6.1.2: How Did She Die?

Kayla Kintzele & Taylor Bould

Body Systems Color Code
Respiratory System
Cardiovascular System
Immune System
Nervous System
Urinary System
Digestive System

Cause of Death Paragraph
At Annas time of death, the ketones in her blood were 1.2 mmol/L (normal
range below 0.6 mmol/L) and her blood was very acidic (pH 6.95). Also, her
blood glucose level was 280 mg/dL (normal range 70-125 mg/dL) and ketones
were present in the urine. These signs indicate that Anna had diabetic
ketoacidosis and it caused her death. If untreated, ketoacidosis can lead to
organ failure, lack of consciousness, and death. A complication that Anna had
is cerebral edema, and it Annas case would be caused by a dramatic change
in blood sugar. Anna must have tried to inject insulin, but due to
complications of ketoacidosis, her muscles were impaired and she could not
reach the muscle. Then, with her dizziness from high blood sugar and
diabetes, she must have tripped and fallen over the desk and become
unconscious and then died.
Anna at 14 Months- May 14th, 1975
Symptoms
Lethargic (Swollen)
Breathing problems
Lots of pain
Tests
Hematocrit- 20%
Blood Oxygen- Lower than
normal levels
CT Scan- Abnormal Spleen
Sickle Cell Test- Positive for
sickle Cell Anemia



Diagnosis
Sickle Cell
Severe Anemia
Splenic Sequestration

No Sign of Diabetes at
this point




Anna at 14 Y/O - May 14th, 1988
Symptoms
Fatigue
Thirsty
Frequent Urination
Lost Weight
Tests
CBC-Normal
Strep Throat-Negative
Urinalysis-Glucose in the Urine
GTT- Positive for Diabetes
Insulin Test- Type one Diabetes
Diagnosis
Anna has Type 1
Diabetes


Annas mother reports a
family history of high
cholesterol and heart
disease.
Anna at 37 Y/O - May 14th, 2011
Symptoms
Self-Resolved Chest Pain
Occasional Tingling Sensation in
her right calf
Tests
EKG-Premature ventricular
contractions, ventricular
tachycardia
Echocardiogram- Slight heart
murmur
Blood Pressure-140/72 mmHg

Diagnosis
Anna has a Heart Murmur
Anna is tachycardic


Family History of Heart
Disease/Hypertension. Her
father had a heart attack when
he was 41 Y/O



Anna at 37 Y/O (cont.) - May 14th, 2011
Symptoms
Self-Resolved Chest Pain
Test
CBC-Normal
Cholesterol Panel
o Total- 389 mg/dL (HIGH!)
o LDL- 243 mg/dL (HIGH!)
o HDL- 60 mg/dL (AVERAGE)
o Triglycerides- 145 mg/dL
Fasting Blood Sugar- 85 mg/dL
Hemoglobin A1c-7.1%

Diagnosis
Cholesterol and LDL is very
high
HDL:LDL ratio is out of whack

Anna at 38 Y/O - 2012
Symptoms
Extreme Pain (associated with sickle
cell crisis)
Persistent Urge to Urinate
Urine is cloudy with slight pink color
Tests
Urinalysis- Positive for Bacteria
Gross Examination-Small, Wavy,
convex, pink
Gram Stain- Negative, Cocci Shaped
Enterotube-Serratia Marcescens
Diagnosis
Anna has the bacterial
infection of Serratia
Marcescens

Treatment
Administration of pain medication
containing Phenazopyridine
Hydrochloride
Administration of antibiotics
Short Term Prevention
Go to emergency room/call 911 when she
starts to experience symptoms
Check Blood-Glucose Level/Inject Insulin
Blood Pressure Test
Take a urine analysis test
Cardiac Testing
Long Term Prevention
Exercise Daily
Eat Healthy
Monitor Blood-Glucose Level/Inject insulin
when needed
Stop drinking wine
Attend frequent doctors appointments
Conclusion Question #2
Nervous System: The abnormally high ketones levels in
the blood made it acidic. This led to cerebral edema,
ventricle size was diminished as brain tissue was swollen.
Endocrine System: Since Anna has type one diabetes and
ketones in her blood, her pancreas was not able to
release insulin into the blood to lower her glucose levels.
Anna tried to inject insulin into her upper thigh, but she
could not reach the muscle.


Conclusion Question #3
If I could have a conversation with Anna
minutes before she died, some symptoms that
she would be experiencing would be frequent
urination, extreme thirst, abdominal pain,
weight loss, a fruity smell on her breath, cold
skin, confusion, and weakness.

Conclusion Question #4
If Anna had an insulin pump connected to an
app on her phone, she would be able to easily
monitor her blood-glucose level and send the
results to her doctor. If she had this, her
doctor would have known her blood-glucose
level was extremely high and that she was in
danger. He could have sent help for her and
prevented her from dying.
Conclusion Question #5
One career that we are interested in is a clinical
geneticist because of the high salary, and Taylor and I
both find genetics interesting. Also, we think it would be
interesting to analyze DNA, and evaluate medical histories
to determine treatment for different genes. Another
career that we think would be interesting is a molecular
biologist, because it would be fun to work with DNA and
cloning molecules. It would also be cool to research new
ways to treat and diagnose disease and we both found the
working with the enterotube fun.