NEET-PG 2017 Practice Questions

Q: The image shows:

Split laceration. ***Split laceration*** - **Split lacerations** result from **blunt force trauma** over a bony prominence, causing the skin to tear with irregular, jagged edges as seen in the image. - The wound shows typical features of tissue tearing rather than clean penetration, with **irregular margins** and evidence of stretching forces. *Stab wound* - **Stab wounds** are caused by **pointed objects** that penetrate cleanly, leaving relatively straight edges with minimal surrounding tissue damage. - The irregular, torn appearance in the image is inconsistent with the **clean, linear defect** typically seen in stab wounds. *Chop wound* - **Chop wounds** are produced by **heavy, sharp-edged instruments** like axes, combining features of incised wounds and lacerations with potential bone involvement. - This type would show a much **wider and deeper cut** with possible bone exposure, which is not evident in this case. *Crush laceration* - **Crush lacerations** occur from **compressive forces**, resulting in **stellate or irregular tears** with extensive soft tissue damage and surrounding bruising. - The wound lacks the **extensive tissue destruction**, **devitalized tissue**, and **significant bruising** characteristic of crush injuries.

Q: The image shows:

Crocodile burn. ***Crocodile burn*** - This image displays a characteristic pattern of **dehydrated skin** that has become **cracked and blackened**, resembling the scales of a crocodile, which is typical of a crocodile burn. - Crocodile burns are often associated with **high-voltage electrical injuries** where the skin is extensively damaged and denatured. *Joule burn* - A Joule burn typically refers to the **internal thermal damage** caused by an electric current flowing through tissues, which may not be immediately visible on the skin's surface in this distinct pattern. - While an electrical injury can cause surface burns, "Joule burn" specifically emphasizes the **heat generation within the body tissues**, not the external appearance shown. *Filigree burn* - A filigree burn, also known as a **Lichtenberg figure**, is a superficial, fern-like skin pattern caused by a **lightning strike**, which is distinct from the extensive, scaly appearance seen here. - These patterns are usually short-lived and represent the path of electrical discharge over the skin, without the widespread tissue destruction evident in the image. *Surface burn* - This is a very general term describing a burn that affects the skin's surface, but it lacks the **specificity** to describe the unique, severe, and distinct desiccation and cracking pattern shown. - The term "surface burn" could apply to many types of burns (e.g., superficial, partial thickness) and does not convey the **characteristic morphology** of a crocodile burn.

Q: The image shows:

Arborescent marks. ***Arborescent marks*** - These are **Lichtenberg figures**, a characteristic branching, fern-like pattern seen on the skin of individuals struck by lightning. - They are cutaneous manifestations of **blood vessel rupture and erythrocyte extravasation** caused by the electrical discharge. *Joule burn* - **Joule burn** is a term for thermal injuries caused by the heat generated from the resistance of tissue to the flow of electrical current, often seen at entry and exit points of an electrical injury. - Unlike arborescent marks, Joule burns present as localized, deep tissue damage, sometimes with charring or necrosis, and do not typically exhibit the branching pattern. *Surface burn* - **Surface burns** are general thermal injuries affecting the skin's outer layers, caused by contact with hot objects, flame, or scalding liquids - They appear as erythema, blistering, or skin loss but do not present with the specific **branching, fern-like pattern** characteristic of electrical injuries. *Crocodile burn* - **Crocodile burn** (or crocodile skin pattern) is a **recognized forensic term** referring to the characteristic splitting and fissuring of heat-exposed skin, resembling crocodile scales. - This pattern results from **heat-induced shrinkage and rupture of the dermis** in bodies exposed to intense fire, and is distinctly different from the branching electrical pattern of arborescent marks.

Q: The image shows:

Hesitation cuts. ***Hesitation cuts*** - The image displays multiple, superficial, parallel incised wounds, primarily on the wrist, which are classic characteristics of **hesitation cuts**. - These wounds are often made by individuals contemplating **suicide** and are typically not immediately life-threatening, reflecting a tentative or experimental attempt before a deeper, fatal cut. *Defense wounds* - **Defense wounds** typically appear on the hands, forearms, and sometimes the legs, resulting from an individual instinctively shielding themselves from an assault. - They tend to be more varied in depth and pattern, often showing signs of struggle and resistance, unlike the uniform, superficial nature seen here. *Radiation injury* - **Radiation injury** or radiation dermatitis presents with skin changes ranging from erythema, desquamation, blistering, or hyperpigmentation, depending on the dose and duration of exposure. - These injuries do not typically involve sharp, incised wounds like those depicted in the image. *Homicidal stab* - A **homicidal stab** implies a deep, forceful wound intended to cause death, often characterized by a single or few much deeper penetrating wounds. - The superficial and numerous nature of the cuts in the image is inconsistent with the typical presentation of a homicidal attack.

Q: A 25-year-old person was repairing the power plug of a geyser at home when he was electrocuted and died. The image shows:

Joule burn. ***Joule burn*** - This lesion is characteristic of an **electrical burn**, also known as a Joule burn or true electrical burn. The intense heat is generated by the passage of electrical current through body tissues (I²R heating), causing direct tissue destruction. - The appearance often includes a **central area of charring or necrosis** (dark, leathery, or blackened tissue) with a raised, crater-like edge, typically seen at entry and exit points of electrical current. *Spark lesion* - A spark lesion is typically a **smaller, superficial burn** caused by a momentary electrical arc or spark that jumps from conductor to skin without current passing through the body. - It usually presents as a **punctate or minor skin defect** with superficial charring and does not involve the extensive, deep tissue damage seen in Joule burns. *Crocodile skin* - "Crocodile skin" is a specific pattern seen in **high-voltage electrical injuries** where the epidermis separates and peels in a characteristic, polygonal pattern resembling crocodile hide. - This is a distinct manifestation of electrical injury, but the question describes a classic Joule burn with entry/exit point characteristics rather than this specific epidermal pattern. *Scald* - A scald is a burn caused by **hot liquid or steam**. - The appearance of scalds typically involves **blistering, redness, and peeling skin**, which is distinctly different from the charred, leathery appearance seen in electrical burns.

Q: The probable cause of death of the patient in the image shown is:

Hanging. ***Hanging*** - The image shows a **ligature mark that is oblique and incomplete**, extending upwards towards the **angle of the jaw or mastoid process** - This is **pathognomonic for hanging** where the knot/point of suspension creates upward pressure - The mark is typically **above the thyroid cartilage** and **higher on one side** (opposite to the knot) - **Key differentiating feature:** Oblique, upward-directed ligature mark with a gap at the knot site *Strangulation* - Ligature strangulation produces a **horizontal, complete ligature mark** that encircles the neck **at or below the thyroid cartilage** - The mark is typically **uniform in depth** and does not show the characteristic upward obliquity - Usually **homicidal**, whereas hanging is most commonly suicidal *Throttling* - A form of **manual strangulation** using hands to compress the neck - Produces **fingernail abrasions**, **finger pad bruises**, and **thumb marks** on the neck - **No ligature mark** is present; instead, there are multiple small contusions and scratch marks - Almost always **homicidal** *Gagging* - Involves **obstruction of the mouth and/or nose** to prevent breathing or vocalization - Does **not produce ligature marks on the neck** - May show injuries around the mouth, lips, or face, but the neck remains unmarked - The mechanism is airway obstruction, not neck compression

Q: The probable cause of death of the patient shown below is:

Hanging. **Hanging** - The image on the left displays a **ligature mark** on the neck that is *oblique* and *incomplete*, which are characteristic signs of judicial or suicidal hanging. The mark is also relatively dry and parchment-like, fitting with a postmortem finding from suspension. - The second image, showing extensive **tissue disruption and hemorrhage** in the neck, is consistent with injuries sustained in a hanging, particularly if the fall from a height causes significant cervical spine and associated soft tissue trauma. *Strangulation* - Strangulation typically presents with a more **horizontal and complete ligature mark** around the neck. - It often shows signs of **external neck compression**, such as petechial hemorrhages above the ligature site, which are not clearly visible or exclusive to this image. *Throttling* - Throttling involves manual compression of the neck by human hands, leading to **finger marks or bruising** on the neck. - It does not typically produce a distinct, continuous ligature mark like the one seen in the first image. *Gagging* - Gagging involves covering the mouth to prevent vocalization or breathing and would cause signs of **asphyxia** localized to the mouth and nose area, not the neck. - There would be no ligature mark or direct neck trauma from gagging itself.

Q: Identify the seeds shown below that produce artificial bruises with their juice? (Recent NEET Pattern 2016-17)

Semecarpus anacardium. ***Semecarpus anacardium*** - The juice of *Semecarpus anacardium* (also known as **marking nut** or **bhilawa**) contains **bhilawanol**, a vesicant oil that causes severe **blistering and inflammation** on contact with skin. - This irritant effect leads to dark, reddish-brown stains that can mimic **contusions or bruises**, hence its use in creating "artificial bruises" for forensic purposes or in cases of simulated injury. *Nux vomica* - *Nux vomica* seeds contain **strychnine** and **brucine**, potent neurotoxins that primarily affect the central nervous system, leading to **convulsions and muscle spasms**. - Its effects are systemic and neurological, and it does not produce localized skin reactions resembling bruises. *Calotropis* - *Calotropis* plants, such as *Calotropis gigantea* (giant milkweed), contain **cardiac glycosides** that are highly toxic if ingested. - While contact with the latex can cause skin irritation, it typically presents as **redness and stinging** rather than dark, bruise-like lesions. *Ricinus communis* - *Ricinus communis* (castor bean) seeds contain **ricin**, a highly potent **protein toxin** that inhibits protein synthesis in cells and can be fatal if ingested or inhaled. - Although the plant can cause allergic reactions on contact, its primary toxic effect is systemic and it does not produce artificial bruises.

Q: Which anti-epileptic drug marked X will act at the site shown?

Tiagabine. ***Tiagabine*** - The image shows the reuptake of **GABA** from the synaptic cleft, and "X" points to this reuptake mechanism. Tiagabine is an anti-epileptic drug that acts by **inhibiting GABA reuptake**. - By inhibiting GABA reuptake, tiagabine increases the concentration of **GABA** in the synapse, enhancing its inhibitory effects and reducing neuronal excitability. *Valproate* - Valproate has multiple mechanisms of action, including inhibiting **GABA transaminase** (GABA-T) which leads to increased GABA levels, but it does not directly act on GABA reuptake. - It also blocks voltage-gated **sodium channels** and T-type calcium channels. *Gabapentin* - Gabapentin is an analogue of GABA but does not act directly on GABA receptors or GABA reuptake. - Its mechanism of action is primarily by binding to the **α2δ subunit of voltage-gated calcium channels**, reducing calcium influx and neurotransmitter release. *Vigabatrin* - Vigabatrin primarily works by irreversibly inhibiting **GABA transaminase (GABA-T)**, the enzyme responsible for the breakdown of GABA. - This leads to a persistent increase in **GABA** levels in the brain, thereby enhancing inhibitory neurotransmission.

Q: Which anti-epileptic drug marked X will act at the site shown?

Tiagabine. ***Tiagabine*** - The image shows site 'X' as a **GABA reuptake transporter** that actively removes GABA from the synaptic cleft back into the presynaptic neuron or glial cells - **Tiagabine** specifically inhibits **GABA reuptake transporters (GAT-1)**, thereby increasing GABA concentration in the synaptic cleft and enhancing its inhibitory effect - This is the mechanism directly targeting the site shown in the diagram *Vigabatrin* - Irreversible inhibitor of **GABA transaminase (GABA-T)**, the enzyme responsible for catabolizing GABA - Acts intracellularly to prevent GABA breakdown, not at the synaptic reuptake transporter shown - Different mechanism from the site depicted *Gabapentin* - GABA analog but does not bind to GABA receptors or interfere with GABA reuptake - Primary mechanism involves modulating **voltage-gated calcium channels (α2δ subunit)**, reducing excitatory neurotransmitter release - Does not act at GABA transporters *Rufinamide* - Prolongs the inactive state of **voltage-dependent sodium channels**, reducing neuronal excitability - Mechanism is distinct from GABA reuptake or metabolism - Does not act at the site shown in the diagram

Question 1

The image shows:

Accepted Answer

Split laceration

Answer

Chop wound

Answer

Crush laceration

Answer

Stab wound

Question 2

The image shows:

Accepted Answer

Crocodile burn

Answer

Joule burn

Answer

Filigree burn

Answer

Surface burn

Question 3

The image shows:

Accepted Answer

Arborescent marks

Answer

Joule burn

Answer

Surface burn

Answer

Crocodile burn

Question 4

The image shows:

Accepted Answer

Hesitation cuts

Answer

Defense wounds

Answer

Radiation injury

Answer

Homicidal stab

Question 5

A 25-year-old person was repairing the power plug of a geyser at home when he was electrocuted and died. The image shows:

Accepted Answer

Joule burn

Answer

Spark lesion

Answer

Crocodile skin

Answer

Scald

Question 6

The probable cause of death of the patient in the image shown is:

Accepted Answer

Hanging

Answer

Strangulation

Answer

Throttling

Answer

Gagging

Question 7

The probable cause of death of the patient shown below is:

Accepted Answer

Hanging

Answer

Strangulation

Answer

Throttling

Answer

Gagging

Question 8

Identify the seeds shown below that produce artificial bruises with their juice? (Recent NEET Pattern 2016-17)

Accepted Answer

Semecarpus anacardium

Answer

Nux vomica

Answer

Calotropis

Answer

Ricinus communis

Question 9

Which anti-epileptic drug marked X will act at the site shown?

Accepted Answer

Tiagabine

Answer

Vigabatrin

Answer

Valproate

Answer

Gabapentin

Question 10

Which anti-epileptic drug marked X will act at the site shown?

Accepted Answer

Tiagabine

Answer

Vigabatrin

Answer

Gabapentin

Answer

Rufinamide

NEET-PG 2017

Forensic Medicine

Pharmacology