Last 5 Year PYQs in Forensic Medicine for INI-CET

Q1. Please rearrange the following options to reflect the correct sequence of symptoms observed in cases of iron toxicity.

1. Healing with scaring
2. Latent phase
3. Gastrointestinal Irritation
4. Liver failure and hypoglycemia

1. 2, 3, 1, 4
2. 2, 3, 4, 1
3. 3, 2, 4, 1
4. 3, 4, 1, 2

Ans. 3) 3, 2, 4, 1

• (3) Gastrointestinal Irritation: As iron toxicity progresses, it can cause damage to the lining of the gastrointestinal tract and irritation. This can lead to gastrointestinal bleeding, which is characterized by the presence of blood in the vomit or stool. Gastrointestinal bleeding is a serious complication of iron toxicity and requires immediate medical attention.
• (2) Latent phase: The initial phase of iron toxicity after GI irritation may often be asymptomatic, meaning that there are no noticeable symptoms. During this phase, the individual may not experience any immediate effects or manifestations of iron toxicity. However, it is important to note that this phase can be transient, and symptoms can develop as the toxicity progresses.
• (4) Liver failure and hypoglycemia: In severe cases of iron toxicity, especially when a large amount of iron has been ingested, it can lead to liver failure and hypoglycemia. Iron overload can cause significant damage to the liver, impairing its normal function. This can result in liver failure, which is a life-threatening condition. Additionally, iron toxicity can also cause hypoglycemia, a condition characterized by low blood sugar levels.
• (1) Healing with scaring: In the context of iron toxicity, pyloric stricture occurs as a late-stage complication. It is typically seen after significant ingestion of iron, usually in the form of iron tablets or supplements. Pyloric stricture can cause symptoms such as vomiting, abdominal pain, and difficulty in food passage.
• Therefore, the correct order of symptomatology seen in iron toxicity is 3 (gastrointestinal irritation), 2 (latent phase), 4 (liver failure and hypoglycemia), and 1 (healing with scaring).

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Q2. A 24-year-old man who was accused of murder was taken into police custody. As a part of the interrogation, the prisoner was kept in a prone position with both his wrists and ankles bound behind his back and secured with a rope. What is this method known as ?

1. Choke/ Carotid hold
2. Carotid steeper hold
3. Hog tie
4. Bar arm

​Ans. 4) Hog tie

• A hog tie is a method of restraining an individual by binding their wrists and ankles together behind their back, typically using ropes or other restraints.
• This position renders the person immobilized and limits their ability to move or escape. It is commonly used in law enforcement or security situations to prevent individuals from fleeing or posing a threat.

Q3. Match the following with the respective ages of fusion :

Bone/Structure	Age of Fusion
1. Medial end of clavicle	A. 21-25 years
2. Sacrum as a single bone	B. 2-50 years
3. Crista scapulae	C. 50-70 years
4. Lambdoid suture	D. 20-25 years

1. 1-A, 2-B, 3-C, 4-D
2. 1-A, 2-D, 3-B, 4-C
3. 4-A, 3-B, 1-C, 2-D
4. 1-A, 4-B, 3-C, 2-D

Ans. 2) 1-A, 2-D, 3-B, 4-C

• (1) Medial end of clavicle: The correct match is option A: 21–25 years.
• The medial end of the clavicle refers to the innermost portion of the collarbone. The fusion of the medial end of the clavicle with the shaft of the clavicle typically occurs around the ages of 21–25 years. This fusion marks the completion of growth and development of the clavicle.
• (2) Sacrum as a single bone: The correct match is option D: 20-25 years.
• The sacrum is a large triangular bone at the base of the spine, composed of fused vertebrae. The fusion of the sacrum, where individual segments of the sacral vertebrae become a single bone, generally occurs between the ages of 20 and 25 years. This fusion contributes to the stability of the pelvic region.
• (3) Crista scapulae: The correct match is option B: 50 years.
• The crista scapulae refers to a bony ridge present on the scapula, also known as the shoulder blade. The fusion of the crista scapulae typically occurs around the age of 50 years. This fusion is a normal age-related change and does not have any significant functional implications.
• (4) Lambdoid suture: The correct match is option C -  50 - 70 years.
• The lambdoid suture is a fibrous joint that connects the parietal bones and the occipital bone in the skull. The upper part of the lambdoid suture fuses at 50–60 years of age and the lower part fuses at 60–70 years of age.

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Q4. Rearrange the following to correspond with alterations in fingerprints.:

Symptom	Condition
1. Incomplete atrophy of ridges	A. Radiation
2. Less of pattern with ridge atrophy	B. Scleroderma
3. Altered ridges	C. Celiac disease
4. Permanent loss of fingerprints	D. Acromegaly
5. Distance between ridges changed but pattern retained	E. Dermatitis

1. 1-E, 2-C, 3-B, 4-A, 5-D
2. 1-D, 2-B, 3-C, 4-E, 5-A
3. 1-C, 2-A, 3-D, 4-B, 5-E
4. 1-D, 2-C, 3-A, 4-E, 5-B

Ans. 1) 1-E, 2-C, 3-B, 4-A, 5-D

• (1) Incomplete atrophy of ridges: This characteristic is matched with dermatitis (option e).
  • Dermatitis refers to inflammation of the skin, which can cause changes in the fingerprint patterns. In cases of dermatitis, there may be incomplete atrophy or flattening of the ridges, leading to altered fingerprint patterns.
• (2) Less pattern with ridge atrophy: This characteristic is matched with celiac disease (option 3).
  • Celiac disease is an autoimmune disorder that affects the small intestine when gluten is ingested.
  • In individuals with celiac disease, ridge atrophy can occur, leading to a decrease in the pattern visibility or clarity of fingerprints.
• (3) Altered ridges: This characteristic is matched with scleroderma (option 2).
  • Scleroderma is a chronic autoimmune disease that affects the connective tissues, including the skin. In cases of scleroderma, the skin can become thickened and hardened, leading to alterations in the ridge patterns of fingerprints.
• (4) Permanent loss of fingerprints: This characteristic is matched with radiation (option 1).
  • Radiation therapy, particularly in high doses, can cause damage to the skin and underlying tissues. In some cases, this can lead to permanent loss or disappearance of the fingerprint patterns.
• (5) Distance between ridges changed but pattern retained:
  • This characteristic is matched with acromegaly (option 4).
  • Acromegaly is a hormonal disorder that occurs due to the excessive production of growth hormone in adulthood.
  • In individuals with acromegaly, the bones and tissues can enlarge, including the hands and fingers. This growth can lead to changes in the distance between ridges, but the overall pattern of the fingerprints remains intact.​

Q5. ​A patient came to the casualty after a road traffic accident. A lacerated wound of 4x1 cm, which is bone – deep, is noted over the scalp of the forehead. Which of the following is the correct mechanism of this lacerated wound?

1. Shearing force
2. Impact of a semi sharp-edged object
3. Overstretching of skin and subcutaneous tissue
4. Tissue crushed between weapon and underlying bone

Ans. 4) Tissue crushed between weapon and underlying bone

• Lacerated wounds are caused by blunt force trauma that results in a tear or cut in the skin and underlying tissues. In this particular case, the wound is described as being "bone-deep," which indicates that the injury extends to the underlying bone.
• Tissue crushed between weapon and underlying bone: This option correctly describes the mechanism of the lacerated wound. When tissue is crushed between a weapon or object and the underlying bone, it can result in a deep laceration that involves both the skin and the underlying tissues, reaching the bone

Q6. During intrauterine life, at how many weeks does the development of fingerprints first occur?

1. 12-16
2. 20-24
3. 28-32
4. 32-36

Ans. 1) 12-16

• Fingerprint development is a fascinating process that begins in the womb. In humans, the formation of unique fingerprints begins around the 12th to 16th week of intrauterine life. During this period, the volar pads (the raised areas destined to become the tips of the fingers and thumbs) start to form. These pads influence the pattern of the ridges in our fingerprints. The ridges then begin to develop on the skin of these pads, and by about the 16th week, the basic patterns of the fingerprint are formed.

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Q7. Identify the given plant.:

1. Datura Alba
2. Argemone Mexicana
3. Nerium Odorum
4. Papaver Somniferum

Ans. 2) Argemone Mexicana

• They're large and showy, with six bright yellow petals arranged around a central capsule. Keep in mind though, the petals sometimes have a slightly crumpled look, which gives the flowers a bit of an interesting flair. Then there's the seed pod, which is another key identifier. Once the flowers have bloomed and fallen off, you'll find seed capsules, which are prickly, oblong, and start off green but turn a dark brown or black as they mature. The foliage of the Argemone mexiana is blue-green in color, lobed, spiky, and has a somewhat thistle-like appearance. It has a prickly feel because of the presence of spines or bristles, which is a distinct characteristic of the plant. The plant as a whole has a very upright growth habit.

​Q8. Post-mortem examination of a patient reveals the following:. What is this finding known as?

1. Hesitation cuts
2. Grazed abrasion
3. Laceration
4. Patterned bruise

Ans. 1) Hesitation cuts

• Hesitation cuts refer to superficial wounds, often found on the wrists or forearms, that are thought to be self-inflicted as part of a suicide attempt. These wounds are usually not immediately life-threatening, being relatively shallow in nature. This contrasts with more decisive, deeper cuts that may pose a greater immediate danger due to more severe blood loss.
• Features of hesitational cuts:
  • Multiple cuts
  • Superficial, linear/parallel cuts
  • Seen in accessible parts of the body [Forearm, neck, thigh, abdomen etc]
  • Suggestive of suicidal tendency

Q9. ​What is the preferred treatment for acute arsenic poisoning?

1. Ipecac
2. Penicillamine
3. Activated charcoal
4. Dimercaprol

Ans. 4) Dimercaprol

• In treating acute arsenic poisoning, the primary choice is D. dimercaprol.
• Dimercaprol, also known as British Anti-Lewisite (BAL), is an agent used in chelation therapy, a medical procedure that involves the administration of chelating agents to remove heavy metals from the body. Dimercaprol forms stable, non-toxic complexes with arsenic, which are then excreted from the body, making this the preferred treatment for acute arsenic poisoning.

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Q10. Which of these is not a cardiac poison?

1. Aconite
2. Cerbera thevetia
3. Nicotiana tabacum
4. Atropa belladonna

Ans. 4) Atropa belladonna

• The deadly nightshade plant, Atropa belladonna, is poisonous. Atropine, hyocyamine, and scopolamine are alkaloids found in their roots, leaves, and fruits. The alkaloids present are called tropane alkaloids, often known as belladonna alkaloids. The anticholinergic syndrome may result from Atropa belladonna poisoning. High doses of the plant may result in drowsiness and unconsciousness. Belladonna contains compounds that can affect the nervous system's operation as well as the production of saliva, sweat, changes in pupil size, urine, and other bodily functions. Additionally, belladonna might raise blood pressure and pulse rate but is not considered a cardiac poison that can affect cardiac function.​

Q11. What is this finding suggestive of:​

1. Drowning after Organophosphate poisoning
2. Antemortem drowning
3. Drowning after Arsenic poisoning
4. None of the above

Ans. 2) Antemortem drowning

• Violent respiratory struggle causes a churning effect, which mixes mucus + surfactant + water + air & results in the production of froth.
• In post-mortem drowning, as this violent respiratory struggle is missing, froth can't be seen.
• Thus, it is a sign of Antemortem drowning.

Q12. A girl was found deceased in a lake and her body was retrieved. Which of the following is false regarding ante mortem drowning?

1. Water in the stomach
2. Froth on nose and mouth
3. No Mud and vegetation in respiratory tract
4. Cadaveric spasm in hand muscle

Ans. 3) No mud and vegetation in the respiratory tract

• This statement is false, as in the case of antemortem drowning, there is fine froth in the respiratory tract along with mud, sand, and vegetation.
• There is no mud or vegetation in the case of post-mortem drowning.

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Q13. Which of the following is correct regarding sample collection in the case of alcohol intoxication?

1. Sample area cleaned with spirit
2. Sample area cleaned with soap and water
3. Samples should be preserved without preservatives.
4. Only one urine sample is required

Ans. 2) Sample area cleaned with soap and water

• The sample area should be cleaned with soap and water instead of spirits or any other substance that might contain alcohol.
• Also, 1:1000 mercuric chloride can be used to clean the area from where the sample is to be collected.

Blood sample collection in Alcohol intoxication

• The sample area should be cleaned with soap and water. 1:1000 mercuric chloride can be used to clean the area from where the sample is to be collected.
• Spirits or any other substance that might contain alcohol should be avoided, as it might affect lab values.
• 100 mg NaF and 30 mg potassium oxalate for 10 ml of blood followed by thorough shaking is used for sample preservation.
• Test name: Kozelka and Hine's test
• Principle: Alcohol-containing test substance reduces potassium dichromate solution

​​Q14. Identify the following image:​

1. Hinderers line
2. Langers lines
3. Blaschko lines
4. Dermatomes

Ans. 2) Langers lines

• Langer's lines, also known as tension lines or cleavage lines, refer to the natural orientation of collagen fibers in the skin.
• Langer's lines correspond to the alignment of collagen fibers in the dermis, which is the second layer of the skin.
• They indicate the direction of the least skin tension and the alignment of the skin's elastic fibers, as shown in the image in the question.
• Thus, making skin incisions parallel to the lines of Langer reduces the wound tension.

Q15. ​Black foot disease with peripheral neuropathy is seen in which metal poisoning?

1. Arsenic
2. Lead
3. Mercury
4. Cadmium

Ans. 1) Arsenic

• Blackfoot disease, also known as Blackfoot or arsenicosis, is a condition associated with chronic arsenic poisoning.
• It is a severe form of peripheral vascular disease in which blood vessels of the lower limb are severely damaged, eventually resulting in gangrene.
• Prolonged exposure to high levels of arsenic, typically through contaminated drinking water or food, can lead to peripheral neuropathy and other health issues.

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Q16. A female was given morphine sulfate during labor for pain following which she developed respiratory distress. Which of the following will be the correct antidote?

1. Naloxone
2. Atropine
3. Pralidoxime
4. Epinephrine

Ans. 1) Naloxone

• Naloxone is an opioid receptor antagonist that rapidly reverses the effects of opioids, including respiratory depression. It competes with opioids for binding to opioid receptors, displacing them and reversing the respiratory depression.
• Morphine sulfate is an opioid analgesic that can cause respiratory depression as a side effect. If a patient develops respiratory distress or respiratory depression due to opioid overdose, naloxone is the appropriate antidote

Q17. Identify the option that does not correspond to a grievous hurt according to Section 320 of the Indian Penal Code (IPC).

1. Emasculation
2. Fracture of femur
3. Permanent privation of hearing
4. 7 days hospital admission

Ans. 4) 7 days hospital admission

• According to Section 320 of the Indian Penal Code (IPC), a mere hospitalization for 20 or more days isn't considered grievous hurt unless a person is unable to follow his ordinary pursuits. (Routine work—eating, sleeping, walking, working, etc.) or in severe bodily pain.

Q18. What causes the blackening around a gunshot entry wound?

1. Smoke particles
2. Unburned gunpowder
3. Muzzle of firearm
4. Fire effect

Ans. 1) Smoke particle

• The blackening is attributed to the deposition of smoke particles.

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