Activity 6.1.

2: How Did
She Die?
A Timeline of Anna Garcias Medical History
and Death
Key of Body Systems
Cardiovascular
Digestive
Urinary
Immune
Respiratory
Nervous
Lymphatic
1975-Anna at age 14 months
Symptoms
large amounts of pain
lethargic
breathing problems
edema of the feet/hands
diarrea
Tests
CBC- Increased WBCs and decreased RBCs
Hematocrit- low Hematocrit (20%)
Blood Oxygen- Lower than normal
CT scan- abnormal spleen (signs of splenic sequestration)
Sickle cell test- Positive for Sickle Cell Disease
Diagnosis
Sickle Cell Disease
Severe Anemia
Splenic Sequestration
1988-Anna at age 14
Symptoms
fatigue
constantly thirsty and frequent urination
weight loss
Tests
CBC- no abnormalities in blood cell count
Cultures for strep throat are negative
Urinalysis- glucose evident in the blood
Glucose Tolerance Testing- positive for Type 1 Diabetes
Diagnosis
Diagnosed with Type 1 Diabetes
May 14th 2011- Anna at age 37
Symptoms
chest pain
hypertension
slight heart murmur
Tests
Cardiac Stress Test and Electrocardiogram (EKG)- decreased blood pressure, PVCs, one run of
ventricular tachycardia, mitral regurgitation, max. Blood Pressure of 190/110
Echocardiogram- left ventricle slightly enlarged and slight mitral valve regurgitation
Diagnosis
Blockage in arteries (recommended for patient to get an Angioplasty with a stent)
2011- Anna at age 37 cont.
Symptoms
hypertension
short of breath
rapid heart rate
Tests
Angiogram (prompted by previous blood work, EKG, and echocardiogram)-
CBC-no abnormalities in blood cell count
Cholesterol test- Total: 389 mg/dl, LDL: 243 mg/dl, HDL: 60 mg/dl, Triglycerides: 85 mg/dl
Fasting Blood Sugar- 85 mg/dl
Hemoglobin A1c- 7.1%
Diagnosis
High levels of Cholesterol
Blockage in arteries
2012- Anna at age 38
Symptoms
extreme pain associated with a sickle cell crisis in leg
fatigue
trouble urinating but when she could urinate, is would be cloudy and slightly pinkish in color
Tests
Urinalysis- Tested positive for a Urinary Tract Infection (UTI)
Gross Examination of Colony Morphology- bacteria identified as Serratia Marcescens
Gram-Stain- Gram negative
Enterotube test- Serratia Marcescens
Diagnosis
Anna has a Urinary Tract Infection of the bacteria Serratia Marcescens
Symptoms Corresponding with Annas Death
Cerebral Edema- Ketoacidosis
Fatigue- caused from cells not being able to get
energy from glucose
Troubled/Painful Urination- UTI
Tingling Sensation in Extremities- high glucose
levels and body not taking energy from it
Factors Contributing to Annas Death
Ketone levels in the blood at 1.2 mmol/L (High) causing high acidity
(pH levels at 6.95)
Organ/tissue failure caused by lack of energy getting to cells
A1C levels at 11%, indicating high glucose levels in blood
Sickle Cell disease caused lack of oxygenation throughout body
cells and tissues, could have aided in organ necrosis/failure
Urinary Tract Infection first triggered the ketoacidosis
Low effectiveness of Annas immune system caused the infection
to spread easier and slowed the eradication of it, which eventually
led to triggering ketoacidosis
Diseases/Risk Factors
Sickle Cell Disease
Causes one to be more susceptible to infection, which caused Anna to easily infected by
Serratia Marcescens from the urinary catheter, eventually triggering ketoacidosis
Type 1 Diabetes
Increased blood glucose levels
Ketoacidosis is common in individuals with type 1 diabetes because they lack natural
insulin in their body
Heart Disease
Ketoacidosis can be triggered by a heart attack or other symptoms of heart disease and
could cause the death of tissues
Urinary Tract Infection (UTI)
The infection caused Annas body to produce hormones, such as adrenaline or cortisol,
and those hormones prevent insulin from being recognized by insulin receptors, which
caused glucose to not be absorbed by body cells
Long Term Prevention Methods
Proper diet and exercise to limit glucose
levels in the blood
Going to a physician and getting insulin
fluids pumped into the bloodstream, to
increase insulin levels
Commit to efficient managing to her diabetes
and blood sugar levels
Short Term Prevention Methods
Use of insulin injection to input more insulin
into her bloodstream
Slight or moderate weight-loss could have
improved her insulin resistance to help her
take to her insulin injections
Self monitoring of ketone levels using take
home tests or frequent doctor visits