Anna Garcia’s
Horrible Life
WILL BIRCH
14 Months (3.1.2)

Complaint:

Anna is running a fever, is extremely lethargic,
experiencing breathing problems, and also is in a lot
of pain.
•
Notes:

Below 5th percentile on growth curve

Weight is between 10 and 25th percentile

Swelling in hands and feet

Abdomen is tender and enlarged on left side

Extremely irritable and fussy
14 Months (Continued)

Tests Performed:


CBC

Reduced Red Blood count levels

Increase WBC count
Hematocrit


Blood Oxygen


Lower than normal
CT Scan


Below Normal (20%)
Abnormal Spleen, Splenic Sequestration
Sickle Cell

Positive for Sickle Cell Anemia
14 Months (Continued)

Diagnosis:

Sickle Cell Anemia

Severe Anemia

Splenic Sequestration

Large collection of blood in spleen because of sickle cell shape.
• Treatment:
- Hydration, Pain Medication, Red Blood
Cell
Transfusion, Antibiotics to
prevent infections
14 Years (2.1.1)

Complaint


Anna has had fatigue and the inability to complete
regular activities without rest. She also always feel
thirsty and uses the bathroom quite frequently.
Physical Exam

All areas look very normal

Found glucose in the urine
14 Years (Continued)

Diagnosis:

Type 1 diabetes. Glucose levels are high and she
uses insulin to regulate her levels.

She is dizzy because her low glucose levels don’t
allow glucose to be used for energy

She uses the restroom a lot because water is being
pulled our of cells which creates more urine and the
thirst quench
37 Years (4.2.1)

Complaint:

Anna has been having self resolved chest pain. She
eats a high diet in both calories and fat. She
consumes 3 glasses of wine after work and has not
kept up with exercise. Takes daily aspirin.

Has family history of early heart disease as well as
uncontrolled hypertension.
37 Years (Continued)

Physical Exam:


Anna is a tachycardic, has occasional tingling in
her right calf, blood pressure was 142/85 (high), and
a slight heart murmur was detected.
Cardiac Test Results:

Blockage in the left anterior descending coronary
artery
37 Years (4.3.1)

Complaint:


Anna has been having self resolved chest pain. She
eats a high diet in both calories and fat. She
consumes 3 glasses of wine after work and has not
kept up with exercise. Takes daily aspirin.
Analysis:

Total Cholesterol: 389 (Normal: 160)

LDL:243 (Normal: 100)

HDL:60 (Normal)

Triglycerides: 145 (Normal)

A1C Test: 7.1% (A little high)
37 Years (Continued)

Recommendations:

She should reduce her intake of saturated fats and
trans fats. This would decrease the amount of fatty
foods she intakes. Eating foods with good fats will
help lower LDL and total cholesterol levels.
6.1.2 Possible Ways of How
She Died



Diabetes:

Ketoacidosis: Kidney failure due to the overworking of Kidneys filtering
glucose out of blood. Also overworking because of the stress of UTI
infection and the high ketones in the urine.

The infections that diabetes may cause due to the delayed reaction
time to fight the infection often related to Diabetic Neuropathy.
Sickle Cell Anemia:

Blood clot in body which causes very high blood pressure. Also, her high
cholesterol included makes blood pressure higher causing a heart
attack and death.

Blood clot in brain which causes a stroke and death.

Lack of oxygen getting to the body which builds up overtime in the
internal organs resulting in organ failure and death.
Heart Disease:

High cholesterol and hypertension causes a heart attack. Heart murmur
and family history of heart problems backs up the evidence.
6.2.1 Cause of Death

The result of Anna’s death was her overall complications with diabetes
and the result of Ketoacidosis. While other things contributed to her
death, the complications that diabetes caused with her body was the
reason she died. Diabetes often causes the failure of kidneys. The waste
material that the kidneys filter through the body that eventually
becomes urine, is contaminated with a high level of glucose in
diabetics. The glucose in the kidneys causes the kidneys to overwork
and overtime causes the kidneys to fail. In the 6.1.2 autopsy report the
blood glucose level was 280 mg/dL and the normal range is between
70-125. Obviously the level of glucose in the kidneys is way too high for
the kidneys to handle which could have caused kidney failure and
eventually death. The autopsy report mentioned a very high level of
ketones in the urine which shows that Ketoacidosis was the cause of
death. Also, the autopsy report mentioned that the level of protein in
Anna’s urine was very high. Having protein in the body is good, but
when the kidney’s have built up protein in the blood, those substances
build up and become useless and toxic. These large build ups of
proteins and other waste material also causes the kidneys to overwork
and eventually fail causing death. While all the problems that Anna
Garcia had, including heart disease, sickle cell, UTI, and Diabetes,
Ketoacidosis led due to the death of Anna Garcia.
Symptoms During Death

Ketoacidosis has symptoms that Anna Garcia
experienced first hand. The medical history reports
and autopsy reports noted that she had very high
quench for thirst, but was always thirsty. This is a
very common symptom. Also, frequent urination
and high glucose and ketones in the urine are the
most common symptoms of Ketoacidosis. Other
symptoms that Anna experienced during her
death were nausea and vomiting, tiredness, and
a flushed skin tone. This would explain the vomit
found at the scene of the crime the day she was
found dead.
Ways to Prevent It

Going to the doctor regularly to have your blood, blood pressure, urine,
and organs tested for other complications of diabetes is
recommended.

Keeping blood sugar levels in range is the best way to make sure that
kidney disease is prevented. This can be done by taking meds for
diabetes (Anna did not take hers 3-4 days before her death) and also
using your insulin injections regularly.

Short Term:


Taking medication

Taking Insulin shots

Healthy Diet (Low glucose diet)
Long Term:

Healthy Lifestyle (Exercise and Diet)

Going to doctor and taking precautions

Kidney Transplant