Asphyxial deaths: seawater versus freshwater drowning: 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 · Asphyxial deaths: seawater versus freshwater drowning

Sample item

Compared with drowning in freshwater, which change in the blood is expected after inhalation of a large volume of seawater?

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

The answer and the reasoning

D. Haemoconcentration with raised sodium and chloride

Seawater is hypertonic, so it draws fluid from the circulation into the alveoli. This leads to pulmonary oedema, haemoconcentration and raised serum sodium, chloride and magnesium. Freshwater is absorbed into the blood and causes haemodilution, haemolysis and hyperkalaemia.

Option by option

  • A. Massive haemolysis with high plasma potassium

    Haemolysis with hyperkalaemia is the freshwater picture.

  • B. Ventricular fibrillation from hyperkalaemia

    Fibrillation from hyperkalaemia is also a freshwater feature.

  • C. Haemodilution with low plasma sodium

    Haemodilution and hyponatraemia belong to freshwater drowning.

  • D. Haemoconcentration with raised sodium and chloride (correct)

    Correct. Hypertonic seawater withdraws plasma water and concentrates the blood.

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 D, Haemoconcentration with raised sodium and chloride. Seawater is hypertonic, so it draws fluid from the circulation into the alveoli.

Why is "Massive haemolysis with high plasma potassium" not the answer?

Haemolysis with hyperkalaemia is the freshwater picture.

Why is "Ventricular fibrillation from hyperkalaemia" not the answer?

Fibrillation from hyperkalaemia is also a freshwater feature.

Why is "Haemodilution with low plasma sodium" not the answer?

Haemodilution and hyponatraemia belong to freshwater drowning.

What concept does this question test?

It tests Asphyxial deaths: seawater versus freshwater drowning in Forensic Medicine. This leads to pulmonary oedema, haemoconcentration and raised serum sodium, chloride and magnesium. Freshwater is absorbed into the blood and causes haemodilution, haemolysis and hyperkalaemia.

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 Asphyxial deaths: seawater versus freshwater drowning?

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.