Toxicology and Cause of Death Analysis Flashcards
7 cards from real ABFM practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Toxicology and Cause of Death Analysis flashcards as text
A body recovered from water shows pink muscle discoloration and carboxyhemoglobin of 5%. What is the most likely explanation?
Answer: Postmortem artifact from water immersion and decomposition
Mild carboxyhemoglobin elevations (typically <10%) can occur postmortem as a decomposition artifact and do not indicate antemortem CO exposure in drowning cases.
Which organ-to-blood concentration ratio (K value) for morphine suggests postmortem redistribution has significantly elevated the blood concentration?
Answer: Liver:blood ratio >10:1
A liver-to-blood ratio greater than 10:1 for morphine indicates substantial postmortem redistribution from the liver into central blood, inflating the blood concentration.
Strychnine poisoning causes death primarily through which mechanism detectable at autopsy?
Answer: Respiratory failure from glycine receptor antagonism causing spastic convulsions
Strychnine competitively antagonizes inhibitory glycine receptors in the spinal cord, causing uncontrolled muscular convulsions that result in respiratory exhaustion and failure.
A forensic case involves suspected insulin homicide. Which laboratory finding best supports exogenous insulin administration at the injection site?
Answer: Elevated C-peptide at the injection site with low systemic C-peptide
Exogenous insulin contains no C-peptide; finding high insulin with low C-peptide at the injection site while systemic C-peptide is low confirms exogenous (not endogenous) insulin.
When reporting a cause of death involving combined drug toxicity, which format best adheres to ABFM standards for the death certificate?
Answer: List each contributing drug with 'combined drug toxicity' as the immediate cause
ABFM and CDC guidelines recommend specifying each detected drug contributing to death with 'combined drug toxicity' as the manner, providing complete toxicological documentation.
Which analytical method is the definitive confirmatory technique in forensic toxicology for both identification and quantification of unknown substances?
Answer: Gas chromatography-mass spectrometry (GC-MS)
GC-MS provides both molecular fragmentation pattern identification (qualitative) and precise concentration measurement (quantitative), making it the gold standard confirmatory method.
A decedent was on therapeutic warfarin. Autopsy reveals fatal intracranial hemorrhage. To determine if supratherapeutic anticoagulation contributed to death, the forensic toxicologist should measure:
Answer: Warfarin blood concentration and correlate with antemortem INR records
Warfarin blood concentration combined with available antemortem INR values provides the best evidence of anticoagulant status, since postmortem coagulation tests are unreliable.