Simplified Approach to Post Mortem Findings in Toxicology –With Mnemonics

Toxicology is one of the less discussed and underrated topics in Forensic Medicine during entire 3rd year. Due to hectic postings and classes in Major subjects, most of the medical students often miss studying this topic until the board exam approaches the door. From exam point of view, Toxicology is really important subject as it carries significant amount of marks. Since it contains wide range of topics, it is impossible to finish studying everything during exam preparation hours.

The list and tables given below will save much of your time spent in memorization during the final exam so that you will be able to spend remaining time in other untouched topics. This approach is framed in systemic way so that it will be easier to remember.

 

Cardiovascular System and Associated Poisonings

Mnemonic- CDE

Post Mortem Changes (CDE)	Associated Poisoning
C –Cardiac Hypertrophy	Lead
D-Dilated Cardiomyopathy	Chronic  Alcohol
E-subEndocardial Hemorrhage	Arsenic Barbiturate

 

Respiratory System and Associated Poisoning

There are 2 important findings and associated poisoning in the Respiratory Tract. Remember those using the Following Visual Mnemonic Aid.

 

Brain and Associated Poisoning

Post Mortem Findings	Associated Poisoning
Brain is edematous and congested	Mnemonic- POEM P-Phenol O-Opium E-Ethanol M-Mushroom
Cerebellar Hemorrhage and Necrosis	Mnemonic-ABC A-Arsenic B-Barbiturate C-Carbon Monoxide

 

 

Post Mortem Findings in Kidney

Post Mortem Findings	Associated Poisoning
Parenchymatous  Degenerative Changes	Mnemonic-MBA M-Mercury B-Barbiturate A-Alcohol
PCT(Proximal Convoluted Tubule)   Necrosis	Mnemonic-2P (P=Pct) P-Phenol P-Plumbum (Latin name for Lead)
Hemorrhagic Nephritis	Phenol

 

The Gastrointestinal Tract

Post Mortem Findings	Associated Poisoning
Esophagus-> Congestion, Corrosion and Inflammation	Mnemonic –MAP M-Mercury A-Acids & AlP4 P-Phenols
Stomach-> Hyperemia and congestion of mucous membranes	Mnemonic-BILES B-Barbiturate I-Irritants L-Lead E-Ethanol S-Strychnine
Stomach-> Color Stains	Adherent White- Arsenic Blackening/Charring of wall -HCl/H2SO4 Yellow Stain on wall-  HNO3 Slate Coloured Stain- Mercury
Stomach-> Presence of seeds/capsule/powder	Capsule/Powder-Barbiturate Seed remains- Strychinine, Datura

 

Liver, the organ of Chronic  Alcohol:

Important Post Mortem Findings include:

1. Congestion
2. Fatty Infiltration
3. Cirrhosis

 

Viscera and internal organs are congested???

There is an obvious temptation to write the above statement at the end at any poisoning question during exams but we need to careful as irrelevant statements might irritate some examiners.   The most important ones where it should not be missed can be remembered by mnemonic “SCABO”

S-Strychnine

C-Cocaine

A- Acute Alcohol, Aluminum Phosphide

B- Barbiturate

O-Opiate, Organophosphate

 

Author Bio-

 

Binay Kafle
Final MBBS Student
KIST Medical College

References:

-The Essentials of Forensic Medicine and Toxicology, K.S Reddy
-Death and Deduction: A Reasoned Approach to Forensic Pathology, AJ. Chapman