A 30 years old woman, she presented with shortness of breathing and low grade

fever for 1 week. Her underlying was poor compliance- HIV infection which was

diagnosed for 10 years prior. Physical exam showed oral candidiasis with desaturation.

Chest x-ray showed bilateral ground-glass appearance. She was given antibiotics to

cover PJP pneumonia and bacteremia. 2 days later she developed septic shock,

her blood culture grew gram negative bacilli and she died.

Which following is the cause of death?

A 50 years old man, presented with flu-like symptoms and mild jaundice last 5 years ago . At that time his LFT

revealed transaminitis and serum HBsAg positive. And 2 years later annual abdominal ultrasonography was

performed and reported liver cirrhosis. Last year he felt early fullness of stomach and progressive abdominal

distension. CT upper abdomen was sent, the results was compatible with advanced hepatoma and ascites.

Yesterday he came to emergency unit due to difficult to breath and his blood pressure was 60/30 mmHg.

Repeat CT whole abdomen was done, it demonstrated bleeding from hepatoma and then he passed away

in shortly.

What following is the cause of death in this patient?

A 70 year-old woman, 5 years ago she presented with episodic dyspnea on exertion. At that period, she was

underwent EKG exam, the results was inverted T in II, III, aVF. Echocardiogram revealed inferior wall hypokinesia

and preserved LV function. Coronary angiography was performed subsequently, it was near totally occlusion

of RCA, drug eluting stent insertion was done. Her underlying disease was type 2DM. Last year she had multiple episodes

of chest pain and relieving by sublingual nitrate, her doctor diagnosed chronic stable angina. 2 days prior she developed

dyspnea at rest and generalized edema. Chest x-ray demonstrated cardiomegaly with pulmonary congestion,

EKG showed ST elevation in V2-V5. She was diagnosed acute myocardial infarction with congestive heart failure.

And she passed away in subsequently.

Which following is the cause of death in this case?

ผู้ป่วยหญิงอายุ 30 ปี

4 วันก่อนทะเลาะกับสามี เกิดอาการน้อยใจ จึงรับประทานยาพาราเซตามอล 30 เม็ดครั้งเดียว ญาติผู้ป่วยพามารพ.ทันที

2 วันต่อมาแพทย์ตรวจพบตัวเหลืองตาเหลือง และการทำงานของตับผิดปกติคือ ระดับเอนไซม์ตับสูง แพทย์วินิจฉัยว่า drug induced hepatitis

2วันต่อมา ต่อมาผู้ป่วยซึมลงต้องใส่ท่อช่วยหายใจ แพทย์วินิจฉัยเพิ่มเติมว่า hepatic encephalopathy with acute respiratory failure

1วันก่อนที่จะเสียชีวิต ผู้ป่วยมีอาการอาเจียนเป็นเลือดและถ่ายเป็นเลือดสดไม่ได้ส่องกล้อง ผลเลือดขณะนั้นมี prolong coagulogram

Which following is the principle diagnosis?

ผู้ป่วยอายุ 50 ปี มาด้วยแขนขาด้านซ้ายอ่อนแรง 1 ชั่วโมงก่อนมารพ. โรคประจำตัวคือเบาหวานและความดันโลหิตสูงรักษาที่รพ. ต่างจังหวัด

ตรวจ CT brain : acute infarction at right MCA territory ผู้ป่วยได้รับการรักษาด้วย rt-PA ต่อมาผู้ป่วยมีอาการซึมลง

ตรวจ CT brainซ้ำ พบว่า มี hemorrhage แพทย์วินิจฉัยเพิ่มเติมว่า ภาวะเลือดออกเป็นจากยา thrombolytic agent ผู้ป่วยได้รับการใส่ท่อช่วย

หายใจและเสียชีวิตในที่สุด

Which following is the cause of death?

50 ปีชาย มีอาการเจ็บหน้าอกแบบ dullness retrosternal pattern มาก มา 1 วัน แพทย์รับไว้ในรพ. สังเกตอาการ ตรวจร่างกายและ

ผลตรวจเบื้องต้นปกติ (EKG 12 leads, cardiac enzymes)

ระหว่างนอนรพ.ได้รับการตรวจคลื่นหัวใจ cardiac enzymes เพิ่มเติม และ MRI heart ผลปกติ แพทย์มีแผนจะให้กลับบ้าน

1 วันก่อนผู้ป่วยจะกลับบ้านมีอาการขาด้านขวาบวม เหนื่อยหอบ แพทย์ทำ Doppler ultrasound และ CTA chest พบว่ามี acute thrombosis at right

Superficial femoral vein และ acute thrombosis at right main pulmonary artery ได้รับการรักษาด้วย anticoagulants

อาการดีขึ้น จึงได้กลับบ้าน

Which following of principle diagnosis?

35 year-old man, chronic alcoholic drinking and presenting with epigastric pain since yesterday. At emergency unit, generalized abdominal guarding was reported and no longer explor-lap was performed. The intra-operation findings were perforated gastric ulcer and secondary peritonitis. 5 Day later he developed aspiration pneumonia, septic shock and finally he passed away.

which of following is the cause of death?

a 50-year-old man presenting with upper gastrointestinal bleeding, chronic viral hepatitis B cirrhosis was his underlying. He was underwent EGD with ligation and findings included esophageal varices and bleeding. 6 hours later he developed re-hemorrhage and hypovolumic shock and he was gone finally. Which of following is a cause of death?

a 50 year-old man diagnosed with adenocarcinoma lung cancer, he presented with GTC seizure. CT brain showed multiple brain metastasis with peri-lesions edema. He was admitted and received WBRT. During staying in hospital he developed hospital acquired pneumonia. His physician prescribed antibiotics and then he was given palliative chemotherapy. He went home with approval. Which of following is the principle diagnosis?

A 40 year-man who presenting with episodic retrosternal chest pain for 2 months and resolving by sublingual nitrate. For hospital course CK-MB and Trop-T level had remained unchanged. His EKG showed inverted T in V1-3 with no dynamic ST-T change. No longer coronary arterial angiography and echocardiography were performed. The findings of investigations were non-significant stenosis of coronary artery and no regional wall dyskinesia. His physician diagnosed non-obstructive coronary arterial disease and later he went home with clinical better. Which following is principle diagnosis?

A 15 -year- old boy who admitted in intensive care unit due to submersion during swimming in the San Sab canal with his friends. At hospital he needed invasive ventilator support and board spectrum antibiotics was prescribed. 2 days later he developed right lobar pneumonia, his sputum culture result was numerous candida. No longer he developed fungemia, septic shock and passed away subsequently.Which of following is the cause of death?