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External exam
Skin
Marbling
Decomposition
Livor mortis
Diabetic ulcer
Hairless legs
Posterior hemorrhoid
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1. Summarize the history and create a differential diagnosis for the cause of death.
2. What behaviors and physical exam findings might you expect in a patient with “poor self-care”?
3. How advanced is the decomposition?
4. What specific decomposition changes are there?
5. What lower leg change(s) may indicate peripheral vascular disease in this patient?
6. In general, what lower leg skin changes can occur with peripheral vascular disease?
7. What lower leg changes fit for diabetes?
8. The history says the patient was found after an unwitnessed collapse.” How do you reconcile the presence of emergency treatment measures and decomposition in the case?
9. What is livor mortis? While is the center of the back pale?
10. What can you possibly infer about the patient based on his hygiene?
11. You are an emergency service provider. You are called to the scene after the family did a wellness check on their loved one and found him unresponsive. When you arrive, there is no pulse. What are the earliest postmortem changes that would tell you the patient has been dead too long to be resuscitated?
12. Based on your answer to 9. and the physical findings in the case, do you think the patient was found quickly after his collapse? Or after a longer gap?
13. Do you think the autopsy was performed quickly after the patient was found? Or after a longer gap?
14. What is the strap seen on the back of the head for?
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