Thanatology: underlying cause of death on the certificate: 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: underlying cause of death on the certificate

Sample item

A 62-year-old man falls from a ladder, develops an acute subdural haematoma, undergoes craniotomy and dies on day 9 of bronchopneumonia. When filling Part I of the medical certificate of cause of death, which entry belongs on the lowest line as the underlying cause?

ABronchopneumoniaBCraniotomyCCardiorespiratory arrestDHead injury from the fall

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

The answer and the reasoning

D. Head injury from the fall

The underlying cause is the disease or injury that started the train of events leading directly to death. Here the fall and its head injury began the sequence through subdural haematoma to pneumonia. Terminal events and modes such as cardiac arrest are not entered as causes, and a treatment is not a cause.

Option by option

A. Bronchopneumonia
Bronchopneumonia is the immediate or terminal complication.
B. Craniotomy
A therapeutic procedure is not a cause of death in this sequence.
C. Cardiorespiratory arrest
Cardiorespiratory arrest is a mode of death and is not accepted as a cause.
D. Head injury from the fall (correct)
Correct. The injury that initiated the chain is the underlying cause.

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 D, Head injury from the fall. The underlying cause is the disease or injury that started the train of events leading directly to death.

Why is "Bronchopneumonia" not the answer?

Bronchopneumonia is the immediate or terminal complication.

Why is "Craniotomy" not the answer?

A therapeutic procedure is not a cause of death in this sequence.

Why is "Cardiorespiratory arrest" not the answer?

Cardiorespiratory arrest is a mode of death and is not accepted as a cause.

What concept does this question test?

It tests Thanatology: underlying cause of death on the certificate in Forensic Medicine. Here the fall and its head injury began the sequence through subdural haematoma to pneumonia. Terminal events and modes such as cardiac arrest are not entered as causes, and a treatment is not a cause.

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: underlying cause of death on the certificate?

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.