Injuries: ageing with haemosiderin: 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 · Injuries: ageing with haemosiderin

Sample item

A bruise on the thigh of a man who died of a head injury shows haemosiderin-laden macrophages on a Perls' Prussian blue stain. What does this finding suggest about that bruise?

AIt was inflicted after death as an artefactBIt was produced by pressure during resuscitation minutes before deathCIt was sustained at least a day or two before death, so survival after injuryDIt was inflicted within the hour before death

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

The answer and the reasoning

C. It was sustained at least a day or two before death, so survival after injury

Haemosiderin forms when macrophages break down extravasated red cells, which takes at least a day or two. Its presence in a bruise therefore indicates ante-mortem injury with survival for some time. A fresh bruise shows only extravasated red cells, with little or no cellular response.

Option by option

A. It was inflicted after death as an artefact
Post-mortem artefacts have no cellular response and no haemosiderin.
B. It was produced by pressure during resuscitation minutes before death
Resuscitation bruises minutes old lack the time needed for haemosiderin.
C. It was sustained at least a day or two before death, so survival after injury (correct)
Correct. Haemosiderin implies survival for at least a day or two after the injury.
D. It was inflicted within the hour before death
A bruise from the last hour would show only fresh extravasated blood without haemosiderin.

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.

Questions about this Forensic Medicine question

What is the answer to this Forensic Medicine question?

The best answer is C, It was sustained at least a day or two before death, so survival after injury. Haemosiderin forms when macrophages break down extravasated red cells, which takes at least a day or two.

Why is "It was inflicted after death as an artefact" not the answer?

Post-mortem artefacts have no cellular response and no haemosiderin.

Why is "It was produced by pressure during resuscitation minutes before death" not the answer?

Resuscitation bruises minutes old lack the time needed for haemosiderin.

Why is "It was inflicted within the hour before death" not the answer?

A bruise from the last hour would show only fresh extravasated blood without haemosiderin.

What concept does this question test?

It tests Injuries: ageing with haemosiderin in Forensic Medicine. Its presence in a bruise therefore indicates ante-mortem injury with survival for some time. A fresh bruise shows only extravasated red cells, with little or no cellular response.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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 Injuries: ageing with haemosiderin?

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.