ABFM Principles of Forensic Pathology 3 — Questions and Answers
Question 1: During autopsy of a decomposed body, which specimen is most reliable for estimating blood alcohol concentration when blood is unavailable?
- Liver tissue
- Vitreous humor (Correct answer)
- Brain tissue
- Urine
Correct answer: Vitreous humor
Vitreous humor is sequestered from the circulation and is resistant to putrefactive change, making it the most reliable alternative fluid for post-mortem toxicology.
Question 2: A victim is found with a gunshot wound to the right temple. The wound shows a muzzle contusion ring, soot, and stippling. What is the most likely range of fire?
- Distant (>3 feet)
- Intermediate (1–3 feet)
- Close-range contact or near-contact (Correct answer)
- Indeterminate range
Correct answer: Close-range contact or near-contact
The combination of a muzzle contusion ring, soot deposition, and stippling (powder tattooing) indicates a near-contact or close-range discharge, where soot and unburned powder contact the skin.
Question 3: Which injury pattern is pathognomonic for shaken baby syndrome (abusive head trauma) in an infant?
- Epidural hematoma with skull fracture
- Subdural hematoma with diffuse axonal injury and retinal hemorrhages (Correct answer)
- Subarachnoid hemorrhage alone
- Coup-contrecoup cerebral contusions
Correct answer: Subdural hematoma with diffuse axonal injury and retinal hemorrhages
The classic triad of subdural hematoma, diffuse axonal injury, and retinal hemorrhages is characteristic of severe rotational acceleration-deceleration forces in abusive head trauma.
Question 4: What does 'cadaveric spasm' (instantaneous rigor) indicate in forensic investigation?
- The body has undergone full post-mortem rigidity
- Intense muscular activity or emotional state immediately before death (Correct answer)
- The decedent died in a cold environment
- Rigor mortis is resolving
Correct answer: Intense muscular activity or emotional state immediately before death
Cadaveric spasm is an instantaneous, permanent muscular contraction at the moment of death associated with extreme physical or emotional exertion, sometimes preserving objects gripped at death.
Question 5: In cases of suspected carbon monoxide poisoning, what characteristic autopsy finding is expected?
- Cherry-red discoloration of skin, blood, and organs (Correct answer)
- Cyanosis of the lips and nail beds
- Jaundice and hepatomegaly
- Gray-brown discoloration of blood
Correct answer: Cherry-red discoloration of skin, blood, and organs
Carboxyhemoglobin imparts a bright cherry-red color to blood, skin, and internal organs, which is a hallmark of carbon monoxide poisoning at autopsy.
Question 6: A forensic pathologist must certify a death involving an elderly patient who died after a 3-week hospitalization following a hip fracture sustained in a fall. What is the most appropriate manner of death certification?
- Natural
- Accident (Correct answer)
- Homicide
- Undetermined
Correct answer: Accident
When an injury (the fall) initiates a chain of events leading to death, even if delayed, the manner of death is accident unless foul play caused the fall.
Question 7: Which type of sharp force injury is characterized by a wound longer than it is deep?
- Stab wound
- Puncture wound
- Incised wound (slash/cut) (Correct answer)
- Chop wound
Correct answer: Incised wound (slash/cut)
Incised wounds are produced by slicing motions and are longer on the surface than they are deep, in contrast to stab wounds which are deeper than they are long.
ABFM Principles of Forensic Pathology 3
During autopsy of a decomposed body, which specimen is most reliable for estimating blood alcohol concentration when blood is unavailable?