ABFM Principles of Forensic Pathology 2 — Questions and Answers
Question 1: Which pattern of lividity (livor mortis) would suggest a body was moved after death?
- Lividity fixed on the posterior surface of a body found face-up
- Lividity on the anterior surface of a body found face-up (Correct answer)
- Lividity consistent with position of discovery
- Absence of any lividity after 12 hours
Correct answer: Lividity on the anterior surface of a body found face-up
When lividity does not correspond to the position in which the body was found, it indicates the body was repositioned after lividity fixed (typically 8–12 hours post-mortem).
Question 2: A forensic pathologist identifies petechial hemorrhages in the conjunctivae of a homicide victim. What mechanism is most commonly associated with this finding?
- Blunt force head trauma
- Asphyxia causing elevated venous pressure (Correct answer)
- Acute myocardial infarction
- Drowning-induced pulmonary edema
Correct answer: Asphyxia causing elevated venous pressure
Conjunctival petechiae result from rupture of small vessels due to increased intravascular pressure during asphyxia, particularly in compression of the neck.
Question 3: In a suspected drowning case, which autopsy finding most specifically supports immersion as the cause of death rather than submersion of an already-dead body?
- Pulmonary edema
- Presence of diatoms in bone marrow (Correct answer)
- Skin maceration
- Frothy fluid in airways
Correct answer: Presence of diatoms in bone marrow
Diatoms reaching bone marrow require active circulation at the time of water inhalation, making marrow diatom presence a strong indicator of drowning as the cause of death.
Question 4: What is the significance of 'defense wounds' in a forensic autopsy?
- They indicate the victim initiated the altercation
- They suggest the victim was conscious and attempted to ward off an attack (Correct answer)
- They are only found on the palms of the hands
- They indicate the attacker was left-handed
Correct answer: They suggest the victim was conscious and attempted to ward off an attack
Defense wounds, typically on the forearms, hands, or ulnar aspects of the arms, indicate the victim was alert and actively trying to protect themselves from an assault.
Question 5: A toxicology report shows a blood ethanol concentration of 0.30 g/dL in a decedent. Which post-mortem artifact must be considered when interpreting this result?
- Ethanol is always accurately reflected in post-mortem blood
- Post-mortem redistribution can only lower ethanol levels
- Putrefaction can produce endogenous ethanol, falsely elevating levels (Correct answer)
- Vitreous humor ethanol is less reliable than blood ethanol post-mortem
Correct answer: Putrefaction can produce endogenous ethanol, falsely elevating levels
Bacterial fermentation during putrefaction can generate endogenous ethanol, potentially elevating measured blood alcohol levels above what was present at the time of death.
Question 6: Which wound characteristic best differentiates an entrance gunshot wound from an exit gunshot wound?
- Exit wounds are always smaller than entrance wounds
- Entrance wounds typically have an abrasion collar; exit wounds typically do not (Correct answer)
- Exit wounds always show soot deposition
- Entrance wounds are irregular and stellate in shape
Correct answer: Entrance wounds typically have an abrasion collar; exit wounds typically do not
The abrasion collar (marginal abrasion) around an entrance wound results from the bullet abrading the skin as it passes through, a feature not present at exit wounds.
Question 7: In forensic pathology, what does the term 'manner of death' refer to?
- The physiological mechanism by which the person died
- The classification of death as natural, accident, suicide, homicide, or undetermined (Correct answer)
- The specific disease or injury that caused death
- The time elapsed between injury and death
Correct answer: The classification of death as natural, accident, suicide, homicide, or undetermined
Manner of death is a medicolegal classification (natural, accident, suicide, homicide, undetermined) that differs from cause of death, which is the specific injury or disease responsible.
ABFM Principles of Forensic Pathology 2
Which pattern of lividity (livor mortis) would suggest a body was moved after death?