Monday, January 7, 2008

5 - forensic medicine mcqs - 26 to 30

26 . The cephalic index of Indian population is between:
1. 70-75.
2. 75-80.
3. 80-85.
4. 85-90.
2. 75-80.
The Essentials of Forensic Medicine and Toxicology 21st Edition : K.S.Narayana Reddy Page 50
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
Ä2 Japanese
Ä3 Chinese
Ä4 South East Asians Broad Headed Round Headed Short Headed / Square headed

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.
Remember that Caucasians are Europeans. (Have you heard about Caucas Montains and Ural Mountrains of Europe)
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

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.
3. Anthropometry.
The Essentials of Forensic Medicine and Toxicology 21st Edition : K.S.Narayana Reddy Page 70

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

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”
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
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

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.
4. Septicemia.
The Essentials of Forensic Medicine and Toxicology 21st Edition : K.S.Narayana Reddy Page 128
Parikh 6th Edition Page 3.29 to 6.31

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

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
Site used for recording internal temperature
Rectum - 4" above Anus
Thermometer used
Chemical Thermometer
Graduation- 0oC or 50oC

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.
3. Aniline dyes.
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
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
Postmortem Staining
Post mortem hypostasis is Blue colour in deaths due to Asphyxia and Poisoning with Aniline
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. )
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
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.

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.
1. Grievous.
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
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.
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.
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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