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Deck Dr Williams Flashcards

1
Q

List 5 common toxic fire gases, not including carbon monoxide

A

Cyanide
Phosgene
Acrolein
Sulfur dioxide
Nitrogen dioxide
Hydrogen chloride
CO2

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2
Q

List and describe 5 types of cervical vertebral fractures below C2

A

Flexion-distraction (injury posterior ligaments, anterior displacement of vertebrae with no fracture)

Flexion-compression (same as flexion distraction, but with anterior and inferior displacement of a vertebrae, causing compression and fracturing of the adjacent vertebra)

Extension distraction (opposite of flexion distraction, no fracture)

Extension compression (opposite of flexion distraction, but with fracture posterior elements)

Vertical compression: compression and fracturing of a vertebra

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3
Q

What is the most important factor determining the state of skeletalized remains?

A

The environment(s) to which they were exposed (much more important than the period of time elapsed since death)

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4
Q

list effects of alcohol

A

CNS depression
Diuresis
Disregulation of heat-regulatory mechanisms (peripheral vasodilation and heat loss)
Electrolyte disturbances
Cerebellar vermal degeneration

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5
Q

3 categories of cardiomyopathy

A

Hypertrophic
Dilated
Restrictive

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6
Q

What are the forensic pathology priorities and necessary examinations in airline crashes?

A

Identification
Determination of COD
Autopsy for pilots/crew
Detection of potential evidence

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7
Q

What is an explanation for low levels of cyanide in the blood of a seemingly natural or traumatic death?

A

Postmortem production, especially if no sodium fluoride added or if stored prolonged before testing

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7
Q

Symptoms of diabetes

A

Polyphagia
Polydypsia
Weight loss
Polyuria

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8
Q

Ways to reduce risks in autopsy suite

A

Staff training
PPE with proper N95 mask
Avoid aerosol
Consider not performing autopsy in certain cases

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9
Q

Explain the biochemical changes in the exercise and post-exercise periods that may contribute to sudden death

A

During:
Sympathetic NS stimulation, leading to increased HR, BP, increased cathecholamines, elevated potassium

Post-exercise:
Cathecholamine levels continue to rise
Potassium levels drop rapidly, leading to hypokalemia

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10
Q

List normal oxygen concentration in atmosphere and common symptoms at lower levels

A

20.9%

10-15%: impaired judgement
8-10%: loss of consciousness
<8% Death

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11
Q

What % of ‘drowning’ cases are so-called dry-lung drowning, with normal lung weights?

A

10-20%

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12
Q

Contrast classical findings in hanging vs ligature strangulation

A

Hanging:
- Uprising ligature mark
- No congestion or petechial hemorrhages

Ligature stangulation:
- Horizontal ligature furrow
- Periligature mark
- Congestion and petechial hemorrhage
- Over or below laryngeal proeminence

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13
Q

Radiographic finding in lead poisoning

A

Lead lines in gums or metaphyseal plate

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14
Q
A
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15
Q

What is the major resistor in the body?

A

Skin

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16
Q

what is methyl alcohol metabolized by and what is the product?

A

Formaldehyde –> formic acid

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17
Q

Give some generalized signs and symptoms of alcohol toxicity at various BACs

A

over 30 - impaired complex skills
50-100 - loss of inhibition, laughter, sensory disturbance
80 - legal limit for driving in Canada
150-200 - obvious drunkeness, nausea, staggering
200-300 - stupor, vomiting, coma
Over 350 - progressive danger of death from respiratory paralysis

***CAUTION - may case examples of high BAC in surviving and functioning individuals exist, eg. woman surviving 1510 mg/dL, Australian drivers at 500 mg/dL at roadside checkpoint stops….

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18
Q

list causes of death for ‘death in dental chair’

A

Natural causes
Anaesthetic related
- Local anaesthetic related (IV or overadministrtion of drugs)
- Allergic reaction

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19
Q

what ECG changes are associated with hypothermia?

A

Inverted T waves
Prolongation QT

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20
Q

What is ‘triple risk’ model of SIDS?

A

A vulverable infant in a critical period of development with environmental factors (external stressor)

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21
Q

What are the 3 conclusions that can be reached with fingerprint comparison?

A

Positive ID
Exclusion
Inconclusive

22
Q

How many phases are in the Lovejoy assessment of the ilium for age estimation?

A

8

23
Q

List 4 general categories of deaths during/after surgery

A

Directly caused by the disease or injury
Disease or abnormality other than for what the procedure was being carried out
Mishap during or complication of rugical or diagnostic procedure
Mishap or complication of the anaesthetic

24
Q

Signs and symptoms of hyponatremia

A

Nausea
Vomiting
Headache
Weakness
Confusion
Seizures

25
Q

What is a flash fire? How can it cause death?

A

Flash: brief flash of fire, due to combustion of vaporised hydrocarbon or rapid consumption of other fire fuel in the air

Cause death:
- Rapid O2 drop
- Co2 and CO rise rapidly
- Intense heat

26
Q

Mechanism of death in hydrogen sulfide

A

production of methemoglobinemia

27
Q

Histo findings in carbon tetrachloride poisoning

A

Centrilobular necrosis
Fatty change
Tubular necrosis

28
Q

Metabolism of ingested methanol

A

Formaldehyde
Formic acid

29
Q

What are the common fatal abdominal injuries in children?

A

Liver laceration
Pancreaticoduodenal laceration
Mesenteric laceration

30
Q

list 3 of the most common blast injuries

A

Tympanic membrane rupture
Lung injury
GI tract rupture

31
Q

What factors most effect insect development?

A

Temperature
Humidity

32
Q

Describe stages of pressure ulcers

A

1: hyperermia
2 : blister or ulceration of skin, not extending past demis (not subcutaneous fat)
3: ulceration of skin and subcutaneous tissues to level of muscular fascia
4 : up to the bone

33
Q

Which 3 organs are most affected by chronic alcoholism?

A

Liver (ASH/cirrhosis)
Brain (Cardiomyopathy)
Heart (hemorrhage and atrophy of mammary bodies, cerebellar vermis degeneration)

34
Q

What is the mechanism of action of organophosphorus pesticides?

A

Inhibition of cholinesterase

35
Q

what is the mechanism of death in methanol poisoning?

A

metabolic acidosis

36
Q

what is the mechanism of death in tricyclic antidepressant overdose?

A

cardiac arrhythmia (widening of QRS, tachycardia, arrhythmia)

37
Q

What is the most common coronary artery anomaly?

A

Origin of the left coronary from the right sinus

38
Q

What is the most common underlying cause of aortic dissection

A

Hypertension

39
Q

What is the most common underlying pathology in sudden cardiac death in exercise < 35 years & > 35yrs

A

< cardiomyopathy, channelopathy, anomalous coronary anatomy

40
Q

What is the most reliable method of age estimation using teeth in adults?

A

Lamendin method. Useds parodontal disease and translucency of root in monoradicular teeth.

41
Q

What is the nature of C14?

A

Interaction of a neutron with N14 ( 14N + n → 14C + p)
Neutron flux from cosmic rays and/or neutron flux from nuclear fission (bombs, reactors)
C14 in atmosphere oxidized to CO2, enters food web via plant biomass and seawater via air-sea exchange

42
Q

What is the pharmacological action of naloxone (Narcan)?

A

μ-opioid receptor (MOR) inverse agonist
κ-opioid receptor (KOR) antagonist
δ-opioid receptor (DOR) antagonist

43
Q

what is the pharmacological effect of cocaine?

A

-inhibits NE reuptake
-stimulates NE release
-moderate similar effects on serotonin and dopamine
-local anesthetic effects via sodium channel blockade

44
Q

What is the proposed mechanism of death in inhaled solvent abuse?

A

Arrhythmia facilitated by sensitization of myocardium to catecholamines

45
Q

what is the relationship between the concentration of EtOH in the alveolar air and the alveolar capillary plasma?

A

1:2300

46
Q

what is the relative affinity of CO for Hb compared to O2

A

CO 200-300x stronger affinity than O2

47
Q

What is the stereotypical position of a body in water?

A

dorsal torso upward, hands, knees, face downward
important to remember as dorsal hands, face, and anterior knees may have postmortem changes related to movements in the water (against floor etc)

48
Q

what is the t1/2 of COHb? what therapy may improve this?

A

4-6 hours on room air
Oxygen therapy
40-80 minutes on normobaric 100% O2
15-30 minutes on hyperbaric O2

49
Q

What is the theory behind diatoms tests in drowning cases?

A

Diatoms will be aspirated and readily cross alveolar wall into bloodstream - if heart beating then will be delivered to organs (brain, kidney, liver, bone marrow). Extremely resistant to decay, so can dissolve away tissue, including bone, but leave the silicaceous exoskeletons of diatoms for microscopic analysis. If present in significant numbers and of species similar to the body of water where found, then supports drowning. (this method is largely considered debunked for lack of specificity)

50
Q

What is the threshold of contemporary forensic interest in skeletal remains?

A

70-100 years

51
Q

what level of ethanol can be produced by postmortem decomposition (fermentation)?

A

Up to 80 mg/dL, some reports up to 220 mg/dL

52
Q

What may be found in electrocutions in bathtub (peculiar postmortem change)?

A

Hypostasis may stop at level of the water

53
Q

what may be found in starvation at autopsy?

A

low BMI
lack of fat stores (abdominal wall, omentum, mesenteric, epicardial)
muscular atrophy
edema & effusions may occur
ulcerations of colonic mucosa have been described (‘pseudo-dysentery’)

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