FORENSIC MEDICINE

LEGAL PROCEDURES:
 Doctrine of diminished responsibility? Partially responsible for crime (b/c unsoundness of mind)
 Leading question is that, which? Is asked during cross examination
 An ambulance carrying serious patient gets involved in a road traffic accident and the patient died before
reaching hospital. Legally, this condition is labelled as? Novus actus interveniens
 Following expert witness are not expected from oral evidence? Hand writing expert, fingerprint expert,
professor of forensic medicine, ballistic expert, radiologist
 A doctor was called in a session court and said something offensive about the law. What’s his
punishment? Detain him in court for the day
 Prisoner dying in jail? Magistrate will order MLO For autopsy
 What’s a dying certificate? Persons will, dying persons last words or something, document stating the
cause of persons death,
 Presumption of case is done in? When person is absent for 7 years related to property
 Girl after 7 years of marriage dies of an unnatural death. Who’s going to carry out the inquest? Police,
forensic medical officer, some magistrate, judge
 A person cans buy/sale Property? at the age of 21 when there is guardian is provided
 Statement made by? Witness deposition
 Subpoena stamped Latter? count to witness
 Death Sentence is by which Court? Session court
 1st class magistrate fine : 15,000
 Summons: letter to a person to appear in court for evidence or anything else
 Dechus tacos...summon
 Civil wrong is called tort
 Voir daire: oath
 Evidence that if remain uncontested can determine the fact? (options were direct, indirect, hearsay
evidence, prima facie evidence
 Dying declaration
 Reexamination is done for?
 Who can volunteer to witness in law court?
 Massotherapeutist ?
 Mass effect
 Deposition? Case that person came to court & give statement by writing & signed.
 A person whose been given a warrant can be sent to jail for? Less than two years, more than two years,
less than 3 yrs., more than 3 yrs., more than 5 yrs.
 A magistrate calls doctor for investigation, Dr,’s fees legally renovation is called? Conduct money
 Evidence based on deceased daily habits
 In a police force muqabla thief killed who will investigate? Magistrate
 Summon also c/a? subpoena
 summon case/ civil etc.
 Which of these is the most valid type of evidence: Oral evidence
 Affirmation statement in court: oath
 Repeated summons, punishment?
 Panel code 170 defines?
 Hostile witness can be cross examined by?
 Oath can be taken by?
 Dying declaration?
 Criminal minimum age?
 Evidence not acceptable? Circumstantial
 Curator bonis is? A Curator bonis (Legal guardian) is a person appointed by a court to manage the
finances, property, or estate of another person unable to do so because of mental or physical incapacity.
NEGLIGENCE:

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 Contributory negligence is a valid defense to a doctor in: Civil Negligence
 Pt died as dr. was busy with his friend? Criminal Negligence, Professional Misconduct Advertisement
 Leaving instrument or cloth swabs in patients’ abdomen during surgery: criminal negligence
 Hospital not providing quality instruments, drugs for treatment: corporate negligence
 When a patient has serious disease, the doctor explains the nature and condition of the patient to the close
family member may not disclose the details of disease to the patient, it is called as: Doctrine of
therapeutic privilege
 A doctor won’t reveal a case to anyone unless? It’s in the interest of the state and law
 A doctor was performing a surgery and had already opened the patient’s abdomen, when he was called out
of the OT to settle a dispute over a case with a patient’s relatives, this is an example of? Civil negligence,
third party negligence
 A lady had a missed abortion, which transfusion would be best to give to her?
 Lady doctor aborted fetus, further investigation?
 dr takes our left kidney instead of right- what negligence?
 dr+ pr negligence
 False charge abortion? Menopause
 Duty of Pakistan penal code is? to define terms and punishments.
 Hospital staff used wrong instruments?
 Rate of silver is fixed for diyat each year on? 1st July
PERSONAL IDENTITY:
 First bone start calcification? Clavicle
 Best bone(s) to identify sex of a person? Pelvis and skull
 Sex of body can be identified by? Pelvis
 A dead infant brought in front of you, claims age of 1 month, confirmation? X-ray Lower end of femur
 Xiphoid Ossify at? at age of 35-40
 Age of Ossification of diff bone? 16-17 for Elbow
 A child’s height doubles at what age? 4 yrs.
 To determine the age of a 13-14 yr. old you examine the? Wrist
 A boy of 15-16-year-old is presented, which x-ray is best? Elbow
 Sacral vertebrae fuse at? 25 years
 Ossification center seen at 3 months in fetus? Clavicle, ribs, Lower end of femur.
 At 6-7 years, following teeth erupt: First molar
 Chest x-ray of a male shows’ fusion of Xiphoid process with the body of sternum. Which one of the
following is correct? 40 years of age
 The most reliable x-ray for estimating the age of children between 2-4 years is: Wrist x-ray
 What are ages at which a School MO should carry out a periodic routine inspection of a child? 5,9,13,17
 skull - age less than 40 Years/ 35 years etc.
 Anterior fontanels close at age of? 1.5 to 2 years
 Inappropriate one; Clavicles fuse by the age of 10 yrs., Lambdoid suture closes by 30-40 yrs.,
Parietosigmoid suture by 40-50 yrs., Occipital by 70 yrs., Anterior fontanels by 1 yr.
 Age and sex determination of a skeleton: skull/mandible
 Which one is most often seen in fingerprints? Loops
 Monogram method- entomology
 Cephalic index is: Ratio of maximum breadth of skull to its maximum length
 Correct statement for age estimation: Gustafson uses microscopic examination of LS to assess changes
due to wear and tear
 For nuclear sexing, you obtain a sample from? Buccal scarping
 Ergonomics is? Fitting person to job
 Mass disaster person can be completely identified by? DNA imaging
 Gustafson most reliable grade for age: transparency
 Surest method of identification- finger print

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 Not to tell the family and pregnant mother about? The baby’s sex, congenital malformations, metabolic
disorders, chromosomal abnormalities
 Patient looks like a male, has smaller testicles, nuclear sex is female, he is: Klinefelter syndrome
 Buffalo hump
 chromatin positive, gynecomastia , small testes- Klinefelter syndrome
 Tobacco chewing leading to oral cancer mostly in? India / china
 cephalic index 76- shape of orbit? oval-round- square- triangle
 race can be determined by- height index
 Body recovered - how will u prove it's an ante mortal wound?
 Cancer related to asbestos – lung cancer
 Guy who shot himself with gun gets instantaneous rigor. how to differentiate it from rigor mortis?
Indicates manner of death
 Advantage of fingerprinting: Can specifically identify a person
 Precipitin test? Agglutination
 People having agglutinogens of the ABO system in their blood are known as secretors. What is the ratio
of secretors to non-secretors? 50:50, 60:40, 70:30, 80:20, 90:10
 Wrist x-ray
 In thin x-ray if lower radius join will ulna, age? 13
 In modified stem fingerprints were taken by immersion of thumb in? ball
 Height of child is doubled? 4 years
 Age on which lateral malleolus epiphysis fused but medial not? 18-19
 Skull & long bones on exam, identification? 98%
DEATH:
 What’s molecular death?
 Thanatology is: the scientific study of death
 Eye changes not occur in? somatic death
 Clinical criteria for declaring death? Flat EEG, Fixed dilated pupils, Absent reflex, No respiration
 A person died during surgery, death is called? iatrogenic deaths
 Death indicated when? EEG flat, ECG flat, stop breathing within 5 min
 Brain death declares? No reflexes, comatose patient
 A body is found in jungle. The body does not blanch on pressure. At least how many hours have elapsed
after the death of this person? 10-12 hours.
 Cattle trucking, the earliest sign of death, is seen in: retina.
 Method by which neck is pressed with elbow is called? Bansdole
 What was the first immediate sign after death? Primary relaxation
AUTOPSY:
 Prisoner autopsy? I incision
 primary incision: Y-shaped incision
 how to have modified y incision?
 During autopsy, heart is dissected from? In the direction of blood flow
 During autopsy "Y" shaped incision make? To study structures of neck
 Incision on autopsy of scalp is made from? Right mastoid to left mastoid across occipital
 Which organ detailed autopsy not done? Spinal cord
 Psychological autopsy is done in which case? Suicidal
 Thorough study of dead body but cause is unknown? Negative autopsy
 Infanticide skull opened by which procedure? Calvarine, transverse, coronal, frontal
 Custody mien dead body ho to kese cut lagaate hain autopsy k lia
 Color of lividity freezed for 2 days or so, pink
 Time limit for exhumation in Pakistan : No time limit
 Most important difference between medico legal and pathological autopsy? Medico legal autopsy is
valid documentary evidence in the court of law.
 Rate of cooling of dead body in tropical areas?

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 What is change in dead body after 12 hours called? postmortem artifacts
 Which of these coronary arteries is mostly found obstructed in autopsies? LAD
 Virtopsy: non-intrusive form of performing autopsy creating images using CT scan and MRI
 The organ that putrefies within 24 to 48 hrs.
 First organ to undergo putrefaction
 Putrefaction first starts where? Iliac fossa
 Which gas is not released in putrefaction?
 body recovered, maggots, petrification . How old? 2-3 days
 Which of following resist purification? Prostate
 Example of negative autopsy Vagal inhibition
 Temperature of putrefaction: 70 to 100
 Organism causing putrefaction?
 What is the first sign of putrefaction?
 Regarding adipocere: Results from hydrogenation and hydrolysis, Rancidification, Foul smell
 Which is not the change seen in eye after death? Optic disc becomes opaque, Taches noises, Trucking, all
of these were seen
 Person is in supine position. Which area would not show post mortem lividity? Occiput, Sacral region,
Back of ears
 Post-mortem lividity red brown color nitrite poisoning
 Preservatives used in forensic labs contain? 5% formalin, 10% formalin
 Rigor mortis up to neck and trunk and PML bluish pink and fixed
 Cadaveric spasm
 PML color will be greyish brown due to? hemorrhage
 PML resembles?
 Suggillation is another name for? Rigor mortis, PML
 After death T increases during 2 hrs. and then falls, death due to? Pneumonia
 First external sign of putrefaction?
 Casper's Dictum : Rigor Mortis, Cooling of the body, PML, Putrefaction *
 Which organ is first to putrefy? Liver, Kidney, Heart, Spleen*, Non gravid uterus
 A dead body was discovered in which PM lividity was fixed and neck and face showed rigor mortis?
Time since death? B/w 2 to 4 hours, B/w 3 to 8 hours, 12 hours have passed, B/w 11 and 12 hours, B/w 8
and 11 hours
 Cafe coronary is caused by? Fatty meals, Fish, Eating meat in café
 First sign of internal putrefaction occurs in? Below the liver, Heart, Kidney, Spleen
 Most common agent used in preservation
 Which artery is most likely blocked in autopsy? RCA, Right circumflex, LCX, LDA
 After exhumation gender of body is determined by which bones? Skull, Pelvis, Skull and pelvis
 Correct statement about Rigor mortis: Called false mortis, also known as instantaneous something, Occurs
after 48 hours
 Post mortem changes? Green discoloration over caecum after 48 hours, Bloating after 48 hours, Marbling
 Time since death can’t be determined by? Cadaveric spasm
 In lividity marks present on lower limbs? Body was hanged with legs
 Body recovered from river side, hand holding hair- rigor mortis? May be
 1st internal sign of putrefaction is seen in:
 Autopsy of heart is done: In direction of blood flow
 There is no limit of exhumation? Pakistan
 Rigor mortis in case of hanging appears: Appear early and long duration
 Which is not an incision of autopsy? Circular incision to dissect skull cap
 Brain weight?1.5 kg
 Most commonly occluded artery of heart that is seen in dead bodies?
 Body was warm, flexible, no PML sign, death time? 1-3hr, 3-6 hrs.
 Dead body lividity marks on face & extremities, position after death was? Onlumated

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 A body brought to you; lividity was fixed, the duration of post-mortem lividity s? 6-8 hrs.
RED EYE(Diagram)
 Condition is due to? Frontal bone injury to head
 Pressure required to block jugular veinis?5kg
 Trucking is seen in?
PML
 PML will be greenish brown due to? Hemorrhage
 After death temp increased during 2 hrs. and then falls due to? Pneumonia
 Suggillation is another name for? RM/PML
 PML resembles ?Ant biting
ASPHYXIA:
 Drowning death confirm by? frothing from mouth
 Surest sign of death from drowning? Froth from mouth
 Choking is seen at which level? Trachea, Larynx, Nose and mouth, Main bronchus, Glottis
 Ante mortem hanging can be differentiated from post mortem hanging by: Emphysematous bullae on
lung, Elongated neck, Saliva dribbling from angle of mouth, Postmortem lividity above the ligature,
 cause of death by drowning in fresh water? Ventricular fibrillation
 Hanged oblique erthymous mark present?
 Antemortem hanging? saliva dribbling from mouth
 Diatom can reach? brain and bone marrow
 Judicial hanging. Neck fracture.
 15kg weight on neck death is? Asphyxia
 Asphyxia caused by anesthesia is called? Iatrogenic asphyxia
 Confirmatory sign of a person dying from drowning: Wet clothes, washerwoman’s hands and feet, cutis
anserine, Rigor mortis, Weed or sand clenched in hand
 Last structure to be dissected in asphyxia death at autopsy: Brain, Heart, Lung, Abdomen, Neck
 Hippophilia is most commonly practiced by: Young boys, Young girls, Middle aged people, Old aged
male, Old aged female
 Which is a feature of drowning? Cadaveric spasm
 Asphyxia death? Bluish face, congested conjunctiva, petechial hemorrhage
 Tardieu’s spots are not seen in: Drowning
 Auto-erotic hanging? Pornographic material
 Brain weight is?1.5 kg
 Pericellular toxic asphyxia death related? Cyanide posing, CO poisoning, cardiac arrest
 Asphyxia during surgery/anesthesia? iatrogenic
 Chemical asphyxiant? CO, phosgene
 Type of injury in a suicidal cut throat by a right-handed person? Tentative cuts at commencement
 Death in fresh water drowning due to? Ventricular fibrillation
 Bandola is a form of? Homicidal strangulation
 Hyoid bone fracture? Is must in throttling, Never occurs in throttling, Mostly involves the greater cornu
 Signs of suicidal cut throat?(hesitation cut marks)
 Violent asphyxia: Mechanical asphyxia
 Typical antemortem drowning: Oropharynx froth
 Antemortem drowning: grasping of sea weeds
 Hyoid bone fracture: a)greater cornua b)must in throttling c)rare before age 40 d) rare in throttling
 Surest cause of death in hanging is? Cervical vertebrae fracture
 Common cause of hanging in females is? Suicidal
 Hanging and strangulation(ligature marks) are examples of: Imprint abrasion
OSPE on Tardieu’s spot
 Tardieu’s spot is not seen in? drowning ,strangulation, asphyxia death
 which part is first occluded in hanging? Jugular vein
 weight to occlude jugular is?2,5,20,10 kg

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 CORROSIVE POISONING:
 Antidote for phenol? Castor oil, charcoal, wax
 Antidotes can be given in poisoning with? Carbolic acid
 Oxalic acid poisoning? tingling
 Corrosive used for cleaning rust: Oxalic acid
 First test to detect whether the poison was acid or alkali? Litmus, Barium chloride
 A child comes with poisoning from rust cleaning agent which one is likely? HCl oxalic acid Sulphur acid
 Stomach wash is not contraindicated in which type of poisoning? HCl
 Question about mechanical and physical antidote. Prevents the absorption of poison?
 What makes a poison a poison? Minimum lethal dose, chemical nature of the poison, intention of
poisoning
 Person comes to you cause of poisoning, initial aim should be? To save the pt.’s life, to gather official
documents
 Amount of charcoal required as an antidote? 15-30 gm, 2-4gm, 50-100gm
 Christison saying is about? Caustic soda, Oxalic acid, Carbolic acid
 Bone sample obtained in which kind of poisoning? Corrosive, heavy metals
 Some successful homicidal poisoning? Symptoms like natural disease
 In gastric lavage stomach wash tube should be passed up to how many centimeters? 20, 30, 35, 40
 Vitriol age? Acid throwing
 Somniferous poison? induce sleep
 Ques related to H2SO4? milk of magnesia, lime water, Na bicarbonate
 Gastric lavage is contraindicated in? Corrosive, Carbolic acid
 Castor oil mode of action?
TRAUMATOLOGY
 Color change in contusion? color change from periphery to center
 A contusion shows the presence of hemotoxin. the contusion is no less than ___ days old
 Counter coup injury
 Fracture of middle cranial fossa leading to accumulation of blood behind the mastoid process? Battle’s
sign
 Ring fracture? Fracture of base of skull
 A boy lies curled up in bed, with his face buried beneath clothes. He is not unconscious but pays no regard
to his surroundings and complains of headache and insomnia. This condition is called? Cerebral
Irritation
 Beveling cut in outer table of skull: sharp injury to head
 Convex shaped hemorrhage on imaging of brain? Subdural, Extra-Dural, Subarachnoid
 Cause of death in a person with extradural hemorrhage? Neurogenic shock, Traumatic shock,
Respiratory failure
 Diffuse axonal injury occurs by damage at what level? Corpus callosum, Putamen, Junction of gray and
white matter, White matter, Basal ganglia
 Best prognostic indicator in head trauma? GCS, Age, CT scan, Duration
 Artery involved in extradural hemorrhage? middle meningeal artery
 Duet’s hemorrhage are seen in? brainstem
 Most common type of hemorrhage? Subarachnoid hemorrhage, Extradural, Subdural
 Most common part of brain affected by brain injury? Occipital lobes, Temporal region
 Rabbit punch: a)Spinal cord laceration b)Whiplash injury c)Spinal cord concussion d)Spinal cord
compression
 Hemorrhage that is always traumatic: a)Pontine b)Subdural c)Subarachnoid
 A person received an injury on the forehead and had a black eye, the age can be determined from
following color changes? red 1st day, green 4th day, green 5-6 day, red vivid 3rd day, bluish black 2nd
 This is due to the flanking and grazing by a bullet which produces a furrow in the outer table of the skull.
Name the fracture: Gutter fracture
 Gutter fracture is caused by

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 Types of intracranial pressure which doesn't play part in fatal cases but is a contributary factor to other
causes? Sub arachnoid
 Cause of death in shaken baby syndrome? pontine hemorrhage subdural hemorrhage
 Common cause of death in a person with cut throat? Neurogenic shock, Traumatic shock, Vagal inhibition
of heart, Tracheobronchial aspiration
 Suicidal cut throat by right-handed person?
 Penetrating injury to chest? Lung is always affected , Hemorrhage related two options
 Ladder tear during an accident? Intimal tear in descending abdominal aorta
 Cause of crib death? Mild upper respiratory tract infection
 Cold injury to foot due to prolonged exposure of foot to moist cold? Trench foot
 Kick on testes what is the cause of death? Vasovagal shock, Rupture testes, Rupture bladder, Hemorrhage
 Sharp kick to the crotch
 Type of skull fracture in infant? Pond fracture, depressed fracture, compressed fracture
 Tear drop sign? Fracture of floor of orbit, fracture of superolateral aspect of orbit, fracture of roof of
orbit, fracture of late wall of orbit, fracture of med wall of orbit
 Knobbing fracture? Battered baby syndrome
 Undertaker fracture? Antemortem fracture of C2-C3, Antemortem fracture of C6-C7, postmortem
fracture of C6-C7, postmortem fracture of C2-C3, it is seen in wrestling match
 Salter Harris fracture? epiphyseal plate
 Butter fly fracture?
 Boxer’s Fracture? fracture of the neck of fourth metacarpal, fracture of the 2nd metacarpal, fracture of
the3rd metacarpal
 A man fell from a tree and landed on his buttocks, with the impact passing upward through the spinal
cord. What kind of fracture did he have? Fracture around foramen magnum
 Name the law which states that when two fractures occur subsequently one after the other, the second
fracture will not cross the line of fracture of the first fracture? Durham’s rule
 Butterfly fracture occurs at which site? Spine, Long Bones
 Spider web or mosaic fracture? Comminuted
 Most common Fracture in children: neck of femur, epiphyseal plate, midshaft fracture, diaphysis fracture
 Slug happy; fracture that doesn’t result in fatal issues but has other consequences
 Greenstick fracture? Infants
 Most common fractured ribs? 2-7, 4-6, 4-8
 Antemortem sign of burns? Carboxyhemoglobin
 Rule of nine for? Burns
 Singeing of hair in which type of burn? Dry burn*, Moist burn
 Rule of nine is used for? Burn
 Lund Browder Chart is used to? Estimate degree of burns in children
 Chawed body, ante mortem burning sign: a)Soot in liver b)Car boxy hemoglobin
 Fire in plastic factory. What gas other than CO will be present in burned employees’ blood? HCN
 Age of bruise? Greenish – 4th day
 Road rash is? Graze
 A person was hit from the side by a car while was crossing road. He fell on the ground and rolls over for
some distance. What type of injury does he have? Grazes(Bhandari)
 Friction burn is type of? Abrasion
 Brush burn is a type of: abrasion
 Pugilistic attitude is due to? Coagulation of muscle proteins
 A 5yr old child presents to casualty with bruises of different ages, what condition is he suffering from?
battered baby syndrome
 Multiple lacerations on face
 Bruising from hot liquids? Extensive Vesication
 Bruise is like: Ant-bite
 Person suffered road accident? Avulsion

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 What is flaying: avulsion
 Gravel rash? Abrasion
 Run over accident, type of injury? Avulsion
 Type of bruises in that appears at distant site? Migratory bruises
 Most commonly affected individual in an RTA is? Driver.
 Chief complication in a run-over injury: Hemorrhage, Infection, Shock, Fracture, Fat embolism
 Bumper accident when the brakes are applied: trauma to parts below the bumper
 A person had an accident and suffered blood loss. He was brought to the ER where CBC was done. The
CBC showed: normocytic, normochromic anemia
 Road accident n bleeding from fracture of femur which is best to transfuse: whole blood
 Road accident, 20-year male, which tetanus vaccine should be given? toxoid & Ig, toxoid, Ig
 A 38yr old female, mother of 5 died in automobile accident, kidneys show irregular u shape
impressions.(periglom fibrosis, interst scars, FSGS, papillary necr)
 Arborescent marks? Lightening, Radiation
 Sweating is not seen in? *Heat exhaustion, Heat stroke
 A lady presents in summer, little sweating? Heat exhaustion, Heat stroke, sun stroke
 Wischnewski ulcers are seen in stomach in? Hypothermia, Corrosives
 Person had stroke and died. Post mortem calority is seen. Rise in temperature is due to? Stroke, Burns,
Sun stroke, Pontine hemorrhage
 Tennis ball bomb? Match stick
 No tearing or singeing if? Firearm is fired from such a distance
 Molotov Cocktail: a)Alcohol + kerosene b)Incid. Bomb c)PM Cocktail party
 Blast lung, death due to: a)Pulmonary hemorrhage b)Septic embolus c)Air embolus
 RDX full form? Research department explosives
 System/organ most effected in blasts? nervous system, skeletal system, Lungs
 What causes most injury in blasts? Hot gases, hot gases + blast
 A bullet left in the brain of an old man due to its removal being impossible surgically. Souvenir bullet
 High velocity bullet? Wound at entry site, Wound at exit site
 A person is shot in the head. Brought to the ER, MRI shows bullet in brain. Doctors perform surgery but
didn’t remove the bullet because it wasn’t doing any residual injury. The patient was discharged 2 weeks
later. The bullet present in the persons head is known as: Magic bullet, Implant bullet, Souvenir bullet
 Firearm wound has blackening, burning, tattooing, surrounding skin of the wound is cherry red in color
and the wound is cruciate in shape. Identity of wound? Close fire entry wound, contact fire entry wound.
 Destructive power of a bullet is determined by: Size, Shape, velocity, jacket
 Gunpowder markers are useful for identifying: weapon used, direction of fire, distance of firing
 Preservation of bullet- immediately sealed
 Magic bullet phenomenon was seen in assassination of : John. F. Kennedy
 Bullet found 15 inches apart from person, shooting range is? 30yards, 12yards, 10 yards, 15 yards, 8 yards
 Shearing occurs in? Lung, Heart, Brain, Spleen, Liver
 Chop wound : sharp cutting edge
 Wound mark: blunt edges
 A person is lying against the wall. He is shot from the front by an unknown person. The exit wound on his
body is not typical and its edges are not everted and ... This wound is known as: Bizarre wound
 Person came to MLO of wounded injury but clear clothes? Fabricated
 A male brought to doctor with stab wound, he should not probe bc?
 Penetrating injury from pointed weapon? Stab Wound
 Injury on skull, exposure of bone without fracture: Shajjah-I-mudihah
 Injury on neck? Shajjah
Flail chest OSPE
 Most common side for heart rupture? Left with apex, Left with base, Rt with apex, Rt with base
 Most dangerous injury in heart due to stab wound? *Base, Apex, Left ventricle, Right ventricle
 Effect of cardiac massage

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 Heart rupture, best statement about it? Atria bleeds profusely, Right ventricle is more dangerous, Left
ventricle is more dangerous, Pneumothorax
Ballistics case
 Caliber of gun is? Inner diameter of barrel
 Phenomenon of direction of bullet to reach target? External ballistics
 If only bullet is fired, entry exit hole found? Jacketed bullet
 Hang fire is due to defect in? primer
 Empty cartage home all except? Bullet/properties
IRRESPIRABLE GASES
 Color of carboxyhemoglobin blood after adding 3% tannic acid? Cherry red, Pink, Purple, White
 A dead body has cherry red discoloration. What percentage of carbon monoxide would have caused this
effect? 70%
 CO poisoning, coma, death, red color carboxyhemoglobin levels are? 50-70%, 30-40%
 Feature of carbon monoxide poisoning?
 Autopsy findings in carbon monoxide poisoning? Hemolytic shock, Froth
 phosgene gas effects on? Lung, brain, heart
 vesicant war gas is? phosgene, mustard gas, CL
 Gas used in world war 1 and 2? Mustard Gas, Hydrogen sulphide, CO, CO2
 Combustible gas of autolysis is? Carbon monoxide, Hydrogen sulphide, Carbon dioxide, NO2, CH4
 which of the following is an example of therapeutic poison?(Aspirin overdose)
 Cyanide poisoning: a)anoxin anoxia b)hypoxic c)histotoxic
METALLIC POISONING
 Raindrops & hyper ketosis? Arsenic
 deep sunken eyes with red velvety luminal stomach? poisoning by Zn, lead, arsenic
 Spots on skin called as raindrops & hyper ketosis is seen in? arsenic poisoning
 Encephalopathy, Clenched hand? Mercury
 Heller tremor: a)Phosphorus b)lead c)mercury.
 Encephalopathy wrist drop. Constipation? Lead, Mercury, Iron, Arsenic
 Erethism? Chronic mercury poisoning, Chronic lead poisoning, Chronic arsenic poisoning, Chronic
phosphorus poisoning
 Milk in contraindicated in? phosphorus poisoning
 Blue (Barton) line in gums due to lead poisoning? Lead sulphide, Lead iodide, Lead chromate
 Postmortem appearance of lead poisoning shows all except? Of acute gastroenteritis, Black line on
stomach walls, Gastric mucosa congested, Large intestine may contain black colored feces
 Most common site of burton’s lines? Gums (TERSE)
 Strychnine poisoning. What to do? Wash stomach, Tracheostomy
ALCOHOLIC POISONING
 Correct regarding alcohol? Absolute contains 100% ethanol, Rectified spirit has 75% ethanol
 Alcohol is mostly converted into what in the liver?
 Alpha alcoholism? Psychological
 McEwan’s sign in? Alcohol intoxication
 Ethanol metabolism follows? zero order kinetics
 Alcohol metabolizes commonly to? Acetaldehyde
 Most important consequence of methanol? Blindness (optic neuritis)
 Most accurate method to determine concentration of alcohol? Gas liquid chromatography
 Percentage of methyl alcohol excreted by lungs? 80%
THERAPEUTIC POISONING
 MOA of antidote of organophosphates i.e. Cholinesterase reactivators? Dephosphorylation of
inactivated Cholinesterase
 Carbamate poisoning antidote? Atropine (immediate)
 What is the antidote of Organophosphorus poisoning? Pralidoxime
 SLUDGE syndrome occurs in which type of poisoning? Organophosphorus

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 SLUDGE syndrome poisoning? Massive discharge of PNS (high level of acetylcholine)
 What is given in DDT poisoning (insecticide poisoning)? (Atropine) gastric lavage, atropine, oxygen,
diazepam, IV ca gluconate
 Barbiturate toxicity potentiated by? Organophosphorus
 Cholinesterase monitoring till weeks of parathion bite?
 Barbiturate toxicity potentiated by? Alcohol, Organophosphorus
 Red tears are seen in? organophosphate poisoning
 Effect of organophosphates on renal system?
 In organophosphorus poisoning, death is due to all except? Uremia (TERSE), Paralysis of muscles,
Respiratory paralysis, Circulatory arrest, Edema of lungs or brain
 Postmortem finding in Dhatura poisoning?
 MOA of organophosphate? Inhibit acetylcholine esterase
 Sui composed of? Onion +opioid + Datura
 True about chlorinated hydrocarbon insecticide is? Absorption is rapid and complete from skin
 Acute toxicity of organophosphate? Acute tubular necrosis, Oliguria, Uremia, Anuria
 In comatose pt. of 4 days, pupil constricted, twisting of facial muscles, additional specimen is required of?
Facial muscles, Brain, Both lungs
 Marquis test is used for? Opium poisoning
 Morphine conc in opium? 10%
 Speed ball? Heroine + cocaine
 What is not true about Aconite?
 Which of these is not a manifestation of aconite? doesn’t affect higher center, it affects myocardium, it
affects muscles, it decreases sweating
SNAKE POISONING
 Cholinesterase is seen in venom of which snake? Cobra – All elatids: Cobra, Krait, mamba, Coral snake
 Rhabdomyolysis in? Viper bite, Krait bite, Sea snake bite
 Which factor is the most responsible for large quantity of snake venom injected per bite? Just after
hibernation
 In snake bite, oxygen is given before atropine to avoid? Respiratory depression, Ventricular
tachyarrhythmia
 Why do we give oxygen before atropine? Hypoxic pts. are at risk of vent. tachy and fib.
 How much a patient needs to be monitored in Parathion poisoning? 2 weeks
 Fatal dose of dry venom of Krait? (6 mg)
 A person sleeping, gets up due to pain, burning sensation, redness at the site of snake bite and
quadriplegia, he was bitten by? (Krait bite)
 How long does a snake bite patient need to be monitored? 24 hours
 Average fatal dose of parathion: 80 mg IV and 125-175 mg orally
 Neurotoxicity is caused by which snake’s venom: Elapids (Cobra, Krait)
VIRGINITY, PREGNANCY, DELIVERY, ABORTION
 Difference between false virgin and true virgin? Hymen edges undulated plus 2 fingers inserted, Non
rugosity of vaginal wall, Narrow vagina
 Normal shape of hymen? (it’s usually annular or crescentic) annular or semilunar that is crescentic with
broader part lying posteriorly
 symmetrical notches on anterior wall? (-fimbriated hymen)
 +ve and conclusive sign of pregnancy? Presence of fetal cells in mothers’ blood
 12th week of pregnancy, confirmed by? U/S
 Fecundate externa is? Fetus in fallopian tube
 Superfecundation? Fertilization of 2 ova by 2 separate
 Fetus of 2 different ages? Superfetation
 Pregnant lady stays away from cat due to the risk of: a)Toxoplasma
 False negative hydrostatic test is seen in?
 Spalding sign seen in? Abortion, Maceration

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 Spalding sign? Intrauterine dead fetus
 Vaginatus uterine ? Unborn baby crying in uterus
 Most conclusive sign that the baby is alive in examination by WMLO? fetal heart sounds, Uterine
contraction and relaxation, Abdomen increases in size, Blowing sound heard on auscultation, Fetal cells
present in mothers’ blood
 Lochia? Uterine discharge
 Parous women, how to confirm lady was pregnant? Hymen, Post commissure rupture
 Which condition does not support maceration? Membranes intact, Membranes ruptured, Fluid around
 Sign of remote delivery on post mortem a)concave from inside round cavity*b)convex from inside wall
c)triangular d)uterus and cervix are of same length
 Peak value of hCG at which gestational week? 8-11 weeks
 Hagar sign is seen for the confirmation of ? Pregnancy (PARIKH)
 Hydrostatic test is done in? macerated fetus, putrefied body
 Breslau 2nd life test, organ testified? Stomach
 Isqat e janin? When parts of fetus have formed
 What does not cause death after criminal abortion? Cupping in hypogastrium, Hemorrhage, Sepsis, Shock
 Not a complication of abortion? Bruising of labia majora
 2nd most fatal complication of criminal abortion? Hemorrhage
INFERTILITY
 Most common cause of impotency? Psychogenic
 A woman physiologically capable of bearing & delivering children? Fertility, Total fertility, Subfertility,
Fecundity
 Infertility definition: woman not able to conceive after 2 years of sexual intercourse.
 Halsbury law is related to ...... Halsbury's Laws of England is a uniquely comprehensive and
authoritative encyclopedia of law
 Reduced sperm production? Oligozoospermia
 Infertility definition? unable to conceive after 1 yr. of having un protected intercourse, unable to
conceive after 2 yr. of having un protected intercourse
 Impotence definition? Inability to perform sexual act
 If male reproductive organs are okay, what statement you will give? There is nothing to suggest that the
person is impotent
 Most common cause of erectile dysfunction in male? Vasculogenic, Hernia, Congenital Anomalies,
Neurogenic
 Quad refers to? male who is impotent towards a woman.
 Indication of artificial insemination homology? Husband impotent but fertile (LECTURE)
 Sperm count according to WHO recommendations should be at least 20 million
SEXUAL OFFENCES,
 Accident that occur after rape in children? Death may occur from freight & suffocation/personality
changes
 Position of examination of a rape victim? Lithotomy
 It was a rape case, sample was taken from woman's vagina and even in the absence of sperm what test will
detect it and confirm that its semen? acid phosphatase test
 First thing we do while examining rape victim? Biodata, Informed consent, preliminary data
 First thing we do while examining rape victim? Ensure privacy
 Acc to Hadood ordinance punishment of Zina with hudd if persons Mushin? Stoned to death
 Fornication? Intercourse on will of both but not married
 Sexual perversions include? Sadism, Bestiality, Rape, Lesbianism, Sodomy
 Incest is? Sexual relationship b/w blood relatives
 Child abuse presents with what fracture? Spiral, Transverse
 Unnatural sexual offence? 377 PPC
 Sodomy punishment PPC? 377
 Habitual of receiving sodomy, the passive person will have? Funnel shaped anus

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 Definite sign of sodomy? Semen in anal canal
 To differentiate whether semen is human or animal in origin? Precipitin test
INFANTICIDE
 Most common method of infanticide? Throttling, Drowning
 Opium poisoning? Naloxone only to give in opium poisoning with or without gastric lavage
 CO+ tannic acid, color change? Pink ppt
CASE- sexual offences
 Active agent of sodomy? Sodomite, sadist
 Which one is sexual perversion? Rape, Bestiality, Sadist
 Rape punishment penal code? PPC 376
 Which one is defined as rape from Husband on wife? With wife who is < 13 years of age with her
consent.
 What is the basic requirement in cases of Rape? Informed written consent
CASE- A dead child recovered from garbage and shifted to the mortuary
 Infanticide is up to? 1 year (PARIKH)
 Fetal hemoglobin converted to adult one in? 6 months
 Following is not found in in a dead born child? Edema of head, Maceration, Mummification, Rigor
mortis
 Lungs after birth if respired? Voluminous (TERSE)
 Act of omission include? Starvation (TERSE), Pithing, Strangulation, Suffocation
FORENSIC PSYCHIATRY & FOOD POISONING
 What feature will not be present in feigned insanity?
 Somnambulism? Sleep walking, Between sleep and awake
 Mental health ordinance launched in? Feb 20th, 2001
 Mangan symptom is a hallucination of which type? Tactile, auditory, visual
 Most common infection which causes rupture of spleen?
 Poor handling at canteen causes food poisoning by which organism?
 True about infectious food poisoning? Salmonella species is the most common cause
 Difference between toxin induced and infectious food poisoning? Fever and foul-smelling diarrhea,
Case
 Schizophrenia is? Mood disorder, Thought, Insight
 Perception without external stimulus: Delusion, Illusion, Hallucination
 Othello syndrome is an example of? Illusion, Delusion, Hallucination
 Illusion? Wavy concepts about real things
 Kleptomania? Stimulus to steal

Compiled by: Shabir Ahmed

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