ABT Forensic Toxicology 2 — Questions and Answers
Question 1: Which drug is associated with 'excited delirium syndrome' and sudden death in forensic cases, often involving restraint?
- Cannabis
- Cocaine or methamphetamine (Correct answer)
- Benzodiazepines
- GHB
Correct answer: Cocaine or methamphetamine
Excited delirium syndrome is frequently associated with stimulant drugs (cocaine, methamphetamine) and is characterized by hyperthermia, agitation, superhuman strength, and sudden death.
Question 2: GHB (gamma-hydroxybutyrate) is particularly challenging in forensic toxicology because:
- It produces distinctive colored urine that fades quickly
- It is an endogenous compound with a short detection window (4–8 hours in urine) (Correct answer)
- It can only be detected in hair specimens
- It is not detectable by GC-MS
Correct answer: It is an endogenous compound with a short detection window (4–8 hours in urine)
GHB is an endogenous brain metabolite with a short half-life (~30 minutes) and narrow detection window (4–8 hours in urine), making it difficult to detect in drug-facilitated sexual assault cases.
Question 3: The Widmark formula is used in forensic alcohol investigations to calculate:
- Time of last drink based on liver enzyme levels
- Retrograde extrapolation of blood alcohol concentration (Correct answer)
- Correlation between breath and blood alcohol levels
- Ethanol elimination rate in postmortem specimens
Correct answer: Retrograde extrapolation of blood alcohol concentration
The Widmark formula uses known elimination rate (β), body weight, and time to retrograde extrapolate what a person's BAC would have been at an earlier time point.
Question 4: Which specimen is most useful for detecting drug exposure in neonates born to substance-using mothers?
- Cord blood
- Neonatal urine
- Meconium (Correct answer)
- Neonatal hair
Correct answer: Meconium
Meconium (first stool) accumulates drug metabolites from fetal swallowing of amniotic fluid throughout the second and third trimesters, providing a longer window of detection than urine.
Question 5: In workplace drug testing regulated by SAMHSA/DOT, which five drug classes must be tested in the federal 5-panel screen?
- Amphetamines, cocaine, opioids, PCP, marijuana (THC) (Correct answer)
- Amphetamines, cocaine, benzodiazepines, alcohol, heroin
- Opioids, marijuana, barbiturates, cocaine, PCP
- THC, opioids, benzodiazepines, alcohol, amphetamines
Correct answer: Amphetamines, cocaine, opioids, PCP, marijuana (THC)
The federally mandated 5-panel workplace drug test screens for amphetamines, cocaine metabolites, opioids/opiates, phencyclidine (PCP), and marijuana metabolites (THC-COOH).
Question 6: Which biotransformation product of heroin is measured in forensic urine testing to confirm heroin use specifically (vs. prescription opioids)?
- Morphine-3-glucuronide
- 6-monoacetylmorphine (6-MAM) (Correct answer)
- Codeine
- Hydromorphone
Correct answer: 6-monoacetylmorphine (6-MAM)
6-Monoacetylmorphine (6-MAM) is a unique heroin metabolite not produced from any other opioid, and its presence in urine or blood confirms heroin use within 2–8 hours of ingestion.
ABT Forensic Toxicology 2
Which drug is associated with 'excited delirium syndrome' and sudden death in forensic cases, often involving restraint?