Burns:Cause of death & Important postmortem findings
All of the following are seen in antemortem burns, EXCEPT:
| A |
Vesicle |
|
| B |
Pus formation |
|
| C |
Inflammatory red line |
|
| D |
Blister with hypermedia base |
All of the following are seen in antemortem burns, EXCEPT:
| A |
Vesicle |
|
| B |
Pus formation |
|
| C |
Inflammatory red line |
|
| D |
Blister with hypermedia base |
|
Features |
Ante mortem burns |
Post mortem burns |
|
Line of redness |
Present around burnt area |
Absent |
|
Vesication |
Blister contain serous fluids with protein and chlorides |
Blister contain fluid and air, proteins and chlorides are not seen |
|
Reparative process |
Present |
Absent |
|
Blood |
May be cherry red due to carbon monoxide |
Not seen |
|
Soot particles in upper respiratory passages |
Present |
Absent |
|
Curling’s ulcer |
May be seen |
Absent |
|
Enzyme activity |
Present |
Absent |
A man found dead in suspicious situation. Injuries are seen all over the body. Antemortem injury is characterized by all, EXCEPT:
| A |
Wound gaping |
|
| B |
Arterial bleeding |
|
| C |
Vital reaction present |
|
| D |
Diminished enzyme activity |
A man found dead in suspicious situation. Injuries are seen all over the body. Antemortem injury is characterized by all, EXCEPT:
| A |
Wound gaping |
|
| B |
Arterial bleeding |
|
| C |
Vital reaction present |
|
| D |
Diminished enzyme activity |
Difference between ante-mortem and post-mortem wounds:
|
Trait |
Ante-mortem wounds |
Post-mortem wounds |
|
Edges |
The edges are swollen, everted, retracted, and wound gapes. |
Edges do not gape, but are closely approximated. |
|
Haemorrhage |
Abundant and usually arterial. |
Slight or more and venous |
|
Spurting |
Signs of spurting of arterial blood on the body, clothing or in its vicinity present. |
No spurting of the blood |
|
Extravasation |
Staining of the edges of the wound and extravasation in neighbouring subcutaneous and interstitial tissues which cannot be removed by washing. |
Edges and cellular tissues are not deeply stained. The stain can be removed by washing. |
|
Coagulation |
Firmly coagulated blood in wounds and tissues present. |
No clotting or soft clott |
|
Vital reaction |
Signs of vital reaction present. |
No signs of vital reaction |
|
Enzyme histochemistry |
Increased activity of esterases, adenosine triphosphate, aminopeptidases, acid and alkaline phosphatase |
Diminished or no enzyme activity
|
Early cause of death due to burns is :
| A |
Shock |
|
| B |
Infection |
|
| C |
Haemorrhage |
|
| D |
Diabetes |
Early cause of death due to burns is :
| A |
Shock |
|
| B |
Infection |
|
| C |
Haemorrhage |
|
| D |
Diabetes |
Pugilistic attitude in burns is seen in :
| A |
Antemortem burns |
|
| B |
Post mortem burns |
|
| C |
Homicidal burns |
|
| D |
Both antemortem burns and post mortem burns |
Pugilistic attitude in burns is seen in :
| A |
Antemortem burns |
|
| B |
Post mortem burns |
|
| C |
Homicidal burns |
|
| D |
Both antemortem burns and post mortem burns |
D i.e. Both antemortem burns and post mortem burns
– Vesicles in antemortem burn contain albuminous fluid & chloride; while vesicles in postmortem burn contain air.t2
– Heat stiffening or heat coagulation is found in bodies exposed to heat ie temperatures above 65°C (Reddy)/ 70°C (Parikh) as is seen in death due to burning, high voltage electrocution (electric shock), or falling into hot liquid.
– Heat coagulates the muscle proteins and cause stiffening and contraction to a greater degree than that seen in rigor mortis. The degree & depth of changes depends on intensity of heat and exposure time.
– Muscles are contracted, desiccated or even carbonized on surface. The body assumes pugilistic (=boxers) attitude with lower limbs and arms semiflexed and hands clenched.
– Normal rigor mortis does not develop in heat stiffeningQ and the stiffening persists until the coagulated albumin liquefies from decomposition.
Difference between antemortem burns & postmortem burns vesicles, favouring AM burn vesicles is/are :
| A |
Tissue beneath vesicle is dry, hard & yellow |
|
| B |
Protein & chlorides in vesicle are more |
|
| C |
Erythema is present |
|
| D |
Fluid in the vesicle is scanty |
Difference between antemortem burns & postmortem burns vesicles, favouring AM burn vesicles is/are :
| A |
Tissue beneath vesicle is dry, hard & yellow |
|
| B |
Protein & chlorides in vesicle are more |
|
| C |
Erythema is present |
|
| D |
Fluid in the vesicle is scanty |
B i.e. Protein and chloride in vesicles are
Difference between antemortem wounds and postmortem wounds, in favour of AM wounds is/are:
| A |
Are larger |
|
| B |
Increased gaping of wounds |
|
| C |
Increased enzyme activity |
|
| D |
b and c |
Difference between antemortem wounds and postmortem wounds, in favour of AM wounds is/are:
| A |
Are larger |
|
| B |
Increased gaping of wounds |
|
| C |
Increased enzyme activity |
|
| D |
b and c |
B i.e. Increased gaping of wounds; C i.e. Increased enzyme activity
Soft friable clot of chicken fat (yellow) or current jelly (red) appearanceQ is found in postmortem wounds. And in antemortem wounds clot is firm, rubbery & variegated in appearance.
Antemortem and postmortem wounds could be differentiated by all, except:
| A |
Everted margins |
|
| B |
Blood clots in surrounding tissue |
|
| C |
Swollen edges |
|
| D |
Sharp edges |
Antemortem and postmortem wounds could be differentiated by all, except:
| A |
Everted margins |
|
| B |
Blood clots in surrounding tissue |
|
| C |
Swollen edges |
|
| D |
Sharp edges |
D i.e. Sharp edges
Antemortem wound shows gaping, everted and swollen edges with vital reactions of inflammation, infection & healingQ. It bleeds freely and shows extensive, deep and firmly adherent clotting (staining) of surrounding tissue which can’t be washed awayQ.
Late deaths in burns is due to –
| A |
Sepsis |
|
| B |
Hypovolemia |
|
| C |
Contractures |
|
| D |
Neurogenic |
Late deaths in burns is due to –
| A |
Sepsis |
|
| B |
Hypovolemia |
|
| C |
Contractures |
|
| D |
Neurogenic |
Answer is ‘a’ i.e. Sepsis
- “Following successful resucitation, most acute morbidity and virtually all mortality in severely burned patients are related to infection.” – Schwartz
- This is because thermal injury causes profound immunosuppression that is proportional to the TBSA of the burn.
- Also know
- Inspite of the burn patient at significant risk to infection, prophylactic systemic antibiotics are not part of modern burn care, as they do not reduce septic complications and only lead to increased bacterial resistance.
Antemortem bruise is differentiated from postmortem bruise by:
AIIMS 09
| A |
Well-defined margin |
|
| B |
Capillary rupture with extravasation of blood |
|
| C |
Yellow color |
|
| D |
Gaping |
Antemortem bruise is differentiated from postmortem bruise by:
AIIMS 09
| A |
Well-defined margin |
|
| B |
Capillary rupture with extravasation of blood |
|
| C |
Yellow color |
|
| D |
Gaping |
Ans. Capillary rupture with extravasation of blood
All are true about antemortem contusion except‑
| A |
Sequential color change |
|
| B |
No inflammation |
|
| C |
Raized enzyme levels |
|
| D |
Blood cells in surrounding tissueAccidendal |
All are true about antemortem contusion except‑
| A |
Sequential color change |
|
| B |
No inflammation |
|
| C |
Raized enzyme levels |
|
| D |
Blood cells in surrounding tissueAccidendal |
Ans. is ‘b’ i.e., No inflammation
