ABFM Toxicology and Cause of Death Analysis 3

Question 1

A forensic toxicologist detects methamphetamine and amphetamine in postmortem blood. Which conclusion is most accurate?

Accepted Answer

Methamphetamine was ingested; amphetamine is its primary metabolite

Answer

Amphetamine is the principal metabolite of methamphetamine via N-demethylation, so detection of both is consistent with methamphetamine ingestion alone.

Question 2

Which metal poisoning classically produces Mees' lines on fingernails and can be confirmed by inductively coupled plasma mass spectrometry (ICP-MS) of hair?

Accepted Answer

Arsenic

Answer

Arsenic poisoning causes Mees' lines (transverse white bands on nails) and deposits in hair chronologically, allowing ICP-MS to establish the timeline of exposure.

Question 3

In a suspected drug-facilitated sexual assault (DFSA) death, which specimen provides the longest detection window for gamma-hydroxybutyrate (GHB)?

Accepted Answer

Hair

Answer

GHB is eliminated rapidly from blood and urine (within hours), but hair analysis can document exposure weeks to months after the event.

Question 4

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:

Accepted Answer

Reflects true antemortem concentrations without redistribution

Answer

Antemortem hospital blood collected before death reflects true circulating drug levels unaffected by postmortem redistribution, providing the most accurate pharmacokinetic snapshot.

Question 5

Which finding on postmortem chemistry most reliably supports hypoglycemia as a contributing cause of death?

Accepted Answer

Vitreous glucose <20 mg/dL

Answer

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.

(ABFM) American Board of Forensic Medicine Certification Practice Test

(ABFM) American Board of Forensic Medicine Certification Practice Test

ABFM Toxicology and Cause of Death Analysis 3