FORENSIC MEDICINE &

TOXICOLOGY – T & d
Dr M Nadeem Zafar
12th Dec 2023
• Q1. A pregnant lady is presented to emergency with severe abdominal pain
and foul smell. Intra-uterine death is suspected on USG abdomen, where
gas is noted in aorta. This is called as:

• A. Spalding sign
• B. Robert’s sign
• C. Ball’s sign
• D. Halo sign
 IUD - MACERATION
• Gas in great vessels and heart chambers:
ROBERT’S SIGN

• Overlapping of cranial bones: SPALDING SIGN.

A pathognomic sign of IUD.

• Hyperflexion of spine – BALL’S SIGN

Ans: B
• Q2. What is the most common cause of death in a case of drowning in cold
water?

• A. Laryngospasm
• B. Asphyxia
• C. Ventricular Fibrillation
• D. Vagal inhibition
Ans: D
DROWNING
TYPICAL DROWNING ATYPICAL DROWNING

- Obstruction of air passages and - After submersion of body in

lungs by water/liquid. water, little or no water enters
- Therefore it is also called as respiratory passages and lungs.
WET DROWNING and findings
of fluid and froth are present in - Frothing is absent
PM examination.
1. Fresh water drowning 1. Dry drowning
2. Immersion syndrome
2. Salt water drowning 3. Submersion of unconscious
4. Near drowning (secondary
drowning syndrome/post
immersion syndrome)
• Q3. What is the diagnosis as per the presentation in given photo?

• A. Partial hanging
• B. Complete atypical hanging
• C. Complete typical hanging
• D. Ligature strangulation
Ans: C
• Q4. A man is brought to hospital after head injury. His CT scan is
shown below. Which of the following is wrong statement related to
medicolegal case in this patient?

• A. He can have a period of consciousness in between

two periods of unconsciousness
B. He can sign a valid contract during the period
of consciousness
c. Can resemble drunkenness
d. Root cause is rupture of bridging veins
Ans: D
EXTRADURAL SUB DURAL SUB INTRACEREBRA
ARACHNOID L
Location Between skull Between dura Between Within the
and dura and arachnoid arachnoid & brain
Pia parenchyma
Most common MIDDLE BRIDGING Arterial Lenticulo-
vessel affected MENINGEAL VEINS aneurysms, striate branch
ARTERY AV of MCA
Malformation

SDH – Child abuse, Shaken baby syndrome

• Q5. For postmortem examination, Incision shown in photo is given
for which of the following condition?

• A. Drowning
• B. Gunshot
• C. Smothering
• D. Hanging
Ans: D
TYPES OF SKIN INCISION USED IN AUTOPSY:
• ‘I’ shaped incision: (chin to symphysis pubis) –
Most common method followed.

• Y- shaped Incision: Acromion to Xiphisternum and then to pubis

• Modified Y-shaped incision: it is used when a detailed study of neck is

required, like in hanging or strangulation.

• T-shaped or ‘bucket handle’ incision:

• X-shaped incision: it is made at back. One acromion to other side of

gluteal region.
To demonstrate the deep bruises in custodial death cases.
• Q6. A 40 year old man (HIV +) died in a RTA. His post mortem
examination should be performed by which technique?

• A. Lettules
• B. Ghon’s
• C. Rokitansky
• D. Virchow’s
Ans: C
METHODS OF AUTOPSY
VIRCHOW’S TECHNIQUE
• Individual organs removed one by one
• Anatomical relations are not preserved

LETTULE’S TECHNIQUE
• Various system organs are removed as en-
masse (all together) – cervical, thoracic,
abdominal and pelvic organs and organ
dissection.
• Anatomical relations are preserved
• Rapid technique
 GHON’S TECHNIQUE
• Organ blocks and organ dissection
• Cervical, thoracic, abdominal and urogenital system
are removed as organ block (separate blocks)

ROKITANSKY’S TECHNIQUE
• In-situ dissection of organs
• Fetal brain dissection
• Infectious disease like HIV, Hep B
• Radiation hazards
• Q7. Mark the right option related to the condition shown below;

• A. Time since death is 36-52 hours

• B. Due to contact pallor
• C. It is arborescent burn
• D. Discoloration is due to oxyhaemoglobin
Ans: A
• Shown photo is MARBLING. It occurs due to sulfhaemoglobin

• Time of appearances:
• Marbling – 36- 48 hours
• Mummification - 6 months – 1 year
• Livor mortis - starts in 30 min to 2 hour progress in 4 hours and
complete in 6-12 hours
• Rigor mortis - begins in 1-2 hours, progress in 3-4 hours and
complete in 6 - 12 hours
• Q8. A 21 year old male presented to emergency department with altered
sensorium. Non contrast CT scan revealed hydrocephalus, which requires
urgent surgical intervention. The patient had nobody accompanying or
any Identity proof. Under which of these sections of IPC (Indian Penal
Code) can the neurosurgeon perform the procedure without obtaining an
informed consent from a guardian?

• A. IPC 87
• B. IPC 88
• C. IPC 89
• D. IPC 92
Ans: D
• Q9. A married female is brought to emergency department with
extensive burns. She has grade 3 burns over her face, neck, back and
arms along with singeing of hairs. Which of the following is not a
proof of inhalational burns?

• A. Blackish soot deposit on posterior part of tongue

• B. Hoarseness of voice & stridor of voice
• C. Yellow colored sputum
• D. Singeing of eyebrows and facial hair
Ans: C
• Patient presented to casualty with grade 3 burns (acute case).

• Yellow colored sputum is mostly a sign of bacterial infection.

• In grade 3 burns, sputum will be carbonaceous colored.

• Q10. A 29 year old woman died in unnatural conditions within 4
years of marriage. Her parents complained of frequent demand of
money from her in laws. Her autopsy will be performed under which
section?

• A. IPC 304 B
• B. IPC 304 A
• C. CrPC 174
• D. CrPC 176
Ans: D
• Police inquest: CrPC 174
• Magistrate inquest: CrPC 176 (Dowry death in given case)
• Q11. Post mortem examination of an asphyxial death is performed.
As per report, one eye was opened on the same side of knotting,
dribbling of saliva was seen, ligature mark was oblique and
suprathyroid and there was fracture of C2 vertebra. Which of the
following is a correct statement related to this case?

• A. It is a case typical hanging

• B. Person died due to manual strangulation
• C. It is a case of partial hanging
• D. Knot was placed at angle of jaw while hanging
Ans: D
As per clinical scenario: This is a case of JUDICIAL HANGING.
Knot is placed at angle of Jaw: Atypical hanging (Not typical)
C2 vertebra fracture is seen: Hangman’s Fracture

HANGING:
• Based on position of knot: Typical and atypical

TYPICAL HANGING
• Knot is at occiput
• Point of suspension is placed centrally
ATYPICAL HANGING
• Knot of ligature is anywhere other than on the occiput
• Q12. A person was found dead in bushes with tied arms and legs.
On post mortem examination, his face was deeply congested and
the nails were blue. Abrasions and nail marks were marked on chin,
face and nostrils. Lips were lacerated internally. Hypostasis was
fixed on back and rigor was seen all over the body. Find out the
wrong statement related to this case;

• A. Homicidal
• B. Throttling
• C. Asphyxia
• D. Duration of death is within 24 hours from post mortem
examination
Ans: B
SUFFOCATION DEATHS:
• Smothering: Mechanical occlusion of external air passages by hand or
cloth.
• Choking: Mechanical occlusion of internal air passages by a foreign object
like coin, seeds etc.
• Gagging: Due to pushing a gag into the mouth & blocking the pharynx.
• Overlaying: Accidental smothering.
• Traumatic asphyxia: Mechanical fixation of chest, so that normal
movements of chest wall are prevented. Eg; stampede, collapse of house
etc
• Burking: Homicidal smothering + Traumatic asphyxia
• Q13. An accused person in court is claiming that he is only 17 year
old so that his punishment could be decreased as a juvenile. Judge
has sent this person to hospital to find out the accurate age. What
should be the best step to calculate the exact age?

• A. X-ray of elbow
• B. X-ray of wrist
• C. IQ test
• D. NCCT head
Ans: B
• Q14. In case of infant deaths, a test is performed
where middle ear contains gelatinous embryonic
tissue which is replaced by air after respiration. What
is the name of this test?

• A. Ploquets
• B. Breslau’s
• C. Wredin’s
• D. Raygat’s
Ans: C
• PLOCQUET’S TEST: Lung and body weight ratio

• HYDROSTATIC TEST (RAYGAT’S TEST, 1st life test): Respired

and unrespired lungs can float/sink in water or not

• BRESLAU’S SECOND LIFE TEST/STOMACH BOWEL TEST: Air

is seen in stomach and bowel

• WREDIN’S TEST: middle ear contains gelatinous embryonic

tissue which is replaced by air after respiration

• FODERE’S TEST: Weight of respired/unrespired lungs.

Respired lungs are heavy
• Q15. A 50 year old woman is brought to emergency department with a
case of stab injury. Her situation is critical. She confessed that someone
tried to kill her but didn’t disclose all information as she is not sure about
that. After 2 hours she feels that she is about to die. She called the doctor
and asked her that she wants to give her statement about her murder
case. Doctor can write the statement in front of two witnesses. This
evidence is called as;

• A. Dying deposition
• B. Subpoena
• C. Compos mentis
• D. Dying declaration
Ans: D
 DYING DECLARATION DYING DEPOSITION
(32 IEA) (Bed Side Court)

Recorded by

Oath

Cross Examination

Leading Question

Compos Mentis

India
• Q16. A surgeon is operating on liver laceration case (assaulted
case). If patient dies intra-operatively, the person who
assaulted will be responsible for this. But if doctor has done
some negligence during surgery, like forgetting any swab or
instrument in abdomen during surgery and if patient dies, then
the responsibility may pass from original incident to later
negligent act of surgeon. This is;

• A. Res Ipsa Loquitor

• B. Novus actus intervenience
• C. Act of God
• D. Therapeutic misadventure
Ans: B
• Q17. What is the usual position of rupture of hymen
after first time sexual intercourse?

• A. 3 or 9 O’clock
• B. 1 or 11 O’clock
• C. 6 or 12 O’clock
• D. 4 or 8 O’clock
Ans: D
RUPTURE OF HYMEN:
• Usually ruptures at the time of first sexual intercourse and
usually ruptures POSTERO-LATERALLY (4 or 8 o’clock position
or 5 or 7 o’clock position.

• After 3 to 4 days, the edges are congested and swollen, which

heal completely in 1 week

• Masturbation by fingering results in hymen rupture at 11 or 1

o’clock position.

• Hymen rupture is not seen in rape among children due to its

deeper location
• Q18. Which of the following is wrong about physical examination of
a woman?

• A. 2 finger test is abolished

• B. Per speculum examination should not be performed in a female
where there is no history of penile insertion
• C. Per vaginal examination should be performed in a 16 year old
female presented with amenorrhea
• D. Consent should be taken before physical examination to a rape
victim
Ans: C
• Q19. Which of the following is not associated with rigor mortis?

• A. Rule of 12
• B. Nysten’s rule
• C. Vibices
• D. ATP depletion
Ans: C
• Q20. Find out right matches:

• 1. Diatom’s test – Drowning

• 2. Shapiro’s rule – Rigor Mortis
• 3. Le Facie Sympathique – Hanging postmortem sign
• 4. Cadaveric spasm – Instantaneous rigor/antemortem sign

• A. 1, 2, 3
• B. 1, 3 and 4
• C. 1, 2 and 4
• D. 1 and 4
Ans: C
• Q21. Find out the wrong match:

• 1. Six Penny bruises – Child abuse

• 2. Butterfly bruises – Battered baby syndrome
• 3. Tramline bruises – Hit by a rod
• 4. Patterned abrasion – Hanging

• A. 1 , 2 and 3
• B. 1 and 4
• C. 2 and 3
• D. Only 4
Ans: D
SIX PENNY BRUISE (as it resembles six penny)
• Discoid-shaped bruises
• Due to pressure from fingertips
• Seen in neck of throttling cases and arms, forearm
• or wrist of child abuse cases.

BUTTERFLY BRUISE:
• Due to skin pinching
• May be seen in child abuse cases
• Q22. A person is presented to casualty with the injury shown below.
Identify the type of injury:

• A. Sharp cut incised injury

• B. Chop wound
• C. Avulsion
• D. Split Laceration
Ans: D
• Q23. Identify the type of wound;

• A. Active defense wound

• B. Passive defense wound
• C. Harakiri
• D. Tentative cuts
Ans: A
• Q24. After RTA, a female is brought to casualty with bone fracture
as shown in X-ray. What could the most probable seat acquired by
the patient in car during the accident?

• A. Driving seat
• B. Front passenger seat
• C. Back seat behind driver
• D. Back seat behind front passenger seat
Ans: B
• Q25. Out of these 2 gunshot injuries, which of the following is true
about big wound?

• A. Inverted edge
• B. Abrasion collar
• C. Fat extrusion can be seen
• D. Tattooing can be seen
Ans: C
 Entry wound Vs Exit wounds
CHARACTER ENTRY WOUND EXIT WOUND
Size Smaller than the Larger
diameter of the bullet
(exception in contact
shot)
Edges Inverted Everted
Abrasion collar & Present Absent
grease collar
Scorching, smudging & May be present Absent
tattooing
Bleeding Less More
Fat extrusion Absent May be present
Cherry red colour May be present Absent
• Q26. A patient is brought to casualty with gunshot injury as presented below. Which of
the following statements are true?

• 1. It can be due to rifled gun

• 2. It can be due to smooth bore gun
• 3. Close range
• 4. Point black range

• A. 1 and 2
• B. 1 and 3
• C. 1, 2 and 3
• D. 1, 2 and 4
Ans: D
• Stellate shaped entry wound is seen in contact (point blank range).
EFFECTS OF DISCHARGES OF A GUN
RIFLED GUN INJURIES
• Contact shot – Muzzle end of the gun is in tight
contact with skin.

• Close shot – Victim lies within the range of flame

• Near shot – Victim lies outside the range of flame

but within the range of gun powder

• Distant shot – outside the range of gun powder.

Appearance of wound of rifled firearm in different ranges:
CONTACT(point blank) CLOSE SHOT
(range of flame)

Muzzle impression Circular entrance wound

Stellate or cruciate margins Burns & Singeing- Present
Burns, blackening & powder Blackening - Present
tattooing seen along the track Tattooing - Present
of the wound (not seen in skin Abrasion/Grease collar -Present
externally)

NEAR RANGE LONG RANGE (beyond the range of gun

(range of gun power) power)

Circular entrance wound Circular wound smaller than the diameter

Burning/ blackening - Absent of the bullet
Tattooing - Present Burning, blackening, tattooing - absent
Abrasion/Grease collar - Present Abrasion collar - Present
RIFLED GUN INJURIES:
RIFLED GUN INJURIES:
SHOT GUN INJURIES:
• In shot gun, there is dispersion of lead shots.
• As the distant increases, the dispersion increases.
• In contact shot, cruciate or stellate appearance is
noted due to blast effect.

• Effects of flame, smoke, tattooing are noted

within 1m. (beyond 1 m, only lead shot injuries
seen).
• Beginning of lead shots dispersion is seen at 2 – 4
m.
• Complete dispersion is seen at 4m.
Definition of ranges in shot gun:

• Contact range: Muzzle end of gun is in tight contact

with skin.
• Close range: less than1 m
• Near range: 1- 2 m
• Intermediate range: 2 -4 m
• Distant: >4 m
 IMPORTANT POINTS
• Wound is cruciate/ stellate in contact shot.

• Burns, blackening & tattooing around

entrance wound till 1 m. (Not in >1m)

• Between 1 – 2m, Lead shots are about to

disperse (but has not begun to disperse)
making the wound rat – hole appearance.
 IMPORTANT POINTS

• All the lead shots enter the skin as single mass

till 2 m.

• After 2 m, lead shots begin to disperse &

individual pellet holes can be found in
addition to central big hole.

• At 4 m, there is complete dispersion of lead

shots and only individual pellet holes are seen.
• Q27. In a case of bullet finger printing, whether the recovered bullet
during post mortem examination, is fired from the same gun can be
confirmed on the basis of;

• A. Primary markings
• B. Secondary markings
• C. Gunshot residues
• D. Harrison and Gilroy test
Ans: B
BULLET FINGER PRINTING
• Primary markings: (CLASS CHARACTERISTICS) Unique
to a manufacturing company

• Secondary markings: (INDIVIDUAL CHARACTERISTICS)

Unique to a particular gun
BULLET FINGER PRINTING – BY COMPARISON
MICROSCOPE – Discovered by Calvin Goddard
• Q28. What is the most important parameter to identify the sex of a
person?

• A. Sub pubic angle

• B. Greater sciatic notch
• C. Pelvic inlet
• D. Pre auricular sulcus
Ans: B
Sex determination from pelvis:
• Best suitedQ for sex determination.

• The greater sciatic notch is the single most important differentiating feature
even in fetal life.

• MALE: deep and narrow sciatic notch

• FEMALE: wide and shallow sciatic notch
FEATURE MALE FEMALE
Pelvic inlet Heart shaped Circular
shapedQ
Pelvic cavity FunnelQ Flat bowl
Pre auricular Narrow, BroadQ, deep
Sulcus shallow More
Not frequent frequentQ
(evidence of
Pregnancy)
Sub pubic ‘v’ shaped ‘u’ shaped
Angle Acute ObtuseQ

Greater sciatic NarrowerQ & WiderQ &

notch (75%) deeper shallower

Ischial Inverted Everted

tuberosity
• Q29. Eruption of upper lateral incisor (primary) is seen mostly at
which age?

• A. 6 months
• B. 7 months
• C. 8 months
• D. 9 months
Ans: C
Sequence of temporary incisors eruption:
• LCI – 6 months
• UCI - 7 months
• ULI - 8 months
• LLI - 9 months

RULE OF HALF DOZEN: (multiples of 6)

Eruption sequence of temporary teeth
• Incisors: 6 months
• 1st Molar: 12 months
• Canine: 18 months
• 2nd Molar : 24 months
Permanent dentition Average age of Age
eruption (years)
(years)
First molar (M1) 6 6-7
(First to erupt)
Central incisor (CI) 7 6-8
Lateral incisor (LI) 8 7-9
First premolar (PM1) 9 9-11
Second premolar 10 10-12
(PM2)
Canine (C) 11 11-12
Second molar (M2) 12 12-14
Third molar (m3) 17-25 17-25
(Last to erupt) –
Wisdom tooth
Period of Mixed dentition:

• The permanent dentition starts with first Molar by 6 years.

• During that process, both the temporary teeth & permanent

teeth present in the oral cavity between 6 years and 11 years
– Period of Mixed Dentition

• Number of permanent teeth = (Age – 5) x 4

• Q30. Old blood stains are found at a crime scene. Which of the
following tests is performed to check the blood if it belongs to
human origin or not?

• A. Florence test
• B. Teichmann’s hemin crystal test
• C. Spectroscopy
• D. Precipitin test
Ans: D
 TESTS FOR BLOOD STAINS
To know the origin; Human or not? To identify blood stains
Serological tests Spectroscopy
Macrochemical tests
Microchemical tests
Immunological methods: Spectroscopy: Most reliable test for detecting
blood in recent and old stains
-Gel diffusion
MICROCHEMICAL TESTS:
-Double diffusion in agar gel -Takayam Haemochromogen Crystal test: pink
-Precipitation electrophoresis feathery crystals of haemochromogen
-Teichmann’s Hemin Crystal test: brown crystals of
-Hemagglutination hemin chloride
-Precipitin test MACROCHEMICAL TESTS: tests based on
-Latex test H2O2
- Benzidine test
-Toluidine blue test
-Leucomalachite green test
-Kastle-Meyer test or Phenolphthalein test
• Q31. Changes in physiological variables of suspect when the patient
is exposed to questioning regarding the crime. This principle is seen
in which Lie Deception Test?

• A. Polygraph
• B. Brain mapping
• C. Narcoanalysis
• D. None
Ans: A
 Deception Detection Tests (DDT)
Polygraph

Brain Mapping

Narcoanalysis

Note: Results of these tests can’t be considered to be the

confession
Can be submitted as evidence.
 POLYGRAPH TEST:
LIE DETECTOR TEST
POLYGRAPH TEST: a/k/a Lie detector test
• Principle: Changes in physiological variables of suspect when the
patient is exposed to questioning regarding the crime.

• Polygraph makes a continuous record of BP, PR, RR, muscular

movements & electrodermal reaction changes in response to stimuli
in the form of questions.

• Fear → Stimulates the Sympathetic nervous system

BRAIN MAPPING – Brain Fingerprinting
BRAIN MAPPING
• A non-invasive test. It involves a special cap on the patient's head,
specifically touching the scalp.

• It is a technique that measures recognition of familiar stimuli by

measuring electrical brain wave responses (P300) to words, phrases
or pictures that are presented on a computer screen.
• a/k/a P300 waves test (Brain Electrical Activation Profile Test)

• Principle: the suspect’s reaction to the details of an event or activity

will reflect if the suspect had prior knowledge of the event or activity.
• It detects evidence stored in the brain.
NARCOANALYSIS – TRUTH SERUM DRUGS
• Narco test – Amytal interview
NARCOANALYSIS
• Principle: At a point very close to unconsciousness, the subject will be
mentally incapable of resistance to questioning, and incapable of
inventing falsehood that he has used to conceal his guilt.

1. ½ mg Scopolamine hydrobromide S/C

2. Sodium amytal or sodium pentothal (truth serum) 2.5 – 5% solution
I/V
3. 0.1 g sodium Seconal

Person loses inhibition & becomes talkative.

• Q32. Which of the following is the most reliable method of human
identification?

• A. DNA fingerprinting
• B. Fingerprinting
• C. Tattoo
• D. Dentition
Ans: B
 DACTYLOGRAPHY – FINGERPRINTING STUDY
These are the impressions produced by dermal ridges on a surface
• Starts appearing in 12th week of IUL and it gets completed by 24th week of IUL

• In practice 10-12 points of comparisonQ are accepted as proof of identity.

DNA
Fingerprinting
• Q33. A factory worker, who is working in matchstick industry,
presented with pain and swelling in jaw with multiple
discharging sinuses of jaw. What is the likely cause of poisoning?

• A. Arsenic
• B. Lead
• C. Phosphorus
• D. Mercury
Ans: C
• 34. Which of the following should be done as per the snake bite management
protocol?
• A. Kill the snake
• B. Apply tight torniquet
• C. Immobilization
• D. Washing
• E. Debridement of wound
• F. ASV administration after admission

• A. C, D, & F
• B. B, C, D & F
• C. C, D, E & F
• D. C & F
Ans: D
• 35. A patient with history of abdominal surgery is admitted in ward. Patient
complaints of severe abdominal pain and fever on post operative day 3. X-
ray of abdomen is taken as shown below. This corresponds to:

• A. Res judicata
• B. Vicarious Liability
• C. Res Ipsa Loquitor
• D. Novus actus interveniens
Ans: C
• Q36. Identify the active ingredient of a poisonous plant which is
used to kill infants and cattle?

• A. Capsaicin
• B. Abrin
• C. Ricin
• D. Calotropin
Ans: D
ORGANIC IRRITANTS
MAJOR ACTIVE PRINCIPLE & TOXICITY
Ricinus communis Active Principle: RicinQ Ricin is a Biological warfare agent
Entire plant is poisonous (category BQ)
(Castor)
Castor oil non poisonous
Unbroken seeds are not poisonous when
swallowed or cooked.
Abrus Precatorius Active Principle: AbrinQ Similar to Viper snake venomQ
Others: Abrine & Abraline
Entire plant is poisonous Used as SUI needlesQ
Seeds are bright scarlet red with a black
spot at one pole Anti abrinQ (antidote)
Semicarpus Active Principle: Semicarpol & Applied to the skin
BhilawanolQ Irritation, itching and a painful blisterQ with
anacardium
acrid serumQ and eruptions of the surrounding
(Marking Nut) skin.

Calotropis gigantea calotoxin & calotropinQ Skin: Blister

Eye: conjunctivitis & blindness
Ingestion: Vomiting & diarrhea
Calotropis root - highly poisonous
Ricinus communis (Castor)
Abrus precatorius
Semicarpus anacardium
(Marking Nut)
Calotropis gigantea
• Q37. Identify the poisoning as per the presentation shown below;

• A. Copper
• B. Arsenic
• C. Aconite
• D. Lead
Ans: D

Lead:

BURTONIAN LINE:
- blue line along gums
- opposite to caries tooth
- deposition of lead sulphide ( Lead + H2S by bacteria)
- 1 week of exposure
• Q38. All of the following are correct statements related to the
shown snake except;

• A. Symptoms like cobra bite

• B. Elapidae
• C. No fang marks
• D. Cause of death is cardiac arrest
Ans: D
 ELAPIDAE: Cobra, VIPERIDAE: Viper HYDROPHIDAE: Sea snake
Krait
NEUROTOXIC Hemotoxic Myotoxic
vasculotoxic

King cobra, common Russels viper, saw Sea snake

cobra, Krait scaled vipers, Hump
nosed vipers
King Cobra Common cobra Krait Russel Viper
Common and King Cobra
• Q39. Wrong statement related to the poisonous seeds;

• A. Brain poison
• B. Antagonizes glycine
• C. Mimics Tetanus
• D. Postmortem caloricity
Ans: A
 SPINAL POISON- STRYCHNOS NUX VOMICA
• Poisonous Seeds are flat, circular discsQ, concave on one side & convex on the
other, covered with silky hairs.
• They resemble enlarged RBCs.

Active Principles
• StrychnineQ—Alkaloid
• BrucineQ—Alkaloid
• Loganin—Glucoside.

Toxic Action:
• Strychnine competitively antagonizes glycineQ (inhibitory neurotransmitter)
in the anterior hornQ cells of spinal cord (Renshaw cells).
Risus sardonicus
• Opisthotonus – body is arched posteriorly
• Emprosthotonus – body is arched anteriorly
• Pleurosthotonus – involuntary muscle contraction
DIFFERNCES BETWEEN STRYCHNINE POISONING AND TETANUS
FEATURES STRYCHININE POISONING TETANUS
Onset Sudden Gradual
Convulsions All parts of the body are involved at Not affected at the same time
the same time
Lower jaw Does not start from lower jaw Usually starts from lower jaw

Muscular condition between Relaxed Rigid

convulsions
Fatal period 1-2 hours >24 hours
Lab analysis Poison can be detected from food Clostridium tetani bacillus can be
demonstrated in microscopy

Fatal dose: 1 crushed seed

Management:
- No specific antidote
- Treat convulsions with barbiturates
- Gastric lavage with KMnO4
- Hyperthermia is treated by active cooling
• Q40. Eli Lilly antidote is used for;

• A. Lead poisoning
• B. Cyanide poisoning
• C. Arsenic poisoning
• D. Thallium poisoning
Ans: B
Treatment of Cyanide Poisoning:
1. Decontamination
2. Antidote therapy
- Hydroxycobalamine
- Nitrites
- Sodium thiosulphate
•
• Eli lilly antidoteQ: ( Sodium nitrite, amyl nitrite & sodium thiosulphate)
• The principle of adding nitrate is to form methemoglobinemiaQ
• Other anitdotes are: CyanokitQ (hydroxycobalamin) & KelocyanorQ
(Dicobalt edetate)
• Q41. A hat industry worker is presented to hospital with
neuropsychiatric symptoms along with recent personality changes.
He is irritated, behaving in a weird manner, disoriented, having
insomnia and dementia. Which of the following perfectly describes
his pathology?

• A. Acrodynia
• B. Erethism
• C. Minimata disease
• D. Hunter russel syndrome
Ans: B
• Q42. X-ray of a hanging case is presented below. Which of the
following is a wrong statement?

• A. Atypical hanging
• B. Knotting at the side of neck
• C. Le facie sympathique can be seen
• D. Complete ligature mark
Ans: D
JUDICIAL HANGING
• In India, Knot is placed under the angle of jawQ.
• Length of rope from the point of suspension is equal to the height of the
individual.
• The ligature around the neck causes a
forceful jerky impact on the neck & results
in Hangman’s fracture.
• Q43. A suicide note is found in a hanging case. Which type of
evidence it should be considered as?

• A. Written
• B. Documentary
• C. Circumstantial
• D. Parole
Ans: C
CIRCUMSTANTIAL EVIDENCE:
• It refers to evidence collected from the circumstances or surroundings
of a case. Eg; suicide note, blood stain, bullet, finger prints, foot
prints etc. it has only limited legal values.
• Q44. A man may be impotent with one woman but potent &
perform the sexual act with another woman. This is called as;

• A. Sterility
• B. Impotency
• C. Quod Hanc
• D. Defloration
Ans: C
• Impotence Quod Hanc/Psychogenic impotence: A person may be
impotent with one woman but potent & perform the sexual act with
another woman.
• Q45. Physical examination to a female is performed. Labia
Majora is thick, firm, fleshy and they oppose each other to
completely close vaginal orifice. Clitoris is small. Vagina is
reddish with rugose wall. She should be considered as:

• A. Virgin
• B. Non virgin
• C. False virgin
• D. Sterile
Ans: A
 SIGNS OF VIRGINITY NON-VIRGIN
LABIA MAJORA Thick, rounded, firm, fleshy Thin, lax and do not
and elastics. They are completely close the
opposed to each other to vaginal orifice.
completely close vaginal
orifice

LABIA MINORA Small, thin, pink and lies Enlarge, cutaneous, and
inside the labia majora projecting outside labia
majora
CLITORIS Small Enlarged

VESTIBULE Narrow Spacious

VAGINA Small, narrow, tight, Spacious, loose, roomy and

reddish with rugose wall elongated
HYMEN Intact Ruptured

FOURCHETTE & Intact Torn

POSTERIOR COMMISSURE
FOSSA NAVICULARIS Normal Conspicuous
• Q46. Find the wrong statements related to the given condition:

• 1. Lichtenberg flower like pattern

• 2. Filigree burn
• 3. Brush burn
• 4. Marbling

• A. 1 and 2
• B. 3 and 4
• C. only 1
• D. only 2
Ans: B
• Q47. A body decomposes in air twice as rapidly as in water and 8
times as rapidly as in earth. It is called as;

• A. Compos mentis
• B. Casper’s dictum
• C. Commotio rentis
• D. Corpus Delicti
Ans: B
• Q48. Find out the method of killing someone as depicted in the
photo:

• A. Bansdola
• B. Smothering
• C. Garroting
• D. Mugging
Ans: D
•
• Q49. Wrong statement regarding autopsy;

• A. Post mortem report should not be given to party

• B. Three copies of report are made
• C. Ranking of police should be head constable
• D. No need of consent from family in a medicolegal autopsy
Ans: C
• Q50. What is the new name for Indian Penal Code?

• A. Bhartiya Sakshya Bill

• B. Bhartiya Nyaya Sanhita
• C. Bhartiya Nagarik Suraksha Sanhita
• D. None
Ans: B
• A. Bhartiya Sakshya Bill, 2023 – IEA

• B. Bhartiya Nyaya Sanhita, 2023 – IPC

• C. Bhartiya Nagarik Suraksha Sanhita, 2023 - CrPC

THANK YOU

GOOD LUCK