Forensic Medicine
7 questionsMarshall's triad is seen in:
Which of the following snakes is most commonly associated with hematologic abnormalities following envenomation?
Contributory negligence is negligence due to:
Stellate wound is produced with firearm in:
Acts both as poison and antidote:
For DNA test, liquid blood is preserved in:
Hydrostatic test (Reygate's test) for lungs is based on:
NEET-PG 2013 - Forensic Medicine NEET-PG Practice Questions and MCQs
Question 1401: Marshall's triad is seen in:
- A. Lightning injury
- B. Explosive injury (Correct Answer)
- C. Gunshot injury
- D. Drowning injury
Explanation: ***Explosive injury*** - Marshall's triad components, including **blast lung**, **abdominal hemorrhage**, and **tympanic membrane rupture**, are characteristic injuries of explosions, especially those involving pressure waves. - The triad highlights distinct patterns of organ damage caused by the high-energy transfer from blast forces. *Lightning injury* - Lightning injuries can cause diverse effects like **cardiac arrest**, **neurological damage**, and **burns**, but they do not typically present as Marshall's triad. - The primary mechanism is electrical, leading to distinct injury patterns different from blast trauma. *Gunshot injury* - Gunshot wounds create localized tissue damage along the projectile's path and a temporary cavity, but they do not cause generalized blast effects or the specific triad of Marshall. - The injury severity depends on the **caliber**, **velocity**, and **trajectory** of the bullet. *Drowning injury* - Drowning is characterized by **respiratory impairment** resulting from submersion or immersion in liquid, leading to **hypoxia** and multi-organ failure. - Its pathophysiology and presentation are entirely distinct from explosive trauma.
Question 1402: Which of the following snakes is most commonly associated with hematologic abnormalities following envenomation?
- A. Sea snake
- B. Krait
- C. Viper (Correct Answer)
- D. Cobra
Explanation: ***Correct Answer: Viper*** - **Viper venom** contains **hemotoxic components** including **metalloproteinases** and **serine proteinases** that directly activate clotting factors - This leads to **consumptive coagulopathy** characterized by **thrombocytopenia**, **hypofibrinogenemia**, and prolonged coagulation times - Clinical manifestations include spontaneous **bleeding**, **ecchymoses**, **hemorrhage** at the bite site, and in severe cases, **disseminated intravascular coagulation (DIC)** - Viper envenomation is the **classic cause** of hematologic abnormalities among snake bites *Incorrect: Sea snake* - Sea snake venoms are primarily **neurotoxic** and **myotoxic**, causing paralysis and muscle damage - While they can cause **rhabdomyolysis** and subsequent **renal failure**, significant primary hematologic abnormalities are not their hallmark feature *Incorrect: Krait* - Krait venom is predominantly **neurotoxic**, leading to **flaccid paralysis** and **respiratory failure** - Does not typically cause the significant widespread **coagulopathies** seen with viper envenomation *Incorrect: Cobra* - Cobra venom primarily contains **neurotoxins** and **cytotoxins**, causing **paralysis**, **tissue necrosis**, and localized pain - While some cobras can cause minor local bleeding, they do not generally induce the severe and systemic **hematologic abnormalities** characteristic of viper bites
Question 1403: Contributory negligence is negligence due to:
- A. Doctor only
- B. Both doctor and patient
- C. Hospital administrator and doctor
- D. Patient only (Correct Answer)
Explanation: ***Patient only*** - **Contributory negligence** specifically refers to negligence on the part of the **plaintiff** (the patient) that contributed to their own injury. - This doctrine can reduce or bar recovery for damages if the patient's own actions played a role in causing the harm. *Doctor only* - This describes **medical malpractice**, where the healthcare provider's negligence directly causes harm to the patient. - While a doctor's negligence is a primary concern in healthcare, it doesn't align with the legal concept of *contributory* negligence, which attributes fault to the injured party. *Both doctor and patient* - This scenario relates to **comparative negligence**, a legal doctrine where fault is apportioned between multiple parties (e.g., doctor and patient). - Contributory negligence, in its strict form, implies the patient's negligence alone contributed significantly enough to preclude full recovery, rather than shared fault. *Hospital administrator and doctor* - This refers to negligence stemming from actions of the hospital administration (e.g., systemic failures, inadequate resources) and individual medical errors by the doctor. - While both can be liable for negligence, this does not represent the patient's own contribution to their injury, which is the core of contributory negligence.
Question 1404: Stellate wound is produced with firearm in:
- A. Close shot
- B. Distant shot
- C. Contact shot (Correct Answer)
- D. Range within 60 cm
Explanation: ***Contact shot*** - In a **contact shot**, gases and matter from the gun barrel are forced directly into the wound, causing the skin to stretch, tear, and burst outward, creating a **stellate or star-shaped wound**. - The hot gases and unburnt powder entering the wound create an exit for themselves, often leading to these characteristic irregular, radiating tears. *Close shot* - A close shot involves the skin being close to the muzzle but not directly touching, leading to a circular or oval wound with a surrounding area of **singeing**, **soot deposition**, and **powder tattooing**. - While there is gas effect, it's not as confined or forceful behind the skin as in a contact shot, thus not typically producing a stellate wound. *Distant shot* - A distant shot occurs when the muzzle is far enough from the target surface that only the **bullet strikes the skin**, leaving a relatively clean, circular or oval entry wound without significant singeing or tattooing. - The effects of gas and unburnt powder are not present at the wound site in a distant shot. *Range within 60 cm* - While a range within 60 cm (approximately 2 feet) can encompass close shots, it's a broad category and doesn't specifically define the conditions necessary for a stellate wound. - A stellate wound requires conditions more specific to a contact shot, where the muzzle is pressed against the skin.
Question 1405: Acts both as poison and antidote:
- A. Mercuric chloride
- B. Silver chloride
- C. Copper sulfate (Correct Answer)
- D. Thallium arsenate
Explanation: ***Copper sulfate*** - **Copper sulfate** acts both as a **poison and antidote**, demonstrating dual properties. - In **large doses**, it is toxic, causing **gastrointestinal distress**, **hepatotoxicity**, **nephrotoxicity**, and potentially death. - Historically, it was used in **small controlled doses as an emetic** (to induce vomiting) in cases of poisoning, acting as an antidote by expelling ingested toxins. - **Note**: Its use as an emetic is now **outdated** due to safety concerns, but it remains the classic example of a substance with both toxic and therapeutic properties. *Mercuric chloride* - **Mercuric chloride** is a highly toxic compound acting primarily as a **corrosive poison**, causing severe damage to the **gastrointestinal tract** and kidneys. - It does not possess any antidote properties and requires aggressive **chelation therapy** for treatment. *Silver chloride* - **Silver chloride** is of **low toxicity** due to its insolubility in water and biological fluids. - While chronic exposure can cause **argyria** (bluish skin discoloration), it has no antidote properties. *Thallium arsenate* - **Thallium arsenate** contains two highly toxic elements (**thallium** and **arsenic**), both potent poisons affecting multiple organ systems. - Used in **pesticides** and **rodenticides** due to its toxicity, it has no beneficial or antidote properties.
Question 1406: For DNA test, liquid blood is preserved in:
- A. Sodium fluoride
- B. Potassium oxalate
- C. Sodium citrate
- D. EDTA (Correct Answer)
Explanation: ***EDTA*** - Ethylenediaminetetraacetic acid (EDTA) is the preferred anticoagulant for DNA extraction because it **chelates metal ions** (like magnesium), which are cofactors for **DNases** (enzymes that degrade DNA). - By inhibiting DNases, EDTA effectively **preserves DNA integrity** in blood samples for genetic testing. *Sodium fluoride* - **Sodium fluoride** is primarily used as an antiglycolytic agent to preserve glucose in blood samples. - It does not specifically function to preserve DNA or inhibit DNA degradation significantly. *Potassium oxalate* - **Potassium oxalate** acts as an anticoagulant by precipitating calcium, but it is not optimal for long-term DNA preservation. - Its anticoagulant properties are less suitable for molecular testing compared to EDTA, and it doesn't protect DNA as effectively. *Sodium citrate* - **Sodium citrate** is an anticoagulant primarily used for coagulation studies (e.g., PT, PTT) by chelating calcium. - While it prevents clotting, it is **less effective than EDTA** in protecting DNA from degradation by DNases, making it a poorer choice for DNA banking.
Question 1407: Hydrostatic test (Reygate's test) for lungs is based on:
- A. Consistency of lung
- B. Volume of lungs
- C. Weight of lung
- D. Specific gravity of lung (Correct Answer)
Explanation: ***Specific gravity of lung*** - The hydrostatic test (also known as **Reygate's test** or **flotation test**) is a forensic test used to determine if a lung has ever respired, based on its **buoyancy in water**. - This buoyancy is directly related to the lung's **specific gravity**, which changes significantly depending on whether it contains air. - Aerated lungs (which have breathed) have a specific gravity less than 1 and will **float**, while non-aerated lungs have a specific gravity greater than 1 and will **sink**. *Consistency of lung* - While lung consistency can vary based on pathology, it is not the primary principle underlying the hydrostatic test. - The test specifically exploits changes in **density**, not just feel or firmness. *Volume of lungs* - Lung volume is a factor influencing buoyancy, but it's the **ratio of mass to volume** (density/specific gravity) that determines if the lung floats. - A larger lung may still sink if it is collapsed and airless, demonstrating that volume alone is not the sole basis. *Weight of lung* - The weight of the lung is important in determining its overall mass, but the hydrostatic test relies on the **weight relative to its volume** (i.e., specific gravity). - A heavy lung can still float if it contains sufficient air to lower its specific gravity below that of water.
Pharmacology
1 questionsWhich of the following is used in the second-line management of strychnine poisoning?
NEET-PG 2013 - Pharmacology NEET-PG Practice Questions and MCQs
Question 1401: Which of the following is used in the second-line management of strychnine poisoning?
- A. Physostigmine
- B. Naloxone
- C. Barbiturates (Correct Answer)
- D. Diazepam
Explanation: ***Barbiturates*** - As a **second-line treatment**, barbiturates like phenobarbital are used to control **refractory seizures** and muscle spasms in strychnine poisoning when benzodiazepines are insufficient. - They enhance the effect of **GABA**, leading to central nervous system depression and muscle relaxation. *Physostigmine* - This is an **acetylcholinesterase inhibitor** and is primarily used to reverse the anticholinergic effects of certain poisonings, not strychnine. - It would worsen seizures by increasing **acetylcholine**, which can cause tremors and convulsions. *Naloxone* - Naloxone is an **opioid antagonist** used to reverse opioid overdose, which presents with respiratory depression and pinpoint pupils. - It has no role in treating strychnine poisoning, which primarily causes **muscle spasms** and seizures. *Diazepam* - Diazepam, a **benzodiazepine**, is the **first-line treatment** for seizures and muscle spasms in strychnine poisoning. - It works by enhancing the effects of **GABA** at the GABA-A receptor, thereby reducing neuronal excitability.
Psychiatry
2 questionsCAGE questionnaire is used in:
What term describes the practice of wearing clothes of the opposite sex?
NEET-PG 2013 - Psychiatry NEET-PG Practice Questions and MCQs
Question 1401: CAGE questionnaire is used in:
- A. Opiate poisoning
- B. Alcohol dependence (Correct Answer)
- C. Dhatura poisoning
- D. Barbiturate poisoning
Explanation: ***Alcohol dependence*** - The **CAGE questionnaire** is a widely used screening tool for identifying potential **alcohol problems** and dependence. - The acronym CAGE stands for Cutting down, Annoyance by criticism, Guilty feelings, and Eye-openers, all related to drinking habits. *Opiate poisoning* - Screening for opiate use or poisoning typically involves asking about **drug use history**, conducting **urine drug screens**, and observing specific clinical signs like **pinpoint pupils** and **respiratory depression**. - The CAGE questionnaire is not designed to screen for opiate use. *Dhatura poisoning* - **Dhatura poisoning** is characterized by anticholinergic symptoms like **dilated pupils**, **dry mouth**, **tachycardia**, and **delirium**. - Diagnosis relies on clinical presentation and a history of exposure, not a specific questionnaire like CAGE. *Barbiturate poisoning* - **Barbiturate poisoning** presents with central nervous system depression, including **sedation**, **respiratory depression**, and **hypotension**. - Diagnosis involves a clinical assessment, history of barbiturate use, and toxicology screens, not the CAGE questionnaire.
Question 1402: What term describes the practice of wearing clothes of the opposite sex?
- A. Masochism
- B. Sadism
- C. Transvestism (Correct Answer)
- D. Fetishism
Explanation: ***Transvestism*** - **Transvestism** (also known as transvestic fetishism in DSM-IV-TR/ICD-10) is the term that describes the practice of dressing in clothes typically associated with the opposite sex. - This involves **cross-dressing** for personal pleasure, comfort, or sexual arousal, without necessarily implying a desire to permanently change one's sex. - **Note:** Modern classifications (DSM-5-TR/ICD-11) now use "transvestic disorder" only when the behavior causes marked distress or impairment, distinguishing pathological behavior from non-clinical cross-dressing. *Masochism* - **Masochism** refers to deriving sexual gratification from experiencing pain, humiliation, or submission. - This is a distinct paraphilic pattern and does not involve wearing clothes of the opposite sex. *Sadism* - **Sadism** involves deriving sexual gratification from inflicting pain, humiliation, or suffering on others. - This is unrelated to cross-dressing behavior. *Fetishism* - **Fetishism** involves sexual arousal from inanimate objects or non-genital body parts (e.g., shoes, feet, leather items). - While it can involve clothing items, it does not specifically refer to wearing clothes of the opposite sex as a complete ensemble, which defines transvestism.