INI-CET 2023 - Forensic Medicine PYQs Practice Questions

Q: A girl from the village was found dead in the lake and was taken out. It is a case of ante mortem drowning. All are true about this case except?

Washerman hand and finger. ***Washerman hand and finger*** - **Washerman's hand and feet** (cutis anserina) refers to the wrinkled, sodden appearance of skin on the palms and soles due to prolonged immersion in water. - This is a **post-mortem change** that develops after death as a result of water absorption into the skin, typically appearing after **2-3 hours** of immersion. - While it indicates immersion in water, it does **not specifically signify ante-mortem drowning** as it can occur in bodies submerged after death (post-mortem submersion). - This is the **correct answer** to the "except" question as it is not a vital sign of ante-mortem drowning. *Froth on nose and mouth* - **Fine, white, tenacious froth** (mushroom-like foam) at the nose and mouth is a classic sign of **ante-mortem drowning**. - Results from violent mixing of air, mucus, and water in the airways during respiratory efforts while drowning. - This is a **vital sign** indicating the person was alive during submersion. *Cadaveric spasm in hand muscle* - **Cadaveric spasm** (instantaneous rigor mortis) can occur in **ante-mortem drowning** when the victim grasps objects like weeds, mud, or clothes in the final moments before death. - This represents a **vital phenomenon** reflecting a final act of vitality and strongly suggests the person was alive and conscious at the moment of submersion. *Water in the stomach* - Presence of water in the stomach is a common finding in **ante-mortem drowning** as the victim actively swallows water during the struggle and aspiration phase. - Indicates **vital swallowing** during life, supporting the diagnosis of ante-mortem drowning. - Typically, more than **500 mL** of water in stomach suggests ante-mortem drowning. [Practice more Forensic Medicine PYQs on OnCourse]

Q: Black foot disease with peripheral neuropathy is seen in which metal poisoning?

Arsenic. ***Arsenic*** - Chronic arsenic exposure is associated with **Blackfoot disease**, a severe form of peripheral vascular disease leading to gangrene. - **Peripheral neuropathy** is another common manifestation of chronic arsenic poisoning, characterized by tingling, numbness, and weakness. *Mercury* - Mercury poisoning (Minamata disease) primarily causes **neurological symptoms** like tremors, ataxia, and cognitive impairment, but not specifically Blackfoot disease. - It does not typically lead to severe peripheral vascular disease and gangrene. *Lead* - Lead poisoning (plumbism) is known for causing **neuropathy** (especially motor neuropathy, "wrist drop") and **abdominal pain**, but not Blackfoot disease. - It also affects hematological (anemia) and renal systems. *Cadmium* - Cadmium poisoning (Itai-itai disease) primarily affects the **bones** (osteomalacia, osteoporosis) and **kidneys**. - While it can cause renal damage, it does not typically lead to Blackfoot disease or prominent peripheral neuropathy. [Practice more Forensic Medicine PYQs on OnCourse]

Q: A man presents with alcoholic smell and congested conjunctiva but normal motor functions (walking normally). What is the most appropriate assessment of his condition?

Alcohol intoxication. ***Alcohol intoxication*** - The presence of **congested conjunctiva** is an **objective sign of alcohol intoxication** from forensic medicine perspective, indicating physiological effects of alcohol on the body. - **Intoxication exists on a spectrum** - motor impairment is not required for diagnosis; early signs like conjunctival congestion and alcoholic odor are sufficient evidence of intoxication. *Severe alcohol poisoning* - This represents **life-threatening alcohol toxicity** with signs like **stupor**, **respiratory depression**, **hypothermia**, and **severe motor impairment**. - The patient's **normal motor functions** and ability to walk clearly rule out severe poisoning, which would present with profound neurological depression. *No evidence of alcohol consumption* - **Alcoholic smell** and **congested conjunctiva** are direct physical evidence contradicting this assessment. - Ignoring these **objective forensic signs** would constitute inappropriate clinical evaluation of alcohol-related conditions. *Alcohol consumption without intoxication* - This would mean alcohol intake with **zero physiological signs** - no conjunctival congestion, no behavioral changes, no physical manifestations. - The presence of **congested conjunctiva** indicates alcohol has already begun affecting the individual's physiology, moving beyond mere "consumption" into the **intoxication spectrum** as defined in forensic medicine texts. [Practice more Forensic Medicine PYQs on OnCourse]

Question 1

A girl from the village was found dead in the lake and was taken out. It is a case of ante mortem drowning. All are true about this case except?

Accepted Answer

Washerman hand and finger

Answer

Froth on nose and mouth

Answer

Cadaveric spasm in hand muscle

Answer

Water in the stomach

Answer

Diatoms test positive

Question 2

Black foot disease with peripheral neuropathy is seen in which metal poisoning?

Accepted Answer

Arsenic

Answer

Mercury

Answer

Lead

Answer

Cadmium

Question 3

A man presents with alcoholic smell and congested conjunctiva but normal motor functions (walking normally). What is the most appropriate assessment of his condition?

Accepted Answer

Alcohol intoxication

Answer

Severe alcohol poisoning

Answer

No evidence of alcohol consumption

Answer

Alcohol consumption without intoxication

INI-CET 2023 — Forensic Medicine