Medicolegal Autopsies Practice Questions

Q: Spalding's sign is seen in:

Deadborn. **Explanation:** **Spalding’s Sign** is a classic radiological indicator of **intrauterine fetal death (IUFD)**. It refers to the irregular overlapping of the fetal cranial bones due to the liquefaction of the brain matter and the loss of intracranial pressure following death. 1. **Why "Deadborn" is correct:** A **deadborn (macerated)** fetus is one that has died in utero and remained there for at least 24–48 hours. During this period, aseptic autolysis occurs. As the brain tissue softens and liquefies, the skull bones lose their internal support and collapse inward, leading to the characteristic overlapping seen on X-ray or Ultrasound. 2. **Why other options are incorrect:** * **Stillborn:** While often used interchangeably with deadborn, "stillborn" technically includes both **macerated** (dead for some time) and **fresh** (died during labor) fetuses. Spalding’s sign specifically requires time for autolysis to occur; it is not seen in "fresh" stillbirths. * **Liveborn:** In a live birth, the cranial bones may overlap slightly during labor (molding), but they return to normal positions shortly after birth. The brain provides internal pressure, preventing the pathological collapse seen in Spalding's sign. * **Premature:** Prematurity refers to gestational age, not the state of vitality. A premature baby can be born alive or dead. **High-Yield Clinical Pearls for NEET-PG:** * **Timeframe:** Spalding’s sign usually appears **24 to 72 hours** after fetal death. * **Deuel’s Halo Sign:** Another sign of IUFD; it is the appearance of a radiolucent halo around the fetal head due to edema of the scalp soft tissues. * **Robert’s Sign:** The presence of gas in the fetal heart and large vessels (occurs as early as 12 hours after death). * **Maceration:** This is a sterile process of decomposition. If signs of maceration are present, it is definitive proof that the fetus was **deadborn**.

Q: In rigor mortis, what happens to the muscles?

Stiffens and shortens. **Explanation:** **Rigor Mortis** is a post-mortem change characterized by the stiffening and slight shortening of muscles due to the depletion of **Adenosine Triphosphate (ATP)**. 1. **Why Option C is Correct:** After death, cellular respiration ceases, leading to a total loss of ATP. ATP is required to break the cross-bridges between **actin and myosin** filaments. Without ATP, these filaments remain permanently locked in a contracted state. This chemical binding results in the muscle becoming **stiff**. Additionally, because the actin filaments slide over the myosin filaments during this process, the muscle undergoes a slight but measurable **shortening**. 2. **Why Other Options are Incorrect:** * **Option A:** While stiffening is the most prominent feature, it is incomplete without acknowledging the physical shortening of the muscle fibers. * **Option B:** Shortening alone does not describe the state of rigidity (hardness) that defines the condition. * **Option C:** Muscles never lengthen during rigor mortis; lengthening only occurs during the subsequent stage of secondary flaccidity (putrefaction). **High-Yield Clinical Pearls for NEET-PG:** * **Order of Appearance:** Rigor mortis follows **Nysten’s Law**, appearing first in the eyelids, then the face, neck, trunk, upper limbs, and finally the lower limbs. It disappears in the same order. * **Timeline (Rule of 12):** In temperate climates, it typically takes 12 hours to form, lasts for 12 hours, and takes 12 hours to disappear. * **Simulated Rigor:** Do not confuse with **Cadaveric Spasm** (instantaneous rigor due to high emotional/physical stress at death) or **Heat Stiffening** (coagulation of proteins due to high temperatures). * **Biochemical Basis:** It is a purely chemical phenomenon, independent of the nervous system.

Q: Which method is not used for autopsy?

Thomas. **Explanation:** In forensic pathology, there are four primary techniques for evisceration during an autopsy. The correct answer is **Thomas**, as there is no recognized autopsy technique by this name. It is often used as a distractor in exams. **Why the other options are incorrect (The 4 Standard Methods):** 1. **Virchow’s Method (Option A):** This is the most common method used in forensic autopsies. It involves the **removal of organs one by one**. While it is excellent for detailed examination of individual organs, it destroys the anatomical relationship between them. 2. **Rokitansky’s Method (Option B):** This involves **in-situ dissection** of organs. The organs are examined within the body cavity itself and are not removed as a block. This is rarely used today but is historically significant. 3. **Lettulle’s Method (Option C):** This is the **"En Masse"** technique. All thoracic, abdominal, and pelvic organs are removed as one single, large block. It is the fastest method and preserves the connections between different organ systems (e.g., the hepatobiliary system and the GI tract). 4. **Ghon’s Method (Not listed, but essential):** This is the **"En Bloc"** technique. Organs are removed in functionally related blocks (e.g., thoracic block, abdominal block, urogenital block). **High-Yield NEET-PG Pearls:** * **Virchow:** Organ by organ (Most common). * **Lettulle:** En Masse (Best for preserving anatomical continuity). * **Ghon:** En Bloc (Functional groups). * **Rokitansky:** In-situ (No removal). * **Modified Wyne-Zanetti Method:** A specialized technique often used for infants or cases involving complex congenital anomalies.

Q: Which of the following features can be noted on postmortem examination of a person who died due to drowning?

All of the above. ### Explanation Drowning is a form of asphyxial death caused by the submersion of the mouth and nostrils in a liquid. The postmortem findings are categorized into external and internal signs, all of which are represented in the options. **1. Washerwoman’s Hand (Option A):** This is an external sign of prolonged immersion. The skin of the hands and soles becomes bleached, wrinkled, and sodden (macerated) due to the imbibition of water into the thick keratin layers. While characteristic of drowning, it is a sign of **immersion** rather than the act of drowning itself. **2. Cadaveric Spasm (Option B):** This is an instantaneous onset of rigor mortis at the moment of death. In drowning victims, it is a **diagnostic sign** of "ante-mortem" drowning when the victim's hands are found tightly clutching weeds, mud, or sand from the water bed, indicating a struggle for life. **3. Paltauf’s Hemorrhages (Option C):** These are internal findings consisting of sub-pleural ecchymoses (large, pale, ill-defined hemorrhages) found on the surfaces of the lungs. They occur due to the rupture of alveolar walls from increased intrapulmonary pressure and are typically seen in the lower lobes. **Conclusion:** Since all three features are classic findings in drowning deaths, **Option D** is the correct answer. ### High-Yield Clinical Pearls for NEET-PG: * **Froth:** Fine, white, leathery, tenacious froth at the mouth and nose is the most reliable external sign of ante-mortem drowning. * **Diatom Test:** Detection of acid-resistant silica shells (diatoms) in the **bone marrow** (femur) is considered the "gold standard" for confirming ante-mortem drowning in decomposed bodies. * **Emphysema Aquosum:** Lungs appear heavy, bulky, and edematous, often overlapping in the midline, and "pit on pressure."

Q: Which of the following procedures is followed while performing a post-mortem examination of the stomach?

Directly cut open. ### Explanation **Correct Answer: D. Directly cut open** In a routine medicolegal autopsy, the standard procedure for examining the stomach is to **directly cut it open** along its greater curvature. This is done to inspect the gastric contents (nature of food, smell, presence of pills/poisons) and the state of the gastric mucosa (congestion, ulceration, or corrosion). The underlying medical concept is that in a standard autopsy, the stomach is opened *in situ* or after removal to facilitate immediate examination. Ligation is only necessary when the stomach contents must be preserved without leakage for specific toxicological analysis. **Analysis of Incorrect Options:** * **A, B, and C (Ligation):** Ligation (tying) of the esophageal and pyloric ends is **not a routine procedure** for the examination itself. It is a preparatory step used only when there is a suspicion of poisoning. In such cases, **double ligation** is performed at both the cardiac (esophageal) and pyloric ends to prevent the escape of contents before the organ is placed in a preservative jar for the forensic science laboratory (FSL). Triple ligation has no standard application in forensic autopsy. **High-Yield Clinical Pearls for NEET-PG:** * **Opening Technique:** The stomach is always opened along the **greater curvature**. * **Preservation:** If poisoning is suspected, the stomach and its contents are preserved in **Saturated Saline** (except in cases of corrosive acid poisoning, where rectified spirit is used). * **Time Since Death:** The presence of an identifiable meal can help estimate the time since death (stomach usually empties 4–6 hours after a heavy meal). * **Smells to Note:** Bitter almonds (Cyanide), Garlic (Organophosphates/Arsenic), or Kerosene (Organophosphates) during the opening of the stomach.

Q: Who investigates a dowry death?

Magistrate. **Explanation:** In India, the investigation of a death is known as an **Inquest**. Under the Code of Criminal Procedure (CrPC), there are two types of inquests: Police Inquest (Section 174) and Magistrate Inquest (Section 176). **Why Magistrate is Correct:** According to **Section 176 CrPC**, a Magistrate Inquest is mandatory in specific circumstances where there is a high suspicion of foul play or custodial negligence. A **dowry death** (death of a woman within 7 years of marriage under suspicious circumstances) falls under this category. The investigation is conducted by an Executive Magistrate (e.g., District Magistrate or Sub-divisional Magistrate) to ensure an impartial inquiry into the sensitive nature of the crime. **Analysis of Incorrect Options:** * **B & C (Sub-inspector/Police):** Under Section 174 CrPC, the police (usually a Sub-inspector) conduct inquests for routine suicides, accidents, or homicides. However, in cases of dowry deaths, the law mandates a higher level of scrutiny by a Magistrate. * **D (Medical Officer):** The role of the Medical Officer is to conduct the post-mortem examination (autopsy) and provide an opinion on the cause of death. They do not "investigate" the legal circumstances of the death. **High-Yield Facts for NEET-PG:** * **Mandatory Magistrate Inquest (Section 176 CrPC) occurs in:** 1. Dowry deaths (within 7 years of marriage). 2. Custodial deaths (death in police custody, prison, or psychiatric hospital). 3. Death due to police firing. 4. Exhumation (digging up a buried body for examination). * **Section 304B of the IPC** defines the punishment for dowry death. * **Section 113B of the Indian Evidence Act** creates a legal presumption of dowry death if cruelty was shown shortly before death.

Question 1

Spalding's sign is seen in:

Accepted Answer

Deadborn

Answer

Stillborn

Answer

Liveborn

Answer

Premature

Question 2

Which of the following is NOT important in the diagnosis of brain death?

Accepted Answer

ECG

Answer

EEG

Answer

Absence of brainstem reflexes

Answer

Body temperature

Question 3

In rigor mortis, what happens to the muscles?

Accepted Answer

Stiffens and shortens

Answer

Stiffens

Answer

Shortens

Answer

Stiffens and lengthens

Question 4

Which method is not used for autopsy?

Accepted Answer

Thomas

Answer

Virchow

Answer

Rokitansky

Answer

Lettulle

Question 5

Part I of the death certificate deals with?

Accepted Answer

Immediate cause and the direct underlying cause which started the whole trend of events leading to death.

Answer

Any significant associated diseases that contributed to the death but did not directly lead to it.

Answer

Approximate interval between onset and cause of death.

Answer

The mode of death.

Question 6

Which of the following features can be noted on postmortem examination of a person who died due to drowning?

Accepted Answer

All of the above

Answer

Washer woman's hand

Answer

Cadaveric spasm

Answer

Paltauf's hemorrhages

Question 7

In cases of custodial deaths, which of the following is NOT a guideline issued by the National Human Rights Commission regarding autopsy procedures?

Accepted Answer

Clothing should be carefully removed, preserved, and sealed by the police.

Answer

A magisterial inquiry must be conducted and reported within 24 hours of the occurrence.

Answer

Video recording of the post-mortem examination is to be done.

Answer

All reports, including post-mortem, videograph, and magisterial inquiry reports, must be sent to the Commission within 2 months of the incident.

Question 8

Which of the following procedures is followed while performing a post-mortem examination of the stomach?

Accepted Answer

Directly cut open

Answer

Single ligation

Answer

Double ligation

Answer

Triple ligation

Question 9

Fencing attitude in dead bodies is caused by and present in which of the following conditions?

Accepted Answer

Coagulation of proteins and present in both ante-mortem and post-mortem burns

Answer

Coagulation of proteins and present in ante-mortem burns

Answer

Coagulation of proteins and present in post-mortem burns

Answer

None of the above

Question 10

Who investigates a dowry death?

Accepted Answer

Magistrate

Answer

Sub-inspector

Answer

Police

Answer

Medical officer

Medicolegal Autopsies — MCQs

Medicolegal Autopsies — MCQs

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