NEET-PG 2013 Practice Questions

Q: Marshall's triad is seen in:

Explosive injury. ***Explosive injury*** - Marshall's triad components, including **blast lung**, **abdominal hemorrhage**, and **tympanic membrane rupture**, are characteristic injuries of explosions, especially those involving pressure waves. - The triad highlights distinct patterns of organ damage caused by the high-energy transfer from blast forces. *Lightning injury* - Lightning injuries can cause diverse effects like **cardiac arrest**, **neurological damage**, and **burns**, but they do not typically present as Marshall's triad. - The primary mechanism is electrical, leading to distinct injury patterns different from blast trauma. *Gunshot injury* - Gunshot wounds create localized tissue damage along the projectile's path and a temporary cavity, but they do not cause generalized blast effects or the specific triad of Marshall. - The injury severity depends on the **caliber**, **velocity**, and **trajectory** of the bullet. *Drowning injury* - Drowning is characterized by **respiratory impairment** resulting from submersion or immersion in liquid, leading to **hypoxia** and multi-organ failure. - Its pathophysiology and presentation are entirely distinct from explosive trauma.

Q: Which of the following snakes is most commonly associated with hematologic abnormalities following envenomation?

Viper. ***Correct Answer: Viper*** - **Viper venom** contains **hemotoxic components** including **metalloproteinases** and **serine proteinases** that directly activate clotting factors - This leads to **consumptive coagulopathy** characterized by **thrombocytopenia**, **hypofibrinogenemia**, and prolonged coagulation times - Clinical manifestations include spontaneous **bleeding**, **ecchymoses**, **hemorrhage** at the bite site, and in severe cases, **disseminated intravascular coagulation (DIC)** - Viper envenomation is the **classic cause** of hematologic abnormalities among snake bites *Incorrect: Sea snake* - Sea snake venoms are primarily **neurotoxic** and **myotoxic**, causing paralysis and muscle damage - While they can cause **rhabdomyolysis** and subsequent **renal failure**, significant primary hematologic abnormalities are not their hallmark feature *Incorrect: Krait* - Krait venom is predominantly **neurotoxic**, leading to **flaccid paralysis** and **respiratory failure** - Does not typically cause the significant widespread **coagulopathies** seen with viper envenomation *Incorrect: Cobra* - Cobra venom primarily contains **neurotoxins** and **cytotoxins**, causing **paralysis**, **tissue necrosis**, and localized pain - While some cobras can cause minor local bleeding, they do not generally induce the severe and systemic **hematologic abnormalities** characteristic of viper bites

Q: Which of the following is used in the second-line management of strychnine poisoning?

Barbiturates. ***Barbiturates*** - As a **second-line treatment**, barbiturates like phenobarbital are used to control **refractory seizures** and muscle spasms in strychnine poisoning when benzodiazepines are insufficient. - They enhance the effect of **GABA**, leading to central nervous system depression and muscle relaxation. *Physostigmine* - This is an **acetylcholinesterase inhibitor** and is primarily used to reverse the anticholinergic effects of certain poisonings, not strychnine. - It would worsen seizures by increasing **acetylcholine**, which can cause tremors and convulsions. *Naloxone* - Naloxone is an **opioid antagonist** used to reverse opioid overdose, which presents with respiratory depression and pinpoint pupils. - It has no role in treating strychnine poisoning, which primarily causes **muscle spasms** and seizures. *Diazepam* - Diazepam, a **benzodiazepine**, is the **first-line treatment** for seizures and muscle spasms in strychnine poisoning. - It works by enhancing the effects of **GABA** at the GABA-A receptor, thereby reducing neuronal excitability.

Q: Contributory negligence is negligence due to:

Patient only. ***Patient only*** - **Contributory negligence** specifically refers to negligence on the part of the **plaintiff** (the patient) that contributed to their own injury. - This doctrine can reduce or bar recovery for damages if the patient's own actions played a role in causing the harm. *Doctor only* - This describes **medical malpractice**, where the healthcare provider's negligence directly causes harm to the patient. - While a doctor's negligence is a primary concern in healthcare, it doesn't align with the legal concept of *contributory* negligence, which attributes fault to the injured party. *Both doctor and patient* - This scenario relates to **comparative negligence**, a legal doctrine where fault is apportioned between multiple parties (e.g., doctor and patient). - Contributory negligence, in its strict form, implies the patient's negligence alone contributed significantly enough to preclude full recovery, rather than shared fault. *Hospital administrator and doctor* - This refers to negligence stemming from actions of the hospital administration (e.g., systemic failures, inadequate resources) and individual medical errors by the doctor. - While both can be liable for negligence, this does not represent the patient's own contribution to their injury, which is the core of contributory negligence.

Q: Stellate wound is produced with firearm in:

Contact shot. ***Contact shot*** - In a **contact shot**, gases and matter from the gun barrel are forced directly into the wound, causing the skin to stretch, tear, and burst outward, creating a **stellate or star-shaped wound**. - The hot gases and unburnt powder entering the wound create an exit for themselves, often leading to these characteristic irregular, radiating tears. *Close shot* - A close shot involves the skin being close to the muzzle but not directly touching, leading to a circular or oval wound with a surrounding area of **singeing**, **soot deposition**, and **powder tattooing**. - While there is gas effect, it's not as confined or forceful behind the skin as in a contact shot, thus not typically producing a stellate wound. *Distant shot* - A distant shot occurs when the muzzle is far enough from the target surface that only the **bullet strikes the skin**, leaving a relatively clean, circular or oval entry wound without significant singeing or tattooing. - The effects of gas and unburnt powder are not present at the wound site in a distant shot. *Range within 60 cm* - While a range within 60 cm (approximately 2 feet) can encompass close shots, it's a broad category and doesn't specifically define the conditions necessary for a stellate wound. - A stellate wound requires conditions more specific to a contact shot, where the muzzle is pressed against the skin.

Q: Acts both as poison and antidote:

Copper sulfate. ***Copper sulfate*** - **Copper sulfate** acts both as a **poison and antidote**, demonstrating dual properties. - In **large doses**, it is toxic, causing **gastrointestinal distress**, **hepatotoxicity**, **nephrotoxicity**, and potentially death. - Historically, it was used in **small controlled doses as an emetic** (to induce vomiting) in cases of poisoning, acting as an antidote by expelling ingested toxins. - **Note**: Its use as an emetic is now **outdated** due to safety concerns, but it remains the classic example of a substance with both toxic and therapeutic properties. *Mercuric chloride* - **Mercuric chloride** is a highly toxic compound acting primarily as a **corrosive poison**, causing severe damage to the **gastrointestinal tract** and kidneys. - It does not possess any antidote properties and requires aggressive **chelation therapy** for treatment. *Silver chloride* - **Silver chloride** is of **low toxicity** due to its insolubility in water and biological fluids. - While chronic exposure can cause **argyria** (bluish skin discoloration), it has no antidote properties. *Thallium arsenate* - **Thallium arsenate** contains two highly toxic elements (**thallium** and **arsenic**), both potent poisons affecting multiple organ systems. - Used in **pesticides** and **rodenticides** due to its toxicity, it has no beneficial or antidote properties.

Q: For DNA test, liquid blood is preserved in:

EDTA. ***EDTA*** - Ethylenediaminetetraacetic acid (EDTA) is the preferred anticoagulant for DNA extraction because it **chelates metal ions** (like magnesium), which are cofactors for **DNases** (enzymes that degrade DNA). - By inhibiting DNases, EDTA effectively **preserves DNA integrity** in blood samples for genetic testing. *Sodium fluoride* - **Sodium fluoride** is primarily used as an antiglycolytic agent to preserve glucose in blood samples. - It does not specifically function to preserve DNA or inhibit DNA degradation significantly. *Potassium oxalate* - **Potassium oxalate** acts as an anticoagulant by precipitating calcium, but it is not optimal for long-term DNA preservation. - Its anticoagulant properties are less suitable for molecular testing compared to EDTA, and it doesn't protect DNA as effectively. *Sodium citrate* - **Sodium citrate** is an anticoagulant primarily used for coagulation studies (e.g., PT, PTT) by chelating calcium. - While it prevents clotting, it is **less effective than EDTA** in protecting DNA from degradation by DNases, making it a poorer choice for DNA banking.

Q: Hydrostatic test (Reygate's test) for lungs is based on:

Specific gravity of lung. ***Specific gravity of lung*** - The hydrostatic test (also known as **Reygate's test** or **flotation test**) is a forensic test used to determine if a lung has ever respired, based on its **buoyancy in water**. - This buoyancy is directly related to the lung's **specific gravity**, which changes significantly depending on whether it contains air. - Aerated lungs (which have breathed) have a specific gravity less than 1 and will **float**, while non-aerated lungs have a specific gravity greater than 1 and will **sink**. *Consistency of lung* - While lung consistency can vary based on pathology, it is not the primary principle underlying the hydrostatic test. - The test specifically exploits changes in **density**, not just feel or firmness. *Volume of lungs* - Lung volume is a factor influencing buoyancy, but it's the **ratio of mass to volume** (density/specific gravity) that determines if the lung floats. - A larger lung may still sink if it is collapsed and airless, demonstrating that volume alone is not the sole basis. *Weight of lung* - The weight of the lung is important in determining its overall mass, but the hydrostatic test relies on the **weight relative to its volume** (i.e., specific gravity). - A heavy lung can still float if it contains sufficient air to lower its specific gravity below that of water.

Q: CAGE questionnaire is used in:

Alcohol dependence. ***Alcohol dependence*** - The **CAGE questionnaire** is a widely used screening tool for identifying potential **alcohol problems** and dependence. - The acronym CAGE stands for Cutting down, Annoyance by criticism, Guilty feelings, and Eye-openers, all related to drinking habits. *Opiate poisoning* - Screening for opiate use or poisoning typically involves asking about **drug use history**, conducting **urine drug screens**, and observing specific clinical signs like **pinpoint pupils** and **respiratory depression**. - The CAGE questionnaire is not designed to screen for opiate use. *Dhatura poisoning* - **Dhatura poisoning** is characterized by anticholinergic symptoms like **dilated pupils**, **dry mouth**, **tachycardia**, and **delirium**. - Diagnosis relies on clinical presentation and a history of exposure, not a specific questionnaire like CAGE. *Barbiturate poisoning* - **Barbiturate poisoning** presents with central nervous system depression, including **sedation**, **respiratory depression**, and **hypotension**. - Diagnosis involves a clinical assessment, history of barbiturate use, and toxicology screens, not the CAGE questionnaire.

Q: What term describes the practice of wearing clothes of the opposite sex?

Transvestism. ***Transvestism*** - **Transvestism** (also known as transvestic fetishism in DSM-IV-TR/ICD-10) is the term that describes the practice of dressing in clothes typically associated with the opposite sex. - This involves **cross-dressing** for personal pleasure, comfort, or sexual arousal, without necessarily implying a desire to permanently change one's sex. - **Note:** Modern classifications (DSM-5-TR/ICD-11) now use "transvestic disorder" only when the behavior causes marked distress or impairment, distinguishing pathological behavior from non-clinical cross-dressing. *Masochism* - **Masochism** refers to deriving sexual gratification from experiencing pain, humiliation, or submission. - This is a distinct paraphilic pattern and does not involve wearing clothes of the opposite sex. *Sadism* - **Sadism** involves deriving sexual gratification from inflicting pain, humiliation, or suffering on others. - This is unrelated to cross-dressing behavior. *Fetishism* - **Fetishism** involves sexual arousal from inanimate objects or non-genital body parts (e.g., shoes, feet, leather items). - While it can involve clothing items, it does not specifically refer to wearing clothes of the opposite sex as a complete ensemble, which defines transvestism.

Question 1

Marshall's triad is seen in:

Accepted Answer

Explosive injury

Answer

Lightning injury

Answer

Gunshot injury

Answer

Drowning injury

Question 2

Which of the following snakes is most commonly associated with hematologic abnormalities following envenomation?

Accepted Answer

Viper

Answer

Sea snake

Answer

Krait

Answer

Cobra

Question 3

Which of the following is used in the second-line management of strychnine poisoning?

Accepted Answer

Barbiturates

Answer

Physostigmine

Answer

Naloxone

Answer

Diazepam

Question 4

Contributory negligence is negligence due to:

Accepted Answer

Patient only

Answer

Doctor only

Answer

Both doctor and patient

Answer

Hospital administrator and doctor

Question 5

Stellate wound is produced with firearm in:

Accepted Answer

Contact shot

Answer

Close shot

Answer

Distant shot

Answer

Range within 60 cm

Question 6

Acts both as poison and antidote:

Accepted Answer

Copper sulfate

Answer

Mercuric chloride

Answer

Silver chloride

Answer

Thallium arsenate

Question 7

For DNA test, liquid blood is preserved in:

Accepted Answer

EDTA

Answer

Sodium fluoride

Answer

Potassium oxalate

Answer

Sodium citrate

Question 8

Hydrostatic test (Reygate's test) for lungs is based on:

Accepted Answer

Specific gravity of lung

Answer

Consistency of lung

Answer

Volume of lungs

Answer

Weight of lung

Question 9

CAGE questionnaire is used in:

Accepted Answer

Alcohol dependence

Answer

Opiate poisoning

Answer

Dhatura poisoning

Answer

Barbiturate poisoning

Question 10

What term describes the practice of wearing clothes of the opposite sex?

Accepted Answer

Transvestism

Answer

Masochism

Answer

Sadism

Answer

Fetishism

NEET-PG 2013

Forensic Medicine

Psychiatry