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Forensic Pathology Board Exam > DiMaio > Flashcards

Flashcards in DiMaio Deck (52):
1

What are signs of fetal alcohol syndrome?

Distinctive facial features, including small eyes, an exceptionally thin upper lip, a short, upturned nose, and a smooth skin surface between the nose and upper lip

Deformities of joints, limbs and fingers

Slow physical growth before and after birth

Vision difficulties or hearing problems

Small head circumference and brain size

Heart defects and problems with kidneys and bones

2

How do you convert mm to caliber?

Multiply by 4 for example, a 9mm is equal to a 36 caliber

3

What is the mechanism of death with low voltage electrocution? High voltage?

Low voltage requires direct contact with charge, death by V Fib

High voltage does not require direct contact, death due to electrothermal injury or respiratory failure

4

What is the mechanism of death in methanol poisoning?

ACIDOSIS, not respiratory depression

5

What are some signs of arsenic poisoning?

Small intestines can have pseudomembranes

FATTY DEPOSITS IN HEART, LIVER, AND KIDNEYS!

ATN

Peripheral neuropathy of both sensory and motor in both acute and chronic poisoning!

6

How stable are the following in vitreous? 1) HCG 2) Cortisol 3) Thyroxin 4) TSH

1) stable 2) stable 3) decreases postmortem but can be used to diagnose hyperthyroid 4) can be used to detect hypothyroid

7

What percent of all deaths show agonal aspiration?

20-25%

8

What is the significant of petechiae in the epiglottis?

no significance

9

Reduction of what amount of oxygen by displacement of oxygen by intert gases produces unconsciousness in seconds and death in minutes?

Reduction to less than 25% of normal (5-6% by volume of oxygen)

10

Toxins such as cobalt and adriamycin have been associated with what heart issue?

Dilated (constrictive) cardiomyopathy

11

Why is bridging of LAD usually benign?

The vessel is compressed during systole and nearly all coronary blood flow to the left ventricle occurs during diastole

12

Most common family of drugs used in suicides?

TCAs

13

Thin film of SAH and SDH localized to the occipital lobes due to?

Decomp/lividity Rest of the brain will not have hemorrhage!

14

What is the most information that can be deduced about a stab wound?

maximum width of the blade, an approximation of the length of the blade, and whether it is single edged

15

What speed is a rifle considered high velocity?

>2000 ft/sec

16

Most deaths due to anaphylactic shock with therapeutic agents is due to?

Penicillin

17

What is amount of pressure needed to compress: 1) jugular vein 2) carotid artery 3) trachea 4) vertebral artery

1) 4.4 lbs of pressure 2) 11 lbs of pressure 3) 33 lb of pressure 4) 66 lbs of pressure

18

In a shotgun wound, how far before the wad does not enter the body anymore yet there may be a mark on the skin adjacent to entrance?

10 feet

19

In venous air embolism, how much air delivered rapidly is necessary to cause death?

between 75 and 250 cm3

20

Fat emboli are associated with:

1) Long bone or pelvic fractures

2) acute pancreatitis

3) extensive burns

4) liposuction

5) decompression sickness

6) parenteral infusion of lipids

7) reaming and nailing procedures of long bone fractures

21

What is the most common scenario of venous air embolism during therapeutic or surgical procedure?

Craniotomy in the sitting position

Here, air emboli occur in 21 to 29% of all craniotomies and 40% of all occipital craniotomies

22

What is the most common coronary artery anomaly?

Anomalous origin of the left coronary artery from the right sinus of Valsalva

23

What are the two most common suffocating gases?

Methane and carbon dioxide

24

With guns, what speed is considered low velocity? High velocity?

Low velocity 650-1400 ft/sec

High velocity 2400 - 4000 ft/sec

25

What type of necrosis is caused by acid burns? Alkaline burns?

Alkaline burns are worse and cause liquefactive necrosis with edema

Acid burns cause coagulative necrosis and the wounds are usually hard and dry

Hydrofluoric acid causes the worst injury of the acids

26

What is the most popular and most commonly fired cartridge in the US?

.22 rimfire

27

What procedure should be performed in all cases of meningitis?

Dissection of the middle ear to see if this is the source

28

Can carbon monoxide pass from materal to fetal blood?

Yes, the final concentration of CO Hb is 10 percent higher than the maternal concentration

29

With shotguns, what are the distances to get: 1) scalloped hole 2) pellets start to separate 3) individual pellets

1) 3 ft 2) 4 ft 3) 9-10 ft

30

What is the most common abdominal organ injured in blunt force injury cases?

Liver

31

What is the most commonly abused inhalant?

Toluene

32

What is responsible for the bright pink color of blood seen in cyanide poisoning?

Oxyhemoglobin, not cyanohemoglobin (which is not made in any significant quantity)

33

Adhesion between cortex and dura can cause?

Epilepsy

34

When is livor present, fixed, and absent?

Usually evident in 30 min to 2 hours, fixed at 8 to 12 hours, disappears when decomp takes over

35

Which artery has higher incidence of thrombosis?

Left compared to right Only 13% show gross thorombosis

36

First statewide system involving a physician as a coroner who would later be known as a medical examiner?

Massachusetts in 1877

Medical examiner system first in New York City in 1918

Medical examiner state system first is Maryland in 1939

37

Why is petechiae present in most strangulation cases and not in hangings?

Because blood continues to pump to the head via the vertebral arteries and cannot escape via the venous system in strangulation whereas in a lot of cases of hangings there is the 66 lb of pressure needed for occlusion

38

What are risk factors for venous air embolism?

1) Therapeutic or diagnostic procedures (particularly with prone, supine, lithotomy, and lateral knee chest position)

2) Trauma

3) During childbirth or abortion

4) During oral-genital sex in a pregnant woman when her partner blows air into the vagina

39

What is force to produce single linear fracture?

33.3 to 75 ft lb

40

What is a complication of phenothiazine therapy in schizophrenics?

Hydrocephalus

41

What color is the blood in hydrogen sulfide poisoning?

Dark colored because oxyhemoglobin is reduced and methemoglobin is formed. Sulfhemoglobin is not formed during acute exposure.

42

When are petal wad marks seen?

1-3 feet

 

43

What is the most popular buckshot load in this country?

12 gauge 2-3/4 shell loaded with NINE 00 buck pellets

44

Fractures of which part of the clavicle is more associated with child abuse? Accidental trauma?

Fx of midportion of clavicle seen in accidental trauma

Fx of distal ends more associated with child abuse

45

What is mechanism of death in electrocution?

Low voltage = v fib High voltage = electrothermal injury or respiratory arrest from paralysis due to central damage to respiratory center by hyperthermic effects of current

46

What voltage is considered low? High?

Low voltage < 600 V

High voltage > 600 V

Residential voltage = 110-120 V

High voltage lines in suburbs and urban areas = 7500 - 8000 V

Transcontinental high tension lines = >100,000 V

47

What findings are associated with: phenol? phosphorous?

Phenol associated with ATN

Phosphorous associated with liver and kidney necrosis

48

When is rigor present and absent?

Usually appears 2-4 hours after death and fully develops in 6 to 12 hours. Usually gone by 36 hours but HUGE variation!! If someone has violent muscular exertion prior to death, can be instantaneous (cadeveric spasm)

49

How long does it take maggots to reach larva stage?

6 to 10 days under normal circumstances Adults emerge in 12 to 18 days

50

What is the most common form of arsenic used for poisoning?

Arsenic trioxide

51

What is the classic hangman's fracture?

fracture of the pedicles of C2 with the posterior arch remaining fixed to C3 C1, the odontoid process, and the anterior arch of C2 remain in articulation with the base of the skull

52

Sudden death due to valvular disease is usually due to what two conditions?

Mitral valve prolapse and aortic stenosis