Asphyxia: positional restraint: 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.

Try it

Forensic Medicine · Asphyxia: positional restraint

Sample item

An obese intoxicated man is restrained prone by police with a knee over his back and becomes quiet in minutes. Autopsy shows congestion, petechiae and no significant injury. Which mechanism best accounts for the death?

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

The answer and the reasoning

A. Restriction of chest wall and diaphragm movement, causing positional (restraint) asphyxia

Prone restraint with weight on the back, especially in an obese or intoxicated person, limits chest expansion and diaphragmatic descent, causing hypoxia and hypercapnia. External injury may be minimal, and the diagnosis rests on the circumstances. Cardiac arrhythmia from stress and drugs often contributes.

Option by option

  • A. Restriction of chest wall and diaphragm movement, causing positional (restraint) asphyxia (correct)

    Correct. Restricted respiratory movement under a prone restraint causes asphyxia.

  • B. Cervical cord transection

    There is no evidence of spinal injury.

  • C. Tension pneumothorax from rib fractures

    No rib fractures are described to cause a pneumothorax.

  • D. Aspiration of water

    Aspiration of water is unrelated to this scenario.

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.

More Forensic Medicine questions

Questions about this Forensic Medicine question

What is the answer to this Forensic Medicine question?

The best answer is A, Restriction of chest wall and diaphragm movement, causing positional (restraint) asphyxia. Prone restraint with weight on the back, especially in an obese or intoxicated person, limits chest expansion and diaphragmatic descent, causing hypoxia and hypercapnia.

Why is "Cervical cord transection" not the answer?

There is no evidence of spinal injury.

Why is "Tension pneumothorax from rib fractures" not the answer?

No rib fractures are described to cause a pneumothorax.

Why is "Aspiration of water" not the answer?

Aspiration of water is unrelated to this scenario.

What concept does this question test?

It tests Asphyxia: positional restraint in Forensic Medicine. External injury may be minimal, and the diagnosis rests on the circumstances. Cardiac arrhythmia from stress and drugs often contributes.

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 Asphyxia: positional restraint?

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.