17 - AIIMS november 2008 forensic mcqs with answers

1q: What is falanga?

answer beating on the soles of foot with a blunt object

2q:. hydrocution refers to?

a. Drowning in cold water
b. Electrocution in water
c. Post mortem immersion
d. Immersion in boiling water

answer a . drowning in cold water

3q: which of the following is not a constituent of embalming fluid?

a. Phenol
b. Ethanaol
c. formalin
d. Glycerine

answer b. ethanol

4q: Thanatology is study of?

answer death in all its aspects

5q: a man working as a pest killer comes to opd with pain abdomen and garlic odour in breath with transverse lines on nails. posoning is due to?

a. Lead
b. arsenic
c. mercury
d. Cadmium

answer b . arsenic. Garlic odour and aldrich mees lines typically point to the diagnosis of arsenic poisoining .

To view all the 200 mcqs of aiims november 2008 click here

16 - paraphilias - part 7

• Other paraphilias

·

• Autogynephilia describes a man's propensity to be sexually aroused by thoughts or images of himself as a woman (with female attributes).
• 
  
• Asphyxiophilia or hypoxyphilia is when a patient uses hypoxia to achieve sexual excitement; this can be complicated by autoerotic asphyxiation.
• 
  
• Video voyeurs derive sexual gratification from videos, usually of women doing natural acts or women involved in sexual activity.
• 
  
• Infantophilia is a new subcategory of pedophilia in which the victims are younger than 5 years.

15 - paraphilias - part 6

• The Marquis de Sade's life was not an ordinary one. From early on, he was rejected by his parents and moved from one place to another. The Marquis would never gain his father's approval, no matter how hard he worked. His life lacked structure, appropriate discipline, balance, and unconditional love/approval. The young Marquis was exposed to complete self-indulgent behavior lacking any form of discipline while raised by his grandmother, aunts, and uncle. Then he was exposed to extreme corporal punishment while attending prep school with the Jesuits. He was also exposed to deviant sexual behavior in both of these very different settings.
• In theory, one might postulate that exposure to these extreme polarities of behavior, especially during the very crucial formative years, might cause the underdeveloped psyche to integrate the 2. Therefore associating pleasure with pain, hence the deviant masochistic behavior.
• Transvestic fetishism

·

• Over a period of 6 months, heterosexual male patients have recurrent, intense, sexually arousing fantasies, sexual urges, or behaviors involving cross-dressing.
• The fantasies, sexual urges, or behaviors cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
• Typically, patients derive sexual gratification from wearing clothes usually worn by the opposite sex, and patients typically are heterosexual married males (not a DSM-IV-TR criterion).
• Voyeurism

·

• Over a period of at least 6 months, patients have recurrent, intense, sexually arousing fantasies, sexual urges, or behaviors involving the act of observing an unsuspecting person who is naked, in the process of disrobing, or engaging in sexual activity.
• The fantasies, sexual urges, or behaviors cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
• Patients derive sexual gratification from seeing sex organs and sexual acts; scopophilia is a synonym for voyeurism (not a DSM-IV-TR criterion).
• Paraphilia not otherwise specified: This category is included so physicians can code paraphilias that do not meet the criteria for any of the other specific categories.

·

• Scatologia involves making obscene phone calls.
• Necrophilia involves an erotic attraction or sexual interest in corpses. This paraphilia is rare and seldom reported to the police. Patients typically work in mortuaries and funeral parlors. This also involves dangerous situations where the individual could actually acquire infections from the corpse.
• Partialism is sexual interest exclusively focused on a particular body part.
• Zoophilia involves sexual activity with animals (ie, both actual sexual contact and sexual fantasies, higher in psychiatric patients).
• Coprophilia is sexual activity involving feces.
• Klismaphilia is sexual activity involving enemas.
• Urophilia is sexual activity involving urine.
• Masturbation is sexual self-gratification.

14 - paraphilias - part 5

• Donatein was quite young to have been uprooted so many times. He was 10 years old when he was enrolled at the prep school. Although the Jesuits had a remarkable reputation as educators, they were infamous for their practices involving sodomy and corporal punishment. The Jesuits would beat, whip, or flog the young boys in front of an assembled student body to humiliate them. The humility of the beatings, oddly enough, could also be sexually arousing. This practice came to be known as sado-masochistic behavior. As an adult, the Marquis de Sade was unable to be aroused by normal sex, so it appeared that his sexuality was arrested at the infantile anal stage.
• After 4 years with the Jesuits, Donatein was transferred to a military academy upon this father's request. In 1755, shortly following his arrival, Donatein served in the King's light cavalry regiment as a sub leutenant. He was only 15 years old at the time. The young Marquis served in the war and was considered a brave and decisive leader. Unsatisfied with Donatein's success in the cavalry, his father had him placed with a cavalry company commanded by one of the members of the royal family. Donatein's bravery, good looks, and social charm made him a very successful soldier. His superiors were quite impressed by the Marquis; therefore, he was promoted to captain at the young age of 18. Donatein seemed able to impress everyone but his own father. His father never praised his son for his many accomplishments, yet had no difficulty pointing out his shortcomings.
• When the Marquis de Sade returned from the war in 1763, he had his sights set on a particular lady whom he wished to marry. However, his father was opposed to the union. Instead, he arranged for the Marquis to marry her elder sister, Renee-Pelagie de Montrieul. The couple had 3 children, 2 boys and a girl.
• The same year the couple was married, the Marquis de Sade frequently traveled away from home for "business" reasons. While away on his travels, he rented several different maisons around Paris where orgies were held. One particularly disturbing encounter took place between the Marquis and a young prostitute. After he was alone with her, he quizzed the young prostitute about her religious convictions regarding the Roman Catholic Church. When he discovered that she was a faithful Roman Catholic, he began degrading her with inconceivable vile insults.
  
  To the young woman's horror, he proceeded to perform sexually explicit acts on her with the aid of religious objects that were extremely blasphemous and sacrilegious in nature. When the young prostitute refused his request to beat each other with a hot whip, he pleasured himself sexually with a pair of crucifixes. Then he held her at knife point, forcing her to repeat vulgarities in the most blasphemous manner. This resulted in the Marquis de Sade's first imprisonment; however, his lewd and debaucherous behavior would result in numerous other imprisonments during his lifetime. He died in 1814 and was buried in Charenton. Later his skull was removed from the grave for phrenological examination.

13 - paraphilias - part 4

• Donatein's mother was a distant cousin to the Prince de Conde, a junior branch of the royal Bourbon family. She served as a lady in waiting to the Princess de Conde and was a governess to her son, the young Prince de Conde. An early account of Donatein's violent nature involved an altercation between he and his young cousin over a toy. When the young Prince tried to retrieve one of his favorite toys from the grasp of his 4-year-old cousin, Donatein pummeled his cousin with increasing blows of violence. Soon after this incident, the young Marquis was sent to live with his paternal grandmother in Avignon.
• The troubled young boy spent his formative years in Avignon surrounded by female relatives who indulged his every need and enveloped him with sensual affection. Donatein's grandmother and aunts continually doted on the child and indulged every one of his selfish demands. There was no mention of discipline in the boy's upbringing. These actions were only detrimental to the child's development; consequently, his behavior became increasingly unruly. When the Comte de Sade (Donatein's father) received report of his son's unconventional upbringing, the young Marquis was sent to live with his father's brother. The Comte hoped that his brother, Abbe de Sade, would be able to provide a masculine presence and influence that was obviously lacking in Donatein's life.
• Abbe de Sade was a noted author, clergyman, and scholar of his time. He was also very much like his sisters in the sense that he enjoyed the sensual side of life and indulged himself with many pleasures. He was referred to as "sybarite of Saumane" meaning one inordinately attached to pleasure and luxury. Once again the young boy was in an atmosphere that encouraged sexuality and sensual indulgence as an expectation rather that an exception to the rule. During Donatein's stay at his uncle's home, the abbe housed many female companions which included a local prostitute.
• Throughout this period of time in Europe, men and women of the cloth, indulged themselves in various sexual escapades with little remorse. There was rumor of orgies taking place in abbeys and convents, where priests, nuns, prostitutes, and nobles all engaged in debaucherous behavior. Abbe de Sade had a library filled with a genre of literature, and some were pornographic in nature. Donatein was free to read all of the literature in the library at his leisure. After becoming abreast of the ever present debauchery in Donatein's life, his father moved him to Paris where he was enrolled in a Jesuit prep school for young men of nobility.

12 - paraphilias - part 3

• Sometime after this event, he witnessed the Countess and her lover caught in the act by her husband and 2 of his friends. The Count, who was obviously stunned, paused momentarily to plot his course of revenge. In the meantime, the Countess beat all 3 men to a bloody pulp. Leopold had been hiding in the room throughout the encounter, and was discovered by the Countess after gasping in astonishment. Upon discovery, she beat him as well. He made his way out of the room, but was still right outside the door watching should anything else occur. Moments later, the boy witnessed the Count, back in the same room where he had been humiliated earlier, begging for her forgiveness. The Countess looked at her husband and with that same calculating smile, all too familiar to Leopold, gave him a big swift kick.
• Sexual sadists

·

• Over a period of at least 6 months, patients have recurrent, intense, sexually arousing fantasies, sexual urges, or behaviors involving the acts in which psychological or physical suffering of the victim is sexually exciting to the patient.
• The fantasies, sexual urges, or behaviors cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
• This variant is named for the activities of the Marquis de Sade (not part of the DSM-IV-TR criterion).

o

• The Marquis de Sade was born in Paris, France on June 2, 1740 and died on December 2, 1814 in Charenton, France. His full name was Donatein Alphonse Francois comte de Sade. The term sadism is a derivative of his name. The Marquis was an aristocrat and an author of violent pornography. The French author's erotic books, mainly written while imprisoned, include Justine, Juliette, and 120 Days of Sodom. The Marquis de Sade regarded criminal/sexually deviant acts as being natural, which was apparent in both his writings and actions. Consequently, his novels were banned into the 20th century.
• The Marquis de Sade's life consisted of numerous acts of cruelty, which were indicative of his total disregard for human life and the law. His acts of extremely violent physical and sexual abuse resulted in numerous imprisonments and consequent escapes. He was also declared insane and admitted to an insane asylum on 2 different occasions. The Marquis was imprisoned or committed to insane asylums for at least 32 years of his life. Most victims of Marquis were young female prostitutes, as well as both male and female employees of his chateau.

11 - paraphilias - part 2

• Sexual masochism

·

• Over a period of at least 6 months, patients have recurrent, intense, sexually arousing fantasies, sexual urges, or behaviors involving the act of being humiliated, beaten, bound, or otherwise made to suffer.
• The fantasies, sexual urges, or behaviors cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
• This variant is named for the activities of Leopold von Sacher-Masoch (not part of the DSM-IV-TR criterion). Sacher-Masoch was born in Lemberg, Austria in 1836. As an author he is most known for his book Venus in Furs. This writing is reportedly based on true events from his life.

o

• Sacher-Masoch's novel is said to be one long masochistic fantasy in which the principle male character desires and encourages his mistress to treat him as a slave. This story appears to parallel his relationship with his wife. He used to plead with her to treat him as a slave, and his outlandish requests would progressively become more demeaning to satisfy his sexual appetite. However, she was not interested in partaking in his deviant self-deprecating fantasies. Eventually they met other partners and parted ways.
• Leopold von Sacher-Masoch was the eldest son of a couple in the town of Galacia, where his father was the Director of Police and his mother was a little Russian lady of noble birth. As an infant, Leopold was very frail and sickly, and not expected to survive. To increase the infant's chances of survival, his parents hired a robust Russian wet nurse who was able to nurse him back to health. Leopold later spoke of the strong bond between the 2 of them. The woman shared strange and melancholy legends about her people with the boy, and he formed a love of the Russians that remained constant throughout his life. He reportedly said that not only did he gain his health from her, but also his soul.
• As a child, Leopold was fascinated by various representations of cruelty. He was especially drawn to pictures of executions, and some of his favorite reading materials pertained to legends of martyrs. At the onset of puberty, he had a recurring dream that he was under the power of a cruel and torturous woman. The term dream is used in this context as opposed to nightmare.
• In the town of Galacia, where Leopold was born, women were said to either rule their husbands or vice versa. At the age of 10, the boy witnessed a sadistic scene that left a permanent impression. The scene involved a female relative from his father's side of the family. This woman was referred to as Countess X. Prior to Leopold witnessing the life-altering event, he was enamored by the Countess and was impressed by her beauty and costly furs. He used to help her with various duties, services, etc. On one occasion, as he was putting on her shoes, he bent down to kiss her feet and she smiled at him and then kicked him. Instead of being hurt, he experienced a perverse sensation of pleasure.

10 - paraphilias - part 1

DSM-IV-TR criteria include the following:

• Exhibitionism

·

• Over a period of at least 6 months, patients have recurrent, intense, sexually arousing fantasies, sexual urges, or behaviors that involve exposing their genitals to unsuspecting strangers.
• The fantasies, sexual urges, or behaviors cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
• Exhibitionism typically involves men exposing themselves to women (not a DSM-IV-TR criterion).
• Fetishism

·

• Over a period of at least 6 months, patients have recurrent, intense, sexually arousing fantasies, sexual urges, or behaviors involving nonliving objects.
• The fantasies, sexual urges, or behaviors cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
• Patients do not limit the fetish objects to articles of female clothing used in cross-dressing or to devices designated for the purpose of tactile genital stimulation.
• Patients may have a particular pathological displacement of erotic interest and satisfaction for their entire lives (not a DSM-IV-TR criterion).
• Frotteurism

·

• Over a period of at least 6 months, patients have recurrent, intense, sexually arousing fantasies, sexual urges, or behaviors involving rubbing against and touching a nonconsenting person.
• The fantasies, sexual urges, or behaviors cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
• Patients typically practice this behavior in crowded places (not a DSM-IV-TR criterion).
• Pedophilia

·

• Over a period of at least 6 months, patients have recurrent, intense, sexually arousing fantasies, sexual urges, or behaviors involving sexual activity with a prepubescent child or children.
• The fantasies, sexual urges, or behaviors cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
• The patient must be aged 16 years or older and at least 5 years older than the child or children involved.

9 - INDIAN PENAL CODE (IPC) SECTIONS of importance

SECTIONS OF IPC important in FORENSIC MEDICINE

1. SECTION : 87 IPC : Act not intended and not known to be likely to cause death or grievous hurt, done by consent. Nothing which is not intended to cause death, or grievous hurt, and which is not known by the doer to be likely to cause death or grievous hurt, is an offence by reason of any harm which it may cause, or be intended by the doer to cause, to any person, above eighteen years of age, who has given consent, whether express or implied, to suffer that harm; or by reason of any harm which it may be known by the doer to be likely to cause to any such person who has consented to take the risk of that harm.
2. SECTION 92 IPC : Act done in good faith for benefit of a person without consent is not punishable. Nothing is an offence by reason of any harm which it may cause to a person for whose benefit it is done in good faith, even without that person's consent, if the circumstances are such that it is impossible for that person to signify consent, or if that person is incapable of giving consent, and has no guardian or other person in lawful charge of him from whom it is possible to obtain consent in time for the thing to be done with benefit:
3. SECTION 191 IPC : perjury – it means giving willful false evidence by a witness while under oath , the witness is liable to be prosecuted for perjury and the imprisonment may extend upto 7 years.
4. SECTION 299 IPC : whoever causes death by doing an act with the intention of causing death or with the intention of causing such bodily injury as is likely to cause death or with knowledge that he is likely by such act to cause death , commits the offence of culpable homicide.
5. SECTION 302 IPC : punishment for murder – death/life + fine .
6. SECTION 304 IPC : punishment for culpable homicide not amounting to murder – life/ 10 years + fine .
7. SECTION 304 A IPC : causing death by negligence – 2 years / fine or both .
8. SECTION 304 B IPC : dowry death . in case of death of a married woman within 7 years of marriage ,due to other than natural causes ,with history of cruelty or harassment prior to death . the charge is framed against the accused under section 304 B IPC.
9. SECTION 320 IPC : definition of grievous hurt
10. SECTION 321 IPC : voluntarily causing hurt .
11. SECTION 325 IPC : grievous hurt is punishable under section 325 IPC .
12. SECTION 338 IPC : the act done rashly and negligently causing minor offence or grievous hurt will be charged under section 338 IPC.
13. SECTION 376 IPC : custodial rape is dealt with under section 376 IPC .
14. SECTION 402 IPC : assembly for purpose of committing decoity .
15. SECTION 497 IPC : adultery is punishable under this section .

16. SECTION 54 Cr.P.C : an arrested person can request a magistrate for medical examination of his body by a registered medical practitioner as per the following provision in the code of criminal procedure .
17. SECTION 2 Cr.P.C : cognizable offence or cognizable case is a case in which a police officer may , in accordance with the first schedule or under any other law for the time being in force, arrest without warrant .

8 - grievous hurt

Section 320. Grievous hurt.
The following kinds of hurt only are designated as "grievous"

First. - Emasculation.

Secondly. - Permanent privation of the sight of either eye.

Thirdly- Permanent privation of the hearing of either ear.

Fourthly. - Privation of any member or joint.

Fifthly. -Destruction or permanent impairing of the powers of any member or joint.

Sixthly. - Permanent disfiguration of the head or face.

Seventhly. - Fracture or dislocation of a bone or tooth.

Eighthly. - Any hurt which endangers life or which causes the sufferer to be during the space of twenty days in severe bodily pain, or unable to follow his ordinary pursuits.

--- punishment for grievous hurt is given under section 325 IPC .

9 - semen identification in a forensic sample - part 3

ABO typing of semen in secretors is conventionally conducted using the technique of absorption-inhibition. The principle behind the technique is simple, and can be illustrated with reference to an A secretor. If anti-A is added to a sample (semen, saliva or a semen stain extract), the antibody will complex with the antigen in the sample. If a suspension of A cells is now added, there will be no agglutination since there is no free antibody in solution. A matrix can be set up to cover A, B, and H. There are some important factors to remember when conducting the test:

• The indicator cells are best prepared as a weak suspension in a saline-albumin solution.
• The antisera should be titrated against the indicator cells and used at the weakest dilution that will give a reliable result.
• The titration is conducted using serial dilutions.
• Negative results in inhibitions may be due to small sample size or a weak expression of the Se gene.
• Negative results should be reported as “No ABH activity detected.”
• Absolute definition of secretor status requires Lewis typing of RBCs and confirmation of the presence of Lewis b substance.

Some laboratories do not perform inhibitions but go straight to absorption-elution. The principle behind this approach is that it will detect ABH activity in all cases, not just secretors. However, certain issues must be noted:

• Invoking conclusions about secretor status from absorbtion-elution results is not reliable since the difference is quantitative.
• High levels of antigen can result in false negative in absorption-elution as the Ab-Ag complex dissolves in the excess Ag.
• It is always best to prepare at least a 1:10 dilution of extract in absorption-elution to try to overcome these problems.

8 - semen identification in forensic sample - part 2

The ability to draw inferences as to the origin of semen in a sexual assault case is obvious. The power to do this in traditional serology was limited, and depended mainly on ABO and PGM typing. The PGM₁ locus is expressed in semen and vaginal secretions, and the methodology and interpretation used in its typing are exactly the same as for blood.

ABO typing is somewhat different. Almost everyone has at least trace levels of antigen in their body secretions that correspond to their ABO blood type. However, about 80% of the population has very high levels of these antigens in body secretions. These persons are described as secretors. The remaining 20% of the population are described as non-secretors and have concentrations of the antigens that are too low for normal detection. The quantitative difference is genetically determined. The gene responsible has two alleles, a dominant form, Se, and a recessive one, se. Thus SeSe and Sese persons are secretors and sese persons are non-secretors.

The A, B, and H antigens are polysaccharides. They are found on RBC surfaces as lipo-polysaccharides and in secretions as glycoproteins. The biochemical genetics involves four genes as shown in the table below.

Biochemical Genetics
Gene	Expression	RBC genotype	Secretions genotype
Le, H and secretor	Dominant H allele in presence of dominant Se allele converts Lea substance to mixture of H, Lea and Leb substances	Depends on A and B alleles	Leaand Leb substances present together with A and/or B depending on A and B alleles
Le, ABO A allele together with H and Se	A blood group, Lewis a and b	A, H, Le(a-b+)	Lea, Leb , A, H
Le, ABO B allele together with H and Se	B blood group, Lewis a and b	B, H, Le(a-b+)	Lea, Leb , B, H
Le, ABO O (silent) allele together with H and Se	O blood group (No A or B blood group), Lewis a and b	H, Le(a-b+)	Lea, Leb , H
Le, H and sese	A, B or H depending on ABO gene	A. B. H depending on ABO gene, Le(a+b-)	Lea only
Le, hh and Se	no ABH or Lewis	No ABO activity (Bombay phenotype)	Lea only
lele, H and Se	ABO depending on ABO gene alleles, no Lewis	A, B, H (depending on ABO alleles), Le(a-b-)	A, B, H (depending on ABO alleles), no Lewis
lele, H and sese	A, B, or H depending on ABO gene	A, B, H depending on ABO gene, Le(a-b-)	No ABH, no Lewis
lele, hh and Se	No ABH or Lewis	No ABO activity (Bombay phenotype) Le (a-b-)	No ABH, no Lewis
Note: Secretors all have an Le allele, an H allele and an Se allele. For simplicity, AB heterozygotes are not listed in the Table – they will have A and B.

7 - semen identification in a forensic sample - part 1

Human semen contains unusually high concentrations of acid phosphatase, which can therefore be the basis of a screening test. The reaction is based on the hydrolysis of phosphate esters and detection of the liberated organic moiety by production of a color complex. For example, the reaction of acid phosphatase with sodium alphanapthylphosphate and fast blue B to produce a purple-blue coloration. As with the screening test for blood, a positive result is the rapid formation of the intensely colored product – less than 20 seconds or so, or 30 seconds at most.

The best identification of semen is from its microscopy. The morphology and dimensions of the human spermatozoon are unique. The small sperm, particularly if they have lost their tails, can be difficult to locate microscopically especially in samples which have bacterial or yeast infection. Detection is simplified by histopathological staining. The most usual stain is popularly known as Christmas tree stain because of the bright colors. It utilizes nuclear fast red that differentially stains the DNA-containing head bright crimson, and a counter-stain of picric acid - indigocarmine (PIC) that stains the tails green-blue-gray. The traditional histological staining of hematoxylin and eosin (H&E) is also used, as is Giemsa stain.

Problems may be encountered if the seminal fluid is from a man who has a low sperm count (oligospermia) or who has no spermatozoa present in his seminal fluid (aspermia). In situations where the presumptive alkaline phosphate test indicates the presence of semen, but the microscopical analysis yields no detectable spermatozoa, tests are carried out to determine the presence of a protein, P30, or prostate specific antigen (PSA), which is only found in high concentration in human semen. Some laboratories even use P30 testing in place of microscopical examination for semen identification. It can be detected by precipitin reaction with a specific antiserum using the Ouchterlony process. There is also a quantitative immunological test utilizing an enzyme-linked reaction (ELISA).

However, the currently accepted method of choice for identification of semen in all circumstances is detection of p30 using the ABAcard^® test strips manufactured by Abacus Diagnostics, Inc. The strips work in the same way as described above for confirmation of blood, except that they use anti-p30 monoclonal and polyclonal antisera, and a pink dye.

6 - forensic medicine mcqs - 31 to 35

Question
31. Contre-coup injuries are seen in:
1. Brain.
2. Heart.
3. Liver.
4. Pancreas.
Answer
1. Brain.
Reference
The Essentials of Forensic Medicine and Toxicology 21st Edition : K.S.Narayana Reddy Page
Discussion
When a static head is struck, there is usually a similar lesion overt the part of the brain of the area. But when the head being in motion, strikes a static or relatively static object, then there will be a Coup (blow, impact) coup lesion at a site diagonally opposite to the site of the impact or the coup injury.
Explanation
Self Explanatory
Comments
Contre Coup is not common in Occipital Region : A coup lesion on the Frontal region produces a contre - coup lesion in the temporal lobe of the brain.
The contre coup lesion may in over
o the vessels à haemorrhage
o the brain matter à Contusion
IF the force is not perpendicular, then the contre-coup lesion may be due to the shearing force
Tips
Note that there is another Contre - Coup : The Contre-copuy Fracture:
When the impact is over the occipital region, the force will be directed anteriorly. In the course of its path, the force causes vibration. Where ever the force passes through a thin and weak bone in its path, it may cause fracture of that bone. Thus in the case of reasonably heavy impact on the occipital bone, there may not be any fracture at the site of impact due to toughness of the occipital bone, but the force, when passes anteriorly causes fracture of the thin orbital plates of the frontal bone. Mechanisms of contre-coup injury to brain is, however, totally different.

Question
32. Hydrogen peroxide is used in all the following chemical tests for blood except
1. Benzedine test.
2. Phenophthalein test.
3. Orthotoluidine test.
4. Teichmann's test.
Answer
4. Teichmann's test.
Reference
The Essentials of Forensic Medicine and Toxicology 21st Edition : K.S.Narayana Reddy Page 381 to 382
Principles of Forensice Medicine 1st Edition : Apoorva Nandy : Pages 115 to 117
Discussion
All the tests use Hydrogen peroxide (H2O2)
Explanation
1. Benzedine test: Stain Extract in Test Tube + few drops of 10 % Benzidine in Glacial Acetic Acid + few drops of H2O2 à Blue Colour indicates Positive test (Similarly the stain is moistened with Normal Saline and a blotter is pressed over the area + Benzidine Solution + H2O2 à Blue Colour indicates Positive test.
2. Phenophthalein test (Kastle mayer test): Diluted Stain Extract + Reduces Alkaline Phenopthaline + few drops of H2O2 à Pink Colour indicates Positive test
3. Orthotoluidine test (Kohn and O’Kelly test): Equal volume of Working Solution (4% Orthotoludine in Ethyl Alcohol + Glacial Acetic Acid + Distilled Water in equal amounts ) and H2O2 are mixed . Then few drops of this mixture is added to the stain extract in a test tube à Blue or Green Colour indicates Positive test
4. Teichmann's test (Haemin crystal test): NaCl + 2 to 3 drops of Galcial Acetic Acid is palced on the stain on a glass slide. Coverslip applied + Evaporated by heating over small flame. Examined under Microscpe. Faint yellowish-red to brownish black rhombic crystals of heamin or haematic chloride arranged single or in clusters are seen if blood is present. Bubbles of gas are given with Addition of a drop of Hydrogen peroxide
Comments
In the first 3 tests, H2O2 is an essential part in DIAGNOSIS, where as in the Haemin Crystal test, Hydrogen peroxide is used only for CONFIRMATION. So we take that as an answer. Also note that the first 3 tests use the presence of Peroxide (which needs of H2O2) as the basis where as Teichmann test queries for Heme
Tips
Leucomalachite Green Test is another test that uses H2O2
Blood can be conveniently detected by Spectroscopic Examination. In fact in this modality we can even find the state of hemogloblin (Oxy or Carboxy etc) based on the absorption bands.
When Carboxy hemoglobin is present in the blood we can tell with confidence that the burns were antemortem (in addition to other findings such soot particles in trachea)
o However note that not all Antemortem burns will have Carbon monoxide. There are few circumstances in which CO may not be found inspite of the burns being antemortem
§ Rapid Death
§ Convection Air Currents
§ Low Production of CO,
§ Flash fire (conflaguration in Chemical Plant)
§ Inhalation of superhated air leading to suffocation
§ Explosion where death is instantaneous

Question
33. Disputed maternity can be solved by using the following tests except:
1. Blood grouping.
2. HLA typing.
3. Preciptin test
4. DNA fingerprinting.
Answer
3. Preciptin test
Reference
The Essentials of Forensic Medicine and Toxicology 21st Edition : K.S.Narayana Reddy Page 383
Discussion
Disputed Maternity (as well as paternity) can be found by
Blood Grouping (See chapter of Virginity, Pregnancy and Delivery - Reddy : Affiliation Cases)
HLA Typing and
DNA Finger printing as well as a whole lot of features
Explanation
Self Explanatory
Comments
Preciptin test is used to find albuminous substances from any part of the human body. It is Species specific (not individual specific) and we can’t use this for disputed paternity. !!!!
Tips
Preciptin test is an Immunological method : Other Immunological methods include
§ Antiglobulin consumption test
§ Gel Diffusion
§ Double Diffusion in Agar Gel
§ Precipitation Electrophoresis
Isoenzyme methods are also used for species identification. They are more specific and less sensitive than Immunological Method

Question
34. A person was brought by police from the railway platform. He is talking irrelevant. He is having dry mouth with hot skin, dilated pupils, staggering gait and slurred speech. The most possible diagnosis is:
1. Alcohol intoxication.
2. Carbamates poisoning.
3. Organophosphorous poisoning.
4. Datura poisoning.
Answer
4. Datura poisoning.
Reference
The Essentials of Forensic Medicine and Toxicology 21st Edition : K.S.Narayana Reddy Page 520
Discussion
Agents that can competitively block the binding of acetylcholine to CNS and parasympathetic postganglionic muscarinic neuroreceptors include
o Antihistamines (H1 blockers),
o Belladonna alkaloids and related agents
§ Atropine, glycopyrrolate, homatropine, hyoscine, ipratropium, scopolamine,
o Drugs for Parkinson's disease
§ Benztropine, biperiden, trihexyphenidyl
o Topical mydriatics
§ Cyclopentolate, tropicamide
o Neuroleptics
§ Clozapine, olanzepine, phenothiazines
o Skeletal muscle relaxants
§ Cyclobenzaprine, orphenadrine
o Smooth-muscle relaxants
§ Clidinium, dicyclomine, isometheptene, oxybutynin
o Tricyclic antidepressants, and
o Plants
§ Datura stramonium, or jimson weed
§ Mushrooms.
Clinical Toxicity
o Within
§ 1 hour of acute overdosage
§ 1 to 3 days in cases of chronic poisoning.
o Toxic doses are only slightly greater than therapeutic ones.
o CNS manifestations
§ Agitation, ataxia, confusion, delirium, hallucinations, and movement disorders (choreoathetoid and picking movements).
§ Lethargy, respiratory depression, and coma may occur.
o Peripheral nervous system findings
§ Decreased or absent bowel sounds,
§ Dilated pupils,
§ Dry skin and mucosal surfaces,
§ Urinary retention,
§ Tachycardia
§ Increased Blood pressure
§ Tachypnea
§ Increased temperature
o Neuromuscular hyperactivity
§ Rhabdomyolysis and
§ Hyperthermia.
o First-generation H1 blockers (diphenhydramine and probably others)
§ Tricyclic antidepressant-like cardiotoxicity and seizures.
o Second-generation antihistamines (astemizole, terfenadine) nonsedating
§ Because of class III antiarrhythmic activity,
§ QT-interval prolongation with subsequent ventricular tachyarrhythmias,
§ especially torsade de pointes,
Diagnosis
o Detecting these agents in the urine.
o Confirmed by demonstrating resolution of anticholinergic toxicity in response to physostigmine.
Explanation
Self Explanatory
Comments : Treatment of AntiCholinergics
Activated charcoal adsorbs these agents effectively and is the preferred method of gastrointestinal decontamination.
Agitation may respond to benzodiazepines, and comatose patients may require intubation and mechanical ventilation.
Cardiovascular toxicity and arrhythmias should be treated as described for antiarrhythmics and tricyclic antidepressants.
Physostigmine, an acetylcholinesterase inhibitor, reverses anticholinergic toxicity.
o It is indicated primarily for uncontrolled agitation and delirium.
o The dose is 1 to 2 mg given intravenously over 2 to 5 min; the dose can be repeated if there is an incomplete response or recurrent toxicity.
o If signs of cholinergic poisoning occur (see "Organophosphate and Carbamate Insecticides," below), they can be reversed by atropine in half the amount of physostigmine given.
o Physostigmine should not be given for seizures or for coma; its arousal effects are nonspecific and cannot be used for diagnostic purposes.
Tips
Physostigmine is contraindicated in the presence of cardiac conduction defects or ventricular arrhythmias because it can cause asystole in such patients.
Remember the Mnemonic for Atropine toxicity
o Hot as a Hare
o Blind as a bat
o Dry as a bone
o Red as a beet
o Mad as a Hen
Atropine was first used as a homicidal poison. The name is derived from the senior of three legendary Fates, Atropos, who cuts with shears the web of life spun and woven by her sisters Clotho and Lachesis (There is a synthetic atropine like drug called as Lachesine) The term belladonna (in Italian meaning beautiful (bella) women (donna) refers to the once fashionable female practice of using an atropine extract to dilate the pupils (as a part of make up.)


Question
35. A middle aged man presents with paraesthesia of hands and feet. Examination reveals presence of Mees. lines in the nails :md rain drop pigmentation in the hands. The most likely causative toxin for the above mentioned symptoms is:
1. Lead.
2. Arsenic
3. Thallium.
4. Mercury.
Answer
2. Arsenic
Reference
The Essentials of Forensic Medicine and Toxicology 21st Edition : K.S.Narayana Reddy Page 462
Discussion
Arsenic is termed a metalloid as it has properties of both metals and non-metals.
Forms
o Trivalent (e.g. arsenic trioxide, arsenious acid, and arsenites) and
o Pentavalent (e.g. arsenic pentoxide, arsenic acid, and arsenates) derivatives.
o Inorganic arsenical compounds may generate arsine gas when in contact with acids and reducing metals (e.g. iron and zinc) or with sodium hydroxide and aluminium.
Use
o Electronics industry,
o Production of special types of crystal and optical glass,
o Hardening lead and copper alloys,
o Manufacture of fireworks,
o Wood preservative and
o Pesticide. It is a byproduct of copper smelting.
In exposed individuals high concentrations of arsenic are present in
o Bone,
o Hair, and
o Nails. The half-life is in the range of 1 to 3 days.
Excretion is predominantly in the
o urine as mono- and dimethyl-derivatives.
CLINICAL FEATURES
Acute poisoning
o This can follow accidental, suicidal, or deliberate ingestion,
o Toxicity being largely dependent on the water solubility of the ingested compound.
§ Within 2 h of substantial ingestion of a soluble arsenical compound, severe haemorrhagic gastritis or gastroenteritis may ensue with collapse and death usually within 4 days.
§ A metallic taste, salivation, muscular cramps, facial oedema, difficulty in swallowing, hepatorenal dysfunction, convulsions, and encephalopthy are reported.
§ A peripheral neuropathy (predominantly sensory), striate leukonychia (Mees' lines) and hyperkeratotic, hyperpigmentated skin lesions are common in those surviving a near fatal ingestion.
§ In moderate or severe arsenic poisoning investigations may show anaemia, leucopenia, thrombocytopenia, and disseminated intravascular coagulation. ECG abnormalities have been reported and include QT prolongation and ventricular arrhythmias.
o Exposure to arsenic trioxide and trichloride dust causes irritation of the eyes, nose, throat, and lower respiratory tract. Corrosive skin damage may follow skin contact with arsenical compounds such as arsenious acid and arsenic trichloride.
Chronic poisoning
o Source
§ Contaminated drinking water or
§ “Tonics” containing inorganic trivalent arsenical compounds
o Features
§ Progressive weakness,
§ Anorexia, Nausea, Vomiting, Stomatitis, Colitis,
§ Increased salivation, Epistaxis, Bleeding gums, Conjunctivitis,
§ Weight loss, and Low grade fever.
§ Hyperkeratosis (palms and soles of the feet)
§ “Raindrop” (skin),
§ “Mees” (nails).
§ Skin cancer (usually squamous cell epithelioma)
§ A symmetrical peripheral neuropathy is typical.
§ Sensory symptoms predominate but motor involvement is also
§ Central nervous system effects
· hearing loss,
· psychological impairment and
· EEG changes.
§ disturbances of liver function
§ Ulceration and perforation of the nasal septum.
Chronic exposure to trivalent and pentavalent forms of arsenic has been linked to excess lung cancer and lung cancer occurring in lead, tin, and copper smelter workers has been attributed to arsenic.
Explanation
1. Lead poisoning presents with a whole lot of features like Aneamia, Colic, Neuropathy, facial pallor, lead line or Burtonian line, lead encephalopathy , optic atrophy etc.
2. Acute Arsenic Resembles Diarrhoea where as Chronic Arsenic resembles “fading Measles”
3. Thallium poisoning resembles Guillain Barre Syndrome.
4. Minamita disease, hatter’s shakes and mercurial erethesm are a few of the prominent features of Mercury Poisoning.
Comments
TREATMENT :
Dimercaprol (British Anti-Lewisite, BAL) given by deep intramuscular injection (2.5-5 mg/kg four hourly for 2 days followed by 2.5 mg/kg intramuscularly twice daily for 1 to 2 weeks).
DMSA (succimer) and DMPS (unithiol) are more effective in reducing the arsenic content of tissues and, unlike dimercaprol they do not cause accumulation of arsenic in the brain DMSA and DMPS may be given orally (in a dose of 30 mg/kg body weight daily).
Tips
The fact that Arsenic is tasteless and odorless was known even eras ago. It is alleged that the governor of St.Helena “slow poisoned” the “petit corporal” while he was in the jail as a prisoner of Britain. But they didn’t perhaps know that Arsenic is a BAD homicidal poison as it can be detected even centuries after in Bone and Hair (as was detected from Napolean’s mortal remains).

5 - forensic medicine mcqs - 26 to 30

Question
26 . The cephalic index of Indian population is between:
1. 70-75.
2. 75-80.
3. 80-85.
4. 85-90.
Answer
2. 75-80.
Reference
The Essentials of Forensic Medicine and Toxicology 21st Edition : K.S.Narayana Reddy Page 50
Discussion
The Indian skull is Caucasian with few Negroid Characters

Cephalic Index = Maximum Breadth of the Skull x 100
Maximum Length of the Skull


Type of Skull Cephalic Index Race
Dolicocephalic 70 - 74.9 Pure Aryans, Aborigens, Negroes Long Headed Long headed Oblong Headed
Mesaticephalic 75 - 79.9 Europeans, Chinese Medium Headed Medium Long Headed Intermediate Headed
Brachy cephalic 80 - 84.9 Mongoloid,
Native Americans,
Asiatic Orientals
Ä1Koreans
Ä2 Japanese
Ä3 Chinese
Ä4 South East Asians Broad Headed Round Headed Short Headed / Square headed

Explanation
Since the Indian skull is Caucasian like (with few Negroid characters), we take the value for Europeans i.e. 75 - 79.9 and in the choices given above 75 - 80.
Comments
Remember that Caucasians are Europeans. (Have you heard about Caucas Montains and Ural Mountrains of Europe)
Tips
Have an Idea about the other Indices
Brachial index = (Length of Radius / Length of Humerus) x 100
§ Europeans : 74.5
§ Negroes : 78.5
Crural index = (Length of Tibia / Length of Femur) x 100
§ Europeans : 83.3
§ Negroes : 86.2
Humero Femoral index = (Length of Humerus / Length of Femur) x 100
§ Europeans : 69
§ Negroes : 72.4
Inter Membral index = (Length of Humerus + Radius / Length of Femur + Tibia) x 100
§ Europeans : more than 70
§ Negroes : less than 70.5

Question
27 . A convict whose family or relations were not known and no biological sample was available with jail authorities, escaped from the jail. A dead body resembling the convict was found in nearby forest, but due to mutilation of face, identity could not be established. The positive identity that he is .the same convict who escaped from jail can be established by:
1. Blood Grouping.
2. DNA Profile.
3. Anthropometry.
4. HLA typing.
Answer
3. Anthropometry.
Reference
The Essentials of Forensic Medicine and Toxicology 21st Edition : K.S.Narayana Reddy Page 70

Discussion
There is no blood sample available. That means we cannot do Grouping, DNA Profile or HLA Typing . Anthropometry does not need Blood samples.

Comments
Anthropometry (introduced by Alphonse Bertillon in 1883) is system is based on the fact that after the age of 21, the dimensions of the skeleton remains unchanged and also that the ratio in size of different parts to one another varies considerably among the individuals. This system includes
Descriptive Data: Colour of hair, eyes, complexion, shape of nose, ears, chin etc
Body marks: Moles, Scars, Tattoo marks (we still follow this for easy identification - those who have ever filled a Accident Register will know this)
Body measurements: Height, AP diameter of Head and Trunk, Span of Out stretched arms, the length of left middle finger, left little finger, left forearm, left foot, length and breadth of Right Ear and Colour of Left Iris.
Photographs of a front view of the head and a profile view of the right side of the head are also taken.
These were filed and indexed using “portrait parle”
Tips
Anthropometry or Bertillon system is applicable only to adults and is not fool proof
It is now replaced by Dactylography (Galton system)
Lip Prints were studied by Le Moyne Snyder
Anecdote
In the Film Alavandhan, the Hero Nandhu who is in jail (whose scar is too well known) makes the same scar to another inmate and escapes with him. The inmate is killed and the head mutilated and tries to convince the police believe that Nandhu is dead - this itself shows that Finger Prints are superior


Question
28 . In which of the following conditions post- mortem caloricity may be seen in death due to:
1. Massive haemorrhage.
2. Cyanide poisoning.
3. Corrosive poisoning.
4. Septicemia.
Answer
4. Septicemia.
Reference
The Essentials of Forensic Medicine and Toxicology 21st Edition : K.S.Narayana Reddy Page 128
Parikh 6th Edition Page 3.29 to 6.31

Discussion
Post mortem Caloricity is a condition where the temperature of the body remains raised for the first two or so hours after death. In certain conditions, instead of promoting the process of cooling of the body, act in a way, so that, the body temperature is either high at the time of death or is increased for sometime after death, so that, at a particular time after death the body may appear disproportionately warmer than what it should have been. This is termed as Post Mortem Caloricity and the conditions are
Post mortem Glycogenolysis
a. This is a normal phenomenon and the rise is 3.6oF or 2oC
Various Causes of Death such as
b. Septicaemia,
i. Infectious diseases,
ii. Bacteremia
iii. Tetanus
c. Asphyxial Conditions
d. Severe convulsions
i. Tetanus
ii. Strychnine
e. Hyperpyrexia at death
i. Heat Stroke
ii. Pontine Haemorrhage
f. High Atmospheric Temperature

Comments
Early cooling of the body delays the process of Rigor Mortis and Decomposition.
When the heat of the body is preserved, the process of Rigor Mortis and Decomposition start Early
Tips
Site used for recording internal temperature
Rectum - 4" above Anus
Subhepatic
Thermometer used
Chemical Thermometer
Graduation- 0oC or 50oC

Question
29 . Deep blue colour of hypostasis is seen in death due to poisoning by:
1. Potassium cyanide.
2. Phophorus.
3. Aniline dyes.
4. Carbon monoxide.
Answer
3. Aniline dyes.
Reference
Apurva Nandy 1st Page 443
The Essentials of Forensic Medicine and Toxicology 21st Edition : K.S.Narayana Reddy Page 131
Narayana Reddy Page 121
Parikh Page 6th Edition Page 3.12
Apoorva Nandy 1st Edition Page 443
Discussion
Hypostasis is discolouration of the skin and organs after death due to accumulation of fluid blood in the dependent parts of the body. Post mortem lividity is also called
Post mortem hypostasis
Livor Mortis
Vivices
Suggilation
Postmortem Staining
Post mortem hypostasis is Blue colour in deaths due to Asphyxia and Poisoning with Aniline
Explanation
One book gives that Post mortem hypostasis is blue coulour in Poisoning with Aniline. So we are going for Aniline as the answer, though few other books give that Aniline produces Brown Colour. And all INDIAN books agree with the postmortem hypostasis in other options. (Let us limit our self to Indian authors, though one foreign book says that the colour is blue in KCN poisoning, but remember this fact if you see this question next time with aniline not in any of the choices, but KCN is there in the list. )
Comments
The colour normally is
at first Bluish pink,
then Bluish purple
The colour of the lividity changes in Poisoning due to various agents are
Pink Cyanide
Bright Cherry Red Carbon monoxide
§ Color of the skin is bright cherry-red if saturation of carbon monoxide in the blood is > 30%.
§ If <>
Blue Aniline (As per Apurva Nandy)
Reddish Brown Aniline, Nitrites
Chocholate Brown Potassium Chlorate
Dark Brown Phosphorus
Greyish Brown Septic abortin caused by C. welchii
Black Opiates
Bluish green Hydrogen Sulphide
Tips
Contact palor is a phenomenon which refers to the paleness of the areas that are in direct contact with the surface. This is similar to Contact Flattening in Rigor Mortis.

Question
30 . A 25 year old person sustained injury in right eye. He developed right corneal opacity following the injury. Left eye was already having poor vision. Corneoplasty of right eye was done and vision was restored. Medicolegally such injury is labelled as:
1. Grievous.
2. Simple.
3. Dangerous.
4. Serious.
Answer
1. Grievous.
Reference
The Essentials of Forensic Medicine and Toxicology 21st Edition : K.S.Narayana Reddy Page 224
Indian Penal Code - Chapter XIV Relevant Sections 319 to 338 - Given in all text books
IPC - Of course J
Discussion
319. Hurt
Whoever causes bodily pain, disease or infirmity to any person is said to cause hurt.
320. Grievous hurt
The following kinds of hurt only are designated as "grievous":-
First- Emasculation.
Secondly- Permanent privation of the sight of either eye.
Thirdly- Permanent privation of the hearing of either ear,
Fourthly- Privation of any member or joint.
Fifthly- Destruction or permanent impairing of the powers of any member or joint.
Sixthly- Permanent disfiguration of the head or face.
Seventhly- Fracture or dislocation of a bone or tooth.
Eighthly- Any hurt which endangers life or which causes the sufferer to be during the space of twenty days in severe bodily pain, or unable to follow his ordinary pursuits.
Explanation
There is a lot of discussion as to the nature of the Injury. Few say that since the loss is not PERMANENT it is simple Injury. That may sound logical, but when we see the clause eight, which says that any hurt which causes the sufferer unable to follow his ordinary pursuit for 20 days is Grievous. It is rational to assume that a person who had injury in Right Eye and had undergone Corneoplasty would not have used his eyes for at least 20 days. So the injury becomes grievous.
Comments
There is another interesting explanation to this question. Cornea is a part of face (Isn’t it?) and Corneoplasty implies that there is Permanent disfigurement of face à which means that the injury undoubtedly is grievous

4 - forensic medicine mcqs - 21 to 25

21-The route of administration of Amyl Nitrate in Cyanide poisoning is

a. Intra Muscular
b. Intra Venous
c. Sub dermal
d. Inhalation

---------------------------------------------

The correct Answer is D

Amyl nitrate is chemically related to nitroglycerin and has been used for many years to treat angina pectoris. It is also effective in the emergency management of cyanide poisoning by causing the oxidation of hemoglobin to the compound methemoglobin. Methemoglogbin reacts with the cyanide ion to form cyanomethemoglogin, which has less affinity for oxygen, thus freeing hemoglogin to react with oxygen.

Onset of action: 30 seconds inhaled
Supplied: 0.3 ml/glass ampule (capsule covered with woven gauze).
Dose/Administration:
Adult: Glass ampule should be broken and inhaled for 30-60 seconds. Repeat as necessary
Pediatric: same as adult

-------------------------------------------------

22-The Commonest type of abrasion seen in road traffic accidents is

a. Scratch abrasions
b. Grazed Abrasions
c. Contact Abrasions
d. Imprint Abrasions

--------------------------

The Correct Answer is B

Abrasions are commonly caused by a 'glancing' impact across the surface of the skin, but if the force is directed vertically down onto the skin surface it may be termed a 'crush' injury.

These wounds are seen where an object has struck the skin (eg a blow from a fist), or where the injured person has fallen onto a rough surface, such as road.

Abrasions may be 'linear', or commonly known as a single 'scratch', whereas if a broader surface is affected, it is called a 'graze' or 'brush abrasion' (eg where a motorcyclist is thrown from their vehicle, and comes into contact with the road surface in a skidding fashion). Such an abrasion often covers a relatively large area of skin, and is often called a 'friction burn' in lay language.

------------------------------

23-In a case of disputed paternity, Father's blood group is A, Mother's blood group is B, the child's blood is

a. A only
b. B only
c. AB only
d. A,AB,B or O

--------------------------------------

The correct Answer is D

Around 1900 it was discovered that there are at least 4 different kinds of human blood. This is based on the fact that on the surface of the red blood cells there may be one or more proteins, called antigens. These antigens are called A and B. Antibodies are produced in the blood plasma against these A and B antigens, and continue to be produced throughout a person’s life.

The antigens determining the four blood groups are the result of the expression of three alleles; O, A and B; the latter two being dominant to O. The genotypes AA and AO, and the genotypes BB and BO cannot be distinguished serologically and are classified as group A and B respectively. Thus only four phenotypes (A, B, AB, and O) can be recognized, although six genotypes occur.

A person’s blood type is inherited from their parents, just like any other genetic trait.
Persons with blood type A have inherited one or two copies of the gene for the A antigen, one from each parent. Persons with blood type B have inherited one or two copies of the gene for the B antigen. Persons with blood type AB have inherited on copy of the A antigen from one parent and one copy of the B antigen gene from the other parent. Persons with blood type O inherited neither A nor B genes from their parents.

Blood typing can be used in legal situations involving identification or disputed paternity. In paternity cases a comparison of the blood types of mother, child, and alleged father may be used to exclude a man as the possible parent of a child. For example, a child with the blood type AB whose mother is type A could not have a father whose blood type is A or O. The father must have blood type B.

-------------------------------------------

24-For DNA test liquid blood is preserved in

a. Sodium Citrate
b. Pot. Oxalate
c. EDTA
d. Sodium Fluoride

-----------------------------------------------

The correct Answer is C

DNA in biological samples is very stable and can tolerate room temperature storage conditions very well. However, over an extended period of time, frozen storage is generally considered to be the optimum storage condition for biological samples. This means that evidence, such as bloodstained clothing, should be held frozen. Liquid blood samples, stored in glass or plastic containers, should be held in the refrigerator since these samples can break in the freezer. Liquid blood samples containing preservatives (e.g. EDTA) are stable for a very long period of time in the refrigerator.

Certain buffers (e.g. those containing EDTA) are designed to inhibit the activity of nucleases that can breakdown DNA and these can preserve DNA in liquid form better than other liquid extractants.

-----------------------------------------------------

25-Caput Succedaneum in a new born is

a. Collection of blood under the pericranium
b. Collection of Sero-sanguineous fluid in the scalp
c. Oedema of the scalp due to grip of the forceps
d. Varicose veins in the scalp

------------------------------------------------------------

The Correct Answer is B

Caput Succedaneum is a collection of blood/fluid in subQ tissues of scalp

* not limited by bony sutures
* benign, self-limited, resolves in days

Collection of bloodunder the pericranium is a Cephalhematoma