Free DHA Forensic Medicine mock test

Forensic Medicine sample questions with answers

4 more original exam-style Forensic Medicine questions, worked in full. They are not real or recalled exam questions, and none of them is in the diagnostic above, so sit that first if you have not.

1. Question 1 · Asphyxia and Drowning

   An agitated man is held face down by three officers, one kneeling on his back, for several minutes. He becomes unresponsive and dies. Autopsy shows no lethal injury or disease. Which mechanism is most likely?

   1. APositional and compression asphyxia
   2. BCommotio cordis from chest impact
   3. CVagal inhibition from carotid pressure
   4. DMassive pulmonary thromboembolism
   Show answer and explanation

   Correct answer: A. Positional and compression asphyxia

   Prone restraint with weight on the back limits chest and diaphragm movement, causing restraint or positional asphyxia, often worsened by exertion, stimulant drugs and agitation. Autopsy findings may be minimal, so the diagnosis rests on the history and exclusion of other causes. Pulmonary embolism would be visible at autopsy.

   Reference: DiMaio and DiMaio, Forensic Pathology, 2nd ed.

2. Question 2 · Clinical Forensic Medicine

   A man detained at an airport has radiographic evidence of multiple wrapped packets in his bowel. Two hours later he becomes agitated, hypertensive, tachycardic and hyperthermic, and has a seizure. What is the most appropriate management after initial stabilisation?

   1. AEndoscopic retrieval of the packets
   2. BWhole bowel irrigation and observation
   3. CUrgent surgical removal of the packets
   4. DOral activated charcoal and discharge
   Show answer and explanation

   Correct answer: C. Urgent surgical removal of the packets

   Signs of cocaine toxicity in a body packer indicate packet rupture, and continuing absorption can be fatal, so urgent surgical removal is indicated after benzodiazepines and supportive care. Endoscopic retrieval risks rupturing more packets. Whole bowel irrigation is reserved for asymptomatic packers.

   Reference: Goldfrank's Toxicologic Emergencies, 11th ed.

3. Question 3 · Forensic Pathology Practice and Sudden Death

   A 24-year-old woman dies suddenly while asleep. A full autopsy, histology and toxicology are all normal. What is the most important step to complete the investigation?

   1. ARecord the death as natural causes and close the case
   2. BRetain tissue for genetic testing and refer the family
   3. CRepeat the toxicology screen on the same blood sample
   4. DRequest exhumation for a second autopsy in a month
   Show answer and explanation

   Correct answer: B. Retain tissue for genetic testing and refer the family

   A structurally normal heart with negative toxicology suggests sudden arrhythmic death, which may be due to an inherited channelopathy such as long QT or Brugada syndrome. Retaining blood or tissue suitable for DNA testing and referring first-degree relatives to a specialist cardiac genetics service can prevent further deaths. Closing the case without these steps misses an inherited risk.

   Reference: Basso et al., Guidelines for autopsy investigation of sudden cardiac death: 2017 update, Virchows Arch

4. Question 4 · Firearm, Blast, Thermal and Electrical Injury

   A gunshot entry wound on the cheek is surrounded by many small reddish-brown punctate marks that do not wash off with water. What do these marks indicate?

   1. ASoot deposited from a contact discharge
   2. BShotgun pellets from a distant shot
   3. CUnburnt powder grains from intermediate range
   4. DBullet fragments from a ricochet
   Show answer and explanation

   Correct answer: C. Unburnt powder grains from intermediate range

   Powder tattooing, or stippling, is caused by unburnt and partly burnt powder grains striking the skin and producing tiny abrasions that cannot be wiped away, which places the muzzle at intermediate range. Soot, by contrast, washes off and indicates closer range. Distant shots show neither feature.

   Reference: DiMaio, Gunshot Wounds, 3rd ed.