Your FREE ABMDI Flashcards 2026 – 100+ Cards

The medicolegal category of circumstances: Natural, Accident, Suicide, Homicide, or Undetermined (NASH + Undetermined).

The specific disease or injury that started the lethal chain of events (e.g., a gunshot wound, a heart attack, blunt-force trauma).

The physiological derangement the cause produced that actually ends life (e.g., exsanguination, an arrhythmia, asphyxia).

Lividity — the gravity-driven settling of blood into the dependent (lowest) areas after death, producing reddish-purple staining.

The stiffening of the body's muscles after death from biochemical changes; begins in the small muscles (jaw, face).

The cooling of the body toward ambient temperature after death; rate depends on environment, clothing, and body size.

The four named manners of death: Natural, Accident, Suicide, Homicide (plus a fifth, Undetermined).

Death resulting solely from disease or the aging process, with no injury or external cause.

Death from an unintentional injury, with no intent to harm self or others.

Death from an intentional, self-inflicted act.

Death caused by the intentional act of another person.

Used when the available evidence does not adequately support any single manner of death.

The estimated time elapsed since death, gauged by combining postmortem changes, decomposition, insect activity, and scene clues.

Livor mortis that no longer blanches (pale) when pressed; it becomes fixed several hours after death.

Lividity that pales under finger pressure and then returns — indicating an earlier, not-yet-fixed postmortem interval.

When the livor pattern does not match how the body was found (e.g., fixed on the front of a face-up body) — suggests the body was moved.

Rigor first becomes noticeable in the small muscles, such as those of the face and jaw.

Under average conditions, rigor is typically fully developed about 12 hours after death, then gradually passes off over the next day.

Once rigor in an area is broken by force, it generally will not re-form.

The early breakdown of the body often begins with greenish discoloration of the abdomen.

The scene and body are photographed, noted, and sketched in place before anything is moved, because position is evidence.

The same cause (e.g., a drug overdose) can be accident, suicide, homicide, or undetermined depending on the circumstances.

Manner is an opinion based on the totality of the investigation — scene findings often drive it more than the autopsy alone.

To respond on behalf of the ME/coroner to document the scene and body, gather history, and help determine cause and manner.

The chronological documentation of everyone who handled, transferred, and stored an item of evidence.

It establishes that the evidence in court is the same item collected and was not altered or substituted.

An unexplained period when an item's whereabouts/security are unaccounted for — it can undermine admissibility.

Each change of possession records the date, time, and identities of the person releasing and the person receiving the item.

Each item is marked with a unique identifier, the collector's initials, and the date and location of collection.

A container sealed with tamper-evident tape and initials across the seal, so any later opening is visible.

In a medicolegal case the decedent's body itself is treated as evidence subject to chain-of-custody documentation.

Designating one person to control evidence collection and transfers at a complex scene prevents confusion and gaps.

A demonstrated undocumented gap can lead to the evidence being challenged or excluded in court.

Evidence is kept in a controlled, access-limited location with no unaccounted-for gaps in time.

Proper collection and preservation protect the integrity of items so they remain legally defensible.

Handing an item to a colleague without recording the transfer creates a gap that can be challenged in court.

An appointed official who is a licensed physician, usually a forensic pathologist, who can perform or oversee autopsies.

Most often an elected lay official whose qualifications vary by jurisdiction; in some states a JP or sheriff serves.

Medical examiner = appointed physician; coroner = most often elected lay official. Both determine cause and manner.

The legal authority of the ME/coroner over a death, created and bounded by state statutes and local ordinances.

A death statute requires be reported — classically sudden, violent, suspicious, or unattended, or due to injury/trauma.

A death resulting from injury (e.g., a fall) is reportable regardless of how much later or where the person dies.

An expected natural death a treating physician can certify (e.g., documented terminal illness in hospice).

Law enforcement generally secures and controls the overall scene and surrounding area.

The medical examiner or coroner holds primary jurisdiction over the decedent's body once a scene is established.

The body should not be moved or released until documented and the ME/coroner authorizes its handling.

State statutes and local ordinances defining reportable and investigable deaths — not family wishes or physician preference.

Once cause and manner are determined, the death certificate is filed with the appropriate vital-records authority.

The closest living blood or legal relative recognized by law to act on the decedent's behalf.

The surviving legal spouse is ordinarily ranked first in the statutory next-of-kin order when present.

Typically: spouse, then adult children, then parents, then siblings, then more distant relatives — set by statute.

A finalized divorce ordinarily removes a former spouse from spousal next-of-kin standing.

A legally recognized registered domestic partner can hold a spousal-equivalent position, ahead of siblings.

Relatives of the same kinship tier generally share equal legal standing; document disputes and follow office/legal guidance.

Confirming the decedent's identity is a prerequisite to identifying the correct next of kin.

Use personal effects, mail, neighbors, and database checks to identify and trace possible relatives before concluding none exist.

Verify each claim through marriage and divorce records to determine the legally valid spouse.

When the only relative is legally incompetent, the court-appointed guardian acts in the next-of-kin role.

Informing the next of kin — delivered timely, accurately, and with sensitivity.

Written reports must be clear, factual, and free of unverified conclusions, since they become part of the legal record.

Lifestyle and circumstances the family can describe: recent alcohol/tobacco/drug use, living arrangements, and occupation.

Chronic conditions, recent symptoms, medications and prescribers, and the providers the decedent saw.

Neutral, open questions gather the most accurate history; leading or dismissive questions distort the account.

Family statements are documented as reported history that may be corroborated by medical records — not as findings.

Names and prescribing details reveal known conditions and guide toxicology and records review.

A recently seen specialist (e.g., a cardiologist) is noted so relevant medical records can be requested.

Asking when the decedent was last in their usual state of health establishes a baseline and timeframe for any decline.

The investigator does not confirm or assign a cause of death to the family — it is determined later through the investigation.

Even a vague reported symptom is documented because it points toward records and pathology that may explain the death.

Ask about the pharmacy used, conditions treated, or whether bottles or a medication list are available.

Relying too heavily on the first piece of information received and failing to adjust as new evidence emerges.

Treat a dispatcher's or officer's early label (e.g., 'obviously a suicide') as an unconfirmed lead to test against the findings.

Deliberately challenging your own preliminary impression surfaces overlooked evidence and reduces premature closure.

Evaluate a new case on its own evidence rather than assuming it mirrors a prior or high-profile case.

Allowing a decedent's status to change how rigorously the evidence is weighed compromises objectivity.

Treat an evidence-free conviction as a hypothesis to test, not a conclusion to act on or record as a finding.

An independent check by a fresh, uninvested colleague can catch bias and errors in the original analysis.

Classifying a genuinely ambiguous death as undetermined reflects what the evidence can and cannot establish.

Case information is released only through proper channels; the investigator protects sensitive details.

Reports and testimony must be factual and legally defensible — any gap or assumption can be challenged in court.

The investigator works within defined authority — the ME/coroner controls the body and the cause/manner determination.

An odorless, colorless, tasteless gas produced by the incomplete combustion of carbon-containing fuel.

The compound formed when carbon monoxide binds hemoglobin; it gives skin and lividity a bright cherry-red color.

The distinctive bright-red discoloration that suggests carbon-monoxide poisoning (confirm with lab testing).

Inadequate oxygen delivery to the body's tissues — the mechanism by which carbon monoxide causes death.

Cold refrigerated storage can keep blood pink and mimic CO color, so quantitative carboxyhemoglobin testing is required.

Headache, dizziness, and confusion — the oxygen-starved brain reacting to reduced oxygen delivery.

Simultaneous deaths of multiple healthy occupants in one enclosed space strongly suggest a common toxic exposure.

The systematic examination of the body by a forensic pathologist to provide objective findings on the cause of death.

Two parts in sequence: the external examination (the body's surface) and then the internal examination (organs and cavities).

Laboratory analysis of body fluids and tissues to detect and quantify drugs, alcohol, and poisons.

Death or injury from inadequate oxygen reaching the tissues — a category that includes carbon-monoxide poisoning.

A lasting change in an investigator's beliefs, worldview, and sense of safety from engaging with others' trauma.

Emotional exhaustion tied specifically to the cost of caring for and being exposed to others' suffering.

The fulfillment and sense of reward derived from helping families and contributing to answers — buffers compassion fatigue.

Gradual exhaustion built up from chronic workplace demands — distinct from the trauma-driven compassion fatigue.

Treating decedents as objects and families with detached cynicism — a hallmark of advanced strain, not health.

Stress symptoms from indirect exposure to others' trauma; individual responses vary by history, support, and coping.

A model where trained colleagues provide early, relatable emotional support and connect others with further help.

A structured, short-term, confidential group support process for early intervention after a distressing event.

What is shared in a debriefing is kept confidential, creating a safe space for honest expression.

A debriefing is short-term early intervention — not a substitute for professional clinical treatment when needed.

Recognizing compassion fatigue is an ongoing professional skill, not a sign of personal weakness.