A young man is rescued from a burning room with extensive full thickness burns. He collapses and dies within ten minutes of the incident, before any resuscitation reaches him. The most likely immediate mechanism of death is:

• A Hypovolaemic shock from plasma loss into the burn surface
• B Acute renal failure from myoglobinuria
• C Septicaemia from infection of the burnt surface
• D Neurogenic (primary) shock due to intense pain and fear ✓

Explanation

Death within minutes of extensive burns is due to primary (neurogenic) shock, triggered by severe pain and emotional stress acting on the vasomotor centre. Hypovolaemic shock from fluid exudation takes hours to develop and kills typically between 12 and 48 hours. Septicaemia is a late cause after several days, and acute renal failure from pigment nephropathy develops over days. Matching the time frame of death to the mechanism is the discriminating skill tested here.

Reference: The Essentials of Forensic Medicine and Toxicology, 35th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.