Thanatology: post-mortem redistribution of drugs: 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 redistribution of drugs

Sample item

At autopsy of a man who collapsed after a suspected drug overdose, the toxicologist asks which blood sample will give the most dependable drug concentration. Heart blood is known to differ from peripheral blood in such deaths. Which sample should be sent?

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

The answer and the reasoning

A. Femoral vein blood, taken after ligating the vessel at the groin

After death, drugs diffuse from solid organs such as the liver, lungs and myocardium into the neighbouring central blood, so heart blood can show falsely high levels. This is post-mortem redistribution. Peripheral blood from the femoral vein, away from these reservoirs, is least affected and is the preferred sample.

Option by option

  • A. Femoral vein blood, taken after ligating the vessel at the groin (correct)

    Correct. Peripheral femoral blood is least affected by redistribution from organs.

  • B. Blood pooled in the pericardial sac

    Pericardial fluid is contaminated by diffusion from the myocardium and lungs and is not a standard blood sample.

  • C. Blood scooped from the pleural cavity

    Pleural blood is mixed fluid from the chest and lies next to the lungs, so the concentration is unreliable.

  • D. Blood aspirated from the right atrium

    Central blood lies next to the organ reservoirs and is the sample most distorted by redistribution.

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 A, Femoral vein blood, taken after ligating the vessel at the groin. After death, drugs diffuse from solid organs such as the liver, lungs and myocardium into the neighbouring central blood, so heart blood can show falsely high levels.

Why is "Blood pooled in the pericardial sac" not the answer?

Pericardial fluid is contaminated by diffusion from the myocardium and lungs and is not a standard blood sample.

Why is "Blood scooped from the pleural cavity" not the answer?

Pleural blood is mixed fluid from the chest and lies next to the lungs, so the concentration is unreliable.

Why is "Blood aspirated from the right atrium" not the answer?

Central blood lies next to the organ reservoirs and is the sample most distorted by redistribution.

What concept does this question test?

It tests Thanatology: post-mortem redistribution of drugs in Forensic Medicine. This is post-mortem redistribution. Peripheral blood from the femoral vein, away from these reservoirs, is least affected and is the preferred sample.

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 Thanatology: post-mortem redistribution of drugs?

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.