FMGE 2019 — Forensic Medicine
8 Previous Year Questions with Answers & Explanations
What type of poisoning is associated with the retention of lead bullets in the body?
McNaughton's rule is related to:
Presence of cut injuries in the scrotum is suggestive of?
Which of the following can be considered as grounds of divorce under matrimonial law?
A patient was found to have pink coloured skin and mucosa, bitter almond smell from breath and frothy discharge. Cause of death in this patient;
In autopsy, which organ is removed with liver?
Posthumous birth is;
The characteristic feature of an entry wound is:
FMGE 2019 - Forensic Medicine FMGE Practice Questions and MCQs
Question 1: What type of poisoning is associated with the retention of lead bullets in the body?
- A. Lead (Correct Answer)
- B. Phosphorus
- C. Nitro cellulose
- D. Iron
Explanation: ***Lead*** - **Lead bullets** are primarily composed of lead, and if retained in the body, lead can leach into the bloodstream causing **lead poisoning**. - This is a well-documented risk, especially when bullets are lodged in areas rich in bodily fluids or bone. *Phosphorus* - Phosphorus poisoning is typically associated with exposure to compounds like **white phosphorus**, often found in fireworks or industrial chemicals, not lead bullets. - Symptoms include severe gastrointestinal distress, multiorgan failure, and a characteristic **garlic-like odor**. *Nitro cellulose* - **Nitrocellulose** is a component of gun propellants (gunpowder), not the bullet itself. - Exposure would primarily be from inhalation of fumes during firing or accidental ingestion of powder, not retention of the bullet. *Iron* - **Iron poisoning** usually results from acute overdose of iron supplements, particularly in children. - While bullets contain trace amounts of iron, the primary toxic component of a retained bullet is **lead**, not iron.
Question 2: McNaughton's rule is related to:
- A. IPC 82
- B. IPC 87
- C. IPC 85
- D. IPC 84 (Correct Answer)
Explanation: ***IPC 84*** - **McNaughton's rule** (also spelled M'Naghten rule) is a legal test for criminal insanity, stating that a defendant is not guilty if they were unaware of the nature of their actions or that their actions were wrong due to a "disease of the mind." - In India, **IPC 84** (Indian Penal Code Section 84) embodies the principles of McNaughton's rule, providing a defense for persons of unsound mind. *IPC 82* - **IPC 82** deals with the age of criminal responsibility, specifically stating that nothing done by a child under seven years of age is an offense. - This section is focused on the **infancy defense**, not mental illness or insanity. *IPC 87* - **IPC 87** pertains to acts not intended and not known to be likely to cause death or grievous hurt, done by consent. - It relates to the defense of **consent**, often in situations involving minor injuries in sports or medical procedures. *IPC 85* - **IPC 85** provides a defense for acts committed by a person who is incapable of knowing the nature of the act, or that it is wrong or contrary to law, due to **intoxication** caused without their knowledge or against their will. - This section specifically addresses involuntary intoxication, not a general "disease of the mind" as covered by McNaughton's rule.
Question 3: Presence of cut injuries in the scrotum is suggestive of?
- A. Accidental wounds
- B. Homicidal wounds (Correct Answer)
- C. Suicidal wounds
- D. None of the options
Explanation: ***Homicidal wounds*** - Injuries to the **scrotum** are highly unusual in accidental or suicidal contexts due to the protective nature and sensitivity of the area. - The presence of **cut injuries** in such a vulnerable and normally protected area often indicates an intentional act of aggression. *Accidental wounds* - Accidental scrotal injuries are typically due to **blunt trauma** or avulsion, rather than sharp, incised cuts. - They usually occur in situations like sports or industrial accidents, which are not described by "cut injuries." *Suicidal wounds* - Suicidal wounds are typically inflicted in areas like the **wrists**, neck, or chest, aiming for vital structures. - The scrotum is not a common site for self-inflicted injuries, as cutting this area is unlikely to be immediately lethal and is extremely painful. *None of the options* - This option is incorrect because the specific location and type of injury (cut injuries to the scrotum) points strongly towards a specific category of wound. - The other options are considered less likely given the highly sensitive and non-lethal nature of the scrotum for self-harm.
Question 4: Which of the following can be considered as grounds of divorce under matrimonial law?
- A. Sterility
- B. Frigidity
- C. Impotence developing after the marriage (Correct Answer)
- D. Temporary Mental illness
Explanation: ***Impotence developing after the marriage*** - **Impotence** (inability to consummate the marriage) can constitute a ground for **nullity** if it existed **at the time of marriage** and was not disclosed. - However, **impotence developing after marriage** may be considered under certain legal frameworks as inability to fulfill marital obligations, though its status varies by jurisdiction. - In the context of medical jurisprudence, **sexual incapacity** affecting the continuation of marriage is recognized as a potential ground in matrimonial disputes. - This is the **most appropriate answer** among the given options as it relates to inability to fulfill a fundamental aspect of marriage. *Sterility* - **Sterility** (inability to conceive children) is generally **not considered a ground for divorce** under most matrimonial laws. - It does not prevent consummation of marriage or fulfillment of other marital duties. - While it may cause personal distress, legal systems distinguish between inability to conceive and inability to engage in sexual relations. *Frigidity* - **Frigidity** (lack of sexual desire or responsiveness) is typically **not a sufficient ground for divorce** on its own. - If the spouse is physically capable of consummating the marriage, lack of desire alone does not constitute legal grounds. - It may overlap with other marital issues but has weaker legal standing compared to actual physical incapacity. *Temporary Mental illness* - **Temporary mental illness** is generally **not a ground for divorce** because it implies a recoverable condition. - For mental disorder to constitute grounds for divorce under Indian matrimonial law (Hindu Marriage Act Section 13), it must be: - **Incurable** or of such nature that cohabitation becomes unreasonable - **Continuous or intermittent** mental disorder of sufficient severity - A **temporary** condition that can be cured does not meet these criteria.
Question 5: A patient was found to have pink coloured skin and mucosa, bitter almond smell from breath and frothy discharge. Cause of death in this patient;
- A. Cyanide poisoning (Correct Answer)
- B. H2S poisoning
- C. Datura poisoning
- D. CO poisoning
Explanation: ***Cyanide poisoning*** - **Pink/cherry-red skin and mucosa** occur because cyanide **inhibits cytochrome oxidase** in the mitochondrial electron transport chain, preventing cellular oxygen utilization. This results in **high venous oxyhemoglobin levels** as oxygen remains in the blood but cannot be used by tissues. - The characteristic **bitter almond smell** is pathognomonic for cyanide, though only detectable by 40-60% of the population due to genetic variations in odor perception. - **Frothy discharge** indicates pulmonary edema, common in acute cyanide toxicity. *H2S poisoning* - **Hydrogen sulfide** poisoning typically presents with a characteristic **rotten egg smell**, not bitter almonds. - It causes cellular hypoxia by **inhibiting cytochrome oxidase**, similar to cyanide, but the clinical presentation, odor, and skin coloration (may be greenish) differ. *Datura poisoning* - **Datura poisoning** is characterized by an **anticholinergic toxidrome**: hot, dry, red skin (flushed from vasodilation, not hypoxia), dilated pupils, delirium, and urinary retention. - It does not cause a bitter almond smell or the characteristic pink coloration seen in cyanide poisoning. *CO poisoning* - **Carbon monoxide (CO) poisoning** is associated with a **cherry-red skin color** due to **carboxyhemoglobin** formation, where CO binds hemoglobin with 200-250x greater affinity than oxygen. - While it also causes cellular hypoxia, there is **no bitter almond smell**, and the mechanism differs (oxygen cannot bind vs. oxygen cannot be utilized).
Question 6: In autopsy, which organ is removed with liver?
- A. Stomach
- B. Kidney
- C. Spleen (Correct Answer)
- D. Brain
Explanation: ***Spleen*** - In autopsy, the **spleen is routinely removed along with the liver** as part of standard dissection protocols (Virchow's method and variations). - This is done to examine the **portal venous system**, assess the **hepatosplenic circulation**, and evaluate pathologies affecting both organs such as **portal hypertension**, **congestive splenomegaly**, or **hepatic cirrhosis**. - The anatomical proximity and shared vascular connections make their removal together both practical and diagnostically valuable. *Kidney* - The **kidneys** are typically removed separately or as part of the **posterior abdominal block** after the liver and spleen have been removed. - While kidneys may be examined in relation to the abdominal vasculature, they are not removed in direct continuity with the liver block in standard autopsy technique. - Their retroperitoneal location makes separate dissection more appropriate. *Stomach* - The **stomach** is removed as part of the **gastrointestinal tract block**, which includes the esophagus, duodenum, and often the pancreas. - Though anatomically adjacent to the liver, it is not part of the hepatosplenic block. - Its examination focuses on mucosal pathology, ulcers, tumors, and gastric contents rather than hepatic circulation. *Brain* - The **brain** is removed as a completely separate organ through **craniotomy** after reflection of the scalp. - It is housed within the cranium and has no anatomical or dissection relationship with abdominal organs. - Brain removal follows examination of the cranial cavity, meninges, and cerebral vessels.
Question 7: Posthumous birth is;
- A. After death of both parents
- B. Child born after death of father (Correct Answer)
- C. Child born after death of mother
- D. After death of mother during delivery
Explanation: ***Child born after death of father*** - A **posthumous birth** specifically refers to a child born after the death of their biological father. - The concept is legally significant for **inheritance rights** and lineage, ensuring the child can inherit from their deceased father. - This is the classical and most widely accepted definition in **medico-legal practice**. *After death of both parents* - This scenario would lead to the child being an **orphan**, but the term "posthumous birth" specifically relates to the father's death before the child's birth. - While tragic, it doesn't align with the precise definition of **posthumous birth**. *Child born after death of mother* - While this represents a tragic scenario of **maternal mortality**, it is not the standard definition of posthumous birth. - The term posthumous birth traditionally refers to the **father's death** prior to birth, not the mother's. - This distinguishes it from cases of maternal death during or after delivery. *After death of mother during delivery* - This describes a case of **maternal mortality during childbirth**, not posthumous birth in the traditional sense. - The mother's death occurs during or after the birth process itself, not before the child's birth. - Posthumous birth specifically relates to the **father's death before the child is born**.
Question 8: The characteristic feature of an entry wound is:
- A. Depression
- B. Pond's fracture
- C. Inversion (Correct Answer)
- D. Eversion
Explanation: ***Inversion*** - An **entry wound** from a projectile, like a bullet, typically creates an **inversion** of the skin edges where it penetrates. - This is due to the **force pushing tissue inward**, causing the wound edges to be depressed below the surrounding skin surface. *Depression* - While it describes a sunken area, "depression" is a general term and does not specifically or accurately describe the **morphology of an entry wound** in forensic pathology. - It lacks the precision of terms like **inversion** when referring to the edge characteristics of a penetrating wound. *Pond's fracture* - **Pond's fracture** is a specific type of skull fracture in infants where a segment of bone is depressed but not completely separated. - This term is **not applicable** to the characteristics of a skin entry wound from a projectile. *Eversion* - **Eversion** refers to the turning outward of edges, which is characteristic of an **exit wound** where tissue is pushed outward by the exiting projectile. - It is the **opposite of what is seen at an entry wound**, where tissue is pushed inward.