American Board of Medicolegal Death Investigators (ABMDI) Practice Exam

How is drowning most accurately diagnosed?

1. By water or fluid in the lungs only

2. Through a combination of autopsy findings and submersion history

3. Based on the absence of traumatic injury

4. By observing water in the stomach

The correct answer is: Through a combination of autopsy findings and submersion history

Drowning is most accurately diagnosed through a combination of autopsy findings and the submersion history. This multifaceted approach is crucial because drowning can sometimes resemble other forms of asphyxia or even cause injuries that might mislead a diagnosis if only one aspect is considered. Autopsy findings are vital in identifying the presence of water in the lungs, specific lung changes such as hyperinflation and edema, and other physiological responses consistent with drowning. However, these findings alone do not provide a complete picture. The history of submersion, including the circumstances leading to the incident, is equally important. Knowledge of how long the individual was submerged, the conditions of the water, and whether the person was conscious or unconscious during the drowning event plays a critical role in the determination of drowning as the cause of death. Relying solely on evidence such as the presence of water in the lungs or stomach does not capture the full clinical context necessary for a reliable diagnosis. Instead, integrating both the medical findings from the autopsy with the circumstantial details surrounding the drowning incident enhances diagnostic accuracy, making the combination of these elements the most precise method for diagnosing drowning.