LATEST PATHOLOGY - FORENSIC PATHOLOGY
CERTIFICATION EXAM OFFERED BY
AMERICAN BOARD OF PATHOLOGY (ABMS) |
COMPLETE EXAM Q&A WITH RATIONALES
1. A 45-year-old man is found dead in a bathtub with
multiple superficial, parallel, linear incisions on the
forearms and wrists. At autopsy, the incisions are of
varying depth, with superficial hesitation marks at the
margins. The deepest incision transects a radial
artery. What is the most likely manner of death?
A) Homicide
B) Suicide
C) Accident
D) Undetermined
Correct answer: B
Rationale: Hesitation marks (superficial, parallel,
tentative incisions) are classic for suicide. Homicidal
wrist cuts are rare and usually deep, forceful, and
single. The presence of multiple superficial marks
indicates self-infliction.
2. A 30-year-old woman is found hanging from a door
frame with a rope around her neck. At autopsy, there
,is a single, deep, pale groove with a "V" shape
pointing upward on the neck, sparing the area under
the knot. No other injuries are present. What is the
most likely cause of death?
A) Cerebral anoxia from carotid artery compression
B) Fracture-dislocation of the cervical spine
C) Airway obstruction
D) Vagal reflex cardiac arrest
Correct answer: A
Rationale: In hanging, death is typically due to
cerebral anoxia from compression of carotid arteries
(and jugular veins), not airway obstruction. Cervical
spine injury is more common in drop hangings
(judicial hanging) than in typical suicidal hanging.
3. A 60-year-old man is found dead in bed with a
history of coronary artery disease. At autopsy, the
heart weighs 550 g. The left anterior descending
coronary artery shows 95% cross-sectional luminal
narrowing by atherosclerotic plaque. No acute
thrombus is identified. What is the most appropriate
cause of death statement?
A) Acute myocardial infarction
B) Atherosclerotic coronary artery disease
,C) Sudden cardiac death due to coronary artery
atherosclerosis
D) Heart failure
Correct answer: B
Rationale: Without acute thrombus or histologic
evidence of acute myocardial infarction, the cause is
severe coronary atherosclerosis. "Acute myocardial
infarction" (A) requires histologic confirmation
(coagulation necrosis, neutrophil infiltrate).
4. A 2-year-old child is brought to the emergency
department unresponsive and later dies. Retinal
hemorrhages are seen on ophthalmologic
examination. Autopsy shows subdural hematomas of
different ages (acute and chronic), diffuse axonal
injury, and rib fractures in various stages of healing.
What is the most likely diagnosis?
A) Shaken baby syndrome (abusive head trauma)
B) Accidental head trauma from fall
C) Glutaric aciduria type I
D) Meningococcal meningitis
Correct answer: A
Rationale: The triad of subdural hematomas (different
ages), retinal hemorrhages, and encephalopathy is
, classic for abusive head trauma (shaken baby
syndrome). Rib fractures of different ages indicate
repeated non-accidental trauma.
5. A 25-year-old man is found dead in an alley with a
single gunshot wound to the chest. At autopsy, the
bullet track is downward (from right to left, superior
to inferior). There is no soot or stippling around the
entrance wound. What is the most likely range of fire?
A) Contact range
B) Near contact (1-5 cm)
C) Intermediate range (10-50 cm)
D) Distant range (>50 cm)
Correct answer: D
Rationale: Absence of soot (carbon) and stippling
(powder burns/tattooing) indicates the muzzle was
far enough away that soot and powder particles did
not reach the skin (typically >50 cm or 2-3 feet).
6. A 40-year-old woman is found dead in a parked car
with the engine running in a closed garage. Autopsy
shows cherry-red lividity. Carboxyhemoglobin
saturation is 65%. What is the most likely cause of
death?
CERTIFICATION EXAM OFFERED BY
AMERICAN BOARD OF PATHOLOGY (ABMS) |
COMPLETE EXAM Q&A WITH RATIONALES
1. A 45-year-old man is found dead in a bathtub with
multiple superficial, parallel, linear incisions on the
forearms and wrists. At autopsy, the incisions are of
varying depth, with superficial hesitation marks at the
margins. The deepest incision transects a radial
artery. What is the most likely manner of death?
A) Homicide
B) Suicide
C) Accident
D) Undetermined
Correct answer: B
Rationale: Hesitation marks (superficial, parallel,
tentative incisions) are classic for suicide. Homicidal
wrist cuts are rare and usually deep, forceful, and
single. The presence of multiple superficial marks
indicates self-infliction.
2. A 30-year-old woman is found hanging from a door
frame with a rope around her neck. At autopsy, there
,is a single, deep, pale groove with a "V" shape
pointing upward on the neck, sparing the area under
the knot. No other injuries are present. What is the
most likely cause of death?
A) Cerebral anoxia from carotid artery compression
B) Fracture-dislocation of the cervical spine
C) Airway obstruction
D) Vagal reflex cardiac arrest
Correct answer: A
Rationale: In hanging, death is typically due to
cerebral anoxia from compression of carotid arteries
(and jugular veins), not airway obstruction. Cervical
spine injury is more common in drop hangings
(judicial hanging) than in typical suicidal hanging.
3. A 60-year-old man is found dead in bed with a
history of coronary artery disease. At autopsy, the
heart weighs 550 g. The left anterior descending
coronary artery shows 95% cross-sectional luminal
narrowing by atherosclerotic plaque. No acute
thrombus is identified. What is the most appropriate
cause of death statement?
A) Acute myocardial infarction
B) Atherosclerotic coronary artery disease
,C) Sudden cardiac death due to coronary artery
atherosclerosis
D) Heart failure
Correct answer: B
Rationale: Without acute thrombus or histologic
evidence of acute myocardial infarction, the cause is
severe coronary atherosclerosis. "Acute myocardial
infarction" (A) requires histologic confirmation
(coagulation necrosis, neutrophil infiltrate).
4. A 2-year-old child is brought to the emergency
department unresponsive and later dies. Retinal
hemorrhages are seen on ophthalmologic
examination. Autopsy shows subdural hematomas of
different ages (acute and chronic), diffuse axonal
injury, and rib fractures in various stages of healing.
What is the most likely diagnosis?
A) Shaken baby syndrome (abusive head trauma)
B) Accidental head trauma from fall
C) Glutaric aciduria type I
D) Meningococcal meningitis
Correct answer: A
Rationale: The triad of subdural hematomas (different
ages), retinal hemorrhages, and encephalopathy is
, classic for abusive head trauma (shaken baby
syndrome). Rib fractures of different ages indicate
repeated non-accidental trauma.
5. A 25-year-old man is found dead in an alley with a
single gunshot wound to the chest. At autopsy, the
bullet track is downward (from right to left, superior
to inferior). There is no soot or stippling around the
entrance wound. What is the most likely range of fire?
A) Contact range
B) Near contact (1-5 cm)
C) Intermediate range (10-50 cm)
D) Distant range (>50 cm)
Correct answer: D
Rationale: Absence of soot (carbon) and stippling
(powder burns/tattooing) indicates the muzzle was
far enough away that soot and powder particles did
not reach the skin (typically >50 cm or 2-3 feet).
6. A 40-year-old woman is found dead in a parked car
with the engine running in a closed garage. Autopsy
shows cherry-red lividity. Carboxyhemoglobin
saturation is 65%. What is the most likely cause of
death?
