Third Semester Practice Exam PDF 2012

**This Practice Exam covers MSE Assignments 15-19: It has been produced to assist you with revision for the Third Semester Examination.** **DEFINITIONS:** 1. DIABETES MELLITUS 2. SENILE PURPURA 3. ARTERIOSCLEROSIS 4. OEDEMA 5. ATHEROSCLEROSIS 6. MALIGNANCY 7. HYDROCELE 8. SKIN SLIP...

**This Practice Exam covers MSE Assignments 15-19: It has been produced to assist you with revision for the Third Semester Examination.** **DEFINITIONS:** 1. DIABETES MELLITUS 2. SENILE PURPURA 3. ARTERIOSCLEROSIS 4. OEDEMA 5. ATHEROSCLEROSIS 6. MALIGNANCY 7. HYDROCELE 8. SKIN SLIP (DESQUAMATION) 9. FORMALDEHYDE GREY 10. GREEN JAUNDICE 11. DISCOLOURATION (In the context of Embalming) 12. ANASARCA 13. HYDROCEPHALUS 14. HYDROTHORAX 15. NEPHRITIS 16. FLUSHING (As it relates to Embalming) 17. PURGE 18. EXSANGUINATION 19. CHEMOTHERAPY 20. ENZYMES 21. RADIONUCLIDE 22. ATROPHY 23. ANEURYSM TRUE & FALSE QUESTIONS ====================== 1. Tissues that need preservation will certainly dehydrate 2. Under-embalmed tissue can dehydrate slower than well-embalmed tissue 3. There will be more chance of leakage from an incision if you end at the "low-end" of the suture track 4. It is easier to cosmetise up from a darker surface than from a lighter surface 5. Ascites is oedema of the thoracic cavity 6. Antemortem subcutaneous emphysema is tissue gas (gas gangrene) that affects the skin prior to death 7. The Sigmoid Colon can be found in the right inguinal region of the abdomen 8. Trocar guidelines include the brain 9. The pancreas is considered to be a solid organ in cavity embalming 10. The lungs are considered to be both a hollow organ and a solid organ in cavity embalming 11. For a hydro-aspirator to work properly and create an optimum level of suction there must be 40 to 50 PSI of water pressure. 12. PSI stands for 'pump suction inclination'. 13. Reaspiration may be required with cases of ascites. 14. Hydrocele is oedema of the brain 15. To aspirate the brain an infant trocar needs to be inserted through the ethmoid bone to enter the cranial cavity. 16. To aspirate the contents of the stomach the trocar from the standard entry point needs to be directed superiorly towards the intersection of the seventh intercostal space and the left mid-axillary line. 17. The urinary bladder (when distended) is found in the epigastric region. 18. The baseball suture is the preferred suture for embalming as it is very secure and literally 'air tight'. 19. Cachexia means general ill-health and malnutrition. 20. When there is atrophy of the mandible it is recommended that the needle injector be used to close the mouth 21. It is best to use a mild arterial solution when embalming an infant. 22. Arteriosclerosis can lead to both decubitus ulcers and amputation of extremities 23. Decubitus ulcers are the result of poor circulation. 24. Rapid injection and continuous drainage can cause dehydration 25. With a ruptured aortic aneurysm it is normally necessary to carry out a multi-point injection. 26. A malignant neoplasm has limited potential for growth. 27. Diabetes Mellitus can cause arteriosclerosis and degenerative changes in small blood vessels. 28. It is preferable to permanently set the lips prior to arterial injection with cases that you know will not purge 29. When embalming infants it is advisable to use the pulsation option during injection. 30. Heparin causes the blood to thicken and coagulate. 31. An elevated environmental temperature will slow the rigor mortis cycle. 32. Refrigeration will not stop decomposition 33. Massaging should be avoided with cases in intense rigor mortis to prevent distension 34. When arterially injecting refrigerated cases the rate of flow must be kept low 35. It is possible to dehydrate a case by using too much humectant 36. All pathological discolourations occur after death 37. Post mortem stain is caused by haemolysis 38. Surface evaporation of moisture is the single most important post mortem cause of tissue dehydration FILL IN THE BLANKS ------------------ \> [ ] [ ] should not be used for surface embalming due to the active dye in the fluid. \> [ ] [( )] oedema is the abnormal accumulation of fluid within the tissues cells, and it [ ] be removed with professional embalming techniques. \> [ ] [( )] oedema is the abnormal accumulation of fluid between tissues cells, and it [ ] be removed with professional embalming techniques. \>The Greater \_\_\_\_\_\_\_\_\_\_\_\_\_\_ can be found in all nine abdominal regions. \>The external \_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_\_\_is the canal from the external ear to the tympanic membrane. \> The worm suture is also know as the \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_suture. \> The Laryngeal-Oesophageal Barrier requires the ligature encircles both the \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ and the \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_to be successful. \>Preservative powders must have a high concentration of \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_. \>With the \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_\_\_\_ suture each passing of the needle occurs just below the surface of the incision. \>. An excess of sugar in the blood (glucose) is known as \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_. \> \_\_\_\_\_\_\_\_\_\_\_ clamps can be used to secure the skull cap with autopsy cases. \> Skin slip is also known as \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \> \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ fungi obtain their nourishment from dead organic matter. \> A \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_drug destroys cancer cells. \> The centre canal in a artery is called a \_\_\_\_\_\_\_\_\_\_\_ \> CVA stands for \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ \> Addison Disease causes the skin to turn a \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_colour \> [ ] [ ] vs. [ ] is an important factor to consider when embalming infants. \>When embalming infants, it is the [ ] [ ] [ ] that governs the actual amount of arterial solution entering the case. \>The condition known as [ ] [ ] is difficult to detect and is the cause of most embalming failures (Mayer's embalming textbook). MULTIPLE CHOICE QUESTIONS ------------------------- 1. Subcutaneous Emphysema is expressed as a: a. Postmortem intravascular condition b. Antemortem intravascular condition c. Postmortem invasion of microorganisms d. Antemortem condition caused by surgery or trauma 2. Which one of the following is not an extra-vascular discolouration: e. Petechiae f. Purpura g. Hypostasis h. Ecchymosis 3. The bile pigment responsible for jaundice is: i. Biliverdin j. Haemolysis k. Bilius l. None of the above 4. Nephritis causes the skin to turn a: m. Bronze-like colour n. Reddish-purplish colour o. Sallow-yellow colour p. Yellow-green colour 5. Formaldehyde grey is caused through: q. Using too strong an arterial solution r. Mixture of blood with the arterial solution s. A too rapid rate of flow t. An inappropriate arterial fluid 6. With ante-mortem dehydration which of the following is not true: u. It can be caused by TB (lungs) v. It can cause blood to become thick and clotted w. It can cause tissue to have an alkalinic value x. It can cause the skin to darken 7. Which of the following is not true: y. Rapid injection and continuous drainage can cause dehydration z. Surface dehydration is the single most important cause of dehydration a. Intermittent drainage will help prevent dehydration b. A hypertonic solution will maintain a good moisture balance **MULTIPLE CHOICE QUESTIONS (CONT):** 8. An aneurysm can be defined as: c. An abnormal dilation of a blood vessel d. Thickening and calcification of an artery wall e. A rupture in a blood vessel f. Heavily congested blood in a blood vessel 9. With carbon monoxide poisoning the colour of the skin often turns a: g. Blue-black colour h. Sickly white colour i. Sallow yellowish colour j. Cherry red colour 10. An infant is: k. 18 to 48 months of age l. From birth to 18 months of age m. 48 months to 12 years of age n. Any baby with a birth weight of 2,500grams or less o. None of the above 11. At birth, body water equals approximately: p. 80% of total body weight q. 70% of total body weight r. 95% of total body weight s. 75% of total body weight 12. One of the advantages of short-term refrigeration is: t. There will be no oedema present u. There will be no tissue gas present v. There will be a slowing of the rigor mortis cycle w. There will be little to no skin slip 13. Diabetes Mellitus is defined as: x. An acute metabolic disorder y. A chronic metabolic disorder z. An acute and chronic metabolic disorder a. None of the above 14. The post-embalming condition whereby Bilirubin is converted over to Biliverdin is called: b. Toxic jaundice c. Obstructive jaundice d. Green jaundice e. Haemolytic jaundice 15. Which of the following is not true: f. Humectants are not recommended for decomposed cases g. It is possible to pass the tissue gas bacillus from one area of a body to another on contaminated instruments h. All decomposed cases involve tissue gas i. Decomposition is a post-mortem chemical change GENERALISED QUESTIONS --------------------- 1. List two (2) differences between Solid (Cellular) Oedema and Pitting (Intercellular) Oedema: a. Solid (Cellular) Oedema: i. ii. b. Pitting (Intercellular) Oedema: 2. List five (5) examples that could cause distension [prior to] the start of the embalming process: c. d. e. f. g. 3. **Explain how you would treat a case that has purge coming from the mouth after cavity embalming has been performed.** 4. **How can you as an embalmer determine if there is a ruptured aorta?** 5. **Why do you think that supplemental forms of embalming cannot fully replace arterial embalming?** 6. **List seven areas where you would apply a preserving gel in an attempt to embalm tissue.** 7. List five (5) examples that could cause distension [after] arterial injection: h. i. j. k. l. 8. List five (5) characteristics you would look for when purchasing a quality instrument disinfectant/sterilant: m. n. o. p. q. 9. List six (6) hollow organs that must be aspirated during cavity treatment and state what materials are aspirated from each organ: 10. List the six solid organs that must be treated during cavity treatment: a. b. 11. List the three abdominal regions (9 region plan) that a healthy liver would normally occupy: r. s. 12. State three (3) advantages of delaying cavity embalming for some time after injection has been completed : t. u. v. 13. List four (4) reasons to carry out cranial cavity embalming: w. x. y. z. 14. List seven (7) advantages for performing cavity embalming immediately following arterial injection : a. b. c. d. 15. List eight reasons (circumstances) whereby you would need to reaspirate and reinject cavity fluid during embalming: 16. What is the difference between Wet Packing and Dry Packing of viscera from an autopsied case: e. Wet Packing: f. Dry Packing: 17. Why is Green Jaundice a possible problem that occurs after embalming a jaundice case with a stronger than normal arterial solution ([STNAS])? 18. List five (5) embalming problems that could be associated with the embalming of an elderly deceased: 19. List five (5) pathological changes that can result from diabetes mellitus: 20. Briefly explain why it is necessary to use a STNAS on a case that has intense rigor mortis? 21. Why is it that Ascites will not dilute the injected arterial solution? 22. What is the difference between the following conditions? g. Solid (Cellular) Oedema: iii. h. Pitting (Intercellular) Oedema: iv. i. Anasarca: v. 23. What is the difference between: j. Ascites: vi. k. Hydropericardium: vii. 24. List two (2) examples of Discolourations -- *[According to Cause:]* l. m. 25. List two (2) examples of Pathological Discolourations: n. o. 26. List four (4) examples of Discolourations due to reactions from embalming chemicals: p. q. r. s. 27. List four (4) examples of [Intravascular] Blood Discolourations: t. u. v. w. 28. List four (4) examples of [Extravascular] Blood Discolourations: x. y. z. a. 29. List five (5) protocols to use to establish and maintain Good Moisture Balance in a non-problematic case before / during / and after embalming: b. c. d. e. f. 30. List five (5) problems associated with a case that has been refrigerated and wrapped in plastic 31. List five (5) problems you might expect with a decomposed case: g. h. i. j. k. 32. List five (5) of the most common vascular problems facing embalming practitioners: **GENERALISE QUESTIONS (CONT.)** 33. What is the main difference between: l. Arteriosclerosis: viii. m. Atherosclerosis: ix. 34. Give a very brief explanation of the three (3) different types of Arteriosclerosis, and then fill in the circles below to indicate where in the lumen of the vessel this particular problem would be located: n. Type 1: x. o. Type 2: xi. p. Type 3: xii. 35. List five (5) end-stage antemortem problems that could affect the embalming of a case with Congestive Heart Failure: q. r. s. t. u. 36. List the eight (8) signs of Renal Failure: v. w. x. y. z. a. b. c. **GENERALISE QUESTIONS (CONT.)** 37. In your opinion what is the most serious problem with embalming renal failure cases and how would attempt to overcome this problem? 38. What embalming protocols do you recommend for a tissue gas case? 39. What is the difference between 1^st^, 2^nd^ and 3^rd^ Degree Burns? 40. List the four (4) problems that will cause the pressure that will eventually lead to Purge: d. e. f. g. 41. List six (6) predisposing conditions to Purge: h. i. j. k. l. m. 42. List the five (5) types of gases that could be found in the tissues of the deceased: n. o. p. q. r. 43. List three (3) methods by which gases can be detected in a deceased: s. t. u. 44. Name the two (2) types of enzymes that are responsible for Decomposition: v. w. **GENERALISED QUESTIONS (CONT.)** 45. List five (5) embalming problems associated with Alcoholism: x. y. z. a. b. 46. Explain one difference between: c. Saprophytic Fungi: xiii. d. Parasitic Fungi: xiv. 47. Live five (5) possible types of cases that could have a fungal infection running parallel: e. f. g. h. i. 48. There is a very important reason why you should use a stronger than normal arterial solution (STNAS) when dealing with a mycotic (fungal) infection case (or one that you suspect as such). Name the reason: j. 49. List four (4) fungal infections important to embalming, and mark the one that you feel is more serious to embalmers with an **\#**: k. l. m. n. 50. On a hanging case, which area of the body will pose the most problems for embalming -- and why: o. The problematic area: xv. p. Why? xvi. **GENERALISED QUESTIONS (CONT.)** 51. What two (2) conditions might you see on every electrocuted case: q. r. 52. What will be the major problem when embalming a case that died from Carbon Monoxide Poisoning? 53. List four (4) common problems that you might encounter with a drowning case: s. t. u. v. 54. List five (5) problems associated with a case that died from poisoning: w. x. y. z. a. 55. List five (5) organs / systems that could be affected by chemotherapeutic agents: b. c. d. e. f. 56. Explain the difference between: g. Formaldehyde Grey: xvii. S h. Flushing: xviii. S 57. Briefly explain how chemotherapy can cause embalming failure and what protocols are needed to correct the problem. **GENERALISED QUESTIONS (CONT.)** 58. Think about the following case conditions: i. 3^rd^ degree burns j. Renal failure k. Liver failure l. Generalised oedema m. Intense rigor mortis n. Long term refrigeration xix. *All of these conditions have several "Common Threads" that run through each of their embalming protocols.* xx. [List two (2) of the Common Threads:] 1. 2. 59. From Mayer's embalming textbook, what is the connection between corticosteroid drugs and TB? 60. Make a drawing of the Nine Abdominal Region Plan, label each region and list all of the organs/structures found within each region. 61. With a full autopsy case where the common carotid arteries have been removed what arteries would you need to locate to embalm the head and face, the upper extremities and the lower extremities? 62. Why should you continually aspirate the cavities of any drainage material during the embalming of an autopsy case? 63. Describe what supplemental forms of embalming you would apply to a decubitus ulcer on the right hip of a case. 64. With a sixteen (16) month non-autopsied child with no apparent problems what artery or arteries would you select as your primary injection site and why? 65. Describe how you would treat skin-slip on the left arm of a case. 66. What arterial solution strength do you recommend to use with a renal failure case? 67. Why is it recommended that the legs of an autopsied infant be injected before the head and arms? 68. Why should you not permanently set the lips prior to arterial injection? **GENERALISED QUESTIONS (CONT.)** 69. Why is it advisable to use pulsation when injecting the head and face from the common carotid arteries? 70. Why is it recommended that the dura mater be removed when embalming an autopsied case? 71. Describe three (3) methods for securing the calvaria to the base of the skull 72. What is meant by a 'well coordinated arterial solution'? 73. Why is good massaging recommended for cases in rigor mortis? 74. What protocols do you recommend for embalming a frozen case? 75. What are the generalised embalming protocols for the treatment of an anasarca case? **SCENARIO QUESTIONS** 1. You have finished the arterial injection of an elderly male case weighing 65 kilos. There are no problems with the case except for an inguinal hernia along with decomposition and skin slip of the scrotum. Explain in a step by step way the entire cavity embalming process from making the insertion point for the trocar through to closing the same incision. Also state how you would treat the problem of skin-slip. 2. You have a non-autopsy case that has had the right femur removed (donor); the femur has been replaced with a length of dowel. With the exception of the right leg you have successfully embalmed the case using the restricted cervical method. To stop the loss of arterial solution during the injection you opened the donor site sutures from the inguinal ligament to the right knee and clamped the severe right femoral artery at its point of origin with a large pair of haemostats. The full length of the femoral artery has been removed along with the femur. Describe how you would embalm the right leg and close the donor site incision. **SCENARIO QUESTIONS (CONT.)** 3. You completed both arterial and cavity embalming with a case that has a decubitus ulcer on the right hip. Due to time constraints you have not yet carried out any treatment of the ulcerated area. Describe now in a step by step form what embalming treatment you would carry out to preserve the area and stop the odour. 4. There is a recent bruise on the back of the right hand of the deceased you are caring for. The family have asked that the bruise be covered with cosmetics. Describe how you would attempt to 'lighten' the discolouration following arterial embalming to make the cosmetising easier. 5. Describe how you would embalm a 16 month old male infant who had died of cardiopulmonary failure due to congenital heart problems. The deceased has been dead for one day (refrigerated) and is in relatively good condition except for some livor mortis in the face. A hospital autopsy was requested but the family refused. - Preparing yourself and the room - Unwrapping the case - Washing and general disinfection of the case - Barrier plugs and the disinfectant used - Positioning of the body - Setting the features -- what (if any) method you used to close the mouth, what you used to close the eyes. 6. You have a full autopsy case to embalm where the common carotid arteries have been removed along with the soft palate and the tongue. You have carried out all of the preliminaries including disinfection, setting the features, opening of the incisions and treatment of the internal organs. You have mixed up your 3% arterial solution in the embalming machine tank and are at the point where you are about to start the arterial injection. Describe in point form how you would arterially embalm this case and include any supplemental forms of embalming that may be necessary to secure preservation of the trunk walls and so on. Finish your description at the point where you are about to carry out the final aspiration of drainage materials from the cavities before reconstituting the case. 7. You have a 60kg case on the table whose D/C states she had Renal Failure (amongst other things). The case also has Anasarca and generalised Jaundice. Explain what type of arterial solution is mixed and injected into one or more regions of this case. Write out the formula for each arterial solution used, including the type, amount and brand name of the chemicals used. **Do not completely embalm this case on paper -- just explain the arterial solution(s) you would mix and into what regions you would inject these solutions**.