Asphyxial deaths: immersion syndrome: 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 · Asphyxial deaths: immersion syndrome

Sample item

A young man who had been drinking jumps into very cold water and is found dead within moments with no struggle. What is the proposed mechanism of death?

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

The answer and the reasoning

B. Reflex cardiac inhibition via the vagus on sudden cold immersion

Sudden immersion in cold water can stimulate receptors in the skin, pharynx and larynx, causing vagal cardiac inhibition and arrest, known as immersion syndrome or hydrocution. Alcohol and fear predispose, and little or no water is found in the lungs. Autopsy is often negative.

Option by option

  • A. Fresh water absorption causing haemodilution

    Haemodilution develops over minutes of fresh water aspiration, not instantly.

  • B. Reflex cardiac inhibition via the vagus on sudden cold immersion (correct)

    Correct. A vagal reflex produces sudden cardiac arrest.

  • C. Osmotic pulmonary oedema from sea water

    Osmotic oedema from sea water also needs aspiration and time.

  • D. Hydrostatic compression of the lungs

    Hydrostatic compression of the lungs is not a mechanism of drowning death.

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 B, Reflex cardiac inhibition via the vagus on sudden cold immersion. Sudden immersion in cold water can stimulate receptors in the skin, pharynx and larynx, causing vagal cardiac inhibition and arrest, known as immersion syndrome or hydrocution.

Why is "Fresh water absorption causing haemodilution" not the answer?

Haemodilution develops over minutes of fresh water aspiration, not instantly.

Why is "Osmotic pulmonary oedema from sea water" not the answer?

Osmotic oedema from sea water also needs aspiration and time.

Why is "Hydrostatic compression of the lungs" not the answer?

Hydrostatic compression of the lungs is not a mechanism of drowning death.

What concept does this question test?

It tests Asphyxial deaths: immersion syndrome in Forensic Medicine. Alcohol and fear predispose, and little or no water is found in the lungs. Autopsy is often negative.

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 Asphyxial deaths: immersion syndrome?

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.