NEET-PG 2024

352 Questions — Page 22 of 36

Forensic Medicine

5 questions

Q211

What is the sequence of rigor mortis in the human body?

Q212

From a medico-legal perspective, in cases of sexual assault involving a female victim, what type of court proceeding is typically used to record medical evidence and testimony to protect the victim's privacy?

Q213

Police brought a person from a railway track with features of dry dilated pupils, dry skin, slurred speech, and altered sensorium. What is the most likely cause of poisoning?

Q214

A child was born 8 months after the father's death. The grandparents filed a case claiming that the baby is not their son's, but DNA testing confirmed paternity. What is the child called?

Q215

In a medicolegal examination, an 18-year-old male claims he is 16 years old. Which joint X-ray should be done to estimate his age?

NEET-PG 2024 - Forensic Medicine NEET-PG Practice Questions and MCQs

Question 211: What is the sequence of rigor mortis in the human body?

A. Centre to periphery
B. Head to foot (Correct Answer)
C. Foot to head
D. Simultaneously

Explanation: ***Head to foot*** - Rigor mortis follows **Nysten's Law**, progressing in a **descending pattern** from head to feet. - Begins in smaller muscles with higher metabolic activity: **masseter (jaw), eyelids, and facial muscles** (2-4 hours post-mortem). - Then progresses to **neck → upper extremities → trunk → lower extremities** (completing over 12 hours). - This sequence relates to muscle size, ATP depletion rates, and surface area-to-volume ratios. *Centre to periphery* - This pattern does **not accurately describe** rigor mortis progression. - While smaller muscles are affected first, the progression follows a **craniocaudal (head-to-foot) direction**, not a radial center-to-periphery pattern. - The anatomical distribution is vertically sequential, not centrifugal. *Foot to head* - This is the **opposite of the established progression** described by Nysten's Law. - Lower extremity muscles develop rigor mortis **last**, not first. - This would contradict classic forensic pathology observations. *Simultaneously* - Rigor mortis is a **time-dependent sequential process**, not simultaneous. - Different muscle groups deplete ATP and accumulate calcium at **varying rates over several hours**. - The progressive nature (2-4 hours onset, 12 hours peak, 36-48 hours resolution) demonstrates it cannot be simultaneous.

Question 212: From a medico-legal perspective, in cases of sexual assault involving a female victim, what type of court proceeding is typically used to record medical evidence and testimony to protect the victim's privacy?

A. Open court proceedings
B. Closed court proceedings
C. Hearing at a different location
D. In camera proceedings (Correct Answer)

Explanation: ***In camera proceedings*** - **In camera proceedings** (Latin for "in chambers") refer to court hearings conducted in **private**, with the public and media excluded, to protect the victim's privacy and dignity. - Under **Section 327(2) of CrPC**, cases of sexual offences against women must be conducted in camera to prevent further trauma and ensure the victim can provide testimony comfortably. - This legal provision ensures **confidentiality** of victim identity and prevents public disclosure of sensitive medical evidence and testimony. - The proceedings are still officially recorded and form part of the legal record, but occur in a closed, private setting. *Open court proceedings* - **Open court proceedings** allow public and media access, which would severely compromise the victim's privacy and cause additional psychological trauma. - Such public exposure is specifically prohibited in sexual assault cases under Indian law to protect the **victim's identity** and well-being. *Closed court proceedings* - While this term might seem similar, **"closed court"** is not the standard legal terminology used in Indian jurisprudence for sexual assault cases. - The specific term **"in camera"** is used in Section 327 CrPC and judicial pronouncements, making it the precise medico-legal answer. *Hearing at a different location* - Changing the location does not inherently provide the **legal framework** for privacy protection that in camera proceedings mandate. - This option lacks the formal legal status and procedural safeguards that Section 327 CrPC provides through in camera hearings.

Question 213: Police brought a person from a railway track with features of dry dilated pupils, dry skin, slurred speech, and altered sensorium. What is the most likely cause of poisoning?

A. Morphine
B. Cannabis
C. Datura (Correct Answer)
D. Alcohol

Explanation: ***Datura*** - **Datura poisoning** presents with anticholinergic symptoms including **dry dilated pupils**, **dry skin**, **tachycardia**, altered mental status (**altered sensorium**), and **slurred speech**. - The classic mnemonic "hot as a hare, blind as a bat, dry as a bone, red as a beet, mad as a hatter" describes the systemic effects of **anticholinergic toxidrome**. *Morphine* - **Opioid poisoning**, such as with morphine, typically causes **pinpoint pupils**, **respiratory depression**, and **CNS depression**. - Skin is usually **cool and clammy**, not dry. *Cannabis* - **Cannabis intoxication** typically causes **conjunctival injection** (red eyes), **tachycardia**, increased appetite, and euphoria or anxiety. - While it can alter perception, it generally does not lead to significantly **dilated pupils**, dry skin, or profound slurred speech in the manner seen with anticholinergics. *Alcohol* - **Alcohol intoxication** leads to **CNS depression**, slurred speech, ataxia, and sometimes nausea/vomiting. - **Pupils** are typically normal or slightly constricted, and the skin is often flushed and warm, not significantly dry or pale.

Question 214: A child was born 8 months after the father's death. The grandparents filed a case claiming that the baby is not their son's, but DNA testing confirmed paternity. What is the child called?

A. Suppositious child
B. Fabricated child
C. Posthumous child (Correct Answer)
D. Illegitimate child

Explanation: ***Posthumous child*** - A **posthumous child** is one born after the death of its father. - In most legal systems, such a child is considered an heir and has rights equivalent to those born before the father's death, especially after paternity is confirmed. *Suppositious child* - A **suppositious child** is one who is falsely substituted for another, typically with the intent to defraud or claim an inheritance under false pretenses. - This term does not apply here as paternity was confirmed by DNA testing, indicating the child is genuinely linked to the deceased father. *Fabricated child* - The term **fabricated child** implies the child does not exist or was created through fraudulent means, often in the context of false claims or elaborate schemes. - In this scenario, the child is real and paternity has been verified, making "fabricated" an inaccurate description. *Illegitimate child* - An **illegitimate child** is historically defined as one born outside of marriage between its biological parents. - While the father died before the child's birth, the question does not provide information about the parents' marital status, and the term primarily refers to marital legality rather than the circumstances of the father's death.

Question 215: In a medicolegal examination, an 18-year-old male claims he is 16 years old. Which joint X-ray should be done to estimate his age?

A. Head & shoulder
B. Elbow and ankle
C. Knee and wrist (Correct Answer)
D. Elbow & hip

Explanation: ***Knee and wrist*** - **Bone age determination** using hand/wrist and knee radiographs is a standard method for estimating skeletal maturity across a wide age range, including late adolescence. - The **epiphyseal fusion** in these joints provides reliable indicators for age estimation up to and slightly beyond 18 years, particularly the **distal radius, ulna, and knee epiphyses**. *Head & shoulder* - While glenohumeral fusion occurs later, **skull sutures** are not reliable for precise age estimation in this age group, and shoulder fusion may not be as precise as wrist/knee for this specific age. - The **skull and shoulder** are generally not the primary sites chosen for age estimation in late adolescence due to less distinct and less consistent markers compared to other joints. *Elbow and ankle* - Although the elbow and ankle joints undergo fusion, the **wrist and knee provide a more comprehensive and widely validated set of ossification centers** for age estimation in the 16-18 year old range. - While useful, these sites may not offer the same level of detailed assessment for skeletal maturity as the combination of **wrist and knee**. *Elbow & hip* - **Hip fusion** (e.g., ilium, ischium, pubis) happens relatively early, making it less useful for distinguishing between 16 and 18 years old. - The **elbow alone** may not provide sufficient distinct markers for accurate age estimation in this specific late adolescent age group, unlike the wrist, which has multiple carpal and epiphyseal centers.

OB/GYN

1 questions

Q211

A 27 -week pregnant woman with a fetus diagnosed with congenital anomalies is considering a Medical Termination of Pregnancy (MTP). Whose presence is not required for the authorization of MTP in this case?

Obstetrics and Gynecology

2 questions

Q211

A pregnant female at 37 weeks of gestation with a history of prosthetic heart valves is currently taking warfarin. She comes for a routine antenatal check-up. What is the appropriate management advice?

Q212

A 14-year-old victim of sexual assault with 22 weeks gestation has been brought for Medical Termination of Pregnancy (MTP). Which of the following statements is true?

NEET-PG 2024 - Obstetrics and Gynecology NEET-PG Practice Questions and MCQs

Question 211: A pregnant female at 37 weeks of gestation with a history of prosthetic heart valves is currently taking warfarin. She comes for a routine antenatal check-up. What is the appropriate management advice?

A. Immediate induction of labor
B. Perform LSCS (Lower Segment Cesarean Section)
C. Continue the same medication
D. Switch to low molecular weight heparin (Correct Answer)

Explanation: ***Switch to low molecular weight heparin*** - **Warfarin** is **teratogenic** and carries a significant risk of **fetal bleeding** and **malformations**, especially close to term. Switching to **low molecular weight heparin (LMWH)** is crucial at 37 weeks. - **LMWH** does not cross the placenta, making it a safer alternative for anticoagulation in late pregnancy for women with prosthetic heart valves. *Immediate induction of labor* - While delivery is approaching, immediate induction of labor without addressing the **warfarin** use directly puts the fetus at high risk of **bleeding complications** during delivery. - This option does not specify concurrent management of the anticoagulation, which is the primary concern. *Perform LSCS (Lower Segment Cesarean Section)* - Similar to induction of labor, performing a C-section while the mother is on **warfarin** significantly increases the risk of **maternal and fetal hemorrhage**. - A C-section is an invasive procedure, and the immediate priority is to switch the anticoagulant rather than select the mode of delivery without addressing the current medication. *Continue the same medication* - Continuing **warfarin** at 37 weeks is highly dangerous due to the increased risk of **fetal intracranial hemorrhage** during labor and delivery. - This approach disregards the well-established **teratogenic effects** and **bleeding risks** associated with warfarin in late pregnancy.

Question 212: A 14-year-old victim of sexual assault with 22 weeks gestation has been brought for Medical Termination of Pregnancy (MTP). Which of the following statements is true?

A. One doctor is involved
B. MTP done in 2nd trimester only when mother's life is in danger
C. MTP can be carried out up to 24 weeks (Correct Answer)
D. MTP cannot be more than 20 weeks

Explanation: ***MTP can be carried out up to 24 weeks*** - The **Medical Termination of Pregnancy (Amendment) Act, 2021**, allows termination of pregnancy up to **24 weeks** for certain vulnerable groups, including survivors of sexual assault and minors. - As a 14-year-old victim of sexual assault, she falls under the category which permits MTP up to 24 weeks. *One doctor is involved* - For pregnancies between 12 and 20 weeks, the opinion of **two registered medical practitioners** is required for MTP. - Beyond 20 weeks up to 24 weeks, as in this case, the opinion of **two registered medical practitioners** is also mandatory. *MTP done in 2nd trimester only when mother's life is in danger* - While danger to the mother's life is a valid reason for MTP, the **MTP Act 2021** has expanded the grounds for MTP in the second trimester (beyond 12 weeks) to include other categories like **sexual assault survivors** and **minors**, even if the mother's life is not immediately in danger. - The primary consideration here is the **vulnerability** of the pregnant person, not solely imminent danger to life. *MTP cannot be more than 20 weeks* - This statement is incorrect as per the **Medical Termination of Pregnancy (Amendment) Act, 2021**. - The Act raised the upper gestation limit from 20 to **24 weeks** for specific categories of women, including victims of sexual assault and minors, aligning with the current case.

Pharmacology

2 questions

Q211

A 30-year-old drug addict presents to the emergency department with signs of unknown drug poisoning. The patient exhibits dilated pupils, diaphoresis, tachycardia, and tremors. On examination, the blood pressure is 180/110 mmHg, and the heart rate is 120 beats per minute. What is the most likely diagnosis?

Q212

A 25 -year-old male presented to the emergency department with head trauma due to a road traffic accident. In the hospital, the patient developed seizures, and an emergency CT scan revealed widespread cerebral edema. Which of the following is the diuretic of choice for cerebral edema in this patient?

NEET-PG 2024 - Pharmacology NEET-PG Practice Questions and MCQs

Question 211: A 30-year-old drug addict presents to the emergency department with signs of unknown drug poisoning. The patient exhibits dilated pupils, diaphoresis, tachycardia, and tremors. On examination, the blood pressure is 180/110 mmHg, and the heart rate is 120 beats per minute. What is the most likely diagnosis?

A. Cocaine intoxication (Correct Answer)
B. Dhatura poisoning
C. Cannabis poisoning
D. Alcohol intoxication
E. Amphetamine intoxication

Explanation: ***Cocaine intoxication*** - Cocaine is a potent **sympathomimetic** drug that leads to a hyperadrenergic state, causing symptoms like **dilated pupils**, diaphoresis, tachycardia, and hypertension. - The patient's presentation with significant **tachycardia (120 bpm)** and **hypertension (180/110 mmHg)**, along with a history of drug abuse, strongly points towards cocaine. - Cocaine has a **shorter duration of action** (30-90 minutes) compared to amphetamines, but the clinical presentation is nearly identical. *Amphetamine intoxication* - **Amphetamines** also cause a sympathomimetic toxidrome very similar to cocaine, with mydriasis, diaphoresis, tachycardia, and hypertension. - However, the acute presentation is clinically indistinguishable from cocaine, though amphetamines typically have a **longer duration of action** (4-8 hours). - Both diagnoses would be managed similarly in the acute setting. *Dhatura poisoning* - **Dhatura** causes an **anticholinergic toxidrome**, characterized by symptoms such as "hot, dry, blind, red, and mad." - Key features of dhatura poisoning include **dry mucous membranes**, dilated pupils (mydriasis), flushed skin, but typically a **normal or elevated temperature** rather than diaphoresis and less pronounced hypertension. *Cannabis poisoning* - **Cannabis intoxication** typically leads to symptoms like **conjunctival injection**, dry mouth, increased appetite, and impaired coordination. - While it can cause mild tachycardia, it generally does not result in the severe **hypertension**, profound diaphoresis, or significant tremors seen in this patient. *Alcohol intoxication* - **Alcohol intoxication** usually presents with central nervous system depression, such as **slurred speech**, ataxia, nystagmus, and drowsiness. - While alcohol can affect blood pressure and heart rate, it typically causes **hypotension** or mild hypertension, and it does not produce the marked sympathomimetic effects such as **mydriasis** and profound diaphoresis observed here.

Question 212: A 25 -year-old male presented to the emergency department with head trauma due to a road traffic accident. In the hospital, the patient developed seizures, and an emergency CT scan revealed widespread cerebral edema. Which of the following is the diuretic of choice for cerebral edema in this patient?

A. A. Mannitol (Correct Answer)
B. B. Spironolactone
C. C. Furosemide
D. D. Hydrochlorothiazide
E. E. Acetazolamide

Explanation: ***Mannitol*** - **Mannitol** is an osmotic diuretic that creates an osmotic gradient, drawing water from the brain parenchyma into the intravascular space, thereby reducing **cerebral edema**. - Its rapid onset of action and ability to cross an intact blood-brain barrier sparingly makes it the drug of choice for acute management of elevated intracranial pressure due to **cerebral edema**. *Spironolactone* - **Spironolactone** is a potassium-sparing diuretic that primarily acts on the distal tubules to inhibit aldosterone, leading to sodium and water excretion. - It is unsuitable for acute cerebral edema as its diuretic effect is too slow and it does not create the necessary osmotic gradient. *Furosemide* - **Furosemide** is a loop diuretic that inhibits sodium-potassium-chloride co-transporter in the loop of Henle, leading to significant diuresis. - While it can remove fluid, it does not create the same osmotic gradient as mannitol and is less effective at rapidly reducing **intracranial pressure** directly related to cerebral edema. *Hydrochlorothiazide* - **Hydrochlorothiazide** is a thiazide diuretic that primarily acts on the distal convoluted tubule to inhibit sodium reabsorption. - Its diuretic action is too slow and relatively mild for the acute management of severe conditions like **cerebral edema**. *Acetazolamide* - **Acetazolamide** is a carbonic anhydrase inhibitor that reduces CSF production and has a role in chronic management of idiopathic intracranial hypertension. - However, it is not suitable for acute cerebral edema following trauma as its onset is too slow and its diuretic effect is relatively weak compared to osmotic diuretics.