Thanatology: death in status asthmaticus: 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: death in status asthmaticus

Sample item

A young asthmatic dies during an acute attack. The lungs are voluminous and do not collapse, and the bronchi contain tenacious mucus plugs. Which microscopic finding is expected?

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

The answer and the reasoning

C. Eosinophils with Curschmann spirals and Charcot-Leyden crystals in the plugs

Fatal asthma shows hyperinflation, mucus plugging and an eosinophil-rich infiltrate with Curschmann spirals and Charcot-Leyden crystals, with thickened basement membrane and hypertrophied bronchial muscle. The other findings point to diffuse alveolar damage, bacterial pneumonia and organising pneumonia.

Option by option

  • A. Neutrophilic consolidation of alveoli

    Neutrophilic alveolar consolidation is the picture of lobar bacterial pneumonia.

  • B. Intra-alveolar fibroblast plugs of organising pneumonia

    Fibroblast plugs in alveolar ducts occur in organising pneumonia and not in an acute asthma death.

  • C. Eosinophils with Curschmann spirals and Charcot-Leyden crystals in the plugs (correct)

    Correct. Eosinophils, Curschmann spirals and Charcot-Leyden crystals characterise fatal asthma.

  • D. Hyaline membranes lining the alveoli

    Hyaline membranes are seen in diffuse alveolar damage and ARDS.

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 C, Eosinophils with Curschmann spirals and Charcot-Leyden crystals in the plugs. Fatal asthma shows hyperinflation, mucus plugging and an eosinophil-rich infiltrate with Curschmann spirals and Charcot-Leyden crystals, with thickened basement membrane and hypertrophied bronchial muscle.

Why is "Neutrophilic consolidation of alveoli" not the answer?

Neutrophilic alveolar consolidation is the picture of lobar bacterial pneumonia.

Why is "Intra-alveolar fibroblast plugs of organising pneumonia" not the answer?

Fibroblast plugs in alveolar ducts occur in organising pneumonia and not in an acute asthma death.

Why is "Hyaline membranes lining the alveoli" not the answer?

Hyaline membranes are seen in diffuse alveolar damage and ARDS.

What concept does this question test?

It tests Thanatology: death in status asthmaticus in Forensic Medicine. The other findings point to diffuse alveolar damage, bacterial pneumonia and organising pneumonia.

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: death in status asthmaticus?

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.