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Forensic Medicine · Thanatology: sudden death with a negative gross autopsy
Sample itemA 25-year-old man dies suddenly at rest. The heart, brain and lungs look normal on gross examination. What should the pathologist do before giving the cause of death?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
C. Retain tissues and body fluids for histology and toxicology
When the gross autopsy is negative, a cause often emerges from histology, toxicology, microbiology or genetic study of preserved tissue, blood and viscera. A cause of death is not certified until these are available, because a cardiac or other natural cause may be wrongly assumed.
Option by option
A. Repeat the gross dissection of the heart alone
Repeating the same gross dissection will not reveal microscopic or chemical causes.
B. Close the case as natural death by exclusion
Natural death by exclusion cannot be accepted without toxicology and histology.
C. Retain tissues and body fluids for histology and toxicology (correct)
Correct. Further laboratory study is needed before a cause is stated.
D. Certify the death as due to heart failure
Heart failure is a mode of dying and not a cause without evidence.
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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