AMERICAN BOARD OF FORENSIC TOXICOLOGY
Study Guide for Examination Preparation
Examination Content
Sample Questions
References
December 2014
STUDY GUIDE FOR EXAMINATION PREPARATION
The ABFT examinations challenge examinees with the fundamental information used in the
practice of forensic toxicology. Examination questions cover the areas of postmortem
toxicology, human performance toxicology and workplace drug testing. Included in these areas
of toxicology are topics such as driving under the influence of alcohol and drugs, drug overdose
deaths, employee drug testing, athletic drug testing, urine and alternate matrices drug testing,
interpretation and expert opinion; and other related forensic toxicology issues. In addition,
related analytical, physiological, pathological, pharmacological, and laboratory practice and
management concepts are included.
Each examination consists of 130 single answer, multiple choice questions relating to basic,
general and specific information, and has a time limit of 3 hours. Each examination is listed
below along with the areas covered by that examination.
Subject areas for the General Toxicology Exams: FELLOW and DIPLOMATE
Laboratory Practice
Laboratory organization, policy and management; governmental and other regulations and
guidelines; laboratory accreditation; expert testimony, laboratory procedures and calculations;
statistics; quality control and quality assurance:
Management
o Responsibilities
o Legal interactions
Rules of Evidence (Frye, Daubert)
DUID laws
o Laboratory security
o Chain of custody
Quality Assurance and Quality Control
o Basic concepts
o Statistics
o Calculations
o Corrective action
o Documentation
o Method validation
o Control charts
Regulatory Oversight
o Standards and guidelines of practice
o Accreditation
ABFT
ISO 17025/15189
SAMHSA
o Privacy and Confidentiality
HIPAA
Expert Testimony
2
Analytical Procedures and Basic Analytical Chemistry
Basic principles and theory, separations, instrumentation, methodology, laboratory techniques,
standardization, interferences, and methods development and validation for specific analytes:
Spectrophotometry – Theory and Application
o Color reactions
o Microdiffusion
o UV/VIS
o IR/FTIR
o Fluorescence
Extraction – Theory and Application
o SPE/SSE
o Liquid/Liquid
o pH/pKa
Immunoassay – Theory and Application
o General
Homogeneous
Heterogeneous
o Cross-reactivity/Specificity
Chromatography – Theory and Application
o TLC
o GC
o LC
o Detectors (Non-MS)
Mass Spectrometry – Theory and Application
o Ionization techniques (EI, CI, ICP, Electrospray)
o Mass discrimination (Tandem MS, TOF, Quadrupole, Ion Trap)
o Interferences, suppression and enhancement
Other – Theory and Application
o Capillary electrophoresis
o AAS/OES
o Breath alcohol testing
Drugs, Xenobiotics, and Other Toxicants – Factual
Nomenclature, chemical structure, composition and classification of drugs and poisons; theory of
pharmacology; mechanism of drug action and disposition, absorption, distribution, metabolism,
and excretion; pharmacokinetics and effects of physiological variables (examples below are not
exhaustive):
Ethanol and Other Volatiles
o Metabolism
o Pharmacokinetics
Carboxyhemoglobin
o Methemoglobin
o Poisoning
o Fire deaths
3
Cyanide
o Poisoning
o Fire deaths
Commonly Encountered Drugs
o Opiates/Opioids
o Cannabinoids
o Stimulants
Cocaine
Amphetamines
o Hallucinogens
o Sedative/Hypnotics
Barbiturates
Benzodiazepines
o Antidepressants
o Antipsychotics
o Novel Psychoactive Substances
Designer stimulants
Synthetic cannabinoids
Others
Metals – Organic and Inorganic
o Arsenic, Lead, Mercury, Thallium, Cadmium
Environmental and Natural Toxicants
o Pesticides (insecticides, rodenticides, fungicides, herbicides, fumigants)
o Gases (cyanide, sulfide, etc.)
o Venoms and antivenins
Drugs, Xenobiotics and Other Toxicants – Interpretative
Interpretation of toxic/lethal concentrations of substances in body tissues and fluids; postmortem
changes; mechanisms of toxicity and antidote therapy; target organs, disposition of poisons, and
systemic effects; effects of underlying disease, drug interactions; interpretation of signs and
symptoms associated with poisoning:
Ethanol and Other Volatiles
o Pharmacological action and effects
o Disease state (ketone bodies)
Commonly Encountered Drugs
o Post-mortem redistribution
o In-vitro and in-vivo instability
o Therapeutic concentrations
o Pharmaco-/Toxicokinetic calculations on post-mortem blood
o Body burden
o Drug interactions
o Pharmaco-/Toxicogenetics
Metals
Clinical Toxicology
o Treatment of Common Poisoning
Anitdotes
4
o Therapeutic drug monitoring
o Drug intoxication
Pathology and Specimens
Pathological findings related to death in poisonings and drug overdose; appropriateness of
specimens:
Common Autopsy Findings
o Pulmonary edema
o Hepatic necrosis
o Cardiac pathology
o Postmortem chemistries
Specimens
o Blood, postmortem and antemortem
o Urine
o Bile
o Vitreous humor
o Tissues (liver, kidney, etc.)
o Hair and nails
o Gastric contents
o Decomposed specimens
Regulated Drug Testing
HHS Regulations
o Cut-offs
o Specimen validity testing
o Security
Interpretation/MRO
DUI/DUID Testing
History
Poisoners and pioneers
History of postmortem detection of poisons
History of separation and detection methods
History of instrumentation
Preparation for the Examination in Forensic Toxicology (Fellow and Diplomate) should involve
both review and updating of information in the areas cited above. Numerous books devoted to
toxicology are now available. In addition to those that cover methodology and general
laboratory practice, there are several that cover specialty areas. The most current information is
found in appropriate journals and at meetings and workshops. The general breakdown of
questions can be seen in Table 1.
5
Table 1: Percent Contribution of Subject Areas
Subject Area Laboratory Analytical Drugs, Drugs, Pathology Regulations History
Practice Procedures: Xenobiotics Xenobiotics and
Certificant Basic and Toxicants: and Toxicants: Specimens
Category Chemistry Facts Interpretation
F-ABFT 10% 30% 20% 25% 10% 3% 2%
D-ABFT-FT 10% 35% 25% 15% 10% 3% 2%
Legend: F-ABFT = Fellow; D-ABFT-FT = Forensic Toxicology Diplomate
Subject Areas for the Forensic Alcohol Exam: DIPLOMATE
Laboratory Practice
Laboratory organization, policy and management; governmental and other regulations and
guidelines; laboratory accreditation; expert testimony, laboratory procedures and calculations;
statistics; quality control and quality assurance as it pertains to alcohol; both breath and blood
testing.
Management
o Responsibilities
o Legal interactions
Rules of Evidence (Frye, Daubert)
DUID laws
Quality Assurance and Quality Control
o Basic concepts
o Statistics
o Measurement of uncertainty
o Calculations
Expert Testimony
Analytical Procedures and Basic Analytical Chemistry
Basic principles and theory, instrumentation, methodology, laboratory techniques,
standardization, interferences;
General chemistry of alcohols
Wet Bath Simulators – Theory and Application
o Partition ratio
o Temperature
Dry Gas – Theory and Application
o Barometric pressure
o Offset
Blood Alcohol
o Postmortem and antemortem
o Whole blood
o Serum
6
Chromatography / Headspace Autosamplers– Theory and Application
o Columns
o Gases
o Detectors
o Peak shape
Breath Alcohol and Breath Alcohol Instrumentation
o Theory
o Blood/Breath Ratio
o Detector types
o Electronics
Pharmacology and Pharmacokinetics of Ethanol – Factual and Interpretive
Pharmacology of alcohol
Pharmacokinetics of alcohol
Pharmacokinetic calculations
o Widmark
o Extrapolation
Related Drugs
General Interactions of Common Drugs with Ethanol
o Synergistic effects
o Additive effects
History
Pioneers in the field of alcohol
General perspective and understanding of the different types of instruments in breath
alcohol testing thru time
Preparation for the Examination in Forensic Alcohol Toxicology should involve both review and
updating of information in the areas cited above. Numerous books devoted to Forensic Alcohol
are now available. In addition to those that cover methodology and general laboratory practice,
there are several that cover specialty areas. The most current information is found in appropriate
journals and at meetings and workshops. The general breakdown of questions can be seen in
Table 2.
Table 2: Percent Contribution of Subject Areas
Subject Area Laboratory Analytical Pharmacology Pharmacology Ethanol and Regulations History
Practice Procedures: and Pharmaco- and Pharmaco- other Drugs
Basic kinetics of kinetics:
Certificant Chemistry Ethanol Interpretation
Category
D-ABFT-FA 10% 30% 25% 15% 10% 5% 5%
Legend: D-ABFT-FA = Forensic Alcohol Diplomate
7
Subject areas for the General Forensic Drug Toxicology Exam: DIPLOMATE
Laboratory Practice
Laboratory organization, policy and management; governmental and other regulations and
guidelines; laboratory accreditation; expert testimony, laboratory procedures and calculations;
statistics; quality control and quality assurance:
Management
o Responsibilities
o Legal interactions
Rules of Evidence (Frye, Daubert)
o Laboratory security
o Chain of custody
Quality Assurance and Quality Control
o Basic concepts
o Statistics
o Calculations
o Corrective action
o Documentation
o Method validation
Regulatory Oversight
o Accreditation
HHS/NLCP
CAP
State regulations
o Privacy and Confidentiality
HIPAA
Expert Testimony
Analytical Procedures and Basic Analytical Chemistry
Basic principles and theory, separations, instrumentation, methodology, laboratory techniques,
standardization, interferences, and methods development and validation for specific analytes:
Spectrophotometry – Theory and Application
o Color reactions
o UV/VIS
o IR/FTIR
o Fluorescence
Extraction – Theory and Application
o SPE/SSE
o Liquid/Liquid
o pH/pKa
Immunoassay – Theory and Application
o General
o Cross-reactivity/Specificity
Chromatography – Theory and Application
8
o TLC
o GC
o HPLC
o Detectors (Non-MS)
Mass Spectrometry – Theory and Application
o Ionization Techniques (EI, CI, ICP, Electrospray)
o Mass Discrimination (Tandem MS, TOF, Quadrupole, Ion Trap)
Drugs, Xenobiotics, and Other Toxicants – Factual
Nomenclature, chemical structure, composition and classification of drugs and poisons; theory of
pharmacology; mechanism of drug action and disposition, absorption, distribution, metabolism,
and excretion; pharmacokinetics and effects of physiological variables (examples below are not
exhaustive):
Commonly Encountered Drugs
o Opiates/Opioids
o Cannabinoids
o Stimulants
Cocaine
Amphetamines
o Hallucinogens
o Sedative/Hypnotics
Barbiturates
Benzodiazepines
o Antidepressants
o Antipsychotics
o Novel Psychoactive Substances
Designer stimulants
Synthetic cannabinoids
Others
Regulated Drug Testing
HHS Regulations
o Cut-Offs
o Specimen validity testing
o Security
o Sample handling
Interpretation/MRO
History
Poisoners and pioneers
History of separation and detection methods
History of workplace drug testing
9
Preparation for the Examination in Forensic Toxicology (Diplomate) should involve both review
and updating of information in the areas cited above. Numerous books devoted to toxicology are
now available. In addition to those that cover methodology and general laboratory practice, there
are several that cover specialty areas. The most current information is found in appropriate
journals and at meetings and workshops. The general breakdown of questions can be seen in
Table 3.
Table 3: Percent Contribution of Subject Areas
Subject Area Laboratory Analytical Drugs, Xenobiotics, Regulated History
Practice Procedures: and Other Toxicants Drug Testing
Basic – Factual and
Chemistry Interpretation
Certificant
Category
D-ABFT-FD 15% 33% 15% 35% 2%
Legend: D-ABFT-FD = Forensic Drug Testing Diplomate
10
Study Guide References All Examinations
These suggested references only represent a guide to information available to prepare for the
examinations. It is not intended to list the only references for study purposes. Some information
is common to several sources. An individual’s study should be conditioned by his or her own
experience and knowledge. Some examination questions are based on practical laboratory
experience rather than textbook information. The most recent edition of each reference listed is
recommended, which may be later than the edition cited.
Key References
Disposition of Toxic Drugs and Chemicals in Man, 10th Edition. R.C. Baselt. Biomedical
Publications, 2014.
Clarke's Analysis of Drugs and Poisons, 4th edition. A.C. Moffat, Pharmaceutical Press, 2011.
Garriott’s Medicolegal Aspects of Alcohol, 6th edition, Y.H. Caplan and B.A. Goldberger,
Lawyers & Judges Publishing, 2015.
Principles of Forensic Toxicology. 4th edition, B. Levine, AACC Press, 2013.
The Clinical Toxicology Laboratory, Contemporary Practice of Poisoning Evaluation, 2nd
edition, Edited by L.M. Shaw, T.C. Kwong, T.G. Rosano, P.J. Orsulak, B.A. Wolf and B.
Magnani, AACC Press, 2013.
Drug Abuse Handbook. 2nd edition, Steven B. Karch, CRC Press, 2006.
Other References
Casarett & Doull’s Toxicology: The Basic Science of Poisons, 8th edition. C.D. Klaassen.
McGraw-Hill, 2013.
Clinical Chemistry: Theory, Analysis, Correlation, 5th edition. L.A. Kaplan and A.J. Pesce.
Mosby, 2010.
Haddad and Winchester’s Clinical Management of Poisoning and Drug Overdose, 4th edition.
M.W. Shannon and S.W. Borron and M. Burns. W.B. Saunders Co., 2007.
Drug Effects on Psychomotor Performance. R.C. Baselt, Biomedical Publications, 2001.
Drug Facilitated Sexual Assault: A Forensic Handbook. M.A. LeBeau and A. Mozayani,
Elsevier, 2001.
Handbook of Drug Interactions: A Clinical and Forensic Guide. A. Mozayani and L. Raymon,
Humana Press, 2011.
11
Goodman and Gilman’s the Pharmacological Basis of Therapeutics, 12th edition. L. Brunton, B.
Chabner and B. Knollman. McGraw-Hill, 2010.
Handbook for Workplace Drug Testing. 2nd edition, J.D. Ropero-Miller and B.A. Goldberger.
AACC Press, 2008.
Handbook of Forensic Drug Analysis. F.P. Smith and J.A. Siegel, Academic Press, 2004.
Introduction to Forensic Toxicology. R.H. Cravey and R.C. Baselt. Biomedical Publications,
1981.
Karch's Pathology of Drug Abuse, 4th. edition, S. Karch, CRC Press, 2008.
Poison Detection Human Organs, 4th Edition. A. S. Curry, Charles Thomas Publisher, 1988.
Tietz Textbook of Clinical Chemistry and Molecular Diagnostics, 5th edition. C.A. Burtis, E.R.
Ashwood and D.E. Bruns, W.B. Saunders Co., 2013.
HHS Mandatory Guidelines for Federal Workplace Drug Testing Programs.
JOURNALS:
Forensic Toxicology
Journal of Analytical Toxicology
Journal of Forensic Sciences
Forensic Science International
12
Sample Questions
Multiple Choice. Choose the best answer:
Concerning Morphine
A. an active metabolite of hydromorphone
B. readily extracted from strong alkaline solution
* C. urinary metabolites include morphine-glucuronide
D. biotransformed to 6-acetylmorphine
E. readily extracted from strong acid solution
Oxazepam is a metabolite of which of the following?
* A. diazepam
B. alprazolam
C. lorazepam
D. flurazepam
E. flunitrazepam
In gas chromatography, which of the following has the longest retention time on a 50%
phenylmethyl or HP-17 liquid phase?
A. nicotine
B. meperidine
* C. strychnine
D. diazepam
E. phentermine
A specimen of known concentration used to verify a calibration is:
A. calibrator
* B. control
C. reference
D. standard
E. blank
A 200 pound man consumes 6x 12-ounce beers and 2x 1-ounce shots of whiskey (100 proof)
between 9:00 PM and 11:00 PM. A breath alcohol test performed at 1:00 AM would be expected
to give an alcohol concentration in the following range (g/210 L):
A. 0.04 to 0.06
B. 0.07 to 0.09
C. 0.13 to 0.15
D. 0.16 to 0.18
* E. 0.10 to 0.12
13
