Doug reported that he saw Anna walking her dog at 6:30am, wearing a sweater despite the heat wave

EMT arrived at 9:56am

Anna was found face down in 73˚F