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Unit 17 Case Study: “What Killed Leah Miller?”

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Alec Hall

on 8 January 2013

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Transcript of Unit 17 Case Study: “What Killed Leah Miller?”

Unit 17 Case Study: “What Killed Leah Miller?” 1.Are Leah’s symptoms and the autopsy findings consistent with shaken baby syndrome? Explain your answer. a.The Millers should not be charged with homicide. This was clearly a death from natural causes. Leah had a genetic liver disorder that caused her body to malfunction. Since she is an Amish baby she did not receive a vitamin K shot. If she didn’t receive her shot it can be easily concluded that is what started the bleeding in her brain. This was all the result of a tragic genetic disorder that was not caught soon enough. 7.It’s time to write up your report and make a recommendation. Do you conclude that the Millers should be charged with homicide, or did Leah die of natural causes? Explain your answer. a.Yes, some of Leah’s symptoms from the autopsy correlate to the symptoms of shaken baby syndrome. Shaken baby syndrome is the result with aggressive behavior towards an infant. By getting angry or abusive shaking the baby back and forth causes damage to their head. This is because their neck muscles are not as well developed so they are unable to support their head. When a baby is shaken it can cause rupturing blood vessels and nerves throughout the brain and even tearing the brain tissue. The brain may hit the inside of the skull, causing bruising and bleeding to the brain. 2.Describe the nature of a subdural hematoma, specifically:
•Where is a subdural hematoma found?
•How can shaking a baby lead to a subdural hematoma?
•How can a subdural hematoma lead to brain injury or death?
a.The subdural hematoma is a collection of blood that is found on the surface of the brain. By shaking a baby their brain can hit their skull and can cause the collection of blood. A hematoma that compresses the brain tissue. If the hematoma keeps growing, the baby’s consciousness begins to slip away, possibly even resulting in death. 3.What could you account for the scratches on Leah’s face? a. Babies can scratch themselves with their own fingernails when sucking on something. This is if their fingernails are too long. 4.Describe the three mechanisms or phases of hemostasis, with particular emphasis on coagulation. What are some of the biological components essential for coagulation? a.The three phases for homeostasis are vascular phase, platelet phase, and the coagulation phase. Vascular phase is where damaged blood vessels cause vascular spasms of the smooth muscle in the vessels walls. This creates a vasoconstriction that slows or stops the blood flow. This reaction can last up to thirty minutes. During platelet phase is where damaged endothelial cells the line the blood vessels let go Willebrand’s Factor. The surfaces of these endothelial cells are now sticky. This could cause some of the small blood vessels to close. Within larger blood vessels platelets can begin to stick to the surfaces of endothelial cells.Last the coagulation phase forms the insoluble protein Fibrin from the plasma protein in Fibrinogen. Fibrin creates groups of fibers that trap blood cells and platelets to create a thrombus or a clot. This can be caused by an excess amount of protein and calcium. Protein and calcium are what help boost production of prothrombin. 5.Why does Dr. Naswani think genetic liver disease could have contributed to Leah’s death? a.It could have been genetic since Leah’s hemorrhage in her eye shown no outer form of abuse. This can indicate that the cause of death was much larger defect than abuse. 6.Explain Dr. Holmes’ theory that Leah’s injuries may have resulted from not receiving an injection of vitamin K. a.In infants that have not have their vitamin K shot it has been known for them to get intracranial bleeding in case of a liver disorder and other genetic disorders.
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