AIIMS Pre-PG 13 November 2011 Forensic Medicine

1- Stack Formula is used to estimate age through dentition is for..

a. infants
b. adults 25-50yrs
c. adult >50yr
d. elderly

Explanation :  (Click on Picture to enlarge view )

2. DNA Is best obtained from autopsy from which organ.

a) Liver
b) Kidney
c) Brain
d) Spleen

Update ( 7 December 2011 ) : After discussion with some of the senior professors of Forensic Medicine, who confirmed that the answer key likely considered Spleen as the answer and cited the following reference from  Post mortem technique handbook By Michael T. Sheaff, Deborah J. Hopster. ( Going by the Golden principle : Examiners are always right..I'm revising the answer from Brain to Spleen )

In the spirit of scientific temperament, please go through the 'Contradictory Reference' which points towards Brain Cortex : " With blood samples, a good HMWDNA recovery from all the bodies investigated was obtained during the first week following the death. In each case, the quality and quantity of the DNA were good enough to realize DNA fingerprints with the SLP system (data not shown). In liver samples, only bodies of postmortem ages ranging from 1 to 7 days allowed us to obtain HMWDNA. HMWDNA was extracted from kidney samples up to one month after death, but the yield of DNA decreased rapidly, becoming very low beyond a period of one week. Past this period, we did not succeed in obtaining DNA fingerprints from DNA extracted. The extraction of DNA from lymph nodes was satisfactory up to one week. Over a postmortem period of 7 days, the DNA was degraded and unsuitable for blotting. HMWDNA was purified from spleen samples up to one week after death and the DNA present in heart tissue or in muscle cells was stable up to one month postmortem period, allowing us to perform DNA fingerprinting. Finally, out of all tissues tested, the brain cortex appeared to be the most stable tissue for DNA recovery, even after long postmortem periods." Source : http://library-resources.cqu.edu.au/JFS/PDF/vol_38/iss_3/JFS383930686.pdf

(Click on Picture  to enlarge view )

3.  Palate print commonly taken from :

 a. anterior part of palate
 b. lateral wall of palate
 c. medial wall of palate
 d. posterior palate

Study of the laterally extended curved
ridges (Rugae) and the grooves on the anterior
part of the palate.

It is also known as ‘Rugoscopy'
Palates have got various characteristics like placed
high up or low, broad or narrow. peculiarities of
the bony ridges and prominences.

Harrison Allen (1889) suggested the study of palate prints as a
method of identification.

Study of this method is advantageous because —
(1) Prints (ridge pattern) do not change during
growth.
(2) It is protected from trauma due to its
situation.
(3) It is protected from heat by bucal pad of
fat and tongue.
(4) Even in twins, the pattern of rugosities may
be similar but not identical.

Thomas and Kotze have classified palate
prints basing on the characteristic of the rugae as
follows -

(1) Primary rugae — 5 to 10 mm and 10 mm or
more.
(2) Secondary rugae — 3 to 5 mm.
(3) Fragmented rugae — Less than 3 mm.

Source: Karmakar's Forensic Medicine and Toxicology Page 385


Q4. Flaying seen in what type of lacerated wound ?
  a. tear
 b. shearing force
 c. avulsion
 d. pressure

 Explanation : Reference K. Vij's FMT

 

 

 

 

 

 

 

Q  Which of the following is wrong :

a. 300- Murder
B. 304 - Culpable homicide not amounting to murder
C. 306 - Attempted suicide
D. 307 Attempt to murder

 

Q, What is the Section under which punishment is given for issuing a false medical certificate-

a) IPC137
b) IPC147
c) IPC157
d) IPC197

Q. Giving False evidence under Oath is defined under section :

a) 151 IPC
b) 161 IPC
c) 181 IPC
d) 191 IPC


Q. maximum punishment to doctor under 304A................2year


:::Medico-legal Important Sections:::

Indian Penal Code

• Sec 44 Injury
• Sec 84 Act of a person of unsound mind/McNaughtens Rule
• Sec 85 Act of a person who is intoxicated against will
• Sec 191 & sec 193 definition and Punishment of perjury(Punishment up-to 7yrs )
• Sec 197 Issuing or signing false certificate

Offense Affecting Human Body

Sec 299 to Sec 377
• Sec 299 Culpable Homicide
• Sec 300 Murder
• Sec 302 Punishment of murder/infanticide*
• Sec 304 Culpable Homicide not amounting to murder
• Sec 304 A Causing death by negligence* ( punishment up-to 2yrs/fine )
• Sec 304 B Dowry Death

Sections Related to Criminal Abortion
• Sec 312 to Sec 316
Abandonment of Child under 12 years
• Sec 317
Concealment of birth
• Sec 318

Hurt
Sec 319
Grievous Hurt
• Sec 320
Assault
• Sec 351
Assault to Outrage the Modesty of Women
• Sec 354

Rape
Definition Sec 375
Punishment Sec 376

Criminal Procedure Code

Sec 174 Police Inquest
Sec 176 Magistrate’s Inquest

Indian Evidence Act
Sec 32 Dying Declaration

Q. 5 : 1st ossification centre appears at :


a. Beginning 2nd I/U month
b. Beginning of 3rd I/U month
c .End of 3rd I/U month
d. 4th month of gestation

(Click on Picture  to enlarge view )

  


































According to organ transplantation act 1994 what punishment for doctor if found guilt ?
 
1. 2 yrs
2. more than 5 yrs
3. 4 yrs
4. 2-5 yrs 


These has been an amendment in Organ Transplantation act in August 2011( both Lok Sabha & Rajya Sabha passed the Bill ) , where the punishment has been made more severe between 5-10 years (Click on Picture  to enlarge view )...Why answe should be 2. more than 5 yrs? Explanation : Why will the examiner suddenly ask about punishment, if there is NO recent development )

Q A chronic alcoholic - assaults neighbor - had quit drinking 4 days back - now has delirium tremens. He is : 
 
A. Responsible for committing the crime
B. Not responsible under Sec 84 IPC
C. Partially responsible
D. Responsibility can't be fixed from the given history ( Click on Picture to enlarge view )

AIIMS Pre-PG MAY 2011( Forensic Medicine)

Q1. Condition promoting adipocere formation

1. Dry and hot
2. Hot and humid `
3. Dry & optimum
4. humid and optimum(temperature) 

Favourable for adipocere:
1. Fat
2. Female
3. Newborn
4. Open wounds
5. No drugs/sudden death
6. Room temperature (36hrs)
7. Autumn or winter
8. Fog, misty & humid
9. corpses buried one over the other
10. More deep graves
11. Oak, lead n Zn coffins
12. clothing made of nylon
13. Moist, clayey, loamy soils
14. pH >7
15. Low redox potential
16. High anaerobic
17. high salt content

Unfavourable for adipocere:

1. Thin
2. Male
3. Older
4. No wounds
5. Antibiotics, drugs, poisons
6. Cold temp(4-7d): Hot temp(decompose) [Clincher*]
7. Spring and summer
8. Dry
9. Individually buried corpses
10. Shallow or surface graves
11. Pine n sprue coffins
12. Straw bedding
13. Hot, Sandy, limey soils

 

 

2. What does the word "cardiac polyp" mean?

1. Acute infarct
2. Cardiac aneurysm
3. Benign tumour
4. Fibrinous clot

Cardiac Polyp : Mural thrombus in the right/left atrium at the time at the time of post-mortem examination appears as pedunculated mass with a stalk attached to wall of the heart and main mass in the lumen in cavity of the hear. 

Q3. In civil negligence, onus of proof is with

1. Judicial first degree magistrate
2. Police not below the level of sub inspector
3. Doctor
4. Patient 

Doctorine of Burden of proof : 

In criminal litigation, the burden of proof is always on the state. The state must prove that the defendant is guilty. The defendant is assumed to be innocent; the defendant needs to prove nothing. (There are exceptions. If the defendant wishes to claim that he/she is insane, and therefore not guilty, the defendant bears the burden of proving his/her insanity. Other exceptions include defendants who claim self-defense or duress.)

In civil litigation, the burden of proof is initially on the plaintiff ( patient in case of Medical Negligence suit) . However, there are a number of technical situations in which the burden shifts to the defendant. For example, when the plaintiff has made a prima facie case, the burden shifts to the defendant to refute or rebut the plaintiff's evidence. 

Q. 4 A man working as a pest killer comes to opd with pain abdomen, garlic odor in breath & transverse meis lines on nails. What is diagnosis

1. Arsenic poisoning
2. Lead poisoning
3. Mercury poisoning
4. Cadmium poisoning

Arsenic  Poisoning  :  

Metallic arsenic is not poisonous, as it is not absorbed from the alimentary canal.

     Poisonous compounds:

     1.  Arsenious oxide or Aresenic trioxide (Sankhya or Somalkar): it is known as white arsenic. It has been found to be useful in treatment of Acute Promylocytic Leukemia (APL)*

     2.  Copper acetoarsenate (paris green): It combines with sulphydryl enzymes and inter­feres with cell metabolism.

     3.  Copper Arsenate (Schcele’s green).

–   Signs and Symptoms:

     1.  The Fulminant type: Large doses of arsenic can cause death in one to 3 hrs from shock.

     2.  The Gastro enteric type: This is acute poison­ing, resembling bacterial food poisoning or cholera.

          –   This is the most common form.

          –   The stools are expelled frequently and involuntarily, are dark coloured, stinking and bloody, but later becomes colorless, odourless and water resembling rice water stools of cholera.**

          –   Sequence of symptoms:

               • Throat pain

               • Vomitting (Bile, Blood and Mucous)

               • Purging (Tenesmus present)

     3.  Narcotic form: Tenderness of the muscle, delirium, coma and death.

     •    Arsenic poisoning resembles

          –   Pre malignant condition

          –   Cholera

          –   Fading measles

          –   Addison’s disease.

–   Treatment

     1.  Freshly prepared precipitated hydrated ferric oxide (arsenic antidote)* is given. Dialysed Iron is substitute.

     2.  In arsenic poisoning BAL is an antidote. (BAL is contraindicated in cadmium and iron poisoning).

     3.  Calcium disodium versenate

     4.  Alkali is contra indicated.

–   Postmortem appearance

     •    Red Velvety* appearance of the stomach mucosa.

     •    Subendocardial haemorrhage of heart.*

–   Chronic poisoning:

     1.  CNS—Polyneuritic, optic neuritis

     2.  Skin—finely mottled brown change mostly on the temples, eyelids and neck (RAIN Drop pigmentation)

          •    There may be a rash resembling fading measles rash*

          •    Hyperkeratosis and Hyperpigmentation of the palms and soles with irregular thicken­ing of the nails is seen.

          •    Nails show ALDRICH MEE’s line (Leuko­paronychia).{Confuser* Beau’s Lines
® Chronic Systemic Disease, also Muehrcke’s Line® hypo proteinemia}

          •    Nails show ALDRICH MEE’s line (Leukoparonychia).

–   Arsenophagists are people who take arsenic daily as tonic or as an aphrodisiac and they acquire a tolerance of up to 0.3gm or more in one dose.

Medicolegal Importance

•    Arsenic is the most popular homicidal poison.

•    Napolean was killed using Arsenic poison (c.f. Socrates was killed using Hemlock poisoning).

•    It delays putrefaction.

•    It can be detected in completely decomposed body.

•    It can be found in bones, hair and nails for a long time.

•    It can be detected in charred bone and ashes.

•    It is sometimes used in abortion sticks.

•    Arsenic causes Black foot disease.*

•    Marsh test and Reinsch test are important Chemical tests*.

     Early stages greatest quantity in liver  Later keratin tissues: BONE, HAIR & NAILS.

     Test for Arsenic®

    I.  Reinsch Test

  II.  Marsh Test (mARSenich)

III.  Gutzeit Test.

 

Q 5 Formication & delusion of persecution occurs together in ( Repeat from AIIMS May 2009 )

1. LSD
2. Cocaine psychosis
3. Canabis
4. Amphetamine

 

Magnan’s symptoms or cocaine bug is char­acteristic, in which there is feeling as if grains of sand are lying under the skin or some small insects are creeping on the skin (tactile hallucinations). This phenomenon is also known as formication. Some subjects report hallucinations of weak flashes of light, termed "snowlights." 

Q.6 During autopsy, if spinal cord is to be examined what is the most commonly used approach

1. Anterior `
2. Posterior
3. Lateral
4. Antero-lateral

 Explanation :                                                               

               

Most commonly used approach : Anterior

BEST approach to examine Spinal Cord: Posterior

 Which approach used to open : Anterior, Posterior & Antero- lateral 

Q. 7 Degrees awarded by Indian universities are mentioned in

1. Schedule I of MCI act
2. Schedule II of McI act
3. Part 1 of schedule III
4. Part 2 of schedule III

RECOGNITION OF MEDICAL QUALIFICATION GRANTED BY UNIVERSITIES OR MEDICAL INSTITUTIONS IN INDIA.

1. The medical qualifications granted by any university or medical Institution in India which are included in the first Schedule shall be recognised medical qualifications for the purposes of this Act.

2. The medical qualifications granted by medical institutions outside India which are included in the Second Schedule shall be recognised medical qualifications for the purposes of this Act.

3. The medical qualifications granted by medical institutions in India which are not included in the First Schedule and which are included in Part I of the Third Schedule shall also be recognised medical qualifications for the purposes of this Act.

4. The medical qualifications granted by medical institutions outside India, before such date as the Central Government may, by notification in the Official Gazette, specify which are included in Part IInd of the Third Schedule shall also be recognised medical qualifications for the purposes of this Act

 

All India Pre PG Exam January 2011

1) Sparrow marks are seen in?

A. Gunshot injuries
B. Stab injury of face
C. Vitriolage
D. Windshield glass injury 

Explanation: 

SparroW*-Foot Mark is bizarre laceration seen on face due contact with Shattered W*ind-screen..

2)  Which organ obtained from a cadaver is not used for transplantation?

A. Blood vessel
B. Lung
C. Liver
D. Bladder

Explanation: The major donor organs and tissues are heart, lungs, liver, pancreas, kidneys, eyes, heart valves, skin, bones, bone marrow, connective tissues, middle ear, blood vessels. Therefore one donor can possibly give gift of life to many terminally ill patients who would not survive otherwise.

Source: http://goo.gl/R3DdP

3)A patient presented to the casuality with bluish grey pigmentation of conjunctiva, mucous membranes, nails and tachycardia after ingestion of a poison. What is the poison:

A. Mercury
B. Arsenic
C. Lead
D. Copper 

answer should be Silver(Ag), if there was no silver in choice... then could be copper... plz check d/d for Blue skin discoloration/Skin color: http://en.diagnosispro.com/differential_diagnosis-for/blue-skin-discoloration-color/37742-154.html

4)  A poison which is illuminous, translucent, cylindrical and waxy?

A. Iodine
B. Ammonium bromide
C. Cobra venom
D. Yellow phosphorous

5) Auto-Rikshaw ran over a child’s thigh, there is a mark of the tyre tracks, it is an

A. Contact bruise
B. Patterned bruise
C. Imprint abrasion

D. Ectopic bruise

6)Rave drug is?

A. Cannabis
B. Cocaine
C. Heroin
D. Ecstasy

Ecstasy (MDMA)

Street names: XTC, X, E, Adam, The hug drug, The love drug
Method of ingestion: Orally
Appearance: Various colors and shapes usually in tablet or capsule form
Effects: Pupil dilation, inattention, increased vitals, hyperactivity, Increased body temperature, sweating profusely or not, bruxism, muscle cramping, trisma, teeth grinding, nausea, hallucinations, blurred vision, paranoia, depression.
Negatives: Hyperthermia (water toxicity) can be fatal and is the leading cause of death. Can kill with first use, rapid tolerance, extreme depression

7)All are true about world health report 2008 except?

A. Social reforms
B. Leadership
C. Polices
D. Economic reforms

• Chapter 1: The challenges of a changing world
• Chapter 2: Advancing and sustaining universal coverage
• Chapter 3: Primary care: putting people first
• Chapter 4: Public policies for the public’s health
• Chapter 5: Leadership and effective government
• Chapter 6: The way forward
• Index

8) Signature fracture refers to?

A. Depressed skull fracture
B. Suture displacement fracture
C. Contrecoup injury
D. Fracture at foramen magnum 

Fracture Skull

 

• Most fragile bone in the skull to get fractured is–temporal.

   1. Linear or fissured fractures:

    • MC type of skull fracture or cracks in the bone, involving entire thickness of bone, or outer or inner table only.

 2. Depressed fracture is also called Signature fracture.

    • Localized depressed fracture is caused by blows from heavy weapon with a small striking surface e.g. stone, stick, axe, hammer, etc.

    • The outer table is driven into the diploe, inner table is fractured irregularly.

 3. Pond or indented fractures: They occur only in skulls, which are elastic, i.e. the skulls of infants.

 4. Gutter fractures: They are formed when part of the thickness of the bone is removed so as to form a gutter e.g. oblique bullet wound.

 5. Comminuted Fracture: Multiple fracture of skull, also called Spider web fracture.

9)  Child brought to casualty with reports of violent shaking by parents. Most likely injury is?

A. Long bone fracture
B. Ruptured spleen
C. Subdural hematoma
D. Skull bone fracture 

Explanation: The term “whiplash shaken-baby syndrome” was coined by Caffey to explain this constellation of infantile subdural and subarachnoid haemorrhages, traction-type metaphyseal fractures, and retinal haemorrhages and was based on evidence that angular (rotational) deceleration is associated with cerebral concussion and subdural haematoma ( being the MOST CHARACTERISTIC FEATURE of violent shaking of an infant by the Parent )

10). Gun powder on clothing can be visualized by?

A. Magnifying lens
B. UV rays
C. Infrared rays
D. Liquid spray/ solution spray 

Infrared spectra that can provide a total chemical picture of the weapon. Gunpowder from different manufacturers and suppliers, for example,may have different chemical formulations

11) A 5 year old child has burns on the surface of his body corresponding to the size of his palm. The percentage of burns is?

A. 1%
B. 5%
C. 10%
D.  9%

The extent of the surface

    • The estimation of the surface area of the body involved is worked out by the ‘rule of nine’ by Wallace*.

    • Rule of Palm: In case of patchy burns, rule of ‘9’ is of less value. Palm of an individual is    1% of the Body Surface Area.

    • Minimum 1/3rd area must be involved to label it grevious*.

    • Involvement of 50% of burn proves fatal, even of first degree.

Parkland formula is used to calculate the fluid to be given in the first 24 hours.  

12) Dental numbering is done by all except?

A. FDI two digit system
B. Anatomic and diagrammatic charting
C. Palmer notation
D. Universal Numbering system

Tooth numbering system is used by dentists for uniquely identifying and referring to a specific tooth. Over the years, over 20 different teeth numbering systems have been developed. Today, general dentists use one of the following two major dental tooth numbering systems for the numbering of human teeth. 

• The Universal Numbering System is used primarily by most general dentists in the  United States
• FDI World Dental Federation notation is widely used by dentists internationally to associate information to a specific tooth.
• A third system is the Palmer Notation Method that is used by some orthodontists, pedodontists and oral surgeons. 

Book Reviews: 4th International Edn of " Review of Forensic Medicine"

It gives me immense pleasure to inform that the 4^th International Edn is now available in book stores. I want to thank all students & readers for their encouragement and constant feedback. 15,000 copies of the earlier three editions were sold in a period of 5 years which is a record among the sale of short books on Forensic Medicine, making it a best seller.

This Book is now also available  in Mauritius, Nepal, China, Pakistan and CIS countries apart from India.

 








Preview of the Book:

 

This Book has been extensively reviewed by Forensic Experts from USA,UK, Australia & India.
 

Their Reviews are as follows:

“It is really a simple and concise handbook on Forensic Medicine. It is awfully useful in homicide investigation for busy investigation officers.”

Shri Tajender Luthra, IPS

" This book is a must have for all pg aspirants, dr seth is both a great teacher & a great author"

Dr Sumer K Sethi,
MBBS, MD (Radiodiagnosis)
Course Director, DAMS
Delhi Academy of Medical Sciences
Author of famous "Review of Radiology' in same series

 "Review of Forensic Medicine" is a concise book with lots of information on Forensic Medicine. I have used this book to prepare question for undergraduates during my stay at UPRIMS & R, Dr RPGMC, Tanda, and SNMC, Agra.The students were very much benefitted as they were also preparing for PG Entrance.

Dr Imran Sabri

Assistant Professor 

Department of Forensic Medicine and Toxicology 

School of Medical Sciences & Research, Sharda University

Webmaster, www.forensicindia.com  

"The book is every student's delight as it has filled a void of a book that single-handedly covers all the topics in forensic medicine with the details precisely to an extent that is needed for the entrance examinations.
It very well de burdens the pressures of time and learning expanse in the already overloaded and taxed life of a medical student."

A "can't afford to miss" book

I READ IT LIKE MY BIBLE


Dr. Parul Gupta
Topper, Delhi PG Exam
LADY HARDINGE MEDICAL COLLEGE



"REVIEW OF FORENSIC MEDICINE IS ONE OF THE BEST POCKET BOOKS FOR INDIAN MEDICAL GRADUATES, IT HAS ALL THE NEEDED POINTS IN LEAST NUMBER OF PAGES “

DR Isha Gupta
Topper Pre-PG Exam
LADY HARDINGE MEDICAL COLLEGE




The whole spectrum of forensic medicine is covered

The MCQs themselves are well thought out and laid out nicely.

On the whole it is a fine book suitable for students of forensic medicine

I would think that this book is the sort of book one reads one last time on the day before the exam!”

Dr. Gyan C. A. Fernando
MBBS, FRCPath, DMJ
Home Office Forensic Pathologist
Devon and Cornwall
United Kingdom


“Student quick pocket guide for forensic medicine and forensic toxicology examination”

Dr. Javed Khan
Forensic Scientist
California Department of Justice
Bureau of Forensic Services
Riverside Crime Laboratory
13723 Stockbrook RoadMoreno Valely, CA 92553, USA


This slim volume is an excellent summary of the important points of forensic medicine.
This is a user friendly book, easy and quick to read, and small enough to carry with you. It covers all fields of forensic medicine .It is an excellent companion to larger volumes on the forensic medicine and pathology.

Dr. Jenny Ball
46 Webster Street
Forensic Odontologist
Nedlands 6009
Western Australia
Australia



Review of Forensic Medicine” by Dr. Sumit Seth (PEEPEE Publishers, New Delhi) is a refreshing departure from the traditional text books on Forensic Medicine. In each of the fourteen chapters of this small concise book the author has explained the intricacies of various facets of Forensic Medicine in a very simple and lucid manner followed by a set of possible Multiple Choice Questions with their answers at the bottom of each page.

Professor P.K. Chattopadhyay
Director
Amity Institute of Forensic Sciences
New Delhi