FMGE 2011 Practice Questions

Q: Bite mark is an example of:

Pattern abrasion. ***Pattern abrasion*** - A **bite mark** is a classic example of a pattern abrasion, as the teeth leave an imprint that reflects their specific arrangement and shape. - This type of abrasion occurs when a **distinct object** presses against and scrapes the skin, leaving a recognizable design. *Scratch abrasion* - A **scratch abrasion** is typically caused by a sharp object drawing across the skin, forming a linear defect. - Unlike a bite mark, it does not usually involve a broad surface area imprint reflecting the shape of the injuring object. *Graze abrasion* - A **graze abrasion** (or brush burn) results from tangential contact with a rough surface, causing superficial layers of the skin to be scraped away over a wider area. - This type of abrasion is more diffuse and lacks the specific, intricate pattern seen in a bite mark. *Pressure abrasion* - While pressure is involved in forming a bite mark, a **pressure abrasion** specifically refers to an injury caused by sustained pressure that crushes or impacts the skin, often leading to a contusion or localized tissue damage. - It typically does not involve the characteristic scraping or patterned imprint of teeth that defines a bite mark.

Q: Ochronosis is seen in poisoning with:

Carbolic acid. ***Carbolic acid (Phenol)*** - Carbolic acid causes **blackish-brown discoloration** of skin and tissues at the site of contact due to its **corrosive action and protein denaturation**. - This characteristic **dark staining of tissues** is a forensic marker of phenol poisoning and is sometimes referred to in forensic literature as "ochronosis-like" changes. - Phenol is absorbed through skin and mucous membranes and can cause **CNS depression, convulsions, and metabolic acidosis**. *Boric acid* - Boric acid poisoning manifests with **"boiled lobster" appearance** of skin (erythematous desquamation). - Causes **gastrointestinal symptoms** (vomiting, diarrhea) and **CNS effects** in severe cases. - Does not cause blackish tissue discoloration. *HCl (Hydrochloric acid)* - HCl is a **strong corrosive acid** causing severe chemical burns. - Produces **white or gray coagulated necrosis** of tissues on contact. - Does not produce the dark discoloration characteristic of phenol. *Oxalic acid* - Oxalic acid poisoning causes **hypocalcemia** by chelating calcium ions. - Leads to **cardiac arrhythmias, tetany, and renal toxicity** (calcium oxalate crystal deposition). - Does not cause tissue discoloration or ochronosis.

Q: Visual hallucinations are most commonly seen in:

Delirium. ***Delirium*** - **Visual hallucinations** are a hallmark symptom of **delirium**, often described as vivid and fluctuating. - Delirium presents with acute onset of **waxing and waning consciousness**, attention deficits, and cognitive impairment. *OCD* - **Obsessive-compulsive disorder** (OCD) is characterized by recurrent, intrusive thoughts (**obsessions**) and repetitive behaviors (**compulsions**). - It does not typically involve hallucinations; rather, individuals are usually aware of the irrationality of their obsessions and compulsions. *Delusional syndrome* - **Delusional disorders** primarily involve fixed, false beliefs (**delusions**) that are not bizarre and are not accompanied by prominent hallucinations. - While hallucinations can occur, they are generally not the most prominent or characteristic feature, unlike in delirium or psychotic disorders. *Mania* - **Mania**, a mood disorder, is characterized by an elevated, expansive, or irritable mood, increased activity, racing thoughts, and decreased need for sleep. - While psychotic features such as delusions (often grandiose) can occur in severe mania, **visual hallucinations** are less common than in delirium and audio hallucinations are more likely if present.

Q: What is the investigation of choice for diagnosing subarachnoid hemorrhage (SAH)?

CT scan. ***CT scan*** - A **non-contrast CT scan of the head** is the immediate investigation of choice for diagnosing SAH due to its high sensitivity for detecting fresh blood. - It can quickly identify the presence of **blood in the subarachnoid space**, especially within the first 6-12 hours after symptom onset. *Radionuclide scan* - This imaging technique uses **radioactive tracers** to evaluate organ function or blood flow. - It is **not used for acute diagnosis** of SAH, as it does not directly visualize blood in the CNS. *X-ray skull* - An **X-ray of the skull** primarily visualizes bone structures and can detect fractures or other bony abnormalities. - It is **ineffective at detecting blood** in the subarachnoid space and is not used for SAH diagnosis. *MRI* - While MRI can detect SAH, especially in subacute or chronic phases, it is **less sensitive than CT for acute SAH** due to longer acquisition times and motion artifacts. - It is often considered if CT is negative and clinical suspicion remains high, but **not as the initial investigation of choice** in an acute setting.

Question 1

Bite mark is an example of:

Accepted Answer

Pattern abrasion

Answer

Scratch abrasion

Answer

Graze abrasion

Answer

Pressure abrasion

Question 2

Ochronosis is seen in poisoning with:

Accepted Answer

Carbolic acid

Answer

Boric acid

Answer

HCl

Answer

Oxalic acid

Question 3

Visual hallucinations are most commonly seen in:

Accepted Answer

Delirium

Answer

OCD

Answer

Delusional syndrome

Answer

Mania

Question 4

What is the investigation of choice for diagnosing subarachnoid hemorrhage (SAH)?

Accepted Answer

CT scan

Answer

Radionuclide scan

Answer

X-ray skull

Answer

MRI

FMGE 2011

Dental

Forensic Medicine

Psychiatry

Radiology