NEET-PG 2013 Practice Questions

Q: Organs first to be injured in air blast:

Ear, lung. ***Ear, lung*** - The **ear** and **lungs** are the first organs injured in an air blast due to their high air-tissue interfaces, making them extremely vulnerable to sudden pressure changes. - The **tympanic membrane** in the ear is very sensitive to barotrauma, and the **alveoli** in the lungs can rupture easily. *Pancreas, duodenum* - These organs are located deep within the abdomen and are primarily protected by other structures, making them less susceptible to direct **blast overpressure** injury. - Injuries to these organs are more typical of **secondary or tertiary blast injuries**, such as blunt trauma from impact or penetrating trauma from fragments. *Liver, muscle* - The **liver** is a solid organ that is relatively resistant to direct blast overpressure, though it can be damaged by crushing forces. - **Muscle tissue** is also dense and less vulnerable to direct air blast effects compared to air-filled organs. *Kidney, spleen* - Similar to the liver, the **kidneys** and **spleen** are solid, dense organs that are less susceptible to direct **primary blast injury**. - Injuries to these organs typically occur from **secondary or tertiary blast mechanisms**, like penetrating trauma or blunt force.

Q: Knockout drops are:

Chloral hydrate. ***Chloral hydrate*** - **Chloral hydrate** is a sedative-hypnotic substance historically used as "knockout drops" due to its quick action in inducing sleep or unconsciousness. - Its use has largely been replaced by safer alternatives due to its narrow therapeutic index and potential for respiratory depression and cardiac arrhythmias. *Kerosene* - **Kerosene** is a flammable hydrocarbon liquid primarily used as fuel or solvent, not as a sedative or hypnotic agent. - Ingestion of kerosene is highly toxic and can cause chemical pneumonitis and gastrointestinal irritation. *Paraldehyde* - **Paraldehyde** is an older sedative and hypnotic drug, but it is not typically referred to as "knockout drops." - It has a very pungent odor and taste, which would make surreptitious administration difficult, and is generally avoided in modern medical practice. *Turpentine* - **Turpentine** is a distillate of pine resin used as a solvent or cleaner, and historically as a liniment or anthelminthic. - It is highly toxic if ingested and can cause severe gastrointestinal distress, kidney damage, and central nervous system depression, but it is not a sedative-hypnotic.

Q: Barium carbonate poisoning causes -

Muscular weakness. ***Correct: Muscular weakness*** - **Soluble barium salts** (barium chloride, barium nitrate, barium sulfide) are highly toxic when ingested, releasing Ba²⁺ ions - Barium blocks **potassium channels** in cell membranes, causing **intracellular shift of potassium** leading to profound **hypokalemia** - This results in **flaccid paralysis** and severe **muscular weakness**, which is the **hallmark feature** of barium poisoning - Can progress to **paralysis of respiratory muscles**, making it life-threatening - **Note:** Barium carbonate itself is **insoluble** and relatively non-toxic; toxicity occurs when converted to soluble forms in stomach acid *Incorrect: Gastrointestinal irritation* - While mild GI symptoms (nausea, vomiting, diarrhea) may occur, they are **not the dominant feature** - The primary toxicity is **neuromuscular** rather than gastrointestinal - GI irritation, when present, is overshadowed by the dramatic muscular manifestations *Incorrect: Cyanosis* - Cyanosis is not a primary feature of barium poisoning - May occur **secondarily** if respiratory muscle paralysis is severe enough to cause hypoxemia - Not a characteristic or early sign *Incorrect: Respiratory distress* - Respiratory distress occurs due to **paralysis of respiratory muscles** from hypokalemia - This is a **complication** of the muscular weakness, not the primary manifestation - While serious and potentially fatal, it represents progression of the neuromuscular toxicity

Q: In sexual assault of a child, the hymen is usually not ruptured due to:

Deep seated. ***Deep seated*** - In prepubertal children, the hymen is **deep-seated within the vaginal orifice**, positioned well inside the vaginal opening - This anatomical location provides **natural protection** from external trauma - The deep position means that superficial contact may not reach the hymenal tissue - This is the **classical forensic medicine teaching** regarding preservation of hymen in child sexual assault cases *Incorrect: Distensible* - While the child's hymen is indeed elastic and distensible (which also contributes to non-rupture), this is not the primary reason cited in forensic literature - Distensibility is a secondary protective factor *Incorrect: Too tough to rupture* - The prepubertal hymen is **not particularly tough or thick** - In fact, it is relatively thin and delicate compared to post-pubertal hymen - Toughness is not the protective mechanism *Incorrect: Underdeveloped* - The hymen is present and developed in children, just positioned differently - "Underdeveloped" does not explain the protection from rupture - The issue is **anatomical position**, not developmental status

Q: Percentage of COHb that usually causes death:

> 80%. ***> 80%*** - While significant symptoms occur at lower levels, **COHb levels above 80%** typically cause profound central nervous system depression leading to **cardiac arrest and death**. - This level indicates almost complete displacement of oxygen from hemoglobin, leading to severe **tissue hypoxia**. *> 70%* - At **COHb levels above 70%**, individuals are often in a **coma**, experiencing severe **cardiac dysfunction** and respiratory failure. - Death is highly probable at this level, though it is not the universally accepted threshold for lethality as higher percentages are more definitive for causing death. *> 60%* - At **COHb levels above 60%**, patients typically experience **coma, convulsions**, and significant **cardiovascular compromise**. - While extremely dangerous and often fatal, **COHb levels above 80%** are more reliably associated with death. *> 50%* - At **COHb levels above 50%**, individuals often experience **coma, seizures**, and severe **metabolic acidosis**. - While critical and life-threatening, death is less common at this percentage compared to those above 70% or 80%, as aggressive medical intervention may still be effective.

Q: Plaintiff is a person who:

Files a case in civil court. ***Files a case in civil court*** - A **plaintiff** is the party who initiates a lawsuit (a civil case) before a court. - They are the party seeking **legal remedy** or damages from another party (the defendant). *Gives judgment* - The act of "giving judgment" is reserved for the **judge** or the **court**, not a plaintiff. - A judge presides over legal proceedings and **makes legal determinations**. *Acts as defender* - The party against whom a lawsuit is brought is called the **defendant**, not the plaintiff. - A defender's role is to **contest the claims** made by the plaintiff. *Same as public prosecutor* - A **public prosecutor** represents the state or government in criminal proceedings, initiating charges against individuals for alleged crimes. - A **plaintiff** initiates civil actions between private parties, seeking compensation or other civil remedies, not criminal conviction.

Q: In civil cases, conduct money is decided by:

Judge. ***Judge*** - In legal proceedings, the **Judge** holds the authority to determine and order the amount of **conduct money** to be paid. - **Conduct money** is an allowance paid to a witness for their reasonable travel expenses and loss of earnings incurred due to attending court. *Doctor* - A **doctor's** role is primarily focused on medical assessment and treatment, and they have no authority over legal financial matters like **conduct money**. - While a doctor might be a witness, they do not decide the compensation for their own or other witnesses' attendance. *Witness* - A **witness** is an individual who provides testimony or evidence in court and is typically the recipient of **conduct money**, not the decider. - They can submit claims for expenses, but the final decision on the amount rests with the court. *Lawyer* - A **lawyer** represents clients and can advise on legal matters, including the right to claim **conduct money**, but they do not make the final determination. - The lawyer's role is to advocate for their client's interests, which might include seeking an order for **conduct money** from the court.

Q: Acrodynia, or Pink disease, occurs in poisoning with which of the following substances?

Mercury. ***Mercury*** - **Acrodynia**, also known as **Pink disease**, is a rare and severe form of **mercury poisoning**, primarily affecting infants and young children. - Key symptoms include **pinkish-red rash** on the hands and feet, hypertension, irritability, profuse sweating, and muscle weakness. *Lead* - **Lead poisoning** typically presents with symptoms such as **abdominal pain**, constipation, developmental delay, and a **lead line on the gums**. - It does not cause the characteristic rash or other symptoms associated with acrodynia. *Thallium* - **Thallium poisoning** is known for causing **hair loss (alopecia)**, excruciating neuropathic pain, gastrointestinal disturbances, and neurological symptoms. - While it is a neurotoxic heavy metal, its clinical picture is distinct from acrodynia. *Arsenic* - **Arsenic poisoning** can manifest with dermatological signs like **hyperpigmentation** and **hyperkeratosis**, as well as gastrointestinal and neurological symptoms. - It does not produce the pinkish rash, irritability, or hypertension typical of acrodynia.

Q: Bansdola is a form of strangulation by?

Sticks. ***Sticks*** - **Bansdola** is a specific term referring to a method of **strangulation using sticks** (typically bamboo). - This technique involves placing sticks on either side of the neck and twisting them together to occlude the airway and blood vessels. - The term comes from "bans" meaning bamboo in Hindi/Urdu. *Bend of elbow* - Strangulation by the **bend of the elbow** is not typically referred to as Bansdola. - This method would be a form of **manual strangulation** using a specific body part to compress the neck. *Hands* - Strangulation by **hands** is known as **manual strangulation** or **throttling**. - This involves direct compression of the neck structures using the fingers and thumbs, distinct from the stick-based method of Bansdola. *Ligature* - **Ligature strangulation** involves using a cord, rope, or other flexible material to constrict the neck. - While both methods use implements, the rigid nature of sticks in Bansdola differentiates it from flexible ligature materials.

Q: Delirium tremens is most commonly seen in:

Alcohol withdrawal. ***Alcohol withdrawal*** - **Delirium tremens (DTs)** is the most severe form of **alcohol withdrawal syndrome**, characterized by **severe disorientation**, **agitation**, and **autonomic instability**. - It typically manifests 2-5 days after the cessation or significant reduction of alcohol intake in individuals with chronic alcohol dependence. *Opioid withdrawal* - Opioid withdrawal symptoms include **dysphoria**, **nausea**, **vomiting**, **diarrhea**, **muscle aches**, **lacrimation**, and **rhinorrhea**. - It does not typically involve the profound **delirium**, **hallucinations**, and **autonomic hyperactivity** seen in DTs. *Opioid intoxication* - Opioid intoxication presents with **central nervous system depression**, including **respiratory depression**, **miosis**, and **decreased level of consciousness**. - These symptoms are opposite to the hyperactive and agitated state characteristic of delirium tremens. *Alcohol intoxication* - Alcohol intoxication causes **central nervous system depression**, leading to **sedation**, **impaired coordination**, and **decreased judgment**. - This is a state of acute impairment from alcohol, not a withdrawal syndrome, and thus presents very differently from delirium tremens.

Question 1

Organs first to be injured in air blast:

Accepted Answer

Ear, lung

Answer

Pancreas, duodenum

Answer

Liver, muscle

Answer

Kidney, spleen

Question 2

Knockout drops are:

Accepted Answer

Chloral hydrate

Answer

Kerosene

Answer

Paraldehyde

Answer

Turpentine

Question 3

Barium carbonate poisoning causes -

Accepted Answer

Muscular weakness

Answer

Gastrointestinal irritation

Answer

Cyanosis

Answer

Respiratory distress

Question 4

In sexual assault of a child, the hymen is usually not ruptured due to:

Accepted Answer

Deep seated

Answer

Distensible

Answer

Too tough to rupture

Answer

Underdeveloped

Question 5

Percentage of COHb that usually causes death:

Accepted Answer

> 80%

Answer

> 70%

Answer

> 60%

Answer

> 50%

Question 6

Plaintiff is a person who:

Accepted Answer

Files a case in civil court

Answer

Gives judgment

Answer

Acts as defender

Answer

Same as public prosecutor

Question 7

In civil cases, conduct money is decided by:

Accepted Answer

Judge

Answer

Doctor

Answer

Witness

Answer

Lawyer

Question 8

Acrodynia, or Pink disease, occurs in poisoning with which of the following substances?

Accepted Answer

Mercury

Answer

Lead

Answer

Thallium

Answer

Arsenic

Question 9

Bansdola is a form of strangulation by?

Accepted Answer

Sticks

Answer

Bend of elbow

Answer

Hands

Answer

Ligature

Question 10

Delirium tremens is most commonly seen in:

Accepted Answer

Alcohol withdrawal

Answer

Opioid withdrawal

Answer

Opioid intoxication

Answer

Alcohol intoxication

NEET-PG 2013

Forensic Medicine

Psychiatry