Asphyxial deaths: selective neuronal vulnerability: 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: selective neuronal vulnerability

Sample item

In a patient who survives cardiac arrest but dies after a week in coma, which neurons show the earliest and most selective damage to global hypoxia?

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

The answer and the reasoning

D. CA1 pyramidal neurons of the hippocampus and Purkinje cells of the cerebellum

Hippocampal CA1 pyramidal cells, cerebellar Purkinje cells and neocortical layers 3, 5 and 6 are the most vulnerable to hypoxia. This selective vulnerability underlies the pattern of ischaemic brain damage seen after arrest. Other neuron groups are relatively resistant.

Option by option

  • A. Oligodendrocytes of the corpus callosum

    Oligodendrocytes are not the earliest cells to die after a hypoxic arrest.

  • B. Neurons of the hypothalamic supraoptic nucleus

    The supraoptic nucleus is not preferentially injured by global hypoxia.

  • C. Motor neurons of the anterior horn

    Anterior horn motor neurons are relatively resistant to global hypoxia.

  • D. CA1 pyramidal neurons of the hippocampus and Purkinje cells of the cerebellum (correct)

    Correct. CA1 hippocampal and Purkinje neurons are the most sensitive to global hypoxia.

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, CA1 pyramidal neurons of the hippocampus and Purkinje cells of the cerebellum. Hippocampal CA1 pyramidal cells, cerebellar Purkinje cells and neocortical layers 3, 5 and 6 are the most vulnerable to hypoxia.

Why is "Oligodendrocytes of the corpus callosum" not the answer?

Oligodendrocytes are not the earliest cells to die after a hypoxic arrest.

Why is "Neurons of the hypothalamic supraoptic nucleus" not the answer?

The supraoptic nucleus is not preferentially injured by global hypoxia.

Why is "Motor neurons of the anterior horn" not the answer?

Anterior horn motor neurons are relatively resistant to global hypoxia.

What concept does this question test?

It tests Asphyxial deaths: selective neuronal vulnerability in Forensic Medicine. This selective vulnerability underlies the pattern of ischaemic brain damage seen after arrest. Other neuron groups are relatively resistant.

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: selective neuronal vulnerability?

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.