INI-CET 2025 — Forensic Medicine
8 Previous Year Questions with Answers & Explanations
As per the MTP (Amendment) Act, 2021, the opinion of two registered medical practitioners is required for termination of pregnancy at which gestational age?
Match the following substances with their type of poisoning: Substance: A. Lead B. Croton C. Opium D. Cocaine Type of Poisoning: 1. Metallic irritant 2. Organic irritant 3. CNS depressant 4. Deliriant
In a suspected case of poisoning, gastric lavage fluid combined with silver nitrate solution gives rise to a black color in which poisoning?
Which X-ray is used to prove that an individual is more than 18 years of age?
As per Bharatiya Nyaya Sanhita (BNS), which of the following is not classified as grievous hurt?
In which of the following poisonings does silver nitrate impregnated filter paper turn black when exposed to gastric lavage contents?
The triad of abrasions, bruises and punctate lacerations are typically seen in:
One of the following statements regarding venom is incorrect:
INI-CET 2025 - Forensic Medicine INI-CET Practice Questions and MCQs
Question 1: As per the MTP (Amendment) Act, 2021, the opinion of two registered medical practitioners is required for termination of pregnancy at which gestational age?
- A. 16-20 weeks
- B. 20-24 weeks (Correct Answer)
- C. Up to 12 weeks
- D. 12-16 weeks
Explanation: ***20-24 weeks*** - The **MTP (Amendment) Act, 2021**, mandates the opinion of **two Registered Medical Practitioners (RMPs)** for termination of pregnancy for pregnancies between **20 and 24 weeks** of gestation. - This extended limit (20-24 weeks) is applicable to specific vulnerable categories of women, such as survivors of sexual assault, minors, and women with disabilities. *16-20 weeks* - For termination up to **20 weeks** (which includes 16-20 weeks), the opinion of only **one RMP** is required under the MTP Act, 2021. - This limit is considered the standard requirement for termination based on risk to the mother's health or fetal abnormality. *Up to 12 weeks* - Termination up to **12 weeks** requires the opinion of only **one RMP** as this is the safest period for the procedure. - The Act does not mandate multiple opinions for terminations performed in this early gestational period. *12-16 weeks* - This gestational age falls under the limit of **20 weeks**, thus requiring the opinion of only **one RMP** for termination. - Requirement for **two RMPs** is exclusively reserved for the 20 to 24-week bracket for specific categories of women.
Question 2: Match the following substances with their type of poisoning: Substance: A. Lead B. Croton C. Opium D. Cocaine Type of Poisoning: 1. Metallic irritant 2. Organic irritant 3. CNS depressant 4. Deliriant
- A. A-2, B-1, C-3, D-4
- B. A-1, B-2, C-3, D-4 (Correct Answer)
- C. A-4, B-3, C-2, D-1
- D. A-3, B-4, C-1, D-2
Explanation: ***A-1, B-2, C-3, D-4*** - **Lead (A)** is a heavy metal, making its poisoning a classic example of **Metallic irritant** poisoning (1). - **Croton (B)** is derived from plants (Croton tiglium) and contains toxins like phorbol esters, causing severe local and systemic irritation, characterizing it as an **Organic irritant** (2). - **Opium (C)** contains morphine and codeine, which primarily depress the central nervous system, classifying it as a **CNS depressant** (3). - **Cocaine (D)** stimulates the CNS initially but, in high doses or with chronic use, can cause acute psychosis, paranoia, and visual/tactile hallucinations (like formication), fitting the definition of a **Deliriant** (4). ***A-2, B-1, C-3, D-4*** - This option incorrectly lists Lead (A) as an Organic irritant (2); Lead is a heavy metal and thus a **Metallic irritant**. - It also incorrectly lists Croton (B) as a Metallic irritant (1), when it is properly categorized as an **Organic irritant**. ***A-3, B-4, C-1, D-2*** - This arrangement incorrectly classifies Lead (A) as a CNS depressant (3) and Opium (C) as a Metallic irritant (1), which are fundamentally incorrect classifications based on their primary toxic effects. - It also misclassifies Croton (B) as a Deliriant (4) and Cocaine (D) as an Organic irritant (2); Cocaine's primary forensic classification is a **stimulant/deliriant**, and Croton is an **Organic irritant**. ***A-4, B-3, C-2, D-1*** - This option incorrectly assigns Lead (A) as a Deliriant (4) and Cocaine (D) as a Metallic irritant (1), contrary to their well-established toxicological profiles. - It also mistakenly classifies Opium (C) as an Organic irritant (2) and Croton (B) as a CNS depressant (3); Opium is distinctly an **opioid/CNS depressant**.
Question 3: In a suspected case of poisoning, gastric lavage fluid combined with silver nitrate solution gives rise to a black color in which poisoning?
- A. Cocaine poisoning
- B. Organophosphorus poisoning
- C. Aluminium phosphide poisoning (Correct Answer)
- D. Opium poisoning
Explanation: ***Aluminium phosphide poisoning*** - The black color formation is the basis of the **Silver Nitrate Test** (tube test or paper test) used for $\text{AlP}$ poisoning confirmation. - Aluminium phosphide reacts with moisture/acid in the stomach to release **phosphine gas ($ ext{PH}_3$)**, which then reacts with $\text{AgNO}_3$ to form a **black precipitate of silver phosphide ($ ext{Ag}_3 ext{P}$)**. ***Organophosphorus poisoning*** - This poisoning is diagnosed clinically by features of **cholinergic crisis** (e.g., SLUDGE syndrome) and confirmed by measuring decreased **cholinesterase activity** in plasma or erythrocytes. - Silver nitrate tests are irrelevant for organophosphorus compounds and do not produce a color change like white or black precipitate with them. ***Opium poisoning*** - Diagnosis is primarily clinical (respiratory depression, coma, and classic **pinpoint pupils**) and confirmed by **urine toxicology screening** for narcotics like morphine. - Opium or its alkaloids do not cause a black color reaction with silver nitrate solution in gastric lavage fluid. ***Cocaine poisoning*** - This poisoning presents as **sympathomimetic toxicity** (agitation, hyperthermia, tachycardia) and is confirmed via **urine immunoassay**. - Cocaine and its metabolites do not rely on the silver nitrate test for diagnosis and do not yield silver phosphide or a black precipitate.
Question 4: Which X-ray is used to prove that an individual is more than 18 years of age?
- A. Appearance of inner end of clavicle, knee joint, and wrist joint
- B. Medial end of clavicle and skull
- C. Fusion of ischial tuberosity and lower end of humerus
- D. Medial end of clavicle and sternum (Correct Answer)
Explanation: ***Medial end of clavicle and sternum*** - The **medial (sternal) end of the clavicle** is the last center of ossification to fuse, typically fusing between 18 and 25 years of age, making it the most reliable skeletal site for confirming legal majority (**age >18 years**). - An X-ray view of this junction determines if the clavicular epiphysis is completely fused to the diaphysis, verifying physical maturity beyond the critical age of 18. ***Appearance of inner end of clavicle, knee joint, and wrist joint*** - The inclusion of the **wrist joint** and **knee joint** makes this option inaccurate, as their major epiphyseal plates (e.g., distal radius/ulna, distal femur/proximal tibia) generally fuse by 16–17 years. - These earlier fusions are useful for estimating age approaching 16 or 17 but are unreliable for determining if an individual has crossed the threshold of **18 years**. ***Fusion of ischial tuberosity and lower end of humerus*** - Fusion of the epiphysis of the **ischial tuberosity** typically occurs around 15 to 16 years of age (sometimes up to 17), making it fuse too early to confirm age greater than 18. - The **lower end of the humerus** often completes fusion significantly earlier (e.g., secondary centers around 13–16 years), rendering it unsuitable for the confirmation of legal majority. ***Medial end of clavicle and skull*** - While the medial end of the clavicle is correct, combining it with the **skull** is inappropriate, as the study of **cranial sutures** is highly variable and unreliable for pinpointing the age of 18. - Cranial suture fusion is generally used for broad age estimation in older adults, and its inclusion in combination renders this option medically and forensically inaccurate for proving the age of majority.
Question 5: As per Bharatiya Nyaya Sanhita (BNS), which of the following is not classified as grievous hurt?
- A. Emasculation
- B. Severe body pain for 5 days (Correct Answer)
- C. Dislocation of elbow
- D. Loss of a member
Explanation: ***Severe body pain for 5 days*** - Grievous hurt requires a specific threshold of duration, which is **severe body pain** or inability to follow ordinary pursuits for a period of **twenty days** or more, as per the definition in the Bharatiya Nyaya Sanhita (BNS) Section 122. Five days of severe pain does not meet this criterion. - This injury would typically be classified as **simple hurt**, which involves pain, disease, or infirmity, but does not meet the specified severity criteria for grievous hurt. *Emasculation* - **Emasculation** (deprivation of the power of procreation) is explicitly listed as the first clause defining **grievous hurt** in BNS Section 122 (formerly IPC Section 320). - Legal definitions of grievous hurt include eight specific types of injuries that are presumed to be severe. *Dislocation of elbow* - **Fracture or dislocation** of a bone or tooth is explicitly defined as an instance of **grievous hurt** under BNS Section 122. - A dislocation of a major joint like the elbow falls under this specified clause of grievous hurt. *Loss of a member* - The **privation of any member or joint** (loss of a limb, eye, ear, etc.) is specifically enumerated as a clause defining **grievous hurt** in BNS Section 122. - This category includes any injury that permanently impairs a significant part of the body's structure or function.
Question 6: In which of the following poisonings does silver nitrate impregnated filter paper turn black when exposed to gastric lavage contents?
- A. Malathion
- B. Opium
- C. Barbiturates
- D. Aluminium phosphide (Correct Answer)
Explanation: ***Aluminium phosphide*** - Aluminium phosphide ($AlP$) reacts vigorously with water or gastric acid to release highly toxic **phosphine gas** ($PH_3$). - Phosphine gas is a strong reducing agent that reacts with **silver nitrate ($AgNO_3$)** impregnated paper, reducing it to black **metallic silver ($Ag$)** and thus turning the paper black, a method known as the field test for Celphos. ***Malathion*** - Malathion is an **organophosphate insecticide**, and its poisoning is diagnosed primarily by clinical features of cholinergic crisis (SLUDGE syndrome) and measuring depressed **serum/RBC cholinesterase levels**. - Organophosphates do not release phosphine gas and therefore do not produce a positive reaction with silver nitrate filter paper. ***Barbiturates*** - Barbiturate poisoning is confirmed using tests like the **Dille-Koppanyi test** (for color change) or advanced **chromatographic methods** on blood or urine samples. - The barbiturate structure does not produce a reducing gas like phosphine upon reaction, so the silver nitrate paper test would remain negative. ***Opium*** - Opium poisoning (due to alkaloids like **morphine**) is confirmed by detecting the drug or its metabolites in urine or blood using **immunoassays** or gas/liquid chromatography. - Opium alkaloids are not detected by this specific qualitative test, as it is designed to detect the highly reducing nature of phosphine gas.
Question 7: The triad of abrasions, bruises and punctate lacerations are typically seen in:
- A. Road traffic accidents (Correct Answer)
- B. Fall from height
- C. Firearm injuries
- D. Bomb blast injuries
Explanation: ***Correct: Road traffic accidents*** - This specific combination of injuries—**abrasions** (due to sliding/friction), **bruises** (due to blunt force), and **punctate lacerations** (often caused by glass, debris, or gravel impacts)—is highly characteristic of **Road Traffic Accidents (RTAs)**. - These injuries reflect the simultaneous interplay of both **blunt impact** and **shearing/grinding forces** sustained as the body strikes the vehicle interior or the external road surface. - The **triad** is a classic forensic finding that distinguishes RTAs from other patterns of traumatic injury. *Incorrect: Fall from height* - Injuries from a fall are typically dominated by **high-energy blunt trauma** resulting in internal organ damage and severe skeletal fractures, such as bilateral calcaneal or vertebral fractures. - While abrasions and bruises are present at points of impact, the organized triad including numerous small, **punctate lacerations** is less distinct than in RTAs. *Incorrect: Bomb blast injuries* - Blast injuries are primarily categorized by specific mechanisms: primary (barotrauma), secondary (penetrating injuries from flying fragments), and tertiary (blunt force from body displacement). - The dominant findings are **severe organ damage** (like blast lung) and penetrating injuries; while trauma occurs, the described superficial triad is not the main characteristic pattern. *Incorrect: Firearm injuries* - Forensic examination of firearm injuries focuses on the **entry and exit wounds**, which are typically perforating or penetrating defects. - Characteristic features include the **abrasion collar**, contusion ring, and presence of GSR residue (soot or tattooing), rather than a diffuse superficial triad across multiple body areas.
Question 8: One of the following statements regarding venom is incorrect:
- A. Viperidae - Hemotoxic
- B. Elapidae - Myotoxic (Correct Answer)
- C. Common krait - Neurotoxic
- D. Common cobra - Neurotoxic
Explanation: ***Elapidae - Myotoxic*** - This statement is **incorrect**. Venom from the **Elapidae** family (e.g., cobras, kraits, mambas) is **predominantly neurotoxic**, affecting the nervous system and causing paralysis. - The primary target of Elapidae venom is the **neuromuscular junction**, leading to respiratory failure, not muscle degeneration (myotoxicity). - While some Elapidae subspecies (certain sea snakes, Australian elapids) may have myotoxic components, the family is **classically characterized as neurotoxic**, especially in the Indian context where cobras and kraits are the main representatives. ***Common cobra - Neurotoxic*** - This statement is **correct**. The venom of the **Common Cobra** (Naja naja), which belongs to the Elapidae family, is highly **neurotoxic**. - It primarily contains long and short-chain neurotoxins that cause rapid, progressive **paralysis** and respiratory failure. ***Common krait - Neurotoxic*** - This statement is **correct**. **Common Krait** (Bungarus caeruleus), also an Elapid, possesses venom that is highly potent and entirely **neurotoxic**. - Krait venom often causes severe, often delayed, **neuromuscular blockade** and paralysis, making it one of the most dangerous snakes in India. ***Viperidae - Hemotoxic*** - This statement is **correct**. Venom from the **Viperidae** family (e.g., Russell's viper, saw-scaled viper) is mainly **hemotoxic** and **cytotoxic**. - It primarily targets the blood and vascular system, causing coagulopathy, massive tissue necrosis, bleeding disorders, and often **disseminated intravascular coagulation (DIC)**.