Forensic Pathology 1 Flashcards
what distance do shotgun wounds show a) central defect, b) scalloped wound, c) central defect w satellite defects, d) individual pellet wounds?
a) 0-2 feet,
b) 2-4 feet,
c) 4-15 feet,
d) >15 feet
what distance does a shotgun wad a) enter the body, b) leave wad mark(abrasion, NOT penetration) on the body?
a) 0-12 feet
b) 12-30 feet(below pellets bc gravity)
What is the half life of CO in a)hyperbaric oxygen, b) 100% oxygen, c) room air?
a) 25 minutes,
b) 90 minutes,
c) 6 hours
What are the histological findings of HIV encephalitis?
p24 antigen immunoreactivity, microglial multinucleated nodules, LITTLE inflammation (bc HIV decreases immune system)
what do inguinal stretch abrasions indicate?
in blunt force injury, that decedent was struck by vehicle at opposite end (i.e. right inguinal stretch abrasions = struck on posterior left)
LEGAL: what is “mens rea”?
principle of a guilty mind
LEGAL: what is “res ipsa loquitur”?
The occurrence of an accident implies negligence
LEGAL: what is “actus rea”?
principle of a guilty act
LEGAL: what is “legal doctrine respondeat superior”?
An employer is responsible for the actions of employees performed in the normal course of duties during their employment
LEGAL: What is a peremptory challenge?
The plaintiff or the defendant in a jury trial can have a juror dismissed before the trial without a stated reason
LEGAL: what is “subpoena duces tecum”?
writ requiring a person to appear in court to give testimony, and to bring documents, books, or other things for the court
What is the most common type of brain herniation and where does it herniate?
Subfalcine (cingulate) herniation: cingulate gyrus of frontal lobe moves under falx cerebri (medial)
Where is transtentorial herniation?
central Temporal lobe/diencephalon, moves inferiorly
when do you see shotgun petals on the body?
between 6 inches and 3 feet (when the petals “fan out”)
What poisoning causes a) brown lividity? b) green lividity?
a) nitrates b) hydrogen sulfide
What common illicit substance inhibits NMDA receptors which bind glutamate? Is it lipid/water/both soluble?
PCP, both lipid and water soluble
What compound is poisonous from “Jimson weed”/Datura stramonium?
anticholinergics (atropine, scopolamine and hyoscyamine)
What compound is poisonous from Rosary Pea and what does it do?
abrin, inhibits protein synthesis
What results in conj petechiae, partial or full suspension hangings?
partial suspension (bc forces occlude the venous return to the heart more than restrict arterial blood flow to the head)
What is despropionylfentanyl and what structural class is it in?
4-ANPP, piperidinamine (NOT opioid). is both precursor and inactive metabolite of fentanyl
What does ammonia and bleach combine to make?
water, sodium chloride, hydrochloric acid (HCl), chlorine gas (Cl2), chorine (Cl-), chloramine (NH2Cl), and hydrazine (N2H4)
Vitamin associations:
what vitamin(s) a) increases iron absorption and can interfere with warfarin, b) interfere with coagulation, c) cause hypercalcemia
a) Vit C,
b) vit K and E,
c) Vit D and A
what is Fitz-Hugh-Curtis syndrome?
result of PID (w N gonorrheae or C. trachomatis), infection travels from pelvis to abdomen and causes adhesion of liver to right hemidiaphragm
Forces causing rapid lateral velocity of the head cause SAH where and by tearing what artery?
base of brain, vertebral artery
What is filler (with GSW) and what kind of injuries does it cause?
white granular substance encased in a shotgun shell WITH the bird/buck shot; causes stippling to 2 - 3 meters
where do a) skin tags and b) skin tears point to in tangential graze GSW?
skin tags point towards the firearm, skin tears point towards the direction of travel of the bullet
what is the most common sarcoma of the heart, and where is it located?
angiosarcoma (in the right atrium, often involves pericardium and causes tamponade)
(rhabdomyosarcoma=most common of childhood)
where is myxoma most commonly located and what mutation is it associated with?
left atrium, PRKAR1A mutation with Carney’s complex/syndrome (myxomas, blue nevis, Schwannomas)
What is the time it takes skin to burn in hot water at: 1) 120F/49C, 2) 125F 3) 140F/60C, 4) 160F/70C
1) 10 min,
2) 2 min,
3) 6 sec,
4) 1 sec
What is Brugada syndrome and what electrolyte abnormalities/genetics are associated with it?
autosomal dominant SCN5A, Na+ channel mutations. sudden cardiac death from arrhythmias
What increases the affinity of hemoglobin for oxygen with: a) temperature,
b) CO,
c) CO2/ acidity/low pH,
d) 2,3 bisphosphoglycerate,
e) methemoglobin
a) decreased temp/hypothermia,
b) increased CO,
c) decreased CO2/high pH,
d) decreased 2,3 BPG,
e) decreased methemoglobin
what drugs are cause of diaphoresis, diarrhea, urination, cough, nasal discharge, vomiting, lacrimation, salivation, bradycardia, and constricted pupils? What is the antidote?
Acetylcholinesterase inhibitors (i.e. organophosphates); atropine is antidote
What does N-acetyl-cysteine replenish in tylenol toxicity and what toxic metabolite does that reduce?
glutathione, which reduces NAPQI (toxic byproduct)
What is Loeffler’s endocarditis?
restrictive cardiomyopathy more common in tropical areas, has hypereosinophilia (like endomyocardial fibrosis but more severe)
How long are a) wet stock tissue and b) paraffin blocks kept in forensic vs non-forensic autopsies?
a) 1 year(forensic), 3 months (non-forensic),
b) indefinitely (forensic), 10 years (non-forensic)
How long are a) microscopic slides, b) reports, c) body fluids & tissue for tox kept in forensic vs non-forensic autopsies?
a) indefinitely (forensic), 10 years (non-forensic),
b) indefinitely (forensic), 10 years (non-forensic),
c) 1 year (forensic), N/A (non-forensic)
NAME maximum SUGGESTED and REQUIRED autopsies per year
suggested: 250,
required: 325
What type of brain herniation is associated with Duret hemorrhages?
transtentorial/uncal herniation
What is a primary blast injury and where are they common in air vs water?
blast wave injuries; in air to the ear and airway, in water to the abdomen
What are a) secondary blast injuries, b) tertiary, and c) quaternary blast injuries?
a) flying debris hitting the body from a blast
b) body in motion striking an object (i.e. wall)
c) burns from fire from a blast or building collapsing on a person
What is Stanford A and Stanford B dissection?
A) ascending +/- descending
B) descending
What is DeBakey I, II, IIIA, and IIIB aortic dissection?
I) ascending + descending
II) ascending
IIIA) descending, extending prox and distal
IIIB) descending, extending distal
What is the most common primary tumor of heart in children?
rhabdomyoma, 50% in association w tuberous sclerosus (while rhadomyoSARComa is most common sarcoma of childhood)
How much stronger is the hemoglobin affinity for CO than O2, and what percent carboxyhemoglobin do you see cherry-red lividity?
250-300x, and >=30%
What is the a) Daubert standard, and b) Frye standard?
a) admissibility of scientific evidence is the responsibility of the judge,
b) scientific principles must be sufficiently established to have gained general acceptance in the particular field in which it belongs
What is rule 702?
Federal Rules of Evidence: expert may give an opinion if 1. The expert’s knowledge will help to understand a fact or evidence, 2. The testimony is based on sufficient data, 3. The testimony is based on reliable principles, and 4. The expert has reliably applied the principles to the case
What specific electrolyte imbalance from bulimia causes death?
hypokalemia (arrythmias)
What cocaine metabolite is metabolically active?
norcocaine
What causes false positive amphetamine screen?
nasal decongestions (ephedrine, pseudo, phenylephrine), antihistamines, some antidepressants(buproprion & trazodone), some antipsychotics (promethazine, chlorpromazine)
How much % blood volume loss is a) class I hemorrhage, b) class IV hemorrhage
a) <15% blood volume loss
b) >40% blood volume loss (class IV=increased risk of dying by exanguination alone)
what causes death with acute altitude/mountain sickness?
pulmonary and cerebral edema
what treats a) cyanide toxicity, b) ethylene glycol/methanol
a) amyl nitrate
b) fomepizole
what environmental element causes intestinal type sinonasal adenocarcinoma?
wood dust
What neurotransmitter change is associated with sudden infant death?
decreased serotonin
How many milliamps of electrical current cause a) tingling sensation, b) painful shock, c) muscular contraction forcing victim to hold on to the electrical force, d) v fib?
a) 1 milliamp,
b) 5 milliamps
c) 16 milliamps
d) 100 milliamps
what are gun cartridge casings made of?
brass (alloy of zinc and copper)
what are most primers (in ammo) made from?
barium, antimony, lead
what is black powder composed of?
potassium nitrate, sulfur and charcoal
What elements are bleach made up of?
NaO- Cl+
What are at least 4 encapsulated organisms that would cause infection in someone with sickle cell anemia?
SHiNE SKiS: Strep pneumo, H flu, N. meningitidis, E Coli, Salmonella, Klebsiella, Group B streptococcus (agalacticae)