NEET-PG 2025 - Forensic Medicine PYQs Practice Questions

Q: A man has killed a person and is brought for forensic evaluation. What is the first step in the medico-legal management of such a case?

Psychiatric evaluation. ***Psychiatric evaluation*** - The initial step in such a case is to determine the accused individual's **fitness to stand trial** and their **criminal responsibility** (sanity) at the time of committing the offense. - This evaluation provides the necessary medical and legal foundation to decide if the case can proceed to trial, especially concerning the defense of **insanity (M'Naghten rule)**. *Immediate trial of the case* - The trial cannot commence until the accused's **competency** to participate in the legal proceedings has been medically confirmed by a psychiatric report. - Proceeding without a psychiatric evaluation risks violating the accused's rights and may lead to a mistrial if they are later deemed **unfit to plead**. *Declared not guilty* - This is a formal verdict or judgment delivered by the court, signifying the **conclusion** of the trial process, not the initial investigative or management step. - The declaration of 'not guilty' (including 'not guilty by reason of insanity') only occurs after all evidence, including the **psychiatric evidence**, has been presented and evaluated. *Sentenced for murder* - Sentencing is the **final stage** of the judicial process, which takes place only *after* the accused has been conclusively tried and found **guilty** of the crime beyond a reasonable doubt. - This step occurs long after the initial arrest, investigation, psychiatric assessment, and full legal trial are completed. [Practice more Forensic Medicine PYQs on OnCourse]

Q: A 16-year-old girl and a 23-year-old boy undergo medical examination following allegations of rape made by the girl's parents. The girl states the sexual act was consensual, and no injuries are found on examination. According to the law, what is the legal status of the consent in this case?

Consent is invalid as the girl is under 18 years. ***Consent is invalid as the girl is under 18 years*** - Under the **Protection of Children from Sexual Offences (POCSO) Act, 2012**, the age of consent for sexual activity is established as **18 years**. - Since the girl is 16, she is legally a **minor**, and her subjective consent, even if freely given, is **legally void** for sexual acts. *No punishment since the act was consensual* - Consent given by a person under the statutory age (18 years) is legally **irrelevant** and does not mitigate the offense under the **POCSO Act**. - The sexual act committed by the 23-year-old boy is automatically classified as a **sexual offence** due to the victim's age, irrespective of self-reported consent. *No punishment since there are no injuries* - The criteria for a sexual offence under **POCSO** depend on the age of the victim and the nature of the act, not the presence or absence of **physical injuries**. - Lack of signs of struggle or injury merely indicates absence of force, but does not validate the **minor's consent**. *Parents must prove that the act was non-consensual* - The legal status of consent here is determined by **statute (POCSO)**, which automatically invalidates a minor's consent based on age. - The **burden of proof** does not fall on the parents to prove non-consent; rather, the state prosecutes based on the victim being a minor. [Practice more Forensic Medicine PYQs on OnCourse]

Q: A patient is brought to the emergency department with acute onset of severe abdominal pain, throat irritation followed by vomiting that contains blood and bile, and diarrhea that initially appears bloody but later becomes colorless, odorless, and rice-water-like. On examination, a distinct garlicky odor is noted in the breath. Which of the following is the most likely agent responsible for the poisoning?

Arsenic. ***Arsenic*** - The combination of **acute severe gastroenteritis** (bloody, then "rice-water" diarrhea) and a distinct **garlicky odor** on the breath is pathognomonic for **acute arsenic poisoning**. - Arsenic is a potent cytotoxin causing widespread capillary damage, leading to severe fluid loss and shock, mimicking cholera. *Phosphorus* - **Phosphorus poisoning** typically presents with a **garlicky odor** (similar to arsenic) and severe gastroenteritis, but the characteristic diarrhea is often described as **smoky or luminous** in the dark, not the rice-water stools seen here. - The main toxicity is hepatotoxicity, leading to acute liver failure (jaundice, coagulation defects) in the second phase after an asymptomatic period. *Aluminium phosphide* - Poisoning from **aluminium phosphide** (often used as a rodenticide/fumigant, marketed as 'Celphos') produces a distinctive, strong odor of **phosphine gas**, usually described as **'rotten fish' or 'carbide'**, not garlicky. - Its main effect is **myocardial toxicity** and refractory hypotension. *Croton seeds* - **Croton seed poisoning** is characterized by intense localized irritation of the GI tract due to the toxin **crotin**, leading to severe **vomiting and purging** (diarrhea). - This poisoning **does not produce a garlicky odor** or the characteristic **rice-water stools** described in this presentation. [Practice more Forensic Medicine PYQs on OnCourse]

Q: During autopsy, a body shows curved scratch marks below the right angle of the mandible, three grouped bruises on the left side of the neck below the thyroid cartilage, and additional bruises over the head, posterior shoulder, backside of the trunk, and hip crests. Fracture of the superior horn of the thyroid cartilage present. What is the most likely cause of death?

Throttling. ***Throttling*** * Throttling, or manual strangulation, is characterized by the use of hands, leading to specific injury patterns. * The presence of **curved scratch marks (fingernail marks)**, **grouped bruises (thumb/finger pressure)** on the neck, and injuries (bruises) to the head and trunk (suggesting struggle/assault) are classic findings. * Fracture of the **superior horn of the thyroid cartilage** is a common Laryngeal fracture seen in throttling. *Garroting* * Garroting specifically refers to strangulation using a **tourniquet** or a constricting device that is tightened around the neck, often causing horizontal neck injury and less commonly laryngeal fractures. * It rarely involves the typical grouped finger/thumb bruises or curved scratch marks associated with manual strangulation. *Ligature strangulation* * This involves using a cord or tie (ligature) to constrict the neck, resulting in a distinct **ligature mark** (horizontal or oblique furrow) on the neck. * It does not typically produce the pattern of discrete **grouped bruises** corresponding to finger/thumb placement seen in throttling. *Mugging* * Mugging is an act (robbery with assault) and not a direct cause of death mechanism like throttling or strangulation. * The injuries described (**scratch marks, grouped bruises, cartilage fracture**) point specifically toward a mechanical asphyxia event sustained from manual force applied to the neck. [Practice more Forensic Medicine PYQs on OnCourse]

Q: What is the Zasko phenomenon?

Tendon reflex occurring after death. ***Tendon reflex occurring after death*** - The Zasko phenomenon refers to the finding where deep **tendon reflexes**, such as the patellar reflex, can be elicited for a short period (usually up to 1-2 hours) **after somatic death**. - This reflex is considered an **early post-mortem phenomenon** indicating residual excitability of the muscle and nervous system components. *Seeping of blood through wounds around the time of death* - This finding is related to **bleeding** or **haemorrhage** that occurred either immediately before or around the time of death, sometimes termed perimortem. - It is generally assessed to determine if the trauma occurred during life (**vital reaction**) or after death, and is not a neurological reflex. *Clotting of blood after death* - This refers to the formation of post-mortem clots within the blood vessels, resulting in the characteristic **current jelly** and **chicken fat** clots. - It is a widespread physiological change distinct from the specific local reflex defined by the Zasko phenomenon. *Gaping of wound along skin tension lines* - This phenomenon describes the tendency of wounds to gape when they run **perpendicular** to the **Langer's lines** (skin tension lines). - It is used in forensic pathology to assess the nature and direction of incised wounds, independent of post-mortem reflexes. [Practice more Forensic Medicine PYQs on OnCourse]

Question 1

A man has killed a person and is brought for forensic evaluation. What is the first step in the medico-legal management of such a case?

Accepted Answer

Psychiatric evaluation

Answer

Sentenced for murder

Answer

Declared not guilty

Answer

Immediate trial of the case

Question 2

A 16-year-old girl and a 23-year-old boy undergo medical examination following allegations of rape made by the girl's parents. The girl states the sexual act was consensual, and no injuries are found on examination. According to the law, what is the legal status of the consent in this case?

Accepted Answer

Consent is invalid as the girl is under 18 years

Answer

No punishment since there are no injuries

Answer

Parents must prove that the act was non-consensual

Answer

No punishment since the act was consensual

Question 3

A patient is brought to the emergency department with acute onset of severe abdominal pain, throat irritation followed by vomiting that contains blood and bile, and diarrhea that initially appears bloody but later becomes colorless, odorless, and rice-water-like. On examination, a distinct garlicky odor is noted in the breath. Which of the following is the most likely agent responsible for the poisoning?

Accepted Answer

Arsenic

Answer

Aluminium phosphide

Answer

Phosphorus

Answer

Croton seeds

Question 4

During autopsy, a body shows curved scratch marks below the right angle of the mandible, three grouped bruises on the left side of the neck below the thyroid cartilage, and additional bruises over the head, posterior shoulder, backside of the trunk, and hip crests. Fracture of the superior horn of the thyroid cartilage present. What is the most likely cause of death?

Accepted Answer

Throttling

Answer

Mugging

Answer

Garroting

Answer

Ligature strangulation

Question 5

What is the Zasko phenomenon?

Accepted Answer

Tendon reflex occurring after death

Answer

Clotting of blood after death

Answer

Seeping of blood through wounds around the time of death

Answer

Gaping of wound along skin tension lines

Question 6

The Protection of Children from Sexual Offences (POCSO) Act covers which of the following groups?

Accepted Answer

All children below 18 years

Answer

Girls below 18 years

Answer

Girls below 16 years

Answer

All children below 16 years

Question 7

A man kills his office colleague and later claims he was experiencing delusions of persecution and other psychotic features at the time of the act. He now asserts that he is not guilty by reason of insanity. What is the most appropriate next step under medico-legal protocol?

Accepted Answer

Refer for psychiatric evaluation to assess criminal responsibility

Answer

He should be sent directly to jail

Answer

Prescribe antipsychotic medication immediately

Answer

Enroll in an anger management program

NEET-PG 2025 — Forensic Medicine