MIDTERM EXAM
FORENSIC MEDICINE Dr. Mokhtar A. Alhrani
(M.B.B.S - [Link]. - MD)
CLINICAL TOXICOLOGY
Question 1
All of the followings belong to death certificate except:
A. A permanent record of an individual's death
B. The final certification of a patient life and cause of death
C. The determination of an individual, weather dead or alive, using certain
physical characteristics
D. The legal and nationally accepted confirmation of death
E. All of the above
Question 2
Regarding verification of death All of the followings are true except:
A. Verification of death does not have any legal status
B. Verification of death does not require any opinion as to the cause of death
C. Verification of death does not constitute authority for a body to be buried or
cremated
D. As per law Verification of death should be done almost always by a doctor or
other healthcare professional
E. None of the above
Question 3
Which of the following items listed as the immediate cause of death on a death
certificate is NOT acceptable?
A. Cardiorespiratory arrest
B. Bronchopneumonia
C. Acute myocardial infarction
D. Hyaline membrane disease.
E. Pneumocystis jiroveci pneumonia
Question 4
Which of the following cases should be referred to the medical examiner to
investigate and certify the death?
A. A 58-year-old man with a history of atherosclerotic heart disease dies following
coronary bypass surgery
B. A 75-year-old woman with Alzheimer disease dies from bronchopneumonia in a
nursing home
C. A 47-year-old man infected with HIV dies from Pneumocystis pneumonia
D. A 63-year-old woman dies from pulmonary thromboembolism following
cholecystectomy
E. A 22-year-old man dies suddenly and unexpectedly while playing a high
school football game
Question 5
A 70-year-old man with a medical history of coronary atherosclerosis and congestive
heart failure is beaten about the head and robbed. He is unconscious when admitted
to the hospital. During his hospital course over the next two weeks he develops
bronchopneumonia, sepsis and renal failure. He dies four days later.
Which of the followings is the most likely underlying cause of death for this man?
A. Blunt head trauma
B. Bronchopneumonia
C. Coronary atherosclerosis
D. Renal failure
E. Sepsis
Question 6
A medical resident puts down the immediate cause of death as 'Prematurity'
followed by the underlying cause of death as 'Hyaline membrane disease' on a
death certificate form.
Which of the following statements regarding this death certificate is most
appropriate?
A. The case should be investigated by the medical examiner
B. A fetal death certificate should be used
C. The listed causes are reversed
D. This is a finding with sudden infant death syndrome
E. A congenital infection was present
Question 7
A 20-year-old man is combative when police arrive at a house from which the neighbors
heard screaming and breaking of glass for the past hour. He suddenly collapses. He is taken
to the hospital, requiring resuscitation with defibrillation en route to try and establish a normal
cardiac rhythm. On physical examination his vital signs show Temp 40°C, RR 36/minute, HR
110/minute, and BP 175/90 mm Hg. His pupils are dilated. He dies within an hour. Autopsy
reveals no signs of major trauma. Which of the following drugs of abuse is most likely to
produce these findings?
A. Cocaine
B. Methamphetamine
C. Ethanol
D. Heroin
E. Marijuana
Question 8
A child ingests 50 tablets in a bottle that she found on a table in the house. Two hours
later, the child becomes progressively obtunded and then lapses into a coma. The child
is taken to a local hospital, where supportive care is given. The child exhibits
tachypnea and tachycardia, but is afebrile. Laboratory studies with blood gas
analysis show pO2 95 mm Hg, pCO2 30 mm Hg, and pH 7.2.
Which of the following substances did this child most likely ingest?
A. Sodium hypochlorite
B. Lead arsenate
C. Methyl alcohol
D. Aspirin
E. Mercuric chloride
Question 9
A 4-year-old previously healthy child ingests a 100 ml bottle containing a clear liquid
he found under the kitchen sink at home. The child is observed to develop CNS
depression over the next 6 hours. Acidosis is documented on admission to the hospital.
Three weeks later, it is noted that the child's visual acuity is markedly decreased.
Which of the following chemical substances was most likely present in the liquid
ingested by this child?
A. Cyanide
B. Mercuric chloride
C. Methanol
D. Ethanol
E. Organophosphate
Question 10
A 43-year-old homeless man is found on a bench in a city park. He is obtunded.
External examination reveals swelling of his hands with pale, cool skin. His vital signs
include temperature 31°C, respirations 12/minute, heart rate 70/minute, and blood
pressure 80/50 mm Hg.
Which of the following drugs was most likely ingested by this man?
A. Acetaminophen
B. Acetylsalicylic acid
C. Amphetamine
D. Cocaine
E. Ethanol