Thanatology: retinal changes after death: practice question

A Forensic Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Forensic Medicine · Thanatology: retinal changes after death

Sample item

A doctor examines the fundus of a patient soon after suspected cardiac arrest and sees the retinal blood columns broken into segments, like a train of boxcars. What does this sign (Kevorkian sign) indicate?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Cessation of circulation, confirming death

After circulation stops, the blood in the retinal vessels breaks into segments, called trucking or cattle-trucking, within minutes of death. It is one of the earliest reliable signs that death has occurred and can be seen with an ophthalmoscope. It does not occur in a person with a working circulation.

Option by option

  • A. Early diabetic retinopathy

    Diabetic retinopathy produces haemorrhages and exudates, not this appearance.

  • B. Raised intracranial pressure

    Raised intracranial pressure causes papilloedema rather than segmentation of blood columns.

  • C. Retinal detachment in a living patient

    Retinal detachment produces an elevated, folded retina with floaters and field loss, not segmentation of the blood columns.

  • D. Cessation of circulation, confirming death (correct)

    Correct. Segmentation of the blood column signals that circulation has stopped.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Forensic Medicine question

What is the answer to this Forensic Medicine question?

The best answer is D, Cessation of circulation, confirming death. After circulation stops, the blood in the retinal vessels breaks into segments, called trucking or cattle-trucking, within minutes of death.

Why is "Early diabetic retinopathy" not the answer?

Diabetic retinopathy produces haemorrhages and exudates, not this appearance.

Why is "Raised intracranial pressure" not the answer?

Raised intracranial pressure causes papilloedema rather than segmentation of blood columns.

Why is "Retinal detachment in a living patient" not the answer?

Retinal detachment produces an elevated, folded retina with floaters and field loss, not segmentation of the blood columns.

What concept does this question test?

It tests Thanatology: retinal changes after death in Forensic Medicine. It is one of the earliest reliable signs that death has occurred and can be seen with an ophthalmoscope. It does not occur in a person with a working circulation.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Thanatology: retinal changes after death?

Learn postmortem changes with their timelines, and toxicology as poison, sign, test and antidote. Then use the flashcards and the other Forensic Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.