American Board of Medicolegal Death Investigators (ABMDI) Practice Exam

Caustic agents, such as Drano, are indeed associated with tissue necrosis due to their destructive chemical properties. These substances are designed to break down clogs in drains and can cause severe damage upon contact with biological tissues. When these agents come into contact with skin or internal tissues, they can lead to chemical burns, inflammation, and ultimately cell death or necrosis because they disrupt the normal cellular structure and function.

Caustic agents can hydrolyze proteins, lipids, and carbohydrates within the cells, leading to cell lysis and an inflammatory response. This process can create a significant amount of damage in a very short period, which emphasizes their danger in both accidental and intentional exposures.

In contrast, the other choices do not commonly lead to direct tissue necrosis. Carbohydrates like fructose and glucose primarily serve as energy sources and are metabolized by the body rather than causing cellular damage. Saline and water usually do not cause necrosis; saline can even be used for irrigation and is safe at appropriate concentrations. Magnesium and calcium are essential minerals that play critical roles in numerous biological processes and are not known to cause tissue necrosis when present in physiological levels.