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).
Monday, January 7, 2008
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
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
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
3 - forensic medicine mcqs - 11 to 20
11) Active component of Ganga –
a.Tetra hydro cannabinols
b. LSD
c. Ethyl Alcohol
d. N metyl tryptophan
Answer : A) Tetra hydro cannabinols
Reference: Narayana Reddy 17th Edition Page 473.
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12.In India Magistatre inquest is done in all of the following cases except
a. Police firing
b. Dowry death
c. Custodial death
d. Murder
Answer : d) Murder
Reference: Narayana Reddy 17th Edition Page 6
---------------------------------------------------------------
13) Police inquest is done
a. By the collector
b. To find the cause of death
c. To hang the person who committed murder
d. None of the above
Answer : b) to find the cause of death
Reference: Narayana Reddy 17th Edition Page 5
----------------------------------------------------------------
14) IPC is
a. Procedure for investigation
b. Code for punishment
c. Both
d. None
Answer : b) Code for punishment
Reference: Narayana Reddy 17th Edition Page 5
-------------------------------------------------------------------------
15) Rigor mortis first seen in
a. Heart
b. Eyelids
c. Foot
d. Diahpragm
Answer : a) Heart
Reference: The Essentials of Forensic Medicine and Toxicology 17th Edition Narayana Reddy Page 123 Principles of Forensic Medicine 1st Edition Apurva Nandy 157.
-------------------------------------------------------------
16) Tachy noire
a. Postmortem caloricity
b. Change in eye after death
c. Postmortem lividity
d. None of the above
Answer : b) Change in eye after death
Reference: Narayana Reddy 17th Edition Page 117
-------------------------------------------------------------------------
17) Spalding’s sign is evident in
a. 2 days
b. 5 days
c. 7 days
d. 14 days
Answer : d) 14 days
Reference: Narayana Reddy 17th Edition Page 342.
------------------------------------------------------------------------
18) Medical etiquette
a. Deals with the conventional laws of the courtesy observed between members of the medical profession
b. deals with legal responsibilities of the physician
c. deals with the study and application of the efeects of violence or unnatural disease in its various forms
d. deals with the moral principles which should guide members of the medical profession in their dealings
Answer : a) Deals with the conventional laws of the courtesy observed between member of the medical profession
Reference: Narayana Reddy 17th Edition Page 1.
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19) Abreaction
a. is a test is for detecting injury due to Electric shock
b. is a test is for detecting injury due to Lighting
c. is a test is for detecting injury due to Laser beam
d. is reviving and bringing into consiousness, forgotten and other traumatic experiences or repressed emotiuons from unconscious levelby catharsis
Answer : d) is reviving and bringing into consiousness, forgotten and other traumatic experiences or repressed emotiuons from unconscious levelby catharsis
Reference: Narayana Reddy 17th Edition Page 365.
-----------------------------------------------------------------------------------------
20) Drug that inhibits Aldehyde dehydrogenase is
a. Disulfiram
b. Phenytoin
c. Valproate
d. Erythromycin
Answer : a) Disulfiram
Reference: Tripathi 5th Edition Page 353
a.Tetra hydro cannabinols
b. LSD
c. Ethyl Alcohol
d. N metyl tryptophan
Answer : A) Tetra hydro cannabinols
Reference: Narayana Reddy 17th Edition Page 473.
------------------------------------------------------------------
12.In India Magistatre inquest is done in all of the following cases except
a. Police firing
b. Dowry death
c. Custodial death
d. Murder
Answer : d) Murder
Reference: Narayana Reddy 17th Edition Page 6
---------------------------------------------------------------
13) Police inquest is done
a. By the collector
b. To find the cause of death
c. To hang the person who committed murder
d. None of the above
Answer : b) to find the cause of death
Reference: Narayana Reddy 17th Edition Page 5
----------------------------------------------------------------
14) IPC is
a. Procedure for investigation
b. Code for punishment
c. Both
d. None
Answer : b) Code for punishment
Reference: Narayana Reddy 17th Edition Page 5
-------------------------------------------------------------------------
15) Rigor mortis first seen in
a. Heart
b. Eyelids
c. Foot
d. Diahpragm
Answer : a) Heart
Reference: The Essentials of Forensic Medicine and Toxicology 17th Edition Narayana Reddy Page 123 Principles of Forensic Medicine 1st Edition Apurva Nandy 157.
-------------------------------------------------------------
16) Tachy noire
a. Postmortem caloricity
b. Change in eye after death
c. Postmortem lividity
d. None of the above
Answer : b) Change in eye after death
Reference: Narayana Reddy 17th Edition Page 117
-------------------------------------------------------------------------
17) Spalding’s sign is evident in
a. 2 days
b. 5 days
c. 7 days
d. 14 days
Answer : d) 14 days
Reference: Narayana Reddy 17th Edition Page 342.
------------------------------------------------------------------------
18) Medical etiquette
a. Deals with the conventional laws of the courtesy observed between members of the medical profession
b. deals with legal responsibilities of the physician
c. deals with the study and application of the efeects of violence or unnatural disease in its various forms
d. deals with the moral principles which should guide members of the medical profession in their dealings
Answer : a) Deals with the conventional laws of the courtesy observed between member of the medical profession
Reference: Narayana Reddy 17th Edition Page 1.
-----------------------------------------------------------------------------------------
19) Abreaction
a. is a test is for detecting injury due to Electric shock
b. is a test is for detecting injury due to Lighting
c. is a test is for detecting injury due to Laser beam
d. is reviving and bringing into consiousness, forgotten and other traumatic experiences or repressed emotiuons from unconscious levelby catharsis
Answer : d) is reviving and bringing into consiousness, forgotten and other traumatic experiences or repressed emotiuons from unconscious levelby catharsis
Reference: Narayana Reddy 17th Edition Page 365.
-----------------------------------------------------------------------------------------
20) Drug that inhibits Aldehyde dehydrogenase is
a. Disulfiram
b. Phenytoin
c. Valproate
d. Erythromycin
Answer : a) Disulfiram
Reference: Tripathi 5th Edition Page 353
2 - asphyxia - mcqs
1: required gm % of reduced Hb to develop cyanosis is
a] 5--------------
b] 10
c] 15
d] 20
2: hyperkinetic circulation is associated with
a] anoxic anoxia--------------
b] ishaemic anoxia
c] stagnant anoxia
d] histotoxic anoxia
3: characteristics of ligature mark in hanging is as follow except
a] up in the neck
b] brown parchmentised
c] incomplete
d] transverse----------------
4 Le facie sympathique is seen
a] drowning
b] hanging---------------------
c] strangulation
d] choking
5 in hanging first to be occluded
a] trachea.----------3
b] jugular vein-----------1
c] carotid artery---------2
d] vertebral artery----------4
JC brothers TV .
6 followig is not seen in Burk and Hare method
a] traumatic asphyxia
b] smoothering
c] throttling
d] strangulation---------------
7 following is not a type of atypical drowning
a] salt water wet drowning-------------
b] dry drowning
c] immersion syndrom
d] secondary drowning syndrom
8 most cardinal sign of antemortem hanging is
a] hyoid bone fracture
b] dribbling of saliva------------------
c] ligature mark on neck
d] postmortem lividity on legs and at upper margin of ligature mark
9 hyoid bone fracture is common in
a] hanging
b] strangulation
c] throttling----------------
d] drowning
10 hyoid bone fracture is common after
a] 10-20 yrs
b] 20-30 yrs
c] 30-40 yrs
d] after 40 yrs-------------
11 bansdola is form of
a] hanging
b] strangulation----------
c] throttling
d] smoothering
12 lynching is form of
a] hanging--------------
b] strangulation
c] throttling
d] smoothering
13 following is not type of strangulation
a] garroting
b] mugging
c] throttling
d] choking------------
14 following is not mode of death
a] shock------?
b] coma-------?
c] syncope------?
d] asphyxia
----------------------------------------------------------------
1: required gm % of reduced Hb to develop cyanosis is 5
2: hyperkinetic circulation is associated with anoxic anoxia
3: characteristics of ligature mark in hanging is as follows
a] up in the neck
b] brown parchmentised
c] incomplete
So, the exception is transverse mark (seen in strangulation, rarely seen in Hanging - partial haning and other types)
4 Le facie sympathique is seen in hanging
5 in hanging first to be occluded - Jugular vein(just a tension of 2kg is enough to occlude it. Carotid arteries is next with a tension of 4 to 5 kg, next is trachea with a tension of 15kg, then comes vertebral arteries with a tension of 20kg)
6 followig is not seen in Burk and Hare method - strangulation
7 following is not type of atypical drowning - salt water wet drowning
8 most cardinal sign of antemortem hanging is dribbling of saliva
9 hyoid bone fracture is common in throttling
10 hyoid bone fracture is common after 40 yrs
11 bansdola is form of strangulation
12 lynching is a form of hanging
13 following is not a type of strangulation - choking
14 following is not a mode of death ??????? Syncope or Coma? Not Sure----- let me know , with reference---post in comments
a] 5--------------
b] 10
c] 15
d] 20
2: hyperkinetic circulation is associated with
a] anoxic anoxia--------------
b] ishaemic anoxia
c] stagnant anoxia
d] histotoxic anoxia
3: characteristics of ligature mark in hanging is as follow except
a] up in the neck
b] brown parchmentised
c] incomplete
d] transverse----------------
4 Le facie sympathique is seen
a] drowning
b] hanging---------------------
c] strangulation
d] choking
5 in hanging first to be occluded
a] trachea.----------3
b] jugular vein-----------1
c] carotid artery---------2
d] vertebral artery----------4
JC brothers TV .
6 followig is not seen in Burk and Hare method
a] traumatic asphyxia
b] smoothering
c] throttling
d] strangulation---------------
7 following is not a type of atypical drowning
a] salt water wet drowning-------------
b] dry drowning
c] immersion syndrom
d] secondary drowning syndrom
8 most cardinal sign of antemortem hanging is
a] hyoid bone fracture
b] dribbling of saliva------------------
c] ligature mark on neck
d] postmortem lividity on legs and at upper margin of ligature mark
9 hyoid bone fracture is common in
a] hanging
b] strangulation
c] throttling----------------
d] drowning
10 hyoid bone fracture is common after
a] 10-20 yrs
b] 20-30 yrs
c] 30-40 yrs
d] after 40 yrs-------------
11 bansdola is form of
a] hanging
b] strangulation----------
c] throttling
d] smoothering
12 lynching is form of
a] hanging--------------
b] strangulation
c] throttling
d] smoothering
13 following is not type of strangulation
a] garroting
b] mugging
c] throttling
d] choking------------
14 following is not mode of death
a] shock------?
b] coma-------?
c] syncope------?
d] asphyxia
----------------------------------------------------------------
1: required gm % of reduced Hb to develop cyanosis is 5
2: hyperkinetic circulation is associated with anoxic anoxia
3: characteristics of ligature mark in hanging is as follows
a] up in the neck
b] brown parchmentised
c] incomplete
So, the exception is transverse mark (seen in strangulation, rarely seen in Hanging - partial haning and other types)
4 Le facie sympathique is seen in hanging
5 in hanging first to be occluded - Jugular vein(just a tension of 2kg is enough to occlude it. Carotid arteries is next with a tension of 4 to 5 kg, next is trachea with a tension of 15kg, then comes vertebral arteries with a tension of 20kg)
6 followig is not seen in Burk and Hare method - strangulation
7 following is not type of atypical drowning - salt water wet drowning
8 most cardinal sign of antemortem hanging is dribbling of saliva
9 hyoid bone fracture is common in throttling
10 hyoid bone fracture is common after 40 yrs
11 bansdola is form of strangulation
12 lynching is a form of hanging
13 following is not a type of strangulation - choking
14 following is not a mode of death ??????? Syncope or Coma? Not Sure----- let me know , with reference---post in comments
1 - forensic medicine - mcqs - 1 to 10
1 - magnan symptom is seen with ?
a- cocaine
b- op poisoning
c- snake bite
d- hanging
answer is a .
Reference: Parikh 6th Edition Page 11.9
--------------------------------------------------------------------
2 - post mortem lividity is useful to access
a- time since death
b- to know the weapon used
c- position of the body after death
d- none of the above
answer is c. to know the position of the body after death .
Reference:
The Essentials of Forensic Medicine and Toxicology by Narayana Reddy Chapter 7 about postmortem changes
Principles of Forensic Medicine by Apurba Nandy 1st Edition Page 151
Parikh 6th Edition 3.10
Facts
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.
--------------------------------------------------
3 . in cases of drowning in sea water
a- hemoglobin decreases
b- hemoglobin increases
c- no change
d- either
answer is a - hemoglobin increases .
Reference: Apurva Nandhi 1st Edition Page 336
-->The blood is thick in case of death due to Drowning in Sea Water (wet drowning Type II – B) and is thin due to hemolysis in case of drowning in fresh water (wet drowning Type II – A)
------------------------------------------------------------------
4 - All are the characteristic features of Superficial burns except
a.-->Damage no deeper than papillary dermis
b.-->Blisters seen
c.-->Loss of Epidermis
d.-->Pinprick is painful
Answer (d) Pinprick is painful
Reference: Bailey and Love 24th Edition Page 270 .
--------------------------------------------------------------------------
5 - The cephalic index of Indian population is between:
a. 70 to 75
b. 75 to 80
c. 80 to 85
d. 85 to 90
Answer 2. 75-80.
Reference The Essentials of Forensic Medicine and Toxicology 21st Edition : K.S.Narayana Reddy Page 50
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6 - Punch drunk syndrome is seen in
a. Boxers
b.Musicians
c. Tailors
d. Carpenters
Answer (a) Boxers
Reference: Narayana Reddy 19th Edition Page 239.
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7 - Viper snake bite resembles poisoning of
a. Abrus precatoris
b. Sulphuric Acid
c.Organophosphorus
d. Thallium
Answer (a) Abrus precatorius
Reference: Narayana Reddy 19th Edition Page 460.
--------------------------------------------------------------
8 - Lesbianism is also called as
a. Tribadism
b. Eonism
c. Sodomy
d. Onanism
Answer (a) tribadism
Reference: Narayana Reddy 19th Edition Page 344.
------------------------------------------------------------
9 - 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:
a. Grievous.
b. Simple.
c. Dangerous.
d. 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
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.
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10 - Green stick fracture occurs in
a. Young age
b. Skull
c. Old Age
d. None of the above
Answer (a) Young Age
Reference: Kalava’s Textbook of Orthopaedics, 1st Edition Page 40
Types of Fractures in Children would include
-->Greenstick Fractures
Incomplete fracture seen exclusively in children. One cortex is broken and other is intact
-->Buckle Fracture - Torus Fracture
Common in Metaphyseal region and is due to compressive force. The cortex is buckled
-->Plastic Bowling
Bone deforms, but does not break and there is micro fracture on the concave side. This is seen in Paired Bones
-->Epiphyseal Injuries
a- cocaine
b- op poisoning
c- snake bite
d- hanging
answer is a .
Reference: Parikh 6th Edition Page 11.9
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2 - post mortem lividity is useful to access
a- time since death
b- to know the weapon used
c- position of the body after death
d- none of the above
answer is c. to know the position of the body after death .
Reference:
The Essentials of Forensic Medicine and Toxicology by Narayana Reddy Chapter 7 about postmortem changes
Principles of Forensic Medicine by Apurba Nandy 1st Edition Page 151
Parikh 6th Edition 3.10
Facts
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.
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3 . in cases of drowning in sea water
a- hemoglobin decreases
b- hemoglobin increases
c- no change
d- either
answer is a - hemoglobin increases .
Reference: Apurva Nandhi 1st Edition Page 336
-->The blood is thick in case of death due to Drowning in Sea Water (wet drowning Type II – B) and is thin due to hemolysis in case of drowning in fresh water (wet drowning Type II – A)
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4 - All are the characteristic features of Superficial burns except
a.-->Damage no deeper than papillary dermis
b.-->Blisters seen
c.-->Loss of Epidermis
d.-->Pinprick is painful
Answer (d) Pinprick is painful
Reference: Bailey and Love 24th Edition Page 270 .
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5 - The cephalic index of Indian population is between:
a. 70 to 75
b. 75 to 80
c. 80 to 85
d. 85 to 90
Answer 2. 75-80.
Reference The Essentials of Forensic Medicine and Toxicology 21st Edition : K.S.Narayana Reddy Page 50
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6 - Punch drunk syndrome is seen in
a. Boxers
b.Musicians
c. Tailors
d. Carpenters
Answer (a) Boxers
Reference: Narayana Reddy 19th Edition Page 239.
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7 - Viper snake bite resembles poisoning of
a. Abrus precatoris
b. Sulphuric Acid
c.Organophosphorus
d. Thallium
Answer (a) Abrus precatorius
Reference: Narayana Reddy 19th Edition Page 460.
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8 - Lesbianism is also called as
a. Tribadism
b. Eonism
c. Sodomy
d. Onanism
Answer (a) tribadism
Reference: Narayana Reddy 19th Edition Page 344.
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9 - 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:
a. Grievous.
b. Simple.
c. Dangerous.
d. 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
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.
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10 - Green stick fracture occurs in
a. Young age
b. Skull
c. Old Age
d. None of the above
Answer (a) Young Age
Reference: Kalava’s Textbook of Orthopaedics, 1st Edition Page 40
Types of Fractures in Children would include
-->Greenstick Fractures
Incomplete fracture seen exclusively in children. One cortex is broken and other is intact
-->Buckle Fracture - Torus Fracture
Common in Metaphyseal region and is due to compressive force. The cortex is buckled
-->Plastic Bowling
Bone deforms, but does not break and there is micro fracture on the concave side. This is seen in Paired Bones
-->Epiphyseal Injuries
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