Sexual Offences and Abortion — MCQs

Sexual Offences and Abortion Indian Medical PG Practice Questions and MCQs

Question 141: The Medical Termination of Pregnancy (MTP) Act does not protect the act of termination of pregnancy beyond which gestational limit?

A. 20 weeks (Correct Answer)
B. 24 weeks
C. 28 weeks
D. 30 weeks

Explanation: **Explanation:** The **Medical Termination of Pregnancy (MTP) Act** was originally enacted in 1971 to provide a legal framework for the termination of pregnancy by registered medical practitioners. Under the **original Act**, the upper gestational limit for termination was strictly **20 weeks**. While the Act was amended in 2021 to extend this limit to 24 weeks for specific categories of women, the core legal protection for a "standard" termination without specific complications or judicial intervention historically and fundamentally centers on the 20-week threshold. * **Option A (20 weeks):** This is the correct answer as per the foundational MTP Act. Beyond 20 weeks, termination requires the opinion of two registered medical practitioners (under the old act) or falls into specialized categories under the new amendment. * **Option B (24 weeks):** This is the limit set by the **MTP Amendment Act (2021)** for "special categories" of women (e.g., survivors of sexual assault, minors, or women with disabilities). It is not the general limit for all cases. * **Option C & D (28 and 30 weeks):** These are incorrect as no general provision in the MTP Act allows termination at this stage unless there are substantial fetal abnormalities (diagnosed by a Medical Board) or an immediate necessity to save the mother's life. **High-Yield Clinical Pearls for NEET-PG:** * **Consent:** If the woman is >18 years and of sound mind, only **her consent** is required. Husband’s consent is NOT mandatory. * **Opinion:** Up to 20 weeks, the opinion of **one** RMP is required. Between 20-24 weeks (for special categories), the opinion of **two** RMPs is required. * **No Limit:** There is no upper gestation limit if the termination is necessary to save the life of the pregnant woman or in cases of substantial fetal abnormalities approved by a state-level Medical Board. * **Confidentiality:** Violation of a woman's privacy regarding MTP is punishable by up to 1 year in prison.

Question 142: What is the term for the passive agent in sodomy in adults?

A. Catamite
B. Paedophile
C. Gerontophilia (Correct Answer)
D. Paederasty

Explanation: **Explanation** In Forensic Medicine, sexual offences are categorized into natural and unnatural acts. Sodomy (anal intercourse) involves two parties: the active agent and the passive agent. **Correct Answer: Gerontophilia** While the term **Gerontophilia** traditionally refers to a paraphilia where an individual is sexually attracted to the elderly, in the context of forensic terminology regarding sodomy, it is used to describe the **adult passive agent**. This distinguishes the adult participant from terms used for minors. **Analysis of Incorrect Options:** * **Catamite (Option A):** This refers specifically to a **boy** (minor) who is the passive agent in the act of sodomy. * **Paedophile (Option B):** This is a psychiatric diagnosis (paraphilia) where an adult has a primary sexual interest in prepubescent children. It describes a preference rather than a specific role in a physical act. * **Paederasty (Option D):** This is the act of sodomy performed by a man (active agent) upon a **young boy** (passive agent). **High-Yield Clinical Pearls for NEET-PG:** * **Active Agent:** Often referred to as the "Sodomite." * **Passive Agent:** If a boy, he is a "Catamite"; if an adult, the term is "Gerontophilia." * **Medical Examination:** In acute cases, look for the **"Triad of Sodomy"** (anal fissures, sphincter spasm, and tenderness). In chronic passive agents, look for a funnel-shaped anus, loss of sphincter tone (patulous anus), and loss of perianal skin folds (rugae). * **Legal Status:** Following the landmark Navtej Singh Johar vs. Union of India (2018) judgment, Section 377 IPC was decriminalized for consensual acts between adults, though it remains an offence for non-consensual acts and bestiality.

Question 143: Medical Termination of Pregnancy (MTP) should be performed by two Registered Medical Practitioners (RMPs) after how many weeks of the gestational period?

A. 12 weeks (Correct Answer)
B. 16 weeks
C. 18 weeks
D. 20 weeks

Explanation: ### Explanation The Medical Termination of Pregnancy (MTP) Act, 1971 (amended in 2021), provides specific legal frameworks regarding who can perform an abortion and when. **1. Why Option A is Correct:** According to the **MTP Amendment Act 2021**, the opinion of **one** Registered Medical Practitioner (RMP) is required for the termination of pregnancy up to **20 weeks** of gestation. However, the opinion of **two** RMPs is mandatory if the pregnancy is between **20 and 24 weeks**. *Note on the Question:* In older versions of the Act (1971), the threshold for two RMPs was **12 weeks**. In the context of the current updated guidelines, the requirement for two RMPs begins **after 20 weeks**. If this question follows the traditional 1971 pattern often seen in older question banks, 12 weeks is the historical answer. Under the **current 2021 amendment**, the transition from one RMP to two RMPs occurs at the **20-week mark**. **2. Why Incorrect Options are Wrong:** * **Options B & C (16 and 18 weeks):** These fall within the first trimester/early second trimester window. Under current laws, only one RMP's opinion is needed during this period. * **Option D (20 weeks):** This is the "cutoff" point. Up to 20 weeks, one RMP suffices. It is only *after* 20 weeks (up to 24 weeks for specific categories) that two RMPs are legally required. **3. High-Yield Clinical Pearls for NEET-PG:** * **Upper Limit:** The ceiling for MTP is now **24 weeks** for specific categories (survivors of rape, minors, mentally ill, etc.). * **No Limit:** There is no upper gestation limit if the termination is necessary due to **substantial fetal abnormalities** diagnosed by a state-level Medical Board. * **Confidentiality:** The name and particulars of the woman must not be revealed (punishable by up to 1 year in prison). * **Consent:** Only the woman's consent is required if she is an adult; if she is a minor or mentally ill, consent from the guardian is mandatory.

Question 144: Under the MTP Act, termination of pregnancy can be done by which of the following medical professionals?

A. Any registered medical practitioner
B. Any registered medical practitioner with an MD/MS degree in Obstetrics and Gynaecology (Correct Answer)
C. Any registered medical practitioner with 6 months of residency in any department
D. Any registered medical practitioner with a minimum of 3 months of residency in Obstetrics and Gynaecology

Explanation: **Explanation:** The **Medical Termination of Pregnancy (MTP) Act** specifies strict criteria for who is authorized to perform a termination to ensure maternal safety. According to the Act and its subsequent rules, a **Registered Medical Practitioner (RMP)** is qualified to perform an MTP if they possess specific postgraduate qualifications or training in Obstetrics and Gynaecology (OBG). **Why Option B is Correct:** An RMP who holds a postgraduate degree or diploma in Obstetrics and Gynaecology (such as MD, MS, or DGO) is automatically qualified to perform an MTP at any stage of pregnancy permitted by the law. Their specialized training is recognized as sufficient expertise for the procedure. **Analysis of Incorrect Options:** * **Option A:** Being a general RMP (MBBS) is not enough. Specific experience or training in OBG is mandatory under the MTP Rules. * **Option C:** Residency in "any department" is irrelevant. The training must be specific to Obstetrics and Gynaecology. * **Option D:** The requirement for residency/house surgery is a minimum of **6 months** in Obstetrics and Gynaecology for an RMP who does not hold a PG degree/diploma. 3 months is insufficient. **High-Yield Clinical Pearls for NEET-PG:** * **Training Requirements for MBBS RMPs:** If they don't have a PG degree, they must have: 1. Assisted in at least **25 cases** of MTP in a government-recognized hospital. 2. Or, completed **6 months** of house surgery in OBG. 3. Or, completed a specialized MTP training program (usually 10-15 days) recognized by the government. * **Opinion Requirements:** Under the 2021 Amendment, an opinion from **one RMP** is needed for termination up to 20 weeks, and **two RMPs** for 20–24 weeks (for specific categories). * **Upper Limit:** The gestation limit is now **24 weeks** for special categories (rape survivors, minors, etc.) and has no upper limit for substantial fetal abnormalities (decided by a Medical Board).

Question 145: In cases of examination of victims of sexual offense, what is the use of spraying toluidine blue?

A. Identification of clotted blood on injuries
B. Partially healed micro injuries
C. Identify dried semen traces
D. Recent micro injuries (Correct Answer)

Explanation: **Explanation:** **Toluidine Blue** is a nuclear-binding acidophilic dye that has a high affinity for the exposed nuclei of the basal layer of the epithelium. **1. Why the correct answer is right:** In cases of sexual assault, **recent micro-injuries** (such as posterior fourchette lacerations or vestibular tears) may not be visible to the naked eye. When a 1% aqueous solution of Toluidine Blue is applied to the genital area and then wiped with a lubricant or saline, the dye is retained in areas where the continuity of the squamous epithelium is broken, exposing the underlying nuclei. This "staining" highlights **acute/recent superficial lacerations** that would otherwise be missed during a routine physical examination. **2. Why the incorrect options are wrong:** * **Option A:** Clotted blood is identified via physical examination or chemical tests like the Kastle-Meyer test; Toluidine blue is not used for blood identification. * **Option B:** As an injury heals, re-epithelialization occurs. Once the epithelial barrier is restored, the dye can no longer penetrate to the basal nuclei, making it ineffective for **partially healed** or old injuries. * **Option C:** Dried semen traces are identified using a **Wood’s Lamp** (fluorescence) or chemical tests like the Acid Phosphatase test. **3. Clinical Pearls for NEET-PG:** * **Colposcopy** is the gold standard for identifying genital trauma, but Toluidine Blue is a cost-effective, "poor man’s colposcopy." * **False Positives:** The dye can stain mucus, semen, or pre-existing inflammatory conditions (like vulvovaginitis), so results must be interpreted carefully. * **Legal Note:** Consent must be obtained before application, as it is an invasive staining procedure.

Question 146: In a rape victim, what is the typical site of hymen tear?

A. 2 o'clock
B. 12 o'clock
C. 10 o'clock
D. 7 o'clock (Correct Answer)

Explanation: ### Explanation In forensic medicine, the location of hymenal tears is a critical finding during the examination of a sexual assault victim. The hymen is a thin vascular membrane that partially occludes the vaginal opening. **1. Why 7 o'clock is correct:** During forceful penile penetration (as seen in rape), the posterior part of the hymen is most vulnerable to injury due to the anatomical orientation of the vaginal canal and the direction of force. Tears most commonly occur in the **posterior-lateral positions**, specifically at the **5 o'clock and 7 o'clock** positions. This is because the posterior fourchette and the lower half of the hymen bear the maximum tension during penetration. **2. Analysis of Incorrect Options:** * **12 o'clock (Option B):** Tears at the 12 o'clock position (anterior) are extremely rare in cases of sexual assault. If present, they are more likely to be associated with medical procedures, instrumentation, or specific types of blunt force trauma rather than consensual or non-consensual intercourse. * **2 o'clock and 10 o'clock (Options A & C):** These represent the superior-lateral aspects of the hymen. While injuries can occur anywhere in a violent struggle, these sites are not typical for the initial point of rupture during penetration. **3. High-Yield Clinical Pearls for NEET-PG:** * **Most common site of hymenal tear:** 5 o'clock and 7 o'clock (Posterior-lateral). * **Hymenal Clefts vs. Tears:** Congenital clefts usually have smooth, rounded edges and do not reach the base of the hymen, whereas traumatic tears have irregular, jagged edges and extend to the base. * **Carunculae Myrtiformes:** These are the small, rounded elevations of tissue that remain after the hymen has been ruptured and healed (typically after childbirth). * **Medicolegal Significance:** A "fresh" tear is characterized by redness, bleeding, and tenderness, usually healing within 7–10 days. A healed tear does not necessarily prove prior sexual intercourse, as the hymen can be ruptured by non-sexual trauma or exercise.

Question 147: Fear of darkness is called:

A. Nyctophobia (Correct Answer)
B. Mysophobia
C. Claustrophobia
D. Agoraphobia

Explanation: **Explanation:** The correct answer is **Nyctophobia**. In Forensic Medicine and Psychiatry, phobias are defined as irrational, persistent fears of specific objects or situations. **1. Why Nyctophobia is correct:** The term is derived from the Greek word *'nyx'* (night). **Nyctophobia** is the pathological fear of darkness or night. In a forensic context, this is relevant when assessing psychological trauma in victims of assault or when evaluating psychiatric comorbidities in criminal profiling. **2. Analysis of Incorrect Options:** * **Mysophobia:** This is the pathological fear of **contamination, dirt, or germs**. It is frequently associated with Obsessive-Compulsive Disorder (OCD), where patients engage in repetitive hand-washing. * **Claustrophobia:** This is the fear of **enclosed or confined spaces** (e.g., elevators, MRI machines). It is one of the most common situational phobias encountered in clinical practice. * **Agoraphobia:** This is the fear of being in **open spaces** or situations where escape might be difficult or help unavailable (e.g., crowds, bridges). It often occurs as a complication of Panic Disorder. **3. NEET-PG High-Yield Clinical Pearls:** * **Acrophobia:** Fear of heights. * **Algophobia:** Fear of pain. * **Pyrophobia:** Fear of fire. * **Thanatophobia:** Fear of death. * **Xenophobia:** Fear of strangers. * **Treatment of Choice:** For most specific phobias, **Cognitive Behavioral Therapy (CBT)** with **Systemic Desensitization** or **Exposure Therapy** is the gold standard. Benzodiazepines or Beta-blockers may be used for short-term symptomatic relief in performance-based anxiety.

Question 148: Which of the following is NOT considered a sexual perversion?

A. Sadism
B. Masochism
C. Undinism
D. Bestiality (Correct Answer)

Explanation: **Explanation:** In Forensic Medicine, sexual deviations are broadly categorized into **Sexual Perversions (Paraphilias)** and **Sexual Offences**. **Why Bestiality is the Correct Answer:** Bestiality (Zooerasty) is defined as sexual intercourse between a human and an animal. Under the Indian Penal Code (IPC), it is classified as an **Unnatural Sexual Offence** (formerly under Section 377). While it involves deviant behavior, in the context of forensic classification for exams, it is categorized as a legal offence rather than a purely psychological perversion like the other options. **Analysis of Incorrect Options:** * **Sadism (Algolagnia):** A sexual perversion where a person derives pleasure from inflicting pain, cruelty, or humiliation on their partner. * **Masochism:** The counterpart to sadism, where sexual gratification is obtained by suffering physical pain or humiliation. * **Undinism (Urophilia):** A perversion where sexual excitement is associated with the sight, sound, or act of urination. **High-Yield Clinical Pearls for NEET-PG:** * **Voyeurism (Scoptophilia):** Deriving pleasure from watching others undress or engage in sexual acts ("Peeping Tom"). * **Exhibitionism:** Achieving arousal by exposing genitals to unsuspecting strangers. * **Frotteurism:** Rubbing one's genitals against a non-consenting person in crowded places. * **Fetishism:** Sexual attraction to inanimate objects (e.g., shoes, hair). * **Important IPC Sections:** While Section 377 was partially decriminalized regarding consensual same-sex acts, it remains applicable to **Bestiality**.

Question 149: Masturbation by fingering in females usually results in rupture of the hymen at which position?

A. 5-7 O'clock
B. 11-1 O'clock (Correct Answer)
C. 3-5 O'clock
D. 8-10 O'clock

Explanation: ### Explanation **Correct Answer: B. 11-1 O'clock** **Medical Concept:** The location of a hymeneal tear is a critical forensic indicator of the mechanism of injury. In cases of **masturbation by fingering**, the female is typically in a sitting or supine position. The anatomical orientation of the hand and the upward/forward pressure applied by the fingers during self-stimulation most frequently causes trauma or stretching at the **anterior aspect** of the hymen. On a clock-face diagram, this corresponds to the **11 to 1 o'clock** position. **Analysis of Options:** * **11-1 O'clock (Correct):** This is the anterior margin. Tears here are characteristic of digital manipulation (fingering) or accidental trauma from below. * **5-7 O'clock (Incorrect):** This is the **posterior margin**. Tears at this position are the hallmark of **penile penetration (sexual intercourse)**. During coitus, the downward and backward thrusting of the penis puts maximum stretch on the posterior fourchette and the inferior aspect of the hymen. * **3-5 and 8-10 O'clock (Incorrect):** These represent the lateral aspects of the hymen. While tears can occur here during forceful trauma or struggle, they are not the classic sites for either masturbation or routine intercourse. **High-Yield Clinical Pearls for NEET-PG:** * **Rule of Thumb:** Anterior tears (11-1) suggest digital/accidental trauma; Posterior tears (5-7) suggest penile penetration. * **Imperforate Hymen:** The most common congenital anomaly leading to hematocolpos. * **Carunculae Myrtiformes:** These are the small, rounded tags of tissue left behind after the hymen is ruptured during childbirth (not just after intercourse). * **Compliant/Elastic Hymen:** A hymen that stretches without tearing; its presence does not rule out sexual intercourse.

Question 150: Female homosexualism is called?

A. Sodomy
B. Bestiality
C. Fellatio
D. Tribadism (Correct Answer)

Explanation: **Explanation:** **Tribadism** (also known as Lesbianism or Sapphism) is the correct term for female homosexuality. It refers to sexual gratification between two females through physical intimacy, often involving the rubbing of genitalia against each other or other body parts. In forensic medicine, it is classified under sexual perversions/deviations. **Analysis of Incorrect Options:** * **Sodomy:** This refers to anal intercourse, typically between two males (male homosexuality) or between a male and a female. Historically, it was classified under Section 377 of the IPC as an "unnatural offence." * **Bestiality:** This is a paraphilia involving sexual contact between a human and an animal. It is also known as zooerasty. * **Fellatio:** This is a form of oral sex involving the stimulation of the penis by the mouth or tongue of another person. **High-Yield Clinical Pearls for NEET-PG:** * **Legal Status:** Following the landmark **Navtej Singh Johar vs. Union of India (2018)** judgment, consensual private sexual acts between adults (including homosexuality) have been decriminalized, striking down portions of **Section 377 IPC**. * **Cunnilingus:** This is the oral stimulation of the female genitalia. * **Buggery:** A synonym often used for sodomy or anal intercourse. * **Signs of Tribadism:** Medico-legally, it is difficult to prove as there are rarely any specific physical signs, though hypertrophied clitoris or local abrasions are occasionally mentioned in older texts.

Practice by Chapter

Sexual Assault Examination

Practice Questions

Rape Investigation

Practice Questions

Child Sexual Abuse

Practice Questions

Collection of Biological Evidence

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DNA Testing in Sexual Offences

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False Allegations

Practice Questions

Medical Termination of Pregnancy

Practice Questions

Criminal Abortion

Practice Questions

Complications of Abortion

Practice Questions

Sexual Perversions

Practice Questions

Legal Aspects of Sexual Offences

Practice Questions

Victim Support and Rehabilitation

Practice Questions

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