Thanatology: commotio cordis: 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: commotio cordis

Sample item

A 15-year-old boy is hit on the chest by a hard cricket ball and collapses within seconds. Resuscitation fails. At autopsy there is no bruise of the chest wall, no rib fracture, and the heart and coronary arteries are structurally normal. What is the most likely cause of death?

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

The answer and the reasoning

B. Ventricular fibrillation triggered by the blow itself

Commotio cordis is sudden cardiac arrest after a non-penetrating blow to the precordium, thought to strike during the repolarisation phase and cause ventricular fibrillation. Because there is no structural injury, the autopsy is negative. It is typically seen in young people playing sports with a hard projectile.

Option by option

  • A. Tension pneumothorax from a ruptured lung

    Tension pneumothorax needs a lung injury, which is not present.

  • B. Ventricular fibrillation triggered by the blow itself (correct)

    Correct. The blow at a vulnerable moment triggers fibrillation without structural damage.

  • C. Rupture of the heart with haemopericardium

    Cardiac rupture leaves haemopericardium that would be seen at autopsy.

  • D. Laceration of the left anterior descending artery

    Coronary laceration would be visible and is not found here.

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 B, Ventricular fibrillation triggered by the blow itself. Commotio cordis is sudden cardiac arrest after a non-penetrating blow to the precordium, thought to strike during the repolarisation phase and cause ventricular fibrillation.

Why is "Tension pneumothorax from a ruptured lung" not the answer?

Tension pneumothorax needs a lung injury, which is not present.

Why is "Rupture of the heart with haemopericardium" not the answer?

Cardiac rupture leaves haemopericardium that would be seen at autopsy.

Why is "Laceration of the left anterior descending artery" not the answer?

Coronary laceration would be visible and is not found here.

What concept does this question test?

It tests Thanatology: commotio cordis in Forensic Medicine. Because there is no structural injury, the autopsy is negative. It is typically seen in young people playing sports with a hard projectile.

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: commotio cordis?

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.