MUST KNOW Flashcards
1
Q
Picture of red burnt foot, straight line of demarcation on ankle.
A
Immersion
2
Q
Isopropanol is?
A
Twice as intoxicating as ethanol
3
Q
What is the most common cause of death in the 24 hours following tonsillectomy?
A
Bleeding (other
choices aspiration pneumonia)
4
Q
Slide: decomp man with elevated blood alcohol and this finding in kidney. Cause?
A
Poisoning (ethylene glycol)
5
Q
How to calculate perimortem blood ETOH based on urine?
A
Urine 1.3 to Blood 1.0
6
Q
Man is assaulted and presents to the ED the following day with abdominal pain. He collapses and
undergoes vigorous resuscitation. At autopsy- marked CAD and anterior liver laceration with 450 cc
hemoperitoneum. What is COD?
A
heart disease
7
Q
What kind of current is lightning?
A
direct, high
8
Q
Two separate questions with images of pons, one gross, one luxol fast blue, both showing central
pontine myelinolysis, associated with?
A
Chronic EtOH
9
Q
Gross picture of brain with periventricular plaques.
A
Autoimmune disease (MS)
10
Q
REPEAT:
What type of ammunition is being shown?
A
ACP ammunition
core and jacket separate so you see small little balls of core and then the jacket
11
Q
What is definition of stopping power?
A
Police term
Stopping power is the ability of a firearm or other weapon to cause enough ballistic trauma to a target (human or animal) to immediately incapacitate (and thus stop) the target
12
Q
Man with helium tank running into bag over head, mechanism of death?
A
Exclusion of oxygen
13
Q
slide: Duodenum with black pigment on mucosal surface (?charcoal). What is cause of death?
A
poisoning
14
Q
Best sample for Channelopathy testing?
A
EDTA tube (other choices fresh frozen heart, blood spot card)
15
Q
Hypoxia in the perinatal period causes what change in the neurons?
A
Basophilia (other choices
karyorrhexis)
16
Q
Xray of child’s head with small, radio-opaque round object (BB sized), ID.
A
Low-velocity weapon vs radiology marker (other choices high velocity weapon)
17
Q
What chemical is a/w an elevated CO?
A
methylene chloride (other choices methyl chloride, methyl bromide, ethylene chloride)
18
Q
Why is benzidine used as a presumptive test for blood?
A
Sensitive and specific (other choices
nontoxic)
19
Q
At what speed does a .38 caliber bullet penetrate the skin?
A
About 200 ft/sec
20
Q
How many CME credits per year do you need?
A
35
21
Q
Picture of detached mandible with soft tissue removed, teeth have pink discoloration, cause?
A
Postmortem change
22
Q
Armpit with charring/burns, what type of electrical injury?
A
High voltage (other choices water electrocution, low voltage)
23
Q
Virtual slide: two hippocampi, one sclerotic. Result?
A
Epilepsy
24
Q
Coronary artery dissection associated with?
A
peripartum
25
Slide of ARVD-COD?
Arrhythmia
26
Traumatic SAH is associated with?
Blow to neck
27
18 yo truck driver pulled from water with scalded-looking skin, burns on face, cause?
Burn from battery acid
28
What knife caused this wound?
Ricasso
29
Virtual slide: 2 day old infant with gross photo of mass around adrenal and this micro appearance
Neuroblastoma
30
slide: lung
coccidioides
31
Close up picture of child’s neck with dried yellow fold, and grouped vertically-oriented parallel
“abrasions”, cause?
Ligature vs serrated knife vs clothing
32
What is most important to examine in lightning death?
clothing
33
Which is last epiphysis to close?
Medial clavicle/proximal humerus (other choices included lateral clavicle, proximal radius, sacroiliac joint – always two given at once)
34
A 16 year old was at party, presented unresponsive to the ER with hyperthermia, most likely
intoxicant?
MDMA
35
Picture man with dicing injuries (versus road rash) on left side of forehead. What can you tell about
position in car?
driver
36
Alcoholic cardiomyopathy associated with?
age greater than 60
37
What is different about cocaethylene compared to cocaine?
more potent
38
Which medication causes agranulocytosis?
Clozapine
39
Mechanism of death in acute mountain sickness?
Noncardiogenic pulmonary edema and/or Cerebral edema
40
Two photos, one showing head with hole in head and one with torso/extremities with penetrating
injuries, cause?
fireworks injury/blast injury (other choices included electrocution, gunshot wounds)
41
Picture of pretty normal looking GEJ, slightly blue – probably varices, person also has?
Coagulopathy
42
Cross section of lungs from homeless woman with numerous small nodules, consistent with?
TB
43
What is the test for GSR detecting?
Antimony, Bismuth, Lead, Nitrate, and Nitrite
44
How much voltage is in power lines?
7-8000 (high voltage)
45
Which body systems is benzene most toxic to (given 2)?
Brain and bone marrow (other choices liver
and kidney, heart and skin)
46
Picture of balcony with shoes and stepstool, manner of death?
suicide
47
One paired stab wound of chest, caused by?
scissors
48
Skeletal survey of infant with healing fracture of left radius/ulna, what is shown?
Remote injury
(other choices included normal, osteogenesis imperfecta)
49
Lady with blood coming out of her mouth, chemical burns like injuries described to her tongue esophagus and stomach. Pungent odor when opening the body.
Hydrogen sulfide
50
slide: young woman died suddenly with this liver. cause?
Eclampsia
showing liver with periportal necrosis
51
slide: woman with this finding in lung, cod?
drug overdose
52
What causes brown lividity?
sodium chloride, inorganic nitrate, methemoglobinemia
53
Picture of whole kidney with triangular infarcts.
fat emboli
54
In postabsorptive phase, what site has lowest alcohol level?
Brain (very fatty, alcohol goes toward water)
55
slide: 32 year old woman dead, this finding in lung
Amniotic fluid embolism
56
What percent of hospitalized patient die from pulmonary emboli?
5-10 percent
57
Which organ has lowest blood alcohol after equilibration?
brain
58
Four pictures of car-pedestrian impact, one of car with front headlight broken, person with 3 parallel
lacs to left occipital skull, stellate lac to right occipital skull, avulsion pocket left thigh, injury caused
by what type of impact?
Secondary (other choices primary, tertiary, quaternary)
59
Man pulled out of water after 3 days, bits of skin all chewed off, cause?
Anthropophagy
60
Cross-section of lung with apical blebs/honeycombing only, cause?
Smoking (other choices alpha-1
anti-trypsin)
61
Chasing the dragon, what is present in blood?
Morphine (other choices pcp, cocaine)
62
What disease is characterized by basal ganglia calcification?
Fahr's disease
63
slide: 36 yo man with this heart finding. what would special stains show?
NOTHING
this is giant cell myocarditis
Difference with sarcoid is no granulomas and no necrosis
both would be negative with special stains
64
Body cavity showing adhesions between liver and chest plate (Fitzhugh Curtis syndrome), A/w?
pid
65
What chemical cannot be detected after embalming?
cyanide
66
Pictures of house, father and son decomposing in separate rooms, and water heater with detached
line and lots of rust, what should emergency responders be careful for?
CO (other choices radon,
natural gas)
67
slide: what is this in lung?
fat embolism
68
REPEAT
micro: Testes of chronic alcoholic
Atrophy
69
Picture of an adult’s neck with a pink, scaly lesion.
Ringworm infection
70
slide: Child’s liver with microvesicular steatosis, cause?
Disorder of fatty acid oxidation
71
Picture of medial aspect pubic symphysis, very rough parallel lines, what is age?
Youngest they give
72
Picture of breasts with two stab wounds, cause?
Stab wounds/due to knife (other choices
therapeutic)
73
Cross section of kidney with changes c/w sepsis. ID
Cross section of kidney with changes c/w sepsis. ID
74
50 kg woman bleeds 1750 ml from a liver laceration. Is this sufficient to cause death?
Yes (70 cc/ kg of body wt = 3500 cc, so she’s lost half her blood volume)
75
Bullet in person is flat with mirror like surface, bullet most likely is?
ricochet
76
What is the most important factor in the damage caused by an electrocution?
amps
77
What organization assumes the central investigative role in airplane crashes?
Where are tox samples sent in plane crashes?
National Transportation Safety Board (NTSB)
Tox samples are sent to the Federal Aviation Administration's Civil Aerospace Medical Institute
78
Purple contusion, what can you tell about age of injury?
nothing
79
Gross picture of diaphragm with plaques, due to?
Exposure to crocidolite
80
What is vitreous alcohol after equilibration?
Same (other choices higher, lower than blood alcohol)
81
Man with bag over head and belt around neck with cloth underneath, MOD?
accident
82
Slide: 46 yo man found dead with this finding in brain
Neurocysticercosis
83
Child with zig-zag pattern on head, caused by?
Run over by truck
84
Nurse administers medication, patient has peaked T waves then dies, what did she give?
potassium
85
REPEAT
Microscopic photo of plant debris barried by bullet through body. What organ did it perforate?
Stomach
86
Blood cysts on heart valve
Blood cysts on heart valve
87
3 separate questions with pictures of striae of groin—
stretch injury from pedestrian struck from
behind by vehicle (some people thought one of them was postmortem insect activity)
88
ragment of skull with yellow discoloration associated with?
Tetracycline
89
How long after trauma does fat embolism usually occur?
1-3 days
90
Picture of emaciated baby, best test to determine mechanism of death?
```
Vitreous electrolytes (other
choices GI sections, liver sections, BMI calculation)
```
91
Slide: 77 yo man found behind bar with this finding in brain. cause?
Trauma/contusion
92
Gross picture of heart with pericarditis. Organ system failing?
renal/GU
93
Picture of crack pipe, identify
Picture of crack pipe, identify
94
There will be pic of young woman with what look like sharp force injuries on face
PICK DOG BITE
95
What antipsychotic drug has been known to cause paralytic ileus and bowel obstruction (sometimes fatal) in schizophrenics?
Clozapine
96
Best way to determine shotgun gauge?
Examine wad (other choices weigh pellets)
97
Hands of black woman with clubbing of fingers, a/w?
vsd
98
What is most common valvular cause of sudden death?
mitral insufficiency (other choices aortic stenosis, tricuspid insufficiency)
99
Story about person got in a car accident, car caught on fire, picture of epidural hemorrhage over
right cerebral convexity, brown and crumbly.
Postmortem fire artifact (versus traumatic)
100
Virtual slide: Woman from southeast Asia with cough/cold for 3-4 weeks, given antibiotics. COD?
PCP pneumonia
101
slide: lung with marked fibrosis
cause?
Paraquat
other choices include berylliosis which would have granulomas
102
Skull with fracture, hair embedded in fracture, how can you tell that fracture occurred before
skeletonization?
hair in crack
103
Sudden death in sewer or tank associated with?
Exclusion of oxygen
104
Picture of .25 expanding point bullet (lead and separate pellet – may have been an xray). ID
Picture of .25 expanding point bullet (lead and separate pellet – may have been an xray). ID
105
What is the half life of carbon monoxide on room air?
4 hours
106
Slide: vet tech found dead in apartment, brain with empty holes. Cause?
Postmortem change
107
Picture of birdshot with fairly tight spread, no central hole, wad mark, range?
5-10 feet (other
choices 12-20)
108
Patients treated with vincristine die after what kind of inadvertent administration?
Intrathecal
109
slide on EVERY TEST
Gunshot wound with maggot
postmortem change is answer
110
At what depth does decompression sickness become a problem?
33 ft
111
Skeletal survey of infant with lipping of epiphyses.
Rickets
112
What is most useful in comparing a stab wound to a blade?
Cartilage marks (other choices wound width, wound depth)
113
What is this ammunition?
Air Rifle Pellet
114
slide: 11yo died acutely in hospital and had this finding in kidney. COD?
Dehydration and ATN
(other choices included lead poisoning and diabetes)
115
Old man’s mouth with radiating red lines coming out, cause?
Gunshot wound of mouth (didn’t look
right, but other choices didn’t make sense)
116
slide: what is this skin finding due to?
senile purpura
117
Picture of elderly woman’s face with yellow punctate lesions, cause?
Postmortem/cockroach activity
118
Flannel shirt with small white particles.
filler from buckshot
119
Long QT syndrome associated with?
Spontaneous mutations (other choices family history of drowning, normal EKG in parents rules it out)
120
Plastic bag on face, what is finding?
Moist face
121
What ammunition?
Shotgun slug
notice c shape
122
Purpose of carotid sleeper hold?
Compress both carotids, produce quick unconsciousness without
damage to trachea
123
What is the purpose of a bullet cartridge?
prevent gas from escaping
124
Iatrogenic air embolism from a central line requires what?
\>100cc of air, 14 gauge needle, left lateral
decubitus position, head \>30 degrees, PFO
\*not sure of answer but first isn't right because as little as 2-3 cc of air can cause it, you definitely don't need a PFO....not sure
125
Child’s skull with red discoloration and missing enamel on most teeth, evidence of?
neglect
126
Picture of already shot, blue plastic cartridge with ruler, measures approximately ¾ inch, what is
ammunition?
12 gauge shotgun (other choices .410, .45, .22)
127
What is the most common cause of death during liposuction?
```
Anesthesia complication (other
choices fat emboli)
```
128
What is the most likely to be injured in a bomb blast?
Lungs (other choices brain, liver)
129
Picture of detached toenails with white lines across them (Mee’s lines). What is associated
symptom?
Peripheral neuropathy
130
Hand with gold paint associated with?
Toluene
131
Xray of hyoid with unilateral non-fusion.
normal variant
132
Cannulures on a bullet are used for?
lubricant
133
slide: two hearts with inflammation and myocyte destruction--one child with recent cold and one adult woman without symptoms. Cause?
Viral myocarditis
other choices included bacterial and acute MI
134
Close up picture of child’s back and bottom with U-shaped scars, what are they?
abuse
135
40 yo man with diabetes, hypertension, has a week of flu like symptoms, presents to hospital with
respiratory distress, rapid influenza negative, grows S. pneumo from lungs and dies, what test will
help you determine the proximate COD?
Influenza PCR (other choices blood culture)
136
slide: 36 yo man found dead. Brain slide with what looked like vacuolization in the corpus callosum
Most thought inhalant abuse (solvent leukoencephalopathy causes demyelination of white matter)
Some thought Marchiafava-Bignami disease which is a demyelination of the corpus callosum specifically from chronic ethanolism
137
Gross picture of brain with laminar necrosis. Associated with?
Hypoxia/anoxia
138
What are changes in brain seen with boxing?
Atrophy of cerebrum and cerebellum (other choices old SDH)
139
What would cause vfib?
110v alternating (other choices 110v direct, 7296v alternating, lightning)
140
Picture of man with upper body hanging over railing, feet on floor, associated with?
EtOH
141
Brugada syndrome due to mutation in?
Na channel (other choices K channel)
142
Time for adult skin to burn when exposed to water at 140-150?
Less than 5 sec (other choices 5-10 sec)
143
Child with cockroach artifact on face.
postmortem
144
slide: heart with this finding--underlying cause?
Transthyretin mutation
145
Retractor artifact of axilla
Retractor artifact of axilla
146
When does barotrauma occur?
rapid ascent
147
Emphysema aquosum is associated with?
drowning
148
Virtual slide: man assaulted within 24 hours-pons with hemorrhage around 4th ventricle and this finding. What was his initial presentation?
Coma (retraction balls from DAI)
149
Picture of leg with postmortem rodent activity. ID
Picture of leg with postmortem rodent activity. ID
150
Picture of person with two gunshot wounds of chest and multiple paired punctures, cause?
taser
151
Brain (gross) in coronal section showing random holes in basal ganglia.
Hypertensive CVD
152
Question on current given 120 volts and 1000 Ohms
120 mA
A = V (volts) / R (ohms)
120 / 1000 = .012 A or 120 mA
153
Man with round, dark brown, patterned lesion on center of chest, cause?
Artifact of medical
intervention
154
Slide: what is this from?
Septic emboli in heart (IVDA)
155
What is mechanism of death in inhalant abuse?
Cardiac arrhythmia
156
Gross photo of brain in an elderly person with bacterial meningitis, ID.
Gross photo of brain in an elderly person with bacterial meningitis, ID.
157
Hand of person buried in sealed casket for 5 years, covered with black substance, cause?
Mold
| (other choices embalming artifact, ground water, thermal injury)
158
Young man found dead in garage with face next to exhaust, car running, suicide note, CO level 13%,
COD?
Carbon dioxide poisoning
159
Picture of man with rectangular abrasion on chest with central patterned abrasions and
contusions on arm, cause?
Struck steering wheel (other choices hit with 2x4, hit with pool cue,
caused by vehicle hood ornament, caused by vehicle grill)
160
A couple questions on blank: whole blood alcohol content
161
Gross picture of thyroid (in situ) with black discoloration.
minocycline
162
Head with paired injuries, splitting of skin, skull with depressed fractures, consistent with?
claw hammer
163
Photograph of crescentic, non-traumatic hymen
(normal variant)
164
Slide: kidney with this finding--what to check?
Vitreous glucose
165
What electricity scenario causes V Fib?
Low voltage, alternating current
166
Micro slide: lung
aspergillus
167
A pH strip that has complicated pattern and the container which shows pattern means pH 12. What is
gastric content?
NaOH
168
Child’s lips with red lesion with white and black center at corner of mouth affecting upper and lower
lip, lips edematous, cause?
Cigarette burn (other choices acid, alkali, electrical)
169
Gross photo of lung with food in bronchus, associated with?
Dementia
170
Gunshot wound of right temple with stippling on shoulder, cause?
Cylinder gap
171
Picture of face, top of head skeletonized, bottom with chunky, chalky white fat, cause?
Adipocere
| (other choices mummification)
172
Picture of muzzle flash suppressor injury with 6 petals – ID
Picture of muzzle flash suppressor injury with 6 petals – ID
173
What can decontaminate CJD?
NaOH (other choices formaldehyde – not formic acid)
174
Hemorrhage in the corpus callosum is associated with (this may have been an image, can’t
remember)?
Trauma (DAI)
175
Woman with star shaped wounds on torso (4 points).
Hunting arrow
176
What is the order of increasing penetration of radioactivity?
Alpha particles, beta particles, x-rays
177
slide: seems like there will definitely be a slide of a dural adhesion but not sure what Q will be...
dural adhesion
178
What is associated with hemoperiteneum and intussuscepted ileum?
Typhoid fever
179
What can be seen with HIV encephalitis?
giant cells
180
Which is fully jacketed?
22 magnum (other choices 22 short, 22 long rifle)
181
Man’s face with red discoloration, sparing of mouth, lateral jaw, medial eyes, forehead, cause?
Radiant burns
182
Need to ID what tooth a cap is on.
What is the name of teeth starting from front?
Central Incisor
Lateral Incisor
Cuspid
1st Bicuspid
2nd Bicuspid
1st Molar
2nd Molar
3rd Molar
Universal system starts numbering from right 3rd molar and goes around clockwise (as if you are looking AT patient)
183
Cylinder blast mark (?cylinder gap) useful for calculating?
barrel length
184
Face with gunshot wound with stippling that is large, somewhat irregular, cause of stippling?
Ball powder (other choices flake powder, filler from buckshot)
185
best specimen for detecting cyanide in a decomp?
muscle
186
Psilocybin comes from?
mushrooms
187
slide: infant heart with this finding--cause?
Rhabdomyoma
188
A woman dies of a small bowel obstruction, what history is most important to determining the
cause of death?
History of TAH/BSO in her 30s
189
Body of alcoholic man with linear excoriations covering torso.
Pediculosis corporis
190
slide: 36 yo day laborer who died-lung with inflammation including many giant cells
Farmer's lung (characterized by non-necrotizing poorly formed granulomas)
other choices included berylliosis which would have well formed granulomas
191
Picture of baby’s face with red nose and dried lips, cause?
Postmortem artifact
192
In a blast injury, what are the bomb fragments considered?
```
Secondary injury (other choices primary,
tertiary, quaternary)
```
193
slide: this is an aorta--how old is lesion?
less than 7 hours
RBCs still intact and no hemosiderin laden macrophages
194
Cross section of lung in homeless woman with prominent perivascular fibrosis, cause?
Intravascular
carcinoma (other choices TB)
195
slide: what is this in the brain?
AVM
196
Xray showing teeth in stomach
Blunt force trauma of head
197
What is the cause of death in an enclosed space (ie well)?
carbon dioxide poisoning
198
Laminar necrosis is associated with?
Barbiturate overdose and anoxia
3rd layer is most susceptible
199
Gross picture of heart with many white plaques, young man.
sarcoid
200
SLIDE: Liver with this finding...cause?
IVDA
201
Most common position in adults associated with positional asphyxia?
Neck hyperflexion
202
Positional asphyxia in adults associated with?
intoxication
203
FREQUENT REPEAT
What is this showing?
Calculi
204
Slide of heart with cytoplasmic clearing of all myocytes (hard to even ID as heart), cause?
Storage disease
205
Gross picture of stomach with black spots?
Hypothermia
206
What % of blood volume lost to cause shock?
33% (other choices 40%, 50%)
207
slide: Woman with this lung finding?
pulmonary hypertension
this is a plexiform lesion
208
Brain (gross) in coronal section showing caudate atrophy.
Huntington disease
209
Virtual slide: 11yo girl dropped dead with this finding-diagnosis?
Hypertrophic Cardiomyopathy
210
What causes chloracne?
digoxin
211
What is this lesion in lung?
Pulmonary hamartoma
212
What % carboxyhemoglobin to see cherry red livor?
35%
213
Picture of green, dilated colon and small intestines in person with diabetes, htn, anemia, COD?
Degenerative (other choices toxic, metabolic, infectious)
214
Slide: 88yo man assaulted--brain with organizing hemorrhagic area, overlying cortex intact
Infarct
215
nfant with petechial rash on upper chest and neck, cause?
viral exanthema (versus asphyxia)
216
not sure about this calculation, but in ALL the remembrances, the numbers are the same....
170 lb man drinks 86 proof alcohol. How many ounces to get maximum BAC of 0.1?
6
217
Picture of elderly woman’s face with red burns. ID as burns
Picture of elderly woman’s face with red burns. ID as burns
218
Tamponade, PE and rupture of chordate tendinae are associated with?
Pulseless electrical activity
219
Velocity for bullet to penetrate skin?
191 ft/s
220
Man enters industrial storage tank and rapidly dies, cause?
Hydrogen sulfide
221
REPEAT
Scombroid poisoning associated with eating?
Fish
222
Spontaneous epidural hemorrhage in a child is most likely due to?
Coagulopathy (other choices
AVM)
223
Torso with numerous small round punctures covering nearly entire chest in no particular pattern,
cause?
Icepick (other choices included birdshot)
224
Picture of brain with SAH. What kind of trauma sustained?
blow to neck
225
MICRO: What is this heart muscle showing?
Right ventricular dysplasia/ARVD
226
At what age is primary dentition complete?
3
227
Calculate ethanol level of zero after drinking certain amount....
228
slide: Kidney with postmortem bacterial overgrowth, otherwise normal. Cause of death?
Sepsis (other
choices included lead poisoning, hyperosmolar coma, other things ruled out by normal kidney)
229
What do you see in barotrauma?
Results in venous air embolism versus can be confined to lungs
230
What does subpoena duces tecum mean?
Appear in court with documents
231
Picture of transtentorial herniation
Picture of transtentorial herniation
232
Multiple paired stab wounds of face, caused by?
```
barbecue fork (other choices included pinking
shears)
```
233
Thin man found decomposing in 70F home, no corneal clouding, rigor breaking, no abdominal
discoloration, how long dead?
\<2 days (versus 2-3 days, versus longer)
234
Skull with hyperostosis frontalis, what can you tell about decedent?
Postmenopausal (other choices
acromegaly, hypoparathyroidism)
235
Slide: kidney with this finding--cause?
Autolysis
236
Three stock jars, all over 1 year old, one with bright red contents, COD?
```
house fire (other choices
included cyanide, but should be degraded by formalin)
```
237
Number of deciduous teeth?
20
238
75 yo woman dies after a 7 year h/o progressive dementia, hallucinations, constipation and frequent
falls. Most likely neuro disease?
Alzheimers with Lewy bodies
239
Question about embalming and vitreous
a small amount of embalming fluid will enter the vitreous and create a minor dilution but the ethanol present in vitreous even after embalming can be considered antemortem
240
The Hydro-Shok bullet is ID'd by its?
lead post
