1
Q
Methanol andtidote
A
Fomipizole 15mg/kg
Ethanol(50%) 60mg every 2h for 4-6days
2
Q
Delerium tremens rx
A
Benzodiazipines and thiamine
3
Q
Delirium tremens post mortem findings
A
Cerebral edema
Liver cirrhosis
Cardiomyopathy
Hypoglycemia
4
Q
Exceptions of rectified spirit
A
Alcohol,acetic acid,phosphorus or paraldehyde poisoning
5
Q
Criminal causes of exhumation
A
Criminal abortion
Homicide
Criminal negligence
Retrieval of evidence
6
Q
Civil cases of exhumation
A
Workmans compensation
Inheritance of property
Insurance claims
Wrong body burial by fraud or mistake
7
Q
Exhumation ordered by
A
First class magistrate or executive magistrate
(District collect,rdo,deputy collector,tahsildar)
8
Q
Obscure autopsy causes
A
Epilepsy
Thyrotoxicosis
Dka
Reflex vagal inhibition
9
Q
Glaistons formula
A
Normal temp-rectal temp/rate of fall of temp(0.5 to 0.7)
10
Q
A
11
Q
Purpose of transplantion
Organs and time
A
Liver and lungs-15min
Kidney-45min
Heart-1h
Cornea-2h
Bone-6h
12
Q
According to organ transplantion act,death certified by
A
Treating physician
Doc in charge of hospital
Doc from kerala govt
Neurologist
13
Q
Livor mortis timing
A
1-2h-mottling
5h- coalesce
Max.-6h
Fixed-6-12h
Merges-36-48h
14
Q
Casper’s dictum
A
Air:water:deep burial=1:2:8
15
Q
Adipocere products
A
Stearic acid
Hydroxy stearic acid
Oleic acid
Palmitic acid
16
Q
Adipocere formation
which enzyme
Which bacteria
A
Lipase
Chlostridium welchii-lecithinase
17
Q
Adipocere odour
A
Rancid butter like
18
Q
Adipocere sites
A
Face
Buttocks
Breasts
19
Q
Organ that doesnt show adipocere
Age of baby where adipocere wont occur?
A
Brain
Below 7months
20
Q
Adipocere formation
A
3weeks to 3months
21
Q
Sudden death due to strenuous exercise
A
Cardiomyopathy
Myocarditis
Commotio corditis
Coronary artery anomalies
22
Q
Postmortem staining
Cyanides?
Co?
Co2?
H2s?
Asphyxia?
Septicemia?
A
Bright red(oxyhb)
Cherry red(carboxy hb)
Deep blue(reduced hb)
Bluish green(sulphmet hb)
Dark purple
Bronze
23
Q
Putrefaction bacteirae
A
Chlostridium welchi
Staphylococci
Streptococci
B.Proteus
24
Q
Putrefaction changes and timings
A
Greenish discoloration of RIF-18h
Marbling-36h
Maggots-48h
Postmortem skin peeling-48-72h
Gas rigidity-48-72h
Hair become loose-72h
Degloving-3-5days
Colliquative putrefaction-5-7days
25
26
Black discoloration due to
H2s+(fe3+)=ferric sulphide
27
Mummification timing
3-6months to 1y
28
Cadaveric spasm features
•Cause:adrenocortical exhaustion or
sudden atp depletion
•No primary flaccidity
•Sudden spasm
•Restricted to a group of muscles
•Greater force to break
•Responds to electrical stimuli
•Body temp is warm
29
Rigor mortis simulating conditions
•Cadaveric spasm
•Heat stiffening-protein coagulation above 65C
•Cold stiffening-frozen below -4C
•Gas stiffening-gas in joints
30
Rigor mortis timing
Heart -1h
Eye lids-1-2h
Establishes in all muscles-4-6h
Begins to pass off-18h
Completely pass off-24-36h
31
Zsakos phenomenon
Response to electric stimuli in primary flaccidity
32
Nystens rule
External Rigor mortis progression
Eyelids
Face
Neck
Upper limb
Lower limb
33
Changes in the eyes after death
Rail roading or kevorkian sign-10-15sec to 1h
Loss of corneal reflex
IOP becomes zero-4-8h
Cornea become opaque-12-36h
Tache Noir
Increase in sodium and decrease in calcium in vitreous humor
34
Sturner’s equation
Time since death=
7.14*(K+ in vitreous humor)
35
Suspended animation seen in
Drowning
Hanging
Electrocution
Sunstroke
Hypothermia
Yoga
Head injury
36
Immediate changes
Primary flaccidity
Pupil dilation
37
Boyde’s method
Method using cross striations or enamel lines of teeth to calculate age of young children
38
Gustafsons method definition
Estatimation of age of dead person by eruption and degradation changes of permanent teeth(upper incisor or canine) of age 25-60y
39
Components of gustafsons method and equation
Attrition
Paradentosis
Secondary dentine
Cementum apposition
Root resorption
Root transparency
5.34*point value-4.08
Std error extend upto +3.63y
40
Which is the most reliable criteria in gustafson method
Root transparency
41
42
Papillary ridges formed
3-4m of IUL and completed 6th m of IUL
43
Permanent fingerprint impairment causes
Adermatoglyphia
Leprosy
Electrical injury
Dyskeratosis congenita
44
Which all are the ridge patterns
Composite(1-2%)
Arches(6-7%)
Loop(67%)
Whorl(25%)
45
Which all are the reference points?
Ridge breaking
Bifurcation
Ridge reunion
Island formation
Island with dot formation
Lake formation
Ridge ending
46
Quetlets rule
Every object in nature shows infinite variations
47
Poroscopy
Ridges have 9-18 microscopic pores
They are examined
48
Tattoo erasure methods?
Caustic substances:papain in glycerine,tannic acid
Overtattooing:tannic acid
Burns
Electrolysis
Laser
Surgery
Co2 snow application
49
Criteria of superimposition
•Eyes should be in the orbits
•Nasion should be at the frontonasal junction
•Nasal spine should be above nose tip
•Menton should be at symphysis menti
•Gonion should be at the angle of mandible
•Outline of the mandible should be congruous with jaw outline
50
51
Dna fingerprinting found out by
Alec Jeffrey
52
Dna fingerprinting method
Dna to single strands to dna fragments by restriction endonuclease
Electrophoresis classify them according to weight(southern blotting)
Hybridization-Add radioactive probes
Excess VNTR washed off
Visulized by autoradiography(xray)
53
54
Rna and protein analysis name?
Northern blotting
Western blotting
55
PCR found out by
Kary B Mullis
56
PCR method
Denaturation(94-96C)
Annealing(68C)
Extension(72C)
57
Cephalic index types
Dolicocephalic-70-75
(aryans,aborigines,negroes)
Mesaticephalic-75-80
(Europeans,indians)
Bradycephalic-80-85
(Mongolians)
58
Intersex types
Gonadal agenesis
Gonadal dysgenesis
True and Pseudohermaphroditism
59
Most common cause of klinefelters syndrome
Hyperthalamic hypogonadism
60
True hermaphroditism
Ovary/testes/ovotestis on both sides
Ext genitilia of both sex
61
Pseudo hermaphroditism
Male hermaphroditism
XY(has testes)
Ext genitilia(blindly ending vagina)are of female form
No uterus,tubes or ovaries inside.
Cause:
androgen receptor deficiency
5 alpha reductase deficiency
Female hermaphroditism
XX(has uterus,tubes,ovaries)
External genitilia:
Labia majora to bifid scrotum
Enlarged clitoris to penis
Cause:
Congenital adrenal hyperplasia
21hydroxylase deficiency
62
Barr bodies
Plano convex bodies beneath nuclear membrane in buccal epithelium
Seen in interphase during mitosis
Fluroscent feulgen reaction-bright yellow spot
63
Davidson body
Drumstick appearance from a lobe of nucleus of 3-6% neutrophils in female
64
Lyons hypothesis
No of x chromosome -1
65
Define torture
The deliberate systemic infliction of physical and mental suffering by one or more persons,acting alone or on the orders of an authority to force another person to yield info or make confession or any other reason
66
Types of torture example
1.physical abuse
(Falanga,telefono,chokeholds,
dry submarine,wet submarine,cattle prod,black slave,starvation)
2.mental torture
(Sleep deprivation,putting in dark room,mock execution)
3.Animal torture
4.Sexual torture
(Introducing object into private parts,undressing infront of others,sexual torture by trained animals)
67
McNaughtens Rule
In order to establish insanity as a defence of a crime,it must be clearly proved that at the time of commiting the act,the accused was laboring under such a defect of reason from disease of mind so as to not know the nature and quality of the act or what he was doing was wrong or legally punishable
68
Sec22BNS
Nothing is a offence which is done by a person who,at the time of doing it,by the reason of unsoundness of mind,is incapable of knowing the nature of the act or that he is doing,what is either wrong or contrary to the law
69
Legal test of insanity
1.unsoundness of mind at the time of doing it
2.doesnt know the nature of the act
3.even if he know the nature of the act,he doesnt know if it is right or wrong
4.the person doesnt know it is contrary to the law of the land
70
Limitations of sec22
Mere certification not acceptable
Mild or borderline mental illness is not excluded
All or none law
Stubborn law
71
"misinterpretation" of a real external stimulus
Illusion
72
Hallucination diff types
Visual(water on floor -ganja addiction)
Auditory
Gustatory
Olfactory
Psychomotor-rising up-ganja addiction
Liliputian-objects seems small
Hypnagogic-just bfr sleep
73
Civil responsibilities of mentally ill
1.Mx of property
2.Consent
3.Contract
4.Marriage
5.Witness
6.Testamatory capacity
(making will)
74
Who coined schizophrenia
Eugene bleuler
75
4a of schizophrenia
Autism
Ambivalence
Affect disturbance
Association disturbance
76
3 poisonous snakes with large head scales
Pit viper
Cobra
Krait
77
Big Four snake
Saw scaled viper
Russels viper
Cobra
Krait
78
Rx of neurotoxin(cobra or krait bite)
10 vials of polyvalent asv iv infusion for 30min
10 vials of poyvalent asv after 1 hour and repeated till symptoms subside
79
Rx of hemotoxin
Low dose infusion therapy
10 vials(russels) or 6 vials (sawscaled) for 30min
2 vials every 2h as infusion in 100ml normal saline till clotting time normalises
High dose
10 ASV for 30min,
6 vials 6th hourly till clotting normalises
80
Additional snake rx
Adrenaline 0.1%
Antihistamine
Steroid
For circulatory collapse glucose salien iv
Tetanus
Antibiotics
Hemodialysis
81
Deliriants examples
Datura,Atropa Belladona
82
Datura active principles
Atropine
Hyoscine
Hyosciamine
83
Atropa active priciples
Atropine
Scopolamine
Hyosciamine
84
Symptoms of datura poisoning
Dysphagia
Dysarthria
Delirium
Drowsiness
Dysuria
Diplopia
Dialation of pupil
Diminshed bowel movements
Dry hot skin
Dilation of cutaneous blood vessels
85
Datura fatal dose and fatal period
0.6-1g
24h
86
Rx of datura poisoning
1:1000 kmn04 stomach wash
Physiostigmine 0.5mg im/iv hourly intervals
Pilocarpine nitrate 5mg sc every 2h
Sedatives for delirium
Diazepam for convulsion
Tepid sponging for hyperthermia
Catheter
87
Postmortem appearnce datura poisoning
Froth at nostrils
Internal organs congested
Seed particles in stomach
88
Road poison or railway poison
Datura
89
What causes death in datura poisoning
Resp paralysis
90
Types of drowning
Typical
(Fresh and salt water)
atypical
1.dry
2.shallow
3.immersion
4.secondary
91
Cause of death in fresh water drowning
Due to vol overload and hyperkalemia,
Ventricular fibrilliation occurs
And heart failure occur—> death
92
Cause of death in salt water drowning
Pulmonary edema
Hemoconcentration
Hypernatremia
Heart failure
93
Fatal period of fresh water and salt water drowning
4-5min
8-12min
94
Post mortem appearances of drowning
External
Wet cloth
Congested face
Congested eyes
Lividity on upper limb,face and shoulders
Fine white leathery tenacious froth due to churning of air,water and mucous in alveoli
Washerwomans hands and feet
Cutis anserina
Cadaveric spasm
Penis and scrotum retracted
Internal
Paltaufs hemorrhage
(Haemorrhage on lower lobes)
Emphysema aquosum lung
95
Secondary drowning causes of death
Pulmonary edema
ARDS
Myocardial anoxia
Septicemia
Hemoglobinuria
Hypoxic brain damage
96
Gettlers test
Normal cl -600mg/dl
In salt water,
Cl content in LV is 42% more than RV due to hemoconc
In fresh h2o,
Cl content in LV is 50% less than normal due to hemodilution
97
Diatom test
5-10g curetted bone marrow
Add conc hno3
Boil for 10-15min
Centrifuge
Sediment is examined under microscope
Look for diatoms
98
Water in sinuses
Sveshnikovs sign
99
Gastric content when allowed to settles it becomes foam,middle layer liquid and sendiment in bottom
Sehrt’s sign
100
Superficial radial ruptured in gastric mucosa
Sehrts sign
101
Accidental food entry into larynx causing laryngeal spasm,vagal inhibition and asphyxia
Rx
Heimlich manoeuvre
Needle cricothyrotomy
Energency tracheostomy
102
Traumatic asphyxia
Mechanical compression of chest wall causing asphyxia
Death due to sudden cerebral venous congestion
103
Antemortem signs in hanging
Parchment like subcutaneous membrane
Pattern abrasion
Discontinuous
Oblique
Above thyroid cartilage
Salivary trickle
Le facie sympathique
Tongue protruded
Glove and stocking lividity
Semen at tip of penis
Feces and urine may discharge
104
Asphyxia definition
Physiological and chemical state in a living organism in which there is acute lack of o2available for cell metabolism associated with inability to eliminate excess co2
105
Mechanical asphyxia type
Gagging
Choking
Strangulation
Hanging
Smothering
Traumatic asphyxia
Drowning
106
Anoxia types
Histotoxic(cyanide)
Anoxic
Stagnant
Aneamic(CO)
107
Co inhibits which all enzymes
Cyta3 oxidase
Cyt p450
108
Dd of co poisoning
Head injury
Electrolyte imbalance
Barbiturate poisoning
Hypoglycemic coma
Alcohol intoxication
109
Dx co poisoning
Kunkel test
Diluted blood1:10+ tannic acid gives crimson red
Hoppe seylers test
Blood +10%naoh= pink
Spectroscopy
Ct globus pallidus putamen low density areas
110
Rx co poisoning
Hyperbaric o2
Blood transfusion
Gastric lavage to prevent aspiration pneumonia
20% Mannitol
111
Co poisoning pm finding
Cherry red hypostasis
Blister on pressure areas
Froth on nostrils and mouth
Internal
Rhabdomyolysis
Congested brain
Puctiform ring hemorrage in white matter
112
Safety lvl of co in air
0.1%
113
Cyanide has what odour
Bitter almond
114
Pm finding of Cyanide
Froth be present in mouth and nostrils
Bright red lividity
Bitter almond smell
115
Dx of cyanide
Lees Jones test
Feso4+5ml gastric contents gives greenish blue color
116
Rx of cyanide poisoning
0.2ml amylnitrite for 30 sec every 3min
Sodium nitrite
Sodium thiosulphate
Alternate
Hydroxocobalamine
Dicobalt edetate
117
Cyanide poisoning kit name
Eli lilly andidote kit
118
Mango like cardiac poison
Active principles
Cerebra odollum
Cerebrin
Cerebrocide
Odollin
odolotoxin
119
Fatal dose and fatal period of cerebra odollum
One kernel fruit
1-2days
120
Pm findings in cerbera odollam
Git:
Bitter taste
Gi irritation
Cns:
Blurring
Weakness
Cvs:
Hyperkalemia
Transaminase deficiency
Eeg:
Av block
Sa block
Sinus bradycardia
121
Rx of cerebra odollam
Atropine
Propanalol
Hyperkalemia shoukd be corrected
Digoxin immune fab
122
Body packer syndrome
Radiological signs
Rosette sign
Double condom sign
123
Aconite active principles
Aconine
Aconitine
Pseudoaconitine
124
Aconite moa
Opens tetradoxin sensitive sodium channels
125
Munchausen syndrome by proxy
Mother suffer from borderline personality disorder
Blood in child urine
Scratch for rash
Insulin to hypoglycemia
Anticoagulant to bleeding
Emetics to vomiting
Laxatives to diarrhoea
Barbiturate to cns depression
126
Sudden infant death syndrome or cot death
2-6months
3:2 M:F
Bottle fed
Alcoholic or smoking mother
Low socioeconmc stds
Cause
Sleep apnoea
Hypothermia
Uri
Staph aureus infection
Hyperthermia
Infant botulism
Hypersensitivity to cow milk
127
Battered baby syndrome
Or caffeys syndrome
Discrepancy of h/o and injury
Delay of injury and medical attention
Age:less than 3y
Low socioeconmc class
Unwanted first or last child
Multiple bruises
Butterfly contusions
Laceration
Burns
Bitemarks
Subconjuctival haemorrhage
6penny bruise
Internal
Subdural hematoma
Rib fracture
Callus formation in bones
String of beads xray
Metaphyseal corner fracture of knee and elbow-bucket handle fracture
Avulsion freacture of clavicle
128
129
Still birth
Stillborn child
More than28w, but didnt show any signs of life after it was born
Cause
Prolonged labour
Toxemia
Excessive moulding
Placental abnormalities
Intrauterine asphyxia
Erythroblastosis foetalis
130
Dead born child
One is already dead in urero
that is before birth process began
Signs
RM(few h before birth)
maceration(3-4d)
•skin slippage(>12h of iud)
•purple skin+vesicle+soft umbilical cord+distended abdomen
•spalding sign(7-10days of iud)
•gas shadow in heart chambers and aorta -robert sign
Mummification(>2w of iud)
Putrefaction
131
Signs of live birth
Civil cases
Cry,yawn,muscle movement
Criminal case
•Expanded drum shaped chest
•3-4th rib lvl to 6-7 rib lvl diaphragm
•Liver redbown to red pink
•foders test
30-40g to 60-70g
•ploucquets test
Lung:body - 1:70 to 1:35
132
Op poison rx
Atropine
2pam
Dam
Pralidoxime
Forensic
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