Tulane at Baylor

MECHANISMS OF DISEASE

AUTOPSY SESSIONS

Suzanne Meleg-Smith, MD, ssmith1@tulane.edu

Head, Tulane Autopsy Service, NOLA

Instructions

We are delighted that as part of the MOD course we are able to give you the opportunity to study an autopsy, just as we have always done in NOLA. The activity will be graded (6% of the MOD final grade) based on the report written by you and the activity of each student during the session.

Goals

Emphasis is placed on the development and use of observational and deductive skills by the students. In each case, students will be able to:

° formulate a differential diagnosis based on a clinical history

° observe and describe gross findings in organs

° differentiate normal and abnormal gross findings at autopsy

° formulate a final diagnosis based on autopsy

° correlate clinical manifestations of the patient with morphologic findings at autopsy

° describe the clinical and pathologic characteristics of common diseases

General information

The activity will start on January 10-2006. Students will not see cases of AIDS nor hepatitis.

Autopsy findings constitute privileged patient information and must be treated with the usual respect for patients’ privacy.

The exact day on which an autopsy is to be performed cannot be predicted. Therefore, there might be more than 1-day’s gap between students’ autopsy sessions.

We expect to have 1-3 sessions a week. Each session is for one group only, Tuesday to Friday, except on weeks when tests are scheduled.

Sessions

For their own safety, students must wear scrubs and closed shoes.

Sessions will be lead by Tulane Pathology faculty.

We (student-group “on call” and pathology faculty) will meet in the Tulane students’ hall in Baylor basement at 8:30 a.m. and go together at 8:45 a.m. to the Ben Taub morgue, where appropriate surgical attire will be provided.

Groups

Students have been divided into groups of 10- see document.

Each group needs to define 2 leaders who have cell phones.

Before 1-7-06, each group of students will provide names and cell phone numbers of leaders to Dr S Meleg-Smith, at ssmith1@tulane.edu

Each group will be “on call” until the session takes place, starting with Group 1 on January 10-06. SMS will notify the leaders as soon as a case is available for the autopsy session. The leaders will then notify the group members that the autopsy session will take place next morning.

After the session, the leaders of the group that has had a session will notify the next group that they are “on call”.

Schedule

On days when there is a session, we will meet in the Students’ Hall in Baylor basement at 8:30 a.m. and go together to the morgue, where appropriate gowns will be provided

The autopsy session will be held from 9:00 to 10:45 a.m.

During the session

In each case, the clinical history will be presented by the pathologist. Students will discuss the onset of signs and symptoms, the clinical and laboratory findings, and the differential diagnosis.

The clinical history presentation and discussion will be followed by examination by the students of the organs obtained at autopsy. Students, with input from faculty, will describe the findings and make correlations between the manifestations of disease during life and the organic abnormalities present at autopsy. A final diagnosis will be formulated.

Report

Students will write a report using the enclosed form and with the help of textbooks/journals/internet, will study the diseases discussed during the session.

Within 5 working days, E-mail your report to Dr Suzanne Meleg-Smith, at ssmith1@tulane.edu . This report will be graded and the grade will be integrated into the final Pathology Course grade.

WHAT ALL PHYSICIANS

- NON-PATHOLOGISTS AND PATHOLOGISTS -

NEED TO KNOW ABOUT THE AUTOPSY

Hospital autopsies are performed by the Department of pathology of many hospitals, when the family has signed a request/authorization. The clinician who has treated the deceased explains the need for an autopsy to the family and requests the consent. Autopsies are performed free of charge at the hospital where the patient was treated.

Coroner’s autopsies are performed by Forensic pathologists, not at the hospital.

Coroner’s cases are autopsies of individuals who die as a result of accident or suspected crime. Patients who die in hospital are also coroner’s cases if they die during the first 24 hours of hospitalization or 24 hours after an intervention. In such cases the clinician needs to report the case to the Coroner, who might authorize the hospital pathologist to perform the autopsy.