CASE HISTORY-7

A male patient by name M. Narasanna, aged about 62 years, was

brought to the casuality of Government General Hospital Kurnool,
yesterday midnight at about 1.35 am with a history of sudden onset of
shortness of breath, fever and dry cough since 2 days. Past history of
illness revealed that, he has a history of hypertension, for 10 years,
and he is on treatment. Recently 1 month back, he was diagnosed with
Acute Myelogenous Leukaemia. On chest X Ray examination, shows
pneumonia and ground glass opacities in the lower lobes of both
lungs. With suspicion of CoVID-19, throat swab was taken and sent
for confirmation. It is confirmed as CoVID-19. Immediately treatment
is started. While he is on treatment, he suddenly develops respiratory
distress and died bedside at about 3.52 am.
As you are a treating doctor of this patient, how will you
issue the Medical Certificate of Cause of Death?
 CASE HISTORY-8
A pregnant female patient by name M. Narasamma, aged about 39
years, with 10 months of amenorrhea, was brought to the casuality of
Government General Hospital Kurnool, today morning at about 07.35
am with a history of sudden onset of labour pains. Past history
revealed that, there is a history of hypertension since 2 years for
which she is on treatment and placental abruption of previous
pregnancy. On general examination, she has a blood pressure about
150/100. Immediately treatment was started for it. Blood pressure
came to normal level. Caesarean section was performed. 30 minutes
after the delivery she has died. While he is on treatment, she suddenly
develops respiratory distress, hypoxia, hypotension and coagulopathy.
She died bedside at about 12.10 pm, despite resuscitation measures
taken.
As you are a treating doctor of this patient, how will you issue
the Medical Certificate of Cause of Death?
 CASE HISTORY-9
A male patient by name M. Ramu, aged about 43 years, who
was working in construction buildings, was brought to the casualty of
Government General Hospital Kurnool, today at about 04.10 am, with
complaints of sudden onset of breathlessness and cough. He was a
known case of type 2 diabetes mellitus and hypertension since 3
years. On examination and investigations, the diagnosis made out was
pleural mesothelioma stage IV. While he is on treatment he died at
bedside at about 10.20 am, despite resuscitation measures.
As you are a treating doctor of this patient, how will you issue
the Medical Certificate of Cause of Death?
 CASE HISTORY-10
A 64-year-old man dies of cerebral hemorrhage following secondary
hypertension. Previously, he was diagnosed with chronic
pyelonephritis due to urinary outflow obstruction as a result of long-
standing benign hypertrophy of the prostate. He was also suffering
from Type Il Diabetes mellitus over the last 10 years.
As you are a treating doctor of this patient, how will you issue the
Medical Certificate of Cause of Death?

CASE HISTORY-11
Shortly after dinner on the day prior to admission to the hospital, a
48-year-old male developed a cramping, epigastric pain, which
radiated to his back, followed by nausea and vomiting. The pain was
not relieved by positional changes or antacids. The pain persisted and,
24 hours after its onset, the patient sought medical attention. He had a
10-year history of chronic alcoholism and a two-year history of
frequent episodes of similar epigastric pain. The patient denied
diarrhea, constipation, hematemesis, or melena. The patient was
admitted to the hospital with a diagnosis of an acute exacerbation of
chronic pancreatitis. Radiological findings included a duodenal ileus
and pancreatic calcification. Serum amylase was very high at 4,032
units per liter. The day after admission, the patient seemed to
improve. However, that evening he became disoriented, restless, and
hypotensive. Despite intravenous fluids and vasopressors, the patient
remained hypotensive and died today at about 1.30 pm. Autopsy
findings revealed several areas of fibrosis in the pancreas with the
remaining areas showing multiple foci of acute inflammation and
necrosis.