Thanatology: sudden death in Marfan syndrome: 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: sudden death in Marfan syndrome

Sample item

A tall 24-year-old man with long limbs and arachnodactyly collapses with tearing chest pain and dies. Autopsy shows haemopericardium from an intimal tear in the ascending aorta. Which histological change underlies the lesion?

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

The answer and the reasoning

D. Cystic medial degeneration of the aortic wall

Marfan syndrome weakens the aortic media through cystic medial degeneration with loss of elastic fibres. This predisposes to dissection and rupture into the pericardium causing tamponade. Look for a young tall person with sudden chest pain.

Option by option

  • A. Atheromatous plaque rupture

    Atheroma is typical of older hypertensive patients and is not the lesion in a young man with a connective tissue disorder.

  • B. Giant cell infiltration of the media

    Giant cell arteritis affects older people and does not cause dissection of the ascending aorta here.

  • C. Obliterative endarteritis of the vasa vasorum from syphilis

    Syphilitic aortitis causes aneurysm in the tertiary stage and does not fit this patient.

  • D. Cystic medial degeneration of the aortic wall (correct)

    Correct. Cystic medial degeneration weakens the media and allows dissection in Marfan syndrome.

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 D, Cystic medial degeneration of the aortic wall. Marfan syndrome weakens the aortic media through cystic medial degeneration with loss of elastic fibres.

Why is "Atheromatous plaque rupture" not the answer?

Atheroma is typical of older hypertensive patients and is not the lesion in a young man with a connective tissue disorder.

Why is "Giant cell infiltration of the media" not the answer?

Giant cell arteritis affects older people and does not cause dissection of the ascending aorta here.

Why is "Obliterative endarteritis of the vasa vasorum from syphilis" not the answer?

Syphilitic aortitis causes aneurysm in the tertiary stage and does not fit this patient.

What concept does this question test?

It tests Thanatology: sudden death in Marfan syndrome in Forensic Medicine. This predisposes to dissection and rupture into the pericardium causing tamponade. Look for a young tall person with sudden chest pain.

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: sudden death in Marfan syndrome?

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.