Exam Essay Prep

Question 1

What are some examples of nerve agents?

Answer 1

Sarin (GB)
VX
And more

Question 2

What is the enzyme that nerve agents inhibit?

Answer 2

Acetycholinesterase (AChE)

Question 3

What do nerve agents target (location)?

Answer 3

Neuromuscular junction

Question 4

What is acetylcholine?

Answer 4

A neurotransmitter

Question 5

What does the enzyme acetylcholinesterase do?

Answer 5

Breaks down the neurotransmitter acetylcholine (ACh)

Question 6

What happens when acetylcholinesterase is inhibited?

Answer 6

Acetylcholine accumulates at the neuromuscular junction which leads to excessive stimulation of the muscles

Question 7

What does excessive stimulation of the muscles cause?

Answer 7

Muscle twitching, weakness, and paralysis

Question 8

Other than the muscles, what else can nerve agents effect and what does it lead to?

Answer 8

CNS, leading to confusion, seizures, and loss of consciousness

Question 9

What type of treatment is used for nerve agent poisoning?

Answer 9

Drugs that reactivate acetylcholinesterase
Drugs that block the effects of acetylcholine

Question 10

What drugs reactivate acetycholinesterase?

Answer 10

Pralidoxime

Question 11

What drugs block the effects of acetylcholine?

Answer 11

Atropine

Question 12

What supportive care can be offered to manage symptoms?

Answer 12

Oxygen therapy (nebulisers), airway control (intubation) and cardiac monitoring

Question 13

What 3 drugs are used as knock-out drugs in crimes?

Answer 13

Rohypnol, GHB, and ketamine

Question 14

What is the analogue of the drug rohypnol?

Answer 14

Flunitrazepam

Question 15

What type of drug is rohyphol?

Answer 15

A benzodiazepine - CNS depressant

Question 16

What are the attributes of using “date rape” drugs?

Answer 16

Ketamine and rohypnol are bitter, GHB is salty - taste is masked
All are colourless and odourless when dissolved

Question 17

How long is rohypnol detectable in blood and urine after ingestion?

Answer 17

72 hours

Question 18

What receptor does GHB and rohypnol act on?

Answer 18

GABA

Question 19

What does GHB and rohypnol do to the receptor?

Answer 19

They act on the neurotransmitter GABA, causing the inhibition of neuronal activity and a decrease in the release of excitatory neurotransmitters, such as dopamine. This causes the hypnotic and sedative effects

Question 20

What are GHB, ketamine, and rohypnol often used as and why?

Answer 20

“Date rape” drugs because they cause sedation, amnesia, muscle relaxation, and can also lower the victim’s inhibitions and impair their judgement

Question 21

What does GHB stand for?

Answer 21

Gamma-hydroxybutyrate

Question 22

What type of drug is GHB?

Answer 22

CNS depressant

Question 23

How long is GHB detectable in blood and urine after ingestion

Answer 23

12 hours

Question 24

What is ketamine?

Answer 24

A general anaesthetic
A horse tranquilliser
A recreational drug

Question 25

What receptor does ketamine work on?

Answer 25

NMDA (antagonist)

Question 26

What does NMDA stand for?

Answer 26

N-methyl-D-aspartate

Question 27

What action does ketamine have on the receptor?

Answer 27

NMDA receptors are involved in pain perception and the regulation of neuronal excitability.

Question 28

What does blocking the NMDA receptor result in?

Answer 28

A dissociative state and pain relief

Question 29

How long is ketamine detectable in blood and urine after ingestion?

Answer 29

72 hours

Question 30

What are the forensic aspects of the 3 drugs used in "drug-facilitated crimes"?

Answer 30

Quick metabolism and short half-life - sample needs to be collected ASAP Proper sample collection, storage, and testing is essential as there is usually not enough time for a second collection In some cases, it is possible to detect traces of the drugs in the containers used to administer the drug to the victim

Question 31

What does ELISA stand for?

Answer 31

Enzyme-linked immunosorbent assay

Question 32

What are the 4 types of ELISA techniques?

Answer 32

Sandwich Competitive Direct Indirect

Question 33

What are the 3 steps in the ELISA technique?

Answer 33

1) Sample preparation 2) Immunoassay 3) Detection

Question 34

What is the 1st step of the ELISA technique?

Answer 34

The biological sample, such as blood or urine, is collected and prepared for analysis

Question 35

What is the 2nd step of the ELISA technique?

Answer 35

The sample is added to a plate that has been coated with an antibody specific to the target drug. If the drug is present in the sample, it will bind to the antibody

Question 36

What is the 3rd step of the ELISA technique?

Answer 36

A second, labelled antibody is added to the plate. This labelled antibody will bind to the drug-antibody complex. The amount of labelled antibody bound can be quantified

Question 37

What is the ELISA technique?

Answer 37

It is used to detect specific proteins or other molecules in a sample

Question 38

Why is the ELISA technique used in "drug-facilitated crimes"?

Answer 38

It detects the presence of drugs of abuse in biological fluids, such as blood, urine, or saliva

Question 39

What are 3 disadvantages of the ELISA technique?

Answer 39

Not a quantitative test, only confirms the presence of a drug (GC-MS to confirm) Specific antibody must be available for each drug Human error resulting in false negative/positive result

Question 40

What are 3 reasons why the ELISA technique is used?

Answer 40

ELISA is highly sensitive and specific It can detect drugs at very low concentrations and can accurately distinguish between different drugs It is relatively simple, cost-effective, and efficient for large-scale drug testing

Question 41

What is cardiac heart disease?

Answer 41

It is a general term that describes a range of conditions that affect the heart and blood vessels

Question 42

What are the cardiac heart diseases to discuss?

Answer 42

Myocardial infraction Coronary artery disease Cardiac arrhythmias (And other valve disorders and cardiomyopathies)

Question 43

What causes cardiac heart diseases?

Answer 43

Genetics, lifestyle choices (smoking, diet, and exercise), and underlying health conditions

Question 44

Why does the forensic pathologist examine the heart?

Answer 44

It plays a vital role in determining the cause of sudden death

Question 45

Define sudden death

Answer 45

A death that occurs within 24 hours of the onset symptoms; it is often caused by cardiac heart disease

Question 46

What does the forensic pathologist look for when examining the heart?

Answer 46

Signs of disease such as: Blockages or abnormalities in the coronary arteries or heart valves Signs of injury such as: Myocardial infraction

Question 47

How does a heart attack occur?

Answer 47

When a blockage in the coronary artery cuts of blood flow to a part of the heart This can damage/kill the heart muscle cells - causing the heart to stop beating

Question 48

In examination, what 2 signs of a heart attack does the forensic pathologist look for?

Answer 48

Scarring or discolouration of the heart muscle Blockages in the coronary arteries

Question 49

How do arrhythmias occur and what can they cause?

Answer 49

As a result of a heart disease or injury Can cause the heart to stop beating

Question 50

In examination, what 2 signs of an arrhythmia does the forensic pathologist look for?

Answer 50

Abnormal electrical activity and structural abnormalities in the heart

Question 51

Other than the heart, what else does the forensic pathologist examine?

Answer 51

Other organs such as the lungs and brain

Question 52

Name 2 other causes of sudden death

Answer 52

Pulmonary embolism and stroke

Question 53

What else does the forensic pathologist examine to gain a comprehensive understanding of the cause of death?

Answer 53

The individual's: Medical history Medication Toxicology tests