Toxicology and Cause of Death Analysis Flashcards
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A forensic toxicologist detects methamphetamine and amphetamine in postmortem blood. Which conclusion is most accurate?
Answer: Methamphetamine was ingested; amphetamine is its primary metabolite
Amphetamine is the principal metabolite of methamphetamine via N-demethylation, so detection of both is consistent with methamphetamine ingestion alone.
Which metal poisoning classically produces Mees' lines on fingernails and can be confirmed by inductively coupled plasma mass spectrometry (ICP-MS) of hair?
Answer: Arsenic
Arsenic poisoning causes Mees' lines (transverse white bands on nails) and deposits in hair chronologically, allowing ICP-MS to establish the timeline of exposure.
In a suspected drug-facilitated sexual assault (DFSA) death, which specimen provides the longest detection window for gamma-hydroxybutyrate (GHB)?
Answer: Hair
GHB is eliminated rapidly from blood and urine (within hours), but hair analysis can document exposure weeks to months after the event.
A decedent who received medical care before death had blood drawn in the emergency department. Compared to postmortem blood, antemortem hospital blood is preferred because it:
Answer: Reflects true antemortem concentrations without redistribution
Antemortem hospital blood collected before death reflects true circulating drug levels unaffected by postmortem redistribution, providing the most accurate pharmacokinetic snapshot.
Which finding on postmortem chemistry most reliably supports hypoglycemia as a contributing cause of death?
Answer: Vitreous glucose <20 mg/dL
Vitreous glucose below 20 mg/dL is accepted as indicative of antemortem hypoglycemia because vitreous is protected from postmortem glycolysis that rapidly depletes blood glucose.
Which substance is uniquely identified by the 'alcohol dehydrogenase' enzymatic assay producing a false positive if the sample contains isopropanol?
Answer: Ethanol
Enzymatic ethanol assays can cross-react with other alcohols like isopropanol, so gas chromatography headspace analysis is required to distinguish individual alcohol species.
A manner of death is ruled undetermined when toxicological findings show a mixed drug overdose. Which factor most often prevents a ruling of accident?
Answer: Drug concentrations in a potentially lethal range without clear intent evidence
When drug concentrations fall in a potentially lethal range but behavioral intent cannot be established, forensic pathologists may classify manner as undetermined rather than accidental or suicidal.