Thanatology: post-mortem biochemistry in diabetic ketoacidosis: 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: post-mortem biochemistry in diabetic ketoacidosis

Sample item

A 24-year-old known type 1 diabetic is found dead at home. Autopsy shows no specific lesion. Post-mortem blood glucose is low-normal. Which specimen and test would best help to support death from diabetic ketoacidosis?

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

The answer and the reasoning

D. Vitreous humour glucose and beta-hydroxybutyrate estimation

Blood glucose is unreliable after death because glycolysis lowers it and agonal glycogenolysis can raise it. Vitreous humour is protected from bacterial and cellular activity, so raised vitreous glucose and ketones, especially beta-hydroxybutyrate (with urine ketones), are used to support ketoacidosis.

Option by option

  • A. Gastric contents glucose estimation

    Gastric contents reflect food intake and not metabolic state.

  • B. Cardiac blood glucose alone

    Blood glucose alone falls through post-mortem glycolysis and can look normal despite hyperglycaemia before death.

  • C. Liver histology for glycogen content

    Liver glycogen histology is non-specific and does not show ketoacidosis.

  • D. Vitreous humour glucose and beta-hydroxybutyrate estimation (correct)

    Correct. Vitreous glucose and beta-hydroxybutyrate are stable and diagnostic markers.

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, Vitreous humour glucose and beta-hydroxybutyrate estimation. Blood glucose is unreliable after death because glycolysis lowers it and agonal glycogenolysis can raise it.

Why is "Gastric contents glucose estimation" not the answer?

Gastric contents reflect food intake and not metabolic state.

Why is "Cardiac blood glucose alone" not the answer?

Blood glucose alone falls through post-mortem glycolysis and can look normal despite hyperglycaemia before death.

Why is "Liver histology for glycogen content" not the answer?

Liver glycogen histology is non-specific and does not show ketoacidosis.

What concept does this question test?

It tests Thanatology: post-mortem biochemistry in diabetic ketoacidosis in Forensic Medicine. Vitreous humour is protected from bacterial and cellular activity, so raised vitreous glucose and ketones, especially beta-hydroxybutyrate (with urine ketones), are used to support ketoacidosis.

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 Thanatology: post-mortem biochemistry in diabetic ketoacidosis?

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.