MCQ-Autopsy

FRCPath Part1 Course

The Autopsy MCQ 1 Who is going to fund Medical Examiners? a. b. c. d. e.

Home Office NHS England Primary Care Trusts Charitable Groups Local Authorities

MCQ 2 Which of the following IS correct? a. Any qualified doctor may issue a death certificate so long as they see the deceased after death. b. The consultant may request a hospital post mortem before issuing a certificate of cause of death. c. The Registrar may report deaths to the Coroner if the certified cause of death appears incorrect. d. The Coroner must order a post-mortem examination on any death due to accident. e. In UK, approximately 15% of deaths are reported to the Coroner MCQ 3 Which one of these deaths would NOT need to be reported to a Manchester area Coroner? a. Woman from Scotland who dies in a motor vehicle collision in Manchester b. Manchester resident who dies in a climbing accident on holiday in Wales c. Man from Liverpool who dies from drowning in France and body is returned via Manchester airport d. Child from Leeds who dies suddenly whilst staying with relatives in Manchester e. Chinese visitor who unexpectedly collapses and dies on arrival in Manchester airport MCQ 4 Which of these deaths would NOT need to be reported to the Coroner? a. An ex-dockyard worker who dies due to known fibrotic interstitial lung disease. b. Woman dies due to metastatic breast cancer. Seen regularly by her GP until last week but GP now away on holiday for 2 weeks. c. 45 year old, who is taken to hospital after binge drinking, died shortly after admission with a very high blood ethanol level. d. 45 year old with hepatic cirrhosis due to excessive alcohol use who dies of liver failure in hospital. e. Young woman who has taken 30g of paracetamol & dies of liver failure in hospital

FRCPath Part1 Course

MCQ 5 You wish to use mesothelioma samples taken from Coronial PMs in your hospital since 2010, for an approved cancer research project. Whose consent is required for use of each tissue sample? a. b. c. d. e.

The HTA designated individual for the Trust The pathologist who reported the case H M Coroner No consent required The nominated representative or highest ranked relative of the deceased person

MCQ 6 Which ONE of the following is NOT potentially a criminal offence under the HT Act 2004? a. Performing DNA analysis on a hospital post-mortem sample without specific consent. b. Using photographs from a post-mortem for a teaching course, without consent. c. Using a retained heart for research following Coroners PM, without relatives’ consent. d. Retaining only a sample of hair from the deceased, without consent. e. Using stored PM histology slides for a demonstration to public at a hospital open day MCQ 7 You have performed a Coroner’s autopsy on a case of death due to an industrial injury. To which ONE of the following legitimately interested parties must you give a copy of your PM report at their request? a. b. c. d. e.

The next of kin of the deceased The Solicitor of the next of kin of deceased Health & Safety Executive officers investigating the case The senior police officer investigating the case The Coroner responsible for the case

MCQ 8 Which of the following tests is most likely to be useful in investigating the death of a poorlycontrolled insulin-dependent diabetic man who was discovered dead at home, with no cause found grossly at autopsy? a. b. c. d. e.

Blood for glucose level Blood for insulin level Vitreous for ketones and glucose level Blood cultures Vitreous for insulin levels

FRCPath Part1 Course

MCQ 9 A 22 year old female student collapses outside a bar late at night and cannot be resuscitated. Which ONE of the following PM toxicology results most likely indicates her cause of death? a. b. c. d.

Blood ethanol level 450 mg% (NB legal limit for driving is 80 mg %) Cannabinoids present at high levels in blood and urine Hair samples show chronic use of ecstasy, amphetamines, cannabis and sertraline Codeine, morphine and morphine metabolites all present (at low levels) in blood and urine e. Lack of anticonvulsant medication in blood or urine MCQ 10 Which of the following features is NOT associated with sudden arrhythmogenic death syndrome (SADS)? a. b. c. d. e.

Young age and previously fit and well Heart appears structurally normal at autopsy Death occurring during physical exertion Inherited genetic mutation found on family screening Histology of the myocardium shows myocyte disarray

MCQ 11 An 18 year old male with a past history of epilepsy is found dead at home with evidence of urinary incontinence. No macroscopic abnormalities are seen at PM examination. You retain the brain.

What are the most likely histological findings? a. b. c. d. e.

Amyloid plaques Intranuclear inclusions within neurons A histologically normal brain Patchy demyelination Diffuse spongiosis of the grey and white matter

MCQ 12 A 14 year old girl collapses and dies at a party after eating birthday cake. At post-mortem there is laryngeal edema. What is the most useful sample to retain to confirm the cause of death? a. b. c. d. e.

Peripheral blood for mast cell tryptase Histology of the larynx Urine for drug screen Peripheral blood for ketones Stool sample for culture

FRCPath Part1 Course

MCQ 13 A 40 year old woman develops shortness of breath, collapses and dies following a complicated full-term delivery. Histology of the pulmonary vessels demonstrates intravascular squames and mucin.

What is the most likely cause of death? a. b. c. d. e.

Pulmonary thromboembolism Squamous cell carcinoma Amniotic fluid embolism Eclampsia DIC

MCQ 14 A 68 year old, non-smoking dock worker dies following 6/12 history of increasing SOB and chest pain. PM examination finds an extensive tumour encasing the right lung. What is the most likely cause of death? a. b. c. d. e.

Squamous cell carcinoma of the lung Metastatic colorectal carcinoma Mesothelioma Pulmonary fibrosis Small cell lung carcinoma

SUGGESTED READING LIST Robbins Pathologic Basis of Disease Knight’s Forensic Pathology Simpson’s Forensic Pathology The Hospital Autopsy – GN Rutty, J Burton Gross pathology atlases