NEET-PG 2014 - Forensic Medicine Practice Questions

Q: Which of the following is true about cadaveric spasm?

Some particular group of muscles are involved. ***Some particular group of muscles are involved*** - **Cadaveric spasm** is characteristically a **localized or partial phenomenon**, typically affecting specific muscle groups that were in intense contraction at the moment of death. - Classic examples include **hand gripping a weapon** (homicide/suicide), **clutching grass or mud** (drowning), or **specific limb muscles** during extreme physical exertion. - While generalized cadaveric spasm can theoretically occur, it is **usually partial and localized** to the muscles involved in the terminal activity. - This is a key distinguishing feature used in **medico-legal investigations** to determine circumstances of death. *Occurs 2-3 h after death* - This describes the typical onset of **rigor mortis**, which begins 2-3 hours post-mortem and follows a predictable progression. - **Cadaveric spasm** occurs **instantaneously at the moment of death** with **no flaccid interval**, unlike rigor mortis which has a pre-rigor flaccid phase. *Disappears with rigor mortis* - This is **incorrect**. Cadaveric spasm does **not disappear** when rigor mortis develops. - Instead, cadaveric spasm **persists and merges into rigor mortis**, becoming indistinguishable from it once rigor mortis is fully established. - Both cadaveric spasm and rigor mortis eventually resolve together during the **resolution phase** (24-36 hours post-mortem), not separately. *Involves involuntary muscles* - **Cadaveric spasm** affects only **voluntary (skeletal) muscles** under conscious control. - Involuntary muscles such as cardiac muscle and smooth muscles of internal organs are **not involved** in cadaveric spasm.

Q: Pica is associated with poisoning:

Lead. ***Lead*** - **Pica**, the craving and consumption of non-food items, is a common symptom of **lead poisoning**, especially in children. - This behavior can lead to further ingestion of lead-containing substances, creating a vicious cycle of exposure. *Arsenic* - **Arsenic poisoning** primarily affects the skin, nervous system, and gastrointestinal tract, causing symptoms like **skin lesions**, neuropathy, and diarrhea. - While various neurological symptoms can occur, **pica** is not a characteristic feature of chronic arsenic exposure. *Phosphorus* - **Phosphorus poisoning** is typically associated with gastrointestinal irritation, liver damage, and cardiovascular effects, often from ingestion of pesticides or fireworks. - It does not commonly present with **pica** as a primary symptom. *Mercury* - **Mercury poisoning** manifests with neurological and psychiatric symptoms such as **tremors**, memory loss, and personality changes (**erethism**). - Pica is not a typical manifestation, although central nervous system effects can cause a range of behavioral changes.

Q: In air blast injury, which is the most commonly affected organ? CMC (Vellore) 07; AI 09; AIIMS 10; NEET 14

Eardrum. ***Eardrum*** - The **eardrum (tympanic membrane)** is the most commonly affected organ in air blast injuries due to its thin, delicate structure and direct exposure to pressure waves. - Its rupture threshold is relatively low, making it highly susceptible to damage from sudden changes in air pressure. *Stomach* - While **hollow organs** like the stomach can be affected by blast injuries (secondary to barotrauma), they are less commonly ruptured than the eardrum. - Injury to the stomach generally requires a higher intensity blast or immersion in water. *Lungs* - **Pulmonary barotrauma** (blast lung) is a serious consequence of blast injury, characterized by hemorrhage, edema, and contusions. - However, the eardrum is far more frequently (and often mildly) injured compared to severe lung damage. *Liver* - The **liver**, being a solid organ, is generally more resistant to direct blast effects compared to hollow or air-filled structures. - Liver injuries from blast are more often due to secondary trauma (e.g., impact from flying debris) rather than the primary blast wave itself.

Q: Penile buccal coitus is:

Fellatio. ***Fellatio*** - **Fellatio** specifically refers to oral sex involving stimulation of the penis with the mouth. - The term "buccal coitus" in the context of penile stimulation directly describes the act of fellatio. *Sadism* - **Sadism** is a paraphilia characterized by deriving sexual pleasure from inflicting pain, humiliation, or suffering on others. - It does not describe a specific sexual act involving penile buccal coitus, but rather the motivation behind certain acts. *Fetishism* - **Fetishism** involves sexual attraction to non-genital body parts or inanimate objects. - While oral sex can be a preference, it is not inherently a fetish unless the focus is exclusively or predominantly on the mouth or penis as an isolated object, rather than interpersonal sexual activity. *Cunnilingus* - **Cunnilingus** is a form of oral sex involving stimulation of the vulva or clitoris. - This term describes oral sex directed at female genitalia, not the penis.

Q: For diagnosis of insanity, maximum limit of observation:

30 days. ***30 days*** - Under **Section 328 of the Criminal Procedure Code (CrPC)** and the **Mental Healthcare Act, 2017**, the maximum observation period for diagnosing insanity in a forensic context is **30 days**. - This duration allows for comprehensive psychiatric evaluation including detailed history, behavioral observation, mental status examination, and necessary psychological tests to determine fitness to stand trial and criminal responsibility. - This is the standard maximum limit for observation in Indian legal practice for determining sanity at the time of the alleged offense. *5 days* - A 5-day observation period is **too short** for adequate assessment of complex mental health conditions like insanity. - Psychiatric symptoms can fluctuate, and brief observation may miss critical diagnostic criteria or behavioral patterns necessary for forensic evaluation. *50 days* - An observation period of 50 days **exceeds the legal maximum** of 30 days stipulated under Indian law. - While observation may be extended in exceptional circumstances with court permission, 50 days is not the standard maximum limit. *10 days* - A 10-day observation period is **insufficient** for definitive diagnosis of insanity in forensic practice. - Though longer than 5 days, it falls short of the legally mandated maximum timeframe required for thorough psychiatric evaluation and documentation.

Q: Method of autopsy in which organs of various systems are removed en masse:

Lettulle. ***Lettulle*** - The **Lettulle method** (or en masse method) involves the removal of organs in large blocks or as a single unit, which helps preserve anatomical relationships. - This technique is particularly useful for studying the **interrelationships between organs** and the spread of disease involving multiple systems. *Virchow* - The **Virchow method** involves the individual removal of each organ, which allows for detailed examination of each organ separately. - This method is straightforward but can disrupt the **anatomical relationships** between organs. *Rokitansky* - The **Rokitansky method** involves *in situ* dissection of organs, with the organs remaining largely in the body during dissection. - This technique is valued for maintaining the **topographical integrity** of organ systems within the body cavity. *Ghon* - The **Ghon method** is a modified block dissection method, focusing on the removal of specific organ blocks. - This often includes the **thoracic and abdominal organs** together, maintaining their anatomical connections.

Q: Gettler's test is used to diagnose death due to:

Drowning. ***Drowning*** - **Gettler's test** is a specific diagnostic test for **drowning** that compares the **chloride concentrations** in blood from the **left and right sides of the heart**. - In freshwater drowning, water enters the bloodstream causing **hemodilution** in the left heart, resulting in **lower chloride levels** compared to the right heart. - In saltwater drowning, the opposite occurs with **higher chloride concentration** in the left heart due to hypertonic fluid absorption. - A **difference of >25 mg/dL** in chloride levels between the two sides suggests drowning, though the test has **limited reliability** and is not routinely used in modern forensic practice. *Strangulation* - **Strangulation** involves mechanical compression of the neck structures causing cerebral hypoxia and asphyxia. - Diagnosed by findings like **petechiae** (conjunctival and facial), **ligature marks**, **laryngeal fractures**, and **neck soft tissue hemorrhage**. - Gettler's test is irrelevant as strangulation does not cause significant fluid shifts between cardiac chambers. *Hanging* - **Hanging** is a form of ligature strangulation caused by suspension of the body by a ligature around the neck. - Characteristic findings include **inverted V-shaped ligature mark** (highest at the point of suspension), **hyoid bone fracture**, and signs of asphyxia. - Diagnosis relies on neck examination and postmortem findings, not cardiac chloride level differences. *Burns* - Death from **burns** results from extensive thermal tissue damage, fluid loss, shock, or smoke inhalation. - Diagnosed by the extent of body surface area burned, presence of **soot in airways** (indicating antemortem inhalation), and thermal injury patterns. - Gettler's test has no application in thermal injury deaths as it specifically addresses fluid electrolyte shifts in drowning.

Q: For DNA test, liquid blood is preserved in:

EDTA. ***EDTA*** - Ethylenediaminetetraacetic acid (EDTA) is the preferred anticoagulant for DNA extraction because it **chelates metal ions** (like magnesium), which are cofactors for **DNases** (enzymes that degrade DNA). - By inhibiting DNases, EDTA effectively **preserves DNA integrity** in blood samples for genetic testing. *Sodium fluoride* - **Sodium fluoride** is primarily used as an antiglycolytic agent to preserve glucose in blood samples. - It does not specifically function to preserve DNA or inhibit DNA degradation significantly. *Potassium oxalate* - **Potassium oxalate** acts as an anticoagulant by precipitating calcium, but it is not optimal for long-term DNA preservation. - Its anticoagulant properties are less suitable for molecular testing compared to EDTA, and it doesn't protect DNA as effectively. *Sodium citrate* - **Sodium citrate** is an anticoagulant primarily used for coagulation studies (e.g., PT, PTT) by chelating calcium. - While it prevents clotting, it is **less effective than EDTA** in protecting DNA from degradation by DNases, making it a poorer choice for DNA banking.

Q: Hydrostatic test (Reygate's test) for lungs is based on:

Specific gravity of lung. ***Specific gravity of lung*** - The hydrostatic test (also known as **Reygate's test** or **flotation test**) is a forensic test used to determine if a lung has ever respired, based on its **buoyancy in water**. - This buoyancy is directly related to the lung's **specific gravity**, which changes significantly depending on whether it contains air. - Aerated lungs (which have breathed) have a specific gravity less than 1 and will **float**, while non-aerated lungs have a specific gravity greater than 1 and will **sink**. *Consistency of lung* - While lung consistency can vary based on pathology, it is not the primary principle underlying the hydrostatic test. - The test specifically exploits changes in **density**, not just feel or firmness. *Volume of lungs* - Lung volume is a factor influencing buoyancy, but it's the **ratio of mass to volume** (density/specific gravity) that determines if the lung floats. - A larger lung may still sink if it is collapsed and airless, demonstrating that volume alone is not the sole basis. *Weight of lung* - The weight of the lung is important in determining its overall mass, but the hydrostatic test relies on the **weight relative to its volume** (i.e., specific gravity). - A heavy lung can still float if it contains sufficient air to lower its specific gravity below that of water.

Q: Artificial bruises are produced by:

Marking nut. ***Marking nut*** - The **marking nut** (*Semecarpus anacardium*) contains a vesicant oil that causes a chemical burn, mimicking a true bruise. - This effect is often described in forensic medicine as producing **artificial bruises** or **factitious injuries**. *Capsicum* - **Capsicum** (found in chili peppers) causes irritation and a burning sensation, but typically does not produce dermal lesions that resemble a bruise. - It might cause redness due to vasodilatation but not the characteristic blue-black discoloration of a bruise. *Rati* - **Rati**, or **Abrus precatorius** (rosary pea), is highly toxic due to abrin, a potent toxin. - While ingestion or injection can cause severe systemic effects, it is not known to produce localized artificial bruises on the skin. *Croton* - **Croton** oil, derived from *Croton tiglium*, is a strong purgative and skin irritant. - It can cause severe blistering and inflammation upon topical application but does not typically create lesions that are mistaken for a bruise.

Question 1

Which of the following is true about cadaveric spasm?

Accepted Answer

Some particular group of muscles are involved

Answer

Occurs 2-3 h after death

Answer

Involves involuntary muscles

Answer

Disappears with rigor mortis

Question 2

Pica is associated with poisoning:

Accepted Answer

Lead

Answer

Arsenic

Answer

Phosphorus

Answer

Mercury

Question 3

In air blast injury, which is the most commonly affected organ? CMC (Vellore) 07; AI 09; AIIMS 10; NEET 14

Accepted Answer

Eardrum

Answer

Stomach

Answer

Lungs

Answer

Liver

Question 4

Penile buccal coitus is:

Accepted Answer

Fellatio

Answer

Sadism

Answer

Fetishism

Answer

Cunnilingus

Question 5

For diagnosis of insanity, maximum limit of observation:

Accepted Answer

30 days

Answer

5 days

Answer

50 days

Answer

10 days

Question 6

Method of autopsy in which organs of various systems are removed en masse:

Accepted Answer

Lettulle

Answer

Virchow

Answer

Rokitansky

Answer

Ghon

Question 7

Gettler's test is used to diagnose death due to:

Accepted Answer

Drowning

Answer

Strangulation

Answer

Hanging

Answer

Burns

Question 8

For DNA test, liquid blood is preserved in:

Accepted Answer

EDTA

Answer

Sodium fluoride

Answer

Potassium oxalate

Answer

Sodium citrate

Question 9

Hydrostatic test (Reygate's test) for lungs is based on:

Accepted Answer

Specific gravity of lung

Answer

Consistency of lung

Answer

Volume of lungs

Answer

Weight of lung

Question 10

Artificial bruises are produced by:

Accepted Answer

Marking nut

Answer

Capsicum

Answer

Rati

Answer

Croton

NEET-PG 2014 — Forensic Medicine