Thanatology: molecular autopsy: 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: molecular autopsy

Sample item

A 16-year-old girl collapses and dies at the edge of a swimming pool. A sister had earlier fainted during exercise. Autopsy shows a structurally normal heart, no water in the lungs and a negative toxicology screen. What is the most useful next step to find the cause?

AGenetic testing for inherited cardiac channelopathies on stored blood or tissueBBacterial culture of heart bloodCNeuropathological examination of the spinal cordDRepeating the toxicology screen with a second immunoassay

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

The answer and the reasoning

A. Genetic testing for inherited cardiac channelopathies on stored blood or tissue

When a young person dies suddenly with a normal heart and negative toxicology, an inherited arrhythmia syndrome such as long QT syndrome is a leading cause. A molecular autopsy, with genetic testing on preserved blood or tissue, can identify it and also allows screening of surviving relatives. The faint of a sibling during exercise supports this.

Option by option

A. Genetic testing for inherited cardiac channelopathies on stored blood or tissue (correct)
Correct. Molecular testing for channelopathies can reveal the cause and protect relatives.
B. Bacterial culture of heart blood
Culture of heart blood looks for sepsis, which does not fit the collapse during exercise.
C. Neuropathological examination of the spinal cord
The spinal cord is not the likely site of pathology in a sudden arrhythmic death.
D. Repeating the toxicology screen with a second immunoassay
A repeat immunoassay adds little when the screen is already negative and the history points to arrhythmia.

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 A, Genetic testing for inherited cardiac channelopathies on stored blood or tissue. When a young person dies suddenly with a normal heart and negative toxicology, an inherited arrhythmia syndrome such as long QT syndrome is a leading cause.

Why is "Bacterial culture of heart blood" not the answer?

Culture of heart blood looks for sepsis, which does not fit the collapse during exercise.

Why is "Neuropathological examination of the spinal cord" not the answer?

The spinal cord is not the likely site of pathology in a sudden arrhythmic death.

Why is "Repeating the toxicology screen with a second immunoassay" not the answer?

A repeat immunoassay adds little when the screen is already negative and the history points to arrhythmia.

What concept does this question test?

It tests Thanatology: molecular autopsy in Forensic Medicine. A molecular autopsy, with genetic testing on preserved blood or tissue, can identify it and also allows screening of surviving relatives. The faint of a sibling during exercise supports this.

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: molecular autopsy?

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.