NEET-PG 2024 Forensic Medicine Recall Questions Review

[00:00:00]hi guys Dr Mahindra of forensic medicine toxicology faculty from Maru here we are for the discussion of recall questions of forensic medicine toxicology from net PG 2024 finally the examination is done so the students uh see any examination will be testing three aspects from the students one the knowledge application of knowledge and the skill of solving mcqs but this npg 2024 was testing another thing from the students as well that is patients postm of examination pre-ot of examination again postp examination allotment of Center re allotment of Center re allotment of centers so the students had to go so many things anyway the finally the examination is done the examination was conducted in two sessions morning and afternoon when it comes to forensic medicine toxicology there are four points number one most of the questions all the questions are from high topics number two we had approximately 11 questions for each sessions number three if you see the difficulty level forensic medicine toxicology questions where easy to moderate level difficulty for most of the students this subject was a lifesaver and uh and you see the last Point most of the questions are case-based scenarios there was no oneliner so let us discuss the questions so first we'll be discussing on the questions from morning session then we'll be discussing on the questions from the afternoon session the first question you see 18-year-old boy was brought by the police accused of sexual assault but the boy claims to be a minor and 16 years old which radiograph will you order for solving this discrepancy so there is a age discrepancy this person is an accused a case of sexual assault but this person wants to take a defense of juvenile you know the criminal responsibility for a juvenile is different from his criminal responsibility of an adult so this person claims that 16 years old but is actually 18 years old so which of the following x-rays will be helping you to solve this uh discrepancy so you basically have to understand in the question they ask you that which of this x-ray will be helping to confirm that is 18 years old fine so let us look at the uh options we had wrist and knee joint shoulder and skull elbow and ankle joint elbow and hip joint so when it comes to shoulder joint when the shoulder joint is complete you can say this is around 18 years and then uh there was elbow joint also given when the elbow joint is complete all the centers are fused and the X-ray when the elbow joint is fused you can say the person is around 17 to 16 to 17 years when it is around wrist joint it is 18 to 19 you can say hip joint this is again 17 to 18 ankle ankle will also be around 17 to 18 fine so when you look at the all the joints shoulder will be giving you 18 to 19 years elbow also will be giving you 16 to 17 years wrist will be giving you 18 to 19 when the hip joint is complete that is upper end of femur is complete it is 17 to 18 right you have the knee joint knee joint will be 18 to 19 years and then ankle joint it is 17 to 18 years so these are the ages in which you can find out the joints will be complete so now look at the option that is given in the question so now look at the options in the question we we have the wrist and knee joint that will be the correct answer for this question look at the other option shoulder and skull skull radiograph will be helping us to primarily find out the suure closure not for the joints right so that is not a correct answer elbow will be 16 to 17 right so this again will not be in correct answer so look at the first option knee and wrist will be the answer for this question if you talk about another important Point given in the question you can see that 18year old boy who assumes that he 16 years old is accused of sexual assault see the person wanted to claim the juvenile defense of being juvenile you know juvenile is a person less than 18 years old but look at the question if the person is accused of sexual assault that is rape when a person is accused of rape if the person is of age between 16 to 18 years committed rape that is heus offense or enus crime this person can be tried as adult that is another point that you need to keep in mind right for a person who has committed heinous crime what is a heinous crime heus crime is any offense where it carries a punishment of more than 7 years of imprisonment when any crime is having a punishment of more than seven years of imprisonment then that crime will be considered as heus crime and if the person happens to be 16 to 18 years old and he has committed a crime that person can be tried as adult right that person will be tried as adult keep that point in mind now let's move on to the next question the next question is about Ram montis rer montis is well established right then it is about 12 to 12 to 24 hours since death what is the order of appearance of ramus right they're asking you the sequence of ramus whether it is head to toe toe to head Center to periphery and all the parts body parts simultaneously get rotus you know rotus is nothing but postmortem stiffening of the body when you talk about rarus remember when you look at the muscle status after death of the person initially we'll get what is called as primary flaccidity followed by stiffening of the muscle we get what is called as RAM mortis and then we have the secondary flacity see you know this is because of the ATP depletion Ram montis is because of the ATP depletion in the muscle that we all know right so now you know the Raam artist starts 60 minutes after death of the person that is is one hour after 1 hour of death we get Ram Martis and when the ram Martis starts it doesn't appear throughout the body it goes in a sequential manner if you talk about rarus remember Ram Martis first starts in the involuntary muscle then comes in the voluntary muscle fine it first starts in the involuntary muscle then comes in the voluntary muscle when you look at the organ the first organ where the r Martis starts it is my ardium right R Martis is seen in both voluntary muscle in voluntary muscle but it first starts inal M the when you talk about the first site of rer marus it is always myocardium then when you talk about the first external site of ram marus then it has to be IIT when it starts in the is externally then it follows the sequential order we have an order that is called nist's order niston was the person who proposed it the first organ to appear is hard then externally it starts in the eyelid then it involves a neck jaw facial muscles thorax Upper Limb abdomen lower limb fingers and toes so it has got a specific ORD starting from top to bottom it has got proximo distal progression it has got proximo distal progression from top to bottom fine right so this was given by a person called nist called niston Rule we also have one more rule in Ram Artis that is called Rule of 12 right the rule of 12 states that the ram arst starts it involves the entire body it appears throughout the body in 12 hours after appearing throughout the body it stays in the body for another 12 hours it remains in the body for another 12 hours then it gradually disappears from the body in another 12 hour so we have got 12 12 and 12 we got this a rule of 12 right and remember when how does it appear in which order the Ral montis appears you have to remember it is upper descending order from upper to lower that is proximo distal we can remember it is a descending order likewise the descend disappearance will also be in the descending order only when they're asking you the appearance that is ascending order sometime they can twist a question they can ask you what about disappearance of ram Artis remember dis of Ron montis is also occurring in the descending order that may be a prospective question fine so remember I told you the cause of ram morus mechanism of r morus that ATP depletion I told you it involves generalized throughout the body it involves it first occurs in the involuntary muscle then comes in the voluntary muscle throughout the body first organ is myocardium first sectional C is IID from proximo distal progression descending order then I told you about the rule of 12 that is appearance 12 LS it remains in the body for 12 hours and then it disappears from the body for another 12 hours we have three 12s as sexual assault Survivor had to testify in the court the in camera Trail was held what is this in camera traal remember this is about the recording of evidence from the rape victim survival usually we get questions on medical examination of rape accused or victim but this is about in camera trial that is recording of evidence in the court remember normally all the trials will be open court where the public and the media will be permitted to attend the court proceedings but this case there are some cases where closed Court proceedings will be done where the public public and the media will not be permitted the entire court trial court proceedings will be held inside a closed Court Chambers particularly for the Privacy cases like poo victims right poo cases rape cases rape victim examination particularly and matrimonial cases all these cases where in camera trial will be conducted that is closed Court proceedings when we say in camera trial that is a misnomer do not think that is recorded in camera not that this means it is a closed Court proceedings where the public and the media will not be permitted so open course proceeding that is wrong proceeding record on camera that is also wrong and in a different location that is wrong so when we mean when we mean to say there's in camera tell that means it is done in a court proceedings Court closed Court Chambers there are certain other sections that we have to know with regard to the victim examination there is something called 397 bnss it says that all the doctors right must to treat victims of rape Vitas you know what is vitria that is acid attack victims either victims of rape or victims of acid attack or Pok so when such victims are coming to the hospital for treatment every doctor whether it is a government doctor or private doctor semi government whatever doctor it is all the doctors must treat these victims immediately free of charge and the police intimation to be done by the doctor this is compulsory this is mandated under section 39 Serv bnss right and any violation of this it is punishable any doctor violating it if any doctor did not treat these victims or if the if any of the doctors charge these victims for the treatment that kind of violation will be punishable right remember this section is very important this can be prospectus questions we can expect this question the future examination there is one more section that we have to discuss here that is related to the uh examination of victim only see presumption of absence of conscent in certain prosecution of rape if you see when the act of sexual intercourse is completely proved and the question is whether the victim has given conscent or not the section 120 BSA B saki ad 120 as per this section when the victim says a consent was not given it is presumed that the consent was not given absence of consent right so it is the victims victim statement that matters as per section 120 BSA then the burden of proof lies on the accuse that the consent was obtained for the act of sexual intercourse right so we'll move on to the next question the woman gave birth to a child 8 months after the death of her husband thus then the in-laws claim that the child is not their sons however the DNA testing confirms the P this was a case of disputed paternity but the DNA testing confirms that the pity of the child right the child is known as this child is known as whether it is a postumus child illegitimate child surrogate child or supposit child right so this is about definitions of these terms that we have to know here you can note that the options were cleverly written you can see they have given that the in-laws claim that child is not their son child and the child DNA test confirms that the paternity of the child so it's a legitimate child right they have given the option legitimate child that is wrong here you can see the child is born after the death of the Ali father this is when the child is born after the death of Ali father it is post humor child you know post means after humus mean death the child born after the death of Ali father right let us look at the definitions of the other options as well so that it'll be helping us in the future examination I told you the child born after the fish father that is postum child if there is a question of disputed paternity we can do this kind of DNA analysis we can identify the paternity of the child fine right legitimate child when will you say a child is legitimate a person who's born during the continuation of legal marriage or within 280 days of dissolution of the marriage either by the divorce or by the death of the husband and provided the mother remains unmarried when the mother got married that's a then that's a different issue but here the mother remains unmarried within 280 days of dissolution of the marriage or by the death of the husband If the child is born you can say that the child is legitimate child either it should be during the continuation of marriage or within 280 days of the dissolution of the marriage legitimate when the child is born out of this thing then it is called legit illegitimate child we have uh certain conditions for that when the child is born out of lawful wilock or not within a competent time after dissolution of marriage what is that competent time that is 280 days that is the competent time or when it is proved that the Ali father is physically incapable to be children or the person is in impotent or sterile or remember if the father is not having access sexually to his wife during that particular period that is 280 days then you can say the child is illegitimate fine remember when the child is born satisfying any of this criteria then you can say that is illegitimate child fine so now there is another definition that you have to know that was one of your uh previous examination question here the female she fakes pregnancy she Fe pregnancy and then she brings a child setting that it is her own child this kind of child is called as suppos child or fabricated child fabricated child suppositious child forced child so you have various synonyms for this remember fabricated suppos F here basically the child is the wom the female did not give birth to the child she might have gotten the baby from somewhere else she might have kidnapped the child from maternity hospital or she might have swab boy for girl girl for boy something like that it is not her child she's faking that pregnancy she is uh bringing a child telling that it is her own child mainly for kind of monetary compensation or blackmailing right so I told you definition of postumus legitimate illegitimate and this is fabricated child there is another uh definition that we have to know right that is called atavism wherein you can see the child does not resemble the parent here the child resemble the grandparent the word atavis means ancestor the child resembling the uh grandparent that is called ancestor the word atavis means ancestor the child assembling ancestor is called atavis fine so these are the definition that you have to keep in mind the railway police has brought a person with suspected poisoning on examination he was confused laring of speech dry mouth dilated pupil what is a probable poisoning right you know this is one of the most frequently Asked question in your examination you get this questions with anti-cholinergic symptomss anticolic toxidrome right we have discussed that in detail fine so when the person is having dried secretion dileted p delirium you know that is basically Thea poisoning and another clue that there was given in the question is Railway poce you know very well this Z is commonly called as Railway poison roadside poison because it is associated with Railway robbery roadside robbery right you can remember dilated pupil can also be due to cocaine but had it been cocaine they would have given you sympath mictic symptom that means a person should be having increased sympathetic activity but here there is no mention about the increased sweating right the person that there's no mention about that there there was mentioned about hot skin was mention about dry mouth and all which is classically seen only with Thea poisoning not with cooking cannabis alcohol can easily be ruled out because there is no mention about those kind of symptoms now you know this datura this is about data plant you know this is data Alba you can see the FL which part of data is toxic every part of data plant is toxic you know that you know that and this is the fruit of Thea this is Thorn Apple they might ask you which which is the most toxic part of Thea you know the roots and seeds will be the most toxic part and what is the active principle very commonly you get questions on active principle you know that is hosin and atrin the major component is hos fine and you know this is Thorn Apple the railway poison roadside poison because you know this is commonly assed with roadside robbery and which seed the data seed resembles Dash seed D seed resemble chili seed right so it is important for you to differentiate how the datra seed and the chili seed will resemble lra seeds will be dark brown in color we'll have a discussion of that as well lra seed will be dark brown Thea seed will be thicker Thea seed will be having rough surface and it is odorless right and it is having kidney Shi the shape was also as in one of your previous examination right so remember these are the important points that you need to know with Thea poison the next question a man sexually aroused when he wears his female partner dress and heals he denies getting attracted to the female this is one important point that you have to keep in mind to rule out the option what is this condition right of course this is not warm because oism is different condition where the person achieves sexual gratification by watching the private acts this is not gender gender dysphoria because gender dysphoria is a condition where the person is uncomfortable towards his own sex he's having a feeling towards opposite sex so here there is no mention about that so this condition this option is also ruled out gay sexual preference can be ruled out with this point he deny is getting attracted towards feale so that can also be ruled out and the next option is transvestism transvestic fetishism right you can also directly choose this because they have given you the condition the person gets sexual pleasure by wearing the dress of opposite sex transv verism again among the sexual perversion sexual perversion itself is one of the very frequently Asked question and among the sexual pervision there are few perversion which are again frequently Asked we know that is called sadism commonly asked massis commonly asked transvestism is also commonly asked you know there are few uh sexual pervision that we need to know for the examination by inflicting pain to the partner you know that is sadism it is also called as algolagnia synonyms are important sadism by suffering of pain or but getting Hur from another person from getting Hur from the partner that is called masochism that you all know but you need to know the synonym that is passive algolagnia right combination of this is bondage by showing his private part of the public place we call this exhibitionism is it a punishable offense yes it is a punishable offense because it is amounting to public nuisance which is punishable under 296 BNS the person CH sexual gratification by watching the private sex of the female remember this is called warm which is also called as scilia the person who does this it's called ping ping Tom remember this is punishable under Section 77 BNS with inanimate objects non- living things we call it as fetishism the objects are called fetish by rubbing the private parts on a female remember that is called fraud turism remember is it a punishable offense yes it is a punishable offense remember that is amounting to sexual harassment we have a specific section for the sexual harassment remember this is 75 BNS any person who is practicing this kind of activity rubbing his private partt on a female in a crowded place like bus and all it is amounting to sexual harassment that is punishable under s 25 BNS by wearing the dress of purpose said this was asked in your examination that is transvestism which is also called as eus by talking obscenity we call it a scatologia if it is over phone there is called Telephone scatology by taking enema either it takes enema to himself or he will ask somebody else to give enema to get sexual pleasure we call it as kismia by the site of smell of urine or the cight of smell of faces that is called urophilia urine coprofilia that is feis fine so this urophilia it is also called as undinism I told you synonyms you need to get exposed because many times they will ask you very simple question but they'll try to twist the question by giving the options synonyms right so you have to know the synonyms as well another very commonly asked question very very commonly asked question I don't know why frequently they if you see for the last four five years every year you tend to get questions on these uh stains questions on seral stains and blood stains fine a police officer brought a child to the hospital there is redness and tenderness around the perianal region so this is a case of sodomi fine sodomi is also called as buggery or Greek love so you can say this is a child rectal swab is taken the image given below is a finding in the microscopy which test is it indicative of so in the image you can see that there is yellow needle crystals yellow needle crystals are there these yellow needle crystals are suggestive of a test called barbaros test right so there are four options given in the question W barbaros test Florence test takayama tikman fine so takayama tikman all these are blood stain test Florence and barbaros they are similar stain test Florence and barbaros and in Florence you get dark brown romic crystals whereas in barbaros we get yellow needle crystals you can just see that this is barbaros test wherein you get yellow needle crystals there was one examination they asked you what is this yellow needle crystals we get these crystals are sperming picrate so they are basically sperming picrate we have to know this and another one there is Florence test these crystals are kin iodite crystals so there is another question they can ask you barbarus test to identify Dash from the sper and Florence is identifi Dash from the C Florence is meant for kolin and barbus is meant for sperming we have this pink feathery which is s diagnostic that is your blood stain test this is Takaya test very very commonly asked in examination and these crystals are hemochromogen hemo chromogen and you can see the next one this is again blood strain test tikman this is him crystals right tikman is where you get him crystals and takayama you get pink FEA crystals which is very easy to find out right there was another examination where you get this blood stain you got to know that is a blood stain but you don't know whether that is a human origin or animal origin NE animal origin if you want to confirm that is human blood or not or if you want to find out the species of the particular stain you have you can do one test that is called precipitant test right precipitant test is the test that is used to identify the species of the origin of the state if precipitant test is not given in the option then you can look for DNA DNA also will be telling you whether it's a human DNA or any other animal DNA right I've given you the other point as well right this is from the asfixia dead question you don't get any examination without a question on asfixia either you get a question on strangulation or smothering or drowning right so this question is on the sming during postmortem examination the following finding is found what is this indicative of the image this is only representative image this is not we don't know the whether this exact image was given in the examination so as per the recall from the students this the image was having some blood stains in the perioral region there was also some injuries in the lip and the inner aspect of the gums right which is so diagnostic to say that it is a case of smothering right you know what is smothering smothering is a closure of mouth and Noles together on the victim right the person is unable to breathe the person gets suffocated right in smothering there is no neck compression right this is so pressure on the mouth and the also together the person gets suffocated you can see the injuries in the perioral region you can also see some injuries in the lip this cannot be a case of choking because uh choking is the obstruction of internal Airway so there is no mention about that in the question so you can easily rule out that throttling is very frequently Asked question but throttling is where you get injuries on the neck and other places so basically it's a neck compression right so you need to get injuries on the neck so this can also be ruled out hanging you can easily ruled out because hanging had it been hanging you should found the injuries on lure Mark in the neck so there is no difficulty for solving this question there should not have been any difficulty in solving the question you need to know it is sming smothering comes Under The Heading called Suffocation because Suffocation is a condition where there is no neck compression right sming I told you it can be accidental it can be homicidal sule is not possible very very unlikely commonly one is homicidal you can uh also see accidental smothering as well accidental smothering can happen when a person falls into a pile of sand the face get closed with the sand the person is unable to breathe then mouth and the nosil gets closed homicidal is very much possible people can use a material like pillow or something to close the mouth and nostrils or the person can also be using hands to close a mouth and nostril if you're using your hands to close a mouth and nostril this is where you get injuries around the perioral region right you can easily identify that this case of small they should not not be any difficulty in identifying this you can see this is by the pillow or any other material or this one is by the hand moving further so these are the typical finding that you can get in smothering moving further a 14-year-old victim of sexual assult with 22 weeks of gestation has been brought for MTP medical termination of pregnancy act which is true about this for the past 3 years right see there was one amendment of medical termination of preg act 2021 after that for the past 3 years you had been consistently getting questions on MTP right you will either get questions on the age of consent or the grounds for conducting MTP or the duration of gestation with regard to the MTP so all these questions we normally get so we need to definitely know MTP the provisions right so this question is about 14y old victim age is 14 years sexual assault so pregnancy is due to rape with 22 weeks of G these were the clues that were given in the question three Clues one age of the victim is 14 and sexual assault pregnancy due to rape and 22 weeks of gestation which is true one doctor in invol when it is 22 weeks of gestation you definitely need to know that you cannot have one doctor you need to have opening of two doctors to conduct MTP MTP is done in the second trimester only when the mother lives in danger right when the mother's life in danger danger there is no time restriction anytime you can do MTP termination of pregnancy though this option is also ruled out MTP can be carried up to 24 weeks MTP cannot be conducted more than 20 weeks this is wrong right when see there are two points in the question which will be helping you to identify the answer when it is a minor coming with pregnancy you can conduct MTP up to 24 weeks that is first point second point when the pregnancy is due to rape again you can conduct MTP up to 24 weeks there are two clues in the question that will be telling you that you can conduct MTP up to 24 weeks so you can easy answer this question it is conducted up to 24 weeks let us look at the provisions of MTP Amendment act 2021 because it is so important what are the indications for conducting MTP you can see whenever it is therapeutic means if there is any metal disease if you're going to continue pregnancy that is going to cause grave injury to the physical or mental health of the female you can conduct MTP or if there is any risk of physical or mental abnormalities in the fetus that means significant risk of causing that abnor the fetus you can conduct MTP not only that if the pregnancy is due to rape because it will cause grave injury to the mental health of the female or if there is any contraceptive failure again you can conduct MTP because it will cause grave injury to the mental these are the broad indications for conducting MTP where you can conduct MTP remember it can be conducted only in the government institutions or in any other place authorized by the appropriate committee only there you can conduct MTP remember what are the other Provisions see with regard to the duration you can conduct MTP if the duration of gation is less than 20 weeks one doctor can conduct MTP if it is more than 20 but less than 24 weeks you need two doctor's opinion to conduct MTP if it is more than 24 weeks remember it can be approved only by the medical board when it is more than 4 weeks the law did not stop you from doing MTP you can still conduct MTP but get the approval from the medical board and in the medical board who are the people members of the medical board there will be one gynecologist right there'll be one pediatrician there'll be one sonologist or another person will be independent member appointed or nominated by the state government right there'll be four members oian pediatrician sonist and the independent member nominated by the state government there is no lawyer right remember only these four members now what are the indications with regard to the duration if it is less than 20 weeks for all the indications you can conduct MTP including failure of contraception including if it is more than 20 but less than 24 weeks you cannot conduct MTP in all the situation there are only selected cases where you can conduct MTP including pregnancy due to rape or incest what is incest when there is sexual inter between blood L you call as incest when the pregnancy occurs because of that you can conduct MTP when the pregnancy is on a minor girl when the pregnan on the mentally ill girl or if she's suffering from physical uh disabilities when the pregnancies occurs in case of mass disaster or if the pregnancy occurs due to in case of marital status change when she got divorced after getting pregnant or the person husband died after she getting pregnant you can conduct MTP only in these selected cases you can conduct MTP up to 24 weeks up to 24 weeks with two doctor's opinion when it is beyond 24 weeks remember you can conduct MTP in only one situation if it is substantial fetal anomaly only when there is significant fetal anomaly you can conduct MTP who will decide is significant or not the medical board has to decide the medical board will approve it only when the medical board approves we can conduct MTP Beyond 24 if the medical board did not approve we cannot conduct MTP suppose if there is an emergency to save the life of the mother there is no restrictions you can conduct MTP at any time even by one doctor can also be conducting MTP because you're going to save the life of the mother and this MTP Amendment act 2021 also gave provision of one more important thing that is about confidentiality all the details of the mother it has to be kept confidential any violation of this if the person person is disclosing anybody is disclosing this kind of details to other person that will be a punishable offense that kind of disclosure can be invoking one year of imprisonment plus or minus F okay so this is very important provision and all the records with regard to this MTP you need to preserve up to 5 years that is another important point and every month you need to keep on forwarding this reports of uh uh MTP to the district CM consern what is is a age of giving consent for termination the age of giving termination consent age of giving consent for the termination is 18 years when the age is less than 18 years when that that means if she is minor or if she is mentally ill you have to get the consent of the Guardian that we all fine so these are the various aspects that we can get mcqs from 27 weeks of gestation 27 weeks with congenital anomaly whose presence is not required to approve MTP I told you Medical Board is needed and I told you four people who's not a part of it lawyer is not a part of it we discussed about this now 5-year-old child consuming overdose of iron syrup accidental iron poisoning is so common with child you got this uh question on iron poisoning last year also in one of your in around 60 migr per kg which among the following is contraindicated they did not last year last time you got question on what is a treatment of choice for iron poisoning but here this n PG you got question on Contra indication of iron poisoning whether it is B desferoxamine calcium irate dtp remember one of the Keating Eng that is contraindicated in Iron poisoning is BL di caol it is not to be given remember when it is about dimer caol you can use di Cal in many situation like our snake lead you can use it in many situation but it is particular contraindicated in few important poisoning what are the contraindication of B that is dier caol it cannot be given in Iron poisoning as I told you just now it cannot be indicated it cannot be given in cadmium poisoning not only that even in organic Mercury you cannot give this iron poisoning I mean you cannot give this B British anti-is side otherwise called as D caol remember these are the metallic poisoning in which this B is contra IND at because this Bal will be Keating with the metal that keate that compound itself that complex itself will be toxic ideally it has to be non-toxic so that it will be exted in the urine but the combination of this B with this metal with itself will be toxic so you cannot be giving this kind of BL in this PO right desox that is a drug of choice we all know fine Eda calcium Eda is contra indicated ated in renal failure patient fine let's move on to session two questions a 30-year-old dead man was brought for a Topsy the doctor noticed graay white waxi layer present over the body with preserved facial features the facial features of preserved and you could see a grayish white vxi layer which of the following statement are true with with regard to osia formation so they gave you the answer itself osier or they could have asked which of the following statement is true we need to find out that is osia fine right so it occurs in hot temperatures or dry climate that is wrong because you know very wellos here is very commonly seen with a warm climate not hot and dry climate the dry and hot climate will be favoring mumification not adiposa formation and it occurs in cold temperatures no it does not Ur in cold temperature it occurs in warm and humid temperatures it is a type of body preservation with saponification of fat yes here what happens in here whatever fat that you have in the body that fat is converted into fatty acid that fatty acid is converted into a waxi substance that waxi substance is nothing but your OS how come this vxi substance is produced these fatty acids will be combining with calcium present in the body that will be forming this vxi substance since it is forming a vxi substance this you can see that is fatty acid formation the body features are preserved as it is the facial features are preserved you don't get the body getting decomposed body will not be decomposed body features will be preserved even mumification also the features are preserved you will be able to identify the body but still the preservation of facial features is more so with ad than when compared to mumification it occurs within few hours of that is wrong because you know it is commonly seen around 3 weeks to 3 months it takes around 3 weeks to 3 months but yes it is earlier seen in 3 days also but not within few hours definitely not within few hour so that option can also be ruled out the answer is your suppon ification of fat right you see let us look at the mechanism of adiposa formation this is called hydrolysis and hydrogenation of fat hydrolysis and hydrogenation of fat that is what is seen with formation fine so you can see this is formation it first starts in sub kitous fats so wherever you have more fat OS is more common wherever you have less fat OS is less common right they might ask you what is the smell of Adipose here it has got ammoniacal smell fine you see this is mummified body you can see the body completely dehydrated when I was talking about osia I told you you have hydrolysis hydrogenation of fat when it comes to mumification remember there is drying and dehydration of tissues all the tissues will get dehydrated when the tissues get dehydrated you get ified body mumification formations fine and what is the smell of this mummified body the smell of this mummified body is typically odorless there is no smell which was one of your previous neat examination question what is a climate that is needed you know it is hot and dry climate that is needed a 36 year old man was found dead following an RTA doctor informed the police officer shifted the body to the March autopsy in this case will be conducted on the request of Dash on the authorization of Dash who has to authorize to know for first of all you have to know what kind of autopsy is done here remember here it is a case of RTA so this is a case of unnatural death we have to do Medico legal autopsy had it been medical legal autopsy if it is medical legal autopsy who has to give you authorization authorization has to be given from the io who IO investigating officer right foreign expert cannot give authorization foreign expert will conduct autopsy but authorization has to be conducted authorization has to be given by the io defense lawyer is wrong prosecution lawyer is wrong so it is a very very easy question so you know there are primarily two types of autopsy one is medicalal autopsy another one is pathological autopsy medical autopsy is the most common type of autopsy is done in India where it is done in unnatural death so you know who has to give you authorization authorization has to be given from the io the io can either be a police or magistrate and do you get do you need to get the consent of relatives in this case no not needed you don't have to get the consent of the relatives because it is mandated by law wherein the io Authority is fine enough whereas pathological autopsy is done in natural deaths where the relatives consent is mandatory what about IO authorization IO authorization is not needed because it is natural de there is no IO fine Medico legal autopsy whom will you hand over the body it is a case of RTA you have conducted autopsy after that whom will you hand over the body you have to hand over the body back to the io that was one of your previous neat examination question right you should not hand it over to the relator 32y old women G3 P2 L2 came to you in active labor the labor process was arrested at around cervical delation of 8 cm she was counseling counseled and regard she was counseled regarding the need of emergency cesarian section the baby was delivered by cesarian section the baby was doing well but the mother developed intractable postpartum hemorage conservative measures were tried initially but failed emergency instruct toy was done as a life saving procedure what is a Medico legal implication though it is a long question the actual question the stem of the question is this that is your emergency lscs is done as a life saving Pro that is the only statement that you should notice in this question that will give you the answer as well what are the medical legal implications the patient can sue the doctor for removing a uterus cannot be done the doctor will be legally protected as it is a life saving procedure yes this is given under 30 BNS right in case of emergency procedures when it is unable to get concern from the person as a life saving procedure you can go ahead to save the life of the person processes can be conducted consent could have been taken at the OT table do not need any counseling nothing those options can easily be ruled out right so the answer for this is the doctor will be legally protected as a life saving Pro this is one kind of question which you typically get in uh frequently in your examination only the case scenario content will differ they can give you an RTA patient has brought for treatment patient is unconscious you have to go ahead with the procedure right the craniotomy has to be done what is the next step in this Pro Management you can go ahead with the procedure because you're going to save the life of the person all day patient has come you have to do some emergency procedures you had done the emergency procedure but the patient is filing a case against the doctor which of the following section can be used for saving the life saving the doctor you can say that is 30 BNS because 30bn States that conscent is not needed in case of emergency to save the life of the person when you are able to get concern in those kind of situations alone this section can be applicable right so you need to read the stem of the question that is so important so you know what is the minimum age of giving consent for just physical examination for just physical examination General physical examination nothing more than that remember 12 years is sufficient when the person is below 12 years you cannot get conscent from the person you have to get the conscent of the guarden major procedure the minimum age of the person to give consent is 18 we all know that it is applying to any surgery any invasive procedure right any radiological procedure blood transfusion any kind of major procedure the consent has to be obtained from the person 18 years old if at all the consent is obtained from the person who is less than 12 years insane influence consent is obtained by means of influence of threat or the consent is obtain from intoxicated person all these concern will be invalid concerns all these consent will be invalid consent 28 BNS right in all the situation you have to get the consent of the Guardian right surrogate con a pregnant female is coming to a gynecologist who sensor for ultrasonogram on USD twin pregnancy is noted but one month one month difference between the age of the fetus two fetuses are there but one fetus is one year older than the other fetus which is true of the following Is it superation superation suppos child postuma child will come in the reverse postuma child you know the child born after the death of the father so this is not an option you know what is suppos child suppos child fabricated child folk child Forge a child you know the child of female fix pregnancy and then she brings the child claiming that it is her own child so this is not the typical scenario the question is about twin pregnancy only two options can be shortlisted one is super ation and super fation to choose the correct answer the clue that is given in the question was one fetus is one month older than the other feters so this obviously will tell you that it is super fation not super fation because super fation is a condition where you have the fertilization of two over in the same ovulatory cycle whereas superfetation is a fertilization of 2 again but it is in a different olary cycle so when you talk about super fation two feers should be of the same age whereas super fation one feeter should be one month different there should be difference of one month between the two feers so in the question it is about the difference that is given so it has to be super fation super fation is very rarely seen when you compare with super fation but it doesn't mean that it is not impossible in human being it is possible but it is quite rare when compared with superfish right but still it is possible in with human beings so that has to be chosen as an answer that is super fittish right so this is super fundation you can see and this will be superfetation there should be a difference in the H the falling was obtained during the autopsy of a patient was brought with Alle of gunshot injury this is the question on gunshot what is the ideal range of The Gunshot the students recall that the image was given in the question and the image was in a circular wound with the tattooing and the blackening was visible around the wound right options where close shot distance shot contact shot cannot be predicted cannot be predicted can be easily ruled out because if it cannot be predicted then there's no point in giving this question itself so that can be easy ruled out is it a contact shot no had it been a contact shot all these effects should be seen in the track not outside the track so it can also be easy ruled out and it was a circular own it's not a state own and all the effects are seen outside the wound so this contact can be ruled out distance can also be ruled out because if it is a distance short you can see only The Bullet Hole with the callers no tattooing no blackening no burning nothing should be visible right so even if you know if you even if you don't know the exact appearance of the wound at different ranges doesn't matter you can answer this question easily by exclusion so all these options can be excluded the only best option that is available is close shot fine so now let us look at the appearance of the wound at different ranges I told you the first one is contact shot contact shot doesn't tight contact with the skin it can be tight contact loose contact doesn't matter right the appearance will vary so this is one contact shot on a bony prominence you can see St at a cruset it is not a around and another one all the effects like tattooing burning and all will be seen inside the track not outside the track right close shot is something that is inside the range of flame so burning should be visible burning along with the other effects like tattooing and blackening burning should also be visible then only you can say that is a close shot right you can see the burning blackening and tatooing all this is visible right you can see tatooing is there blackening is there burning is also there along with the entry one if you see all the effects like this you can say that is a close shot what is the near shot near shot is something that is outside the flame but inside the smoke so burning will not be there blackening will be there tattooing will be there and the bullet entry hon will be there with two callers fine so if you see something like this it has to be a close shot then you have intermediate shot intermediate shot is something where it is outside the smoke but inside the gunpowder so burning is not there blackening is not there tattooing should be there and the bullet entry Hound with two callers should be there and you see wound like this you can see there is entry wound around the entry wound you can see some powder effects right peppering effect is there tattoing effect is there you can say that is intermediate shot what is a distance shot it is even outside the gunpowder when it is even outside the gunpowder none of the effects will be there no burning no blackening no tattering only the entry wound with abration color grease colar will be there so this should be an entry W of distance short so you can easily find out which short it is right from the question question you can easily answer by exclusion itself now moving further we'll talk about uh another question on toxicology a person presented the OPD with this kind of finding the image that is given below identify the type of poisoning in this patient there was a skin finding given in the Palm another Finding was in the nail you can typically see that it is transverse white line on the na these transverse white lines are called as Al Rich M line Al Rich M line there are two important poison that should come to your mind one is arsenic another one is thalium right thalium another one is arsenic to exclude that Arsenic and thalium you can easily find out the another finding that was given in the examination that skin finding dark brown pigmentation so you can and another point is salium is not of course not given in the options so you can easily choose that is arsenic okay so arsenic is the answer for this you know arsenic is something that is caus ing both acute poisoning and chronic poisoning as well acute poisoning of fastening causes intense gastro intis so you can see acute arenic poisoning it resembles Cola and if you see the stomach mucosa of this acute Asic poisoning patient it will be reddish pink velvety mucosa that is so inflamed so that's why it causes pink velvety mucosa another one is chronic arenic poisoning chronic arenic poisoning is called as arsenicosis if it to drinking water which has got arsenic in it you call it as hydro arsenism and arsenic paring is something that affects every system of your body you got lot of manifestations with regard to arsenic right I've given you a pneumonic arsenic itself to remember it alich me line you can see the transverse white lines in the nails something like this you call as alich me line alopecia will be there raindrop pigmentation dark brown pigmentation that is so typical with Arsenic and you can see the skin eruptions hyper keratosis in the palms and Soles you will find palmoplantar hyper keratosis right which can be a spotter in arsenic poisoning right palmoplantar bilateral bilateral palmoplantar hyper keratosis you can easily find out it causes neuropathy it causes peripheral sensory motor polyneuropathy poly neuropathy again which is so specific for Asic it causes nasal septal perforation it causes peripheral esia you got this question last year it causes intense vasospasm when there is vasospasm you get periphal gangar we call this kind of condition as black food disease right we call as black foood disease initially there is vasospasm this vasospasm is called peripheral eskia eventually the person GLS peripheral gangar it is carcinogenic of course arenic will be carcinogenic it causes skin malignancies basil carcinoma scamell carcinoma it not only causes skin malignancies it also caused malignancies of the lung liver bladder all these malignancy incidence will be increased due to arsenic poison right and we have few test Marsh and R test old test this is very frequently asked but the latest test are two important test one is Neutron Act activation analysis another one is atomic absorption spectrometer right and this arsenic can be directed by these latest tests NAA and a can see the Alish M line you can see the pigmentation and 19-year-old girl child came agitated to the emergency department after consuming some drug right with previous of su Tendencies the parents do not know the mode the root of administered root of Drug Administration she presented with Tachi cardia tpia diaphoresis dilated pupil tachicardia tpia diaphoresis and dilated pupil all this will tell you that is increased sympathetic activity right increase sympathetic sympotic toxidrome right even without looking at the options you can easily find out the answer when it is increased sympotic sympathetic activity two common things to be coming to your mind one is amphetamine another one is cocaine right amphetamin is not commonly encountered in the question so cocaine should be chosen right so now you look at the options you can see cocaine is given mafine heroin chloramine mafine heroin is a suif ferous group both will be having same kind of symptom but in the if it is mafine poisoning remember you should be having a feature of coma you should be having respiratory depression not tpia right that is very important if if it is had it been mafine there should be respir depression not tpia and you will also be seeing constricted pupil you can see pinpoint pupil not dilated pupil right so these things will tell you that it is not mafine or heroin poisoning it has to be cocaine poisoning fine and in the morning session you had a question on datura where cocaine was given in the option I told you how to differentiate between cocaine and Thea poisoning in the afternoon session you got a question on cocaine B itself right remember dioris is mentioned here so you can easily remember this cocaine what is a treatment for cocaine poisoning it is M nitrate cocaine and you know there is one important syndrome where cocaine poing is quite very commonly encountered that is body package syndrome where the person used to smuggle the drug you get body Packer syndrome cocaine is commonly associated fine so remember there is another question they can ask you with regard to cocaine chronic cocaine chronic cocaine abuse you have a Triad in chronic cocaine abuse we have a Triad of septal perforation septal or pelletal ulceration we have black staining of tongue peripheral Gang Green why peripheral gangin because it causes Vaso constriction eventually the person lands up with peripheral gang remember if you get this triod it is a triod of chronic cocaine abuse this can also be expected and one very commonly asked question in your cocaine very very frequently Asked question is this tactile hallucination in cocaine abuse we call it as cocaine bugs also called as magnon symptom we also call it as formication so all these things should be remembered when you remember cocain a person comes to emergency department after consumption of a substance the form and dose is not known to the relatives the patient shows tpia and hypotension on metabolic assessment High anionic Gap acidosis is found right you have got agma i anionic g metabolic acidosis along with hypocalcemia this hypo calcium is a clincher for you to identify the option right so remember here you can see acidosis is there and hypocalcemia is also there now you need to find out the drug which is associated right if you want to remember if you want to go by exclusion you can go by exclusion you it is not a case of datura poisoning obviously it is not a case of ethanol you have only two options one is methanol another one is ethylene glycol and if you talk about methanol methanol does not produces hypocalcemia so that can also be ruled out ethylin glycol so to understand about this ethylin glycol poisoning we have to understand the metabolism of ethylin glycol only then we'll be able to find out the toxic effects you see ethylin glycol is commonly used as what is called as antifreeze solution anti Free Solution right here it is colorless it is odorless right sometimes it is adulterated also if you talk about the metabolism the ethine glycol is converted into glycol glyco alide see normally any alcohol will be converted into metabolized into alide first and then the alide will be metabolized into acid if you talk about uh ethanol ethanol is converted into acet alide acetal is converted into atic acid formal I mean methanol is converted to formal formal is converted to formic acid likewise here ethylin glycol is converted to glyco alide then you have glycol glycolic acid and this glycolic acid will be liberating what is called as oxalic acids that is one important point so if you talk about the metabolic products of this ethylene glycol there are two things which are so toxic one that is glycolic acid that is so toxic which is so important for producing High anionic Gap metabolic acidosis agma acidosis another one this oxalic acid you know very well oxalic acid causes hypocalcemia because oxalic combines with calcium it produces calcium oxide Crystal right and of course it produces oxal UA as well and because it combines with calcium it produces hypoc calcium hypoc calcium is one of the most significant finding in oxalic acid right so if you get both acidosis and hypocalcemia you can easily remember that it is ethylin glycol poisoning right it is ethylin glycol poisoning and how do you treat you have to treat like you have to give fisol you have to give either you can give fisol or you can give ethanol right and you should also be giving IV calcium gluconate because the person presents to you with hypocalcemia the person will be present to you with features of tros sign and chastic sign you can easily find out that it is hypocalcemia right this is about ethylin glycol fine now moving further another question on the same group many people have consumed cheap alcohol present with abdominal pain confusion decreased Vision abdominal pain is there decrease blurring of vision is there methanol in the blood was deducted around 20 mgram percentage and on assessment which of the following metabolites will be found in the blood so they give you the diagnosis that is methanol poisoning you need to find out which metabolite it produces I told you just now any alcohol will produces aldhy and then acid this methanol will will be converted to formal deide formal will be converted into formic acid if you remember you can easily choose that it is formic acid with lactic acid this option option D will also be having formic acid but this cannot be chosen because methanol does not produces your oxalic acid right so that option can be ruled out the correct answer is formic acid with lactic acid how do you get lactic acid and formic acid we'll discuss about that but before that I need to tell you some points from the question itself see methanol the the common symptom that patient comes to you with abdominal pain vomiting blurring of fion so this is very important finding the person will present you with optic netis sometimes it can go for optic atropy itself right you see that the p in the question they gave you 20 milligram percentage that is so important level see that is a toxic level of methanol in the blood above which you need to treat the patient right so if they ask you what is a toxic level of methanol in the blood you can remember that is 20 milligram percentage that can be a prospective question your future examination you remember about the metabolism methanol is converted to formal deide formal convert to formic acid so which is toxic the formal deide is toxic formic acid is also toxic which is most toxic formic acid is most toxic this is also toxic this is also toxic most toxic is formic acid when you talk about ethylin glycol remember in ethylin glycol which is toxic glycolic acid is toxic oxyc acid is toxic when you talk about methanol which is toxic your formal is toxic formic acid is toxic remember these things again Pro prospective examination questions right so this formic acid will be contributing to acidosis and not only that even lactic acid will be produced why there is lactic acid because of interference in Na nadh and Metabolism remember the person the cells will be having anerobic metabolism you have increased lact acid formation when you have increased lactic acid formation again the person will be having acidosis right how do you treat this person you have to give the antidote that is formip pisol you can also give ethanol any one you can give fine so this is the treatment for methanol poisoning and uh I think they have given you another clue in the examination question that is cheap labor methanol is called as ilcd liquor Mass consumption many people Mass consumption huge tragedy all these are key wordss in the question that will be helping you to diagnose it this methanol right so remember all these are key words in a case of drowning autopsy the following organism was isolated from the water present in the internal organs which of the following is correct true regarding the organism that was isolated the image that was given was this that is diom so option A it contains silica and the chlorophyll in the outer wall it is present only in the bone marrow it is an unicellular bacteria and is non resistant to acid in alkal see remember this is a diome it contains outer wall the outer wall of this item contains silica chlorophyll will also be there silica is an important component because the silica because of the presence of silica the otter wall is so harder even if you pour acid or alkaly you cannot destroy it is resistant to acid and alkaly and that is why the option D is wrong right and this is not bacteria remember this is an alga so that option is also ruled out it is only present in bone marrow it is present in bone marrow but that is not only with bone marrow it is present with bone marrow it is present with visceral organs in all the organs you can find out provided the person is alive right if it is an antim morm drowning the person will be the water will enter into the lung right the datom along with the water diom Al enter into the lung when the person is alive the person will be having entire circulation along with the blood datom will be circulated inside the body so if you are able to take a sample of bone marrow and the VIS organs like brain liver spin kidney right and you see in the microscopy if you're able to see the diom present in it that means the person was having intact circulation if it is intact circulation obviously the person has to be alive antim morm droning fine so in the question it is given as only present in bone marrow so that is why this option is also wrong right the only correct answer is it contains silica and the chlorophyll that is the correct answer so this dietr test is one test that can be done in a case of drowning along with this dietr test we also have one more test that is g lless test get lless test is something where you check chloride concentration Gess test right where you check chloride concentration from the blood sample of right side of the heart and you also take blood sample from the left side of the heart you estimate the chloride concentration whether it is equal or it is more or less in which side you just basically have to compare the chloride concentration different blood samples if it is freshwater drowning the right side chloride should be more than the left side chloride if it is salt water drowning the left side chloride should be more than the chloride if it is equal then it has to be normal for normal people it will be equal the difference should be more than 25 milligram percent if it is more than 25 milligram percentage only between the a difference of more than 25 milligram percentage between the two samples then only it is significant if it is less than that it is not significant right so remember this is another test that is called get lless test fine so these are the questions that was asked in uh n PG 2024 from forensic medicine in toxicology