CATALYST. Ea PrepLadder aeae ; FRA a =x Day 22 Subject Burden to prove defense lies with the doctor in case of: A. Mens rea Res sa loquitor Poser C. Res judicata D. Respondent superior + Generally, professional negligence of a doctor must be proved in the court by expert evidence of another physician. + The patient need not prove negligence in case where the rule of res ipsa loquitur applies, which means ‘the thing or fact speaks for itself’ + Applies to both civil and criminal negligence. + Error is so self-evident that the patient's lawyer need not prove the doctor's guilt with medical evidence. The doctor has to prove his innocence. + Res judicata means‘the things have been decided’ According to this principle, once the case is completed between two parties, it cannot be tried again between the same parties. Suppose a patient sues a hospital for any malpractice and the things are decided, he cannot subsequently sue the doctor again separately for the same To join Catalyst 100 download the PrepLadder App Featsaves. Ea PrepLadder 4) p= TT Day 22 Subject = E Vicarious Liability/Respondent Superior Definition: An employer is responsible not only for his own negligent act, but also for the negligent act of his employees by the principle of ‘respondent superior’ (Latin, ‘let the master answer’), if three conditions are satisfied: i) There must be an employer-employee relationship iil) The employee's conduct must occur within the scope of his employment ili) Incident must occur while on the job. + Italso called the ‘Master-Servant Rule. To join Catalyst 100 download the PrepLadder App FeatsCATALYST. Ea PrepLadder 4) p= TT Day 22 Subject HH E As per the MTP Act, abortion can be dane by one doctor till: PW PAT cy B. 16 Weeks Cc. 20Weeks D. 24 Weeks MTP Act Rules Emergency cases: Pregnancy can be terminated by any RMP, even without required experience at any place, irrespective of duration of pregnancy, ifit is necessary to save the life of pregnant woman. Length of pregnancy: Under MTP Act, pregnancy cannot be terminated after 20 weeks of pregnancy. Above 20 weeks, the pregnancy can be terminated only on therapeutic considerations, i.e. to save the life of the mother.* In such cases, decision can be taken by a single doctor. + Upto 12 weeks of pregnancy, pregnancy can be terminated on the opinion of a single doctor. + Between 12-20 weeks, decisian should be taken jointly by two doctors. Consent: Consent of woman is mandatory, except when she is minor (<18 years) or mentally ill, where consent of the guardian is obtained. Consent of husband is not necessary. To join Catalyst 100 download the PrepLadder App easeCATALYST. Ea PrepLadder 4) p= TT Day 22 Subject HH E Amarried woman died in unnatural conditions within 5 years of her marriage. Her parents complained of frequent demand of dowry. Her autopsy will be conducted under which section: A. Sec. 174. CrPC ae en C. Sec. 302 IPC D. Sec. 304B IPC (It comes under magistrate inquest i.e. Sec 176 CrPC) MAGISTRATE INQUEST: Sec 176 CrPC deals with inquiry by Magistrate into cause of death INDICATIONS OF MAGISTRATE INQUEST: 1. Deaths due to police firing, 2. Disappearance or deah of a person in police custody or during police interrogation. 3. Death of a convict in jail. 4, Exhumation cases. 5. Rape alleged to have been committed on any woman i custod To join Catalyst 100 download the PrepLadder App ease«& ATA TS Tee Ea PrepLadder 4) penth 2 EE LT] A => «= Day 22 Subject 6. Dowry deaths (suicide /death of a woman within 7 years of marriage). 7. Admission of a mentally ill person in a psychiatric hospital under certain provisions of Mental Health Act. POLICE INQUEST + The provision for holding of inquest is outlined in Sec. 174 CrPC. + Police inquest is held by a police officer (known as the Investigation Officer-10) not below the rank of senior head constable in all cases of unnatural deaths with the exceptions mentioned under Magistrate inquest. To join Catalyst 100 download the PrepLadder App a aoe res ES (elgCATALYST. Ea PrepLadder aes ; FR ia cc Day 22 Subject Age estimation from teeth can be done by all the following methods, except: A. Gustafson's method B. Miles’ method C. Boyde’s method fone + Stack's method: Stack evolved a method to estimate the age from the weight of the erupting teeth of fetus and infant. He provided a regression line of weight of growing dental tissues against age (from 5 months in utero to postnatal age of 7 months). + Boyde'’s method: This method, applicable mainly to estimate age of dead infant, is based on counting the number of cross striations in the enamel of teeth (incremental lines) from neonatal line onward. Neonatal line is formed soon after birth and can be seen in about 3 weeks, or by electron microscopy 1-2 days after birth. To join Catalyst 100 download the PrepLadder App agen ren eee a2nNE7.. Ea PrepLadder 4) penth 2 EE LT A > § cx Day 22 Subject Estimation of age from teeth beyond 25 years + Miles’ method: The amount of wear on all three permanent molar ‘occurs at comparable rates which can be assessed, and age estimation made on the basis of comparison to the baseline. Miles also developed a method to determine age at death by measuring the thickness of enamel and dentin from neonatal line and divided it by appropriate daily rate of formation. ; Gustafson’s Method Age estimation consists of microscopic examination of longitudinal section of central part of the tooth to assess changes in teeth as a result pf wear and tear with advancing age. Estimate age between 25-60 years. Useful only while examining a dead body or skeletal remains, as teeth need to be extracted for examination. + Aspartic acid racemization + Chemical method: Estimation of nitrogen content of enamel (increases with age), carbonate content (decreases with age) and concentration of ions-Cu, Se and Fe (increases with age). + Radiocarbon dating of tooth enamel: It may give precise estimation of an individual's date of birth. Of the non-destructive methods (where tooth is not required to be taken out), assessing stages of development of the mineralization of the teeth using radiographs are more reliable than those using tooth counts. Amino acid racemization is considered to be most reliable destructive method of dental age estimation. To join Catalyst 100 download the PrepLadder App Feats«& ATA TS Tee Ea PrepLadder 4) pth 2 AAA oot Day 22 Subject Two identical twins will not have same: B. Iris color c. DNA D. Blood group Dactylography (dermatoglyphics, Galton system) is the study of fingerprints as a method of identification. A fingerprint match is widely accepted as most reliable evidence of identification. This system was first used by Sir William Herschel in 1858. Sir Francis Galton systematized this method in 1892. Dermal cravings or ridges appear for the first time from the 12th - 16th week of IUL and their formation gets completed by 24th week, i.e. 6th month |ULand remain constant throughout embryonic life,birth and the life of the individual. The arrangement and distribution of the patterns are unique to an individual, and NO TWO HANDS RESEMBLE EACH OTHER. OLD To join Catalyst 100 download the PrepLadder App App Storeje CATAL ST [)PrepLadder ‘fel “LT Day 22 Subject Sr.No._| Type Percentage (%) 1.__| Loop (Uinar/radiol) 60-70 2.__| Whor 3035. 3. | Arch 5-40 4. | Composite 23 Porascopy is the term applied to a specialized study of pore structure found on the papillary ridges of the fingers as means of identification. LIP PRINTS : The study of lip prints is called CHEILOSCOPY To join Catalyst 100 download the PrepLadder AppCATALYST. Ea PrepLadder aes ; FR ia c=. Day 23 Subject Fluoride, used in the collection of blood samples, inhibits the enzyme: A. Glucokinase B. Hexokinase \C. Enolase Pees D. Glucose-6-phosphatase (Sodium fluoride is the most commonly used agent to prevent glycolysis. It inhibits the enzyme enolase) Preservation of Samples + The ideal samples are the ones in which no preservative has been added and sent to CFSL within few hours. But, practically, it usually gets delayed. + The specimen is preserved at 4°C until they are analyzed. for long-term storage, it has to be kept in freezer (-10°C) + In order that putrefaction may not set in and render chemical analysis difficult, certain preservatives are used. CS To join Catalyst 100 download the PrepLadder App easeCA TALS Teo Ea PrepLadder 4) penth 2 EE LT] A Day 23 Subject 1. Viscera + The most commonly used preservative for viscera is saturated solution of common salt. It is easily available, cheap and effective preservative, However, the best preservative for preservation of viscera is rectified spirit. + In case of suspected alkali or acid poisoning (except carbolic acid), only rectified spirit is used. It is not used in cases of suspected poisoning with: . Alcohol ° Chloroform . Kerosene . Ether . Chloral Hydrate . Phosphorus . Formaldehyde . Formic Acid . Paraldehyde . Acetic acid 2. Blood for toxicological analysis (for alcohol, cocaine, cyanide and CO) is preserved in sodium or potassium fluoride at the concentration ‘of 10 mg/ ml of blood and anticoagulant potassium oxalate, 30 mg/10 ml f blood. + If blood is required only for grouping, no preservative is necessary and small amount of blood is well preserved by soaking in a blotter. + Incase of suspected CO poisoning, a layer of 1-2 cm of liquid paraffin is added immediately over the blood sample to avoid exposure to atmospheric oxygen. + If solvent abuse and anesthetic death is suspected, the glass container should have a foi-lined lid to prevent gas from To join Catalyst 100 download the PrepLadder App FeatsCATALYST. Ea PrepLadder 4) penth 2 EE LT A Day 23 Subject Rigor mortis occurs first in which voluntary muscle: (yet Tee Cy B. Small muscles of hands C. Neck muscles D. Face muscles RIGOR MORTIS Muscles Involved + Rigor mortis occurs both in the voluntary and involuntary muscles. + It occurs earlier in the involuntary or smooth muscles than in the voluntary or striated muscles. Onset and Duration + In tropical countries like India, roughly, it commences in 1-2 h after death, takes about 9-12 h to develop from head to foot, persists for another 12 h and takes 12 h to pass off (Rules of 12) To join Catalyst 100 download the PrepLadder App easea CA TALS Teo Ea PrepLadder 4) penth 2 EE LT] A =D ETS Day 23 Subject escaping (as gas can permeate rubber) and the container is completely filled to prevent gas from escaping in ‘dead’ air space. + Blood for hematological examination including glycosylated hemoglobin in diabetics should be sent in a clean glass container with anticoagulant (e.g. EDTA). 3. Urine is persevered by adding small amount of phenyl mercuric nitrate or thymol. Fluoride should be added to urine if alcohol, cyanide or cocaine is suspected in the sample. 4. Vitreous humor is preserved using sodium fluoride (10 mg/ ml). 5. For bones, hair and nails, preservative is not required. It has ta be dried in normal temperature and sealed in plastic bag. But, bone marrow is preserved in a test tube containing 45 ml f 5% albumin-normal saline solution and stored at 4.C. + Sodium fluoride is the most commonly used agent to prevent glycolysis. inhibits the enayme enolase and is also effective at inhibiting bacterial growth. * EDTA can effectively chelate the calcium ion of blood, therefore it can prevent the blood coagulation, does not affect the count and size of the leukocyte and keep erythrocyte invariable. Other anticoagulants are potassium oxalate, citrate or lithium heparin. To join Catalyst 100 download the PrepLadder App orn App Storea CA TALS Teo Ea PrepLadder 4) penth 2 EE LT] A Day 23 Subject Orders of Appearance + Rigor mortis first appears in the heart muscle within an hour after death. + Among the voluntary muscles, rigor mortis usually develops sequentially and follows a descending pattern, the so-called Nysten’s law: it first appears in the muscles of the eye lids (orbicularis oculi) [3-5 h], then in jaw, facial muscle [4-5 h], neck, thorax [5-7 h] upper limb (from shoulder to the hand) [7-9 h], abdomen, lower limb (from the hip tthe foot) [9-11 hj, and lastly in the small muscles of fingers and toes [11-12 hj. of eyelids then jaw, followed by those of the 3d lastly the legs and feet. Nyston’s Law: Rigor mortis affects first the rm face and neck, then muscles of the trunk and oreCATALYST. Ea PrepLadder 4) penth 2 EE LT] A Day 23 Subject Death occurs faster ii Fresh water drowning fo B. Salt water drowning C. Near Drowning D. Warm water drowning Fatal Periods + Fresh water drowning: 4-5 min. + Sea water drowning: 8-12 min. Classification of drowning Frimary/Typical/Wet drowning Atypical drowning + Fresh water drowning Dry drowning ‘+ Salt water drowning Immersion syndrome «Secondary drowning Shallow water drowning To join Catalyst 100 download the PrepLadder App easenn, Ea PrepLadder Lond HET mn IO 4) penth 2 EE LT] A Day 23 Subject In both fresh water and salt water drowning, there is terminal pulmonary edema. Mechanism of fresh and sea water drow Fresh water drowning (Hypotonic Sea water drowning (Hypertonic) i — — L 1. Dry drowning + In dry drowning, water does not enter the lungs due to laryngeal spasm induced by small amounts of water entering the larynx. Death may be extremely rapid and time elapsed is insufficient for typical drowning to occur. Two mechanisms have been postulated: | Reflex cardiac arrest due to vasovagal stimulation. ee To join Catalyst 100 download the PrepLadder App FeatsCATALYST, CLs !OO + Subconjunctival hemorrhage does not show similar color changes owing to hemoglobin being kept oxygenated by air. It is red at first then becomes yellow and finally disappears. Similar changes are seen in meningeal hemorrhages owing to O2 supplied from CSF. + Notall bruises pass through a yellow phase before they resolve. en Download on the Le (Tete aay App StoreCA TALS Teo Ea PrepLadder 4) p= TT a 8 cr Day 23 Subject Brown color of contusion is due to: A. Biliverdin B. Reduced hemoglobin D. Bilirubin + Hemosiderin is a granular brown iron-storage complex composed of ferric oxide, commonly found in macrophages and derived from breakdown of hemoglobin. + Biliverdin is 2 green pigment formed as a byproduct of heme breakdown. + Bilirubin is the yellow pigment called as‘hemotoidin’ Fresh Red (oxygenated blood) Few hours to 3 days Biue (deoxyhiemogiobin) 45 days Bluish black to brown (hemosiderin) SG days Green [biliverdin) 7-12 days Yellow (bilirubin) weeks Normal Pe To join Catalyst 100 download the PrepLadder App«& ATA TS Tee Ea PrepLadder 4) penth 2 EE LT] A => cx Day 23 Subject Tattooing around the entry wound is seen in: A. Contact shot Close shot Poe C. Distant shot D. All of the above Tattooing is seen in Close shot Contact shot + Whole of the discharge containing flame ,gases,powder,smoke and metallic particles will be blown under pressure into the track taken by the bullet through the body , often leaving little evidence that one is dealing with a contact wound. + There isa little or no evidence of burning , singeing, blackening and tattooing. + Burning, blackening and powder grains deposits will be found in the depths of the wound (examination of the wounds with dissecting microscope is of value) + Hair nearby may get burnt or clubbed by fire/heat. + Muzzle impression may be present around the wound To join Catalyst 100 download the PrepLadder App App Store2nNE7.. Ea PrepLadder 4) penth 2 EE LT] A => <=> Day 23 Subject Close shot (Flame Range) Body lies within the range of flame, smoke and powder blast, ie. within 2-3 inches (5-8 cm). + Entry wound is small and circular in shape having inverted and contused lacerated margins. + Skin adjacent to the entry wound shows evidence of grease/dirt collar on the inner zone, and abraded-contused collar on the outer zone. + Evidence burning, singeing, blackening and tattooing of the skin in and around the entry wound. + Clothings over the part will be burnt from flame of discharge. Near Shot (Medium-Range or Intermediate Range) Gunshot entry wounds with powder tattooing, but no soot, are commonly referred to as‘near-shot’ or ‘intermediate range’ wounds, ie. when the range is within 24 inches (60 cm). + Entry wound will be circular in shape, approximately the same size as the bullet, with lacerated, inverted edges surrounded by narrow zone of the greases and abrasion collar, with no evidence of any burning and singeing Distant Shot Gunshot entry wounds with no associated soot or gunpowder stippling are referred to as ‘distant’ wounds, i.e. range is beyond 2 feet. + Entry wound is usually circular in shape, smaller than the bullet, because of elasticity of skin, with lacerated, inverted skin margins, a bigger dirt collar and usual zone of abraded collar. To join Catalyst 100 download the PrepLadder App Featsra CATAL ST [)PrepLadder Day 24 Subject Blister formation in burn is classified as: A. First degree CMT rede t ces tai cana C. Second degree deep D. Third degree Differentiation: Classification of burns (Degree of burns) 5.N._| Feotures Fist Second Third Z| Desth Epdermis Epidermis an@derms | Deepertodermis 2 Color Red/pink Dark ree ‘White/aray black (Charm inal 3. Pain to stm | Painful, render Very paintal Painless (destruction of nerve endings) | Blanching Yes Yes, but slow Ne 5._| Blisters Ne present May or may not be seen 6 7. Appearance | Dry Dry/leathery Healing time | 3-6 days; skin peelira Small areas may take months; large areae need skin grafting Ne sear, slight Yes discoloration Sunburn, scald, Rash Scalds, Flash burns, Contact with fame, hot flame chemicals surface, hot liquid, chemical, electric 10._| Medic-lagally | Simole Grievous Grievous To join Catalyst 100 download the PrepLadder App Download App Bearda CATALYST. Ea PrepLadder 4) penth 2 AH ood => == Day 24 Subject A 25-year-old person developed right corneal opacity following injury to the eye. Corneoplasty of right eye was done and vision was restored. Medico-legally such injury is: UOTE) B. Simple C. Dangerous D. Serious Clauses of grievous hurt Clause Kind of hurt First Emasculation. Second Permanent privation of the sight of either eye. Third Permanent privation of the hearing of either car. Fourth Privation f any member or joint. Fifth Destruction or permanent impairing of the powers of any member of joint. Sixth Permanent disfiguration of the head or face. Seventh Fracture or dislocation of a bone or tooth. Eighth ‘Any hurt which endangers life, or which causes the suffers to be during the space of 20 days in severe bodily pain or unable to follow his ordinary pursuits. To join Catalyst 100 download the PrepLadder App App StoreCA TALS Teo Ea PrepLadder 4) penth 2 EE LT] A Day 24 Subject Allare tests done on Blood, except: A. B. Benzidine test Pee eer aoe ro C. Hemochromogen test D. Teichmann’s test PRESUMPTIVE TESTS FOR BLOOD: Catalytic Color Tests + Catalytic tests employ chemical oxidation of a chromogenic substance by an oxidizing agent (H202). + The heme group of hemoglobin exhibit peroxidase activity which catalyzes the breakdown of hydrogen peroxide. H202 + reduced reagent (color 1) H20 + oxidized reagent (color 2) To join Catalyst 100 download the PrepLadder App a aoe App Storeje CATAL ST [)PrepLadder 4) 2 FH ia c= Day 24 Subject Punishment for some offences committed by any individual = | Secion [Offence Punishment imatenens) | Fe x_|otire 1 [302 | Murder Deathor We mavtonment | Ves 3} 30 | Tulpmbleharidide net} 10 yeast fe imprisonment] Yes | smountng temurder | | 3 [308A — [Death oy rash and pte 2years negligent ct 7 [088 — [Downy death Tyra We ieparornent |= 5 [306 Abetment ef sella?” | Unte 10 years Ye & [307 [attempt murcer 40 yeas of We imprisenment | Yes 7. | 303 | Attempt to commit suicide | Not punishable No. 8. 323 Voluntarily causing simple | Upto 1 year ‘without fing hare (usio 1000) 5 [sae —[Wolurtaniy causing simple | Unto Sears Wah without ine hurt by dangerous 10. [325 | Voluntarily easing Upto Fyears Yes frevous hurt 14, [326 | Voluntary casing Uoto 10 years Yes freevous hurt by dangerous weapons/means 12, [3260 | Voluntary easing 40 yeast ie imprsaninent | Yes [oad to the grievous hurt by use of ») I sar TRS [Voluntary rowing or ST years Te tempting to throw aid [ies | Votan encsing Upto To yeare ve Irleous hurt 0 emt Tonfesson, rt compel restoration of property To join Catalyst 100 download the PrepLadder App Canal eres > Google Play |) @ App Store2nNE7.. Ea PrepLadder 4) penth 2 EE LT] A => == Day 24 Subject Methods: |. Benzidine (Adler test):The reaction is carried out in ethanol/acetic acid solution and results in a characteristic blue color. I. Phenolphthalein (Kastle-Meyer) test: The reaction shows phenolphthalein (colorless in alkaline solution) being oxidized to phenolphthalein (bright pink in an alkaline environment). lll. O-Tolidine (Kohn or O’kelly) test: The reaction, similar to that oof benzidine, is conducted under acidic conditions and produces a green-blue color reaction. IV. Tetramethylbenzidine (TMB): Color change is from green to blue-green. V. Leucomalachite green (LMG) produces a green color. Tests using chemiluminescence and fluorescene: A washed drag/spatter pattern in large areas is tested with luminol and fluorescein tests. Luminol (3-aminophthal-hydrazide) gives blue-white to yellowish-green glow which indicates presence of blood (again a catalytic test). To join Catalyst 100 download the PrepLadder App FeatsCATALYST, CLs !OO Other Tests + Spectroscopic examination: It is a delicate and reliable test for detecting presence of blood in both recent and old stains, but seldom used, + Thin layer chromatography (TLC) Presumptive tests for semen are based on colorimetry, and are qualitative in nature. |. Florence Test Il, Barberio’s test IIL Brentamine fast blue test en Download on the Le (Tete aay App StoreCA TALS Teo Ea PrepLadder 4) penth 2 EE LT] A Day 24 Subject DNA fingerprinting can be done with all, except: C. Saliva D. spermatozoon (RBCs lack the DNA-containing nuclei) DNA fingerprinting + DNA fingerprinting was first developed in England in 1985 by Alec Jeffreys, professor of genetics at the University of Leicester who made the discovery by accident while tracking genetic variations in myoglobin. + Two methods of DNA analysis are in common use |, RFLP (restriction fragment length polymorphism) Il. PCR (polymerase chain reaction) To join Catalyst 100 download the PrepLadder App a aoe App StoreCA TALS Teo Ea PrepLadder 4) penth 2 EE LT] A Day 24 Subject In polygraph test’GSR’ stands for: A. Guilt Score Reaction CUI stati) C. Galvanic Sensor reaction D. Guilt Sensitivity Reaction A polygraph (‘lie detector) is a device which makes a continuous record of several physiological variables, such as blood pressure, heart rate, respiration and electro-dermal reaction, while a series oof questions are being asked, in an attempt to detect lies. + Apolygraph test is also known as a psychlophysio-logical detection of deception (PDD) examination. Procedure: There are two major testing techniques in use - + The Relevant / Irrelevant Technique (RIT) and + The Control Question Technique (CQT) To join Catalyst 100 download the PrepLadder App App Storeaves. Ea PrepLadder 4) penth 2 EE LT] A => == Day 24 Subject Samples Collected from Living Subjects |. Blood (most common sample). 5 ml of venous blood is collected in a purple stoppered vacutainer (EDTA tube) and mixed thoroughly without shaking. Heparin is not used as an anticoagulant since it interferes with PCR. Il. Buccal epithelial cells Ill. Hair follicles with roots (plucked hair), about 10-20, from the head is used as a reference standard Samples Collected from Dead Bodies: Best material is said to be muscle or spleen if decomposition is establishing; bone marrow (from femur) and teeth (usually molars) are also recommended. Samples Encountered in Forensic Practice + Blood (EDTA/heparinized/clotted/stain on cloth, newspapaer, wood or tiles). + Semen (Stain on cloth/ papery floor). + Hair (head/ body/ pubic). + Tissue (bne marrow/ muscle/ spleen/ fingernail scrapings). + Mouth swabs, and saliva stain on cigarette buds/ licked envelope/ glass. To join Catalyst 100 download the PrepLadder App Featsaves. Ea PrepLadder 4) penth 2 EE LT] A => == Day 24 Subject Polygraph test starts with a pre-test interview to gain some preliminary information which will later be used for‘control question’ (CQ). Some of the questions asked are ‘irrelevant’ or IR, others are ‘probable-lie' control questions that most people will lie about, and the remainder are the ‘relevant question, or RQ, that the tester is really interested in. The different types of questions may alternate. It s is also known as galvanic skin response (GSR), electro dermal response (EDR) or skin conductance response (SCR) - a method of measuring the electrical conductance of the skin, which varies with its moisture level.1 To join Catalyst 100 download the PrepLadder App Featsa CA TALS Teo Ea PrepLadder 4) penth 2 EE LT] ia c= Day 25 Subject Odor Phosphorus, heavy metal poisoning Garlic-like arsenic, selenium, thallium), parathion, malathion, alphs | 2 Ethanol, methyl or propyl alcohol, Sweet and fruity chloroform, nitrites, acetone 3. Paraldehyde, chloral hydrate ‘Arid 4 [HiS, mercaptans, disulfirum [ Rotten eges 5. HCN Bitter almond 6 Carbolic acid Phenolic 7. Organaphosphates Kerosene-like 8 Zinc phosphide Fishy 9. Methyl salicylates oil of wintergreen 10. Marijuana Burnt rope, hemp To join Catalyst 100 download the PrepLadder App orn App StoreCATALYST. Ea PrepLadder aes ; FR ia c= Day 25 Subject A dead body with suspected poisoning is having hypostasis of red brown in colour. It is suggestive of poisoning due to: B.C C. Cyanides D. Hydrogen sulfide Poison Color of PM staining 1. | Carbon monoxide (CO) | cherry red 2 Carbon dioxide (CO2) Deep Blue (reduced hemoglobin) 3 Cyanide Bright red/pink 4 | Phosphorus or copper [ Dark brown / yellow 5 Hydrogen sulfide Bluish green 6. | Opiates Black 7. Nitrites, aniline, nitrobenzene, chlorates | Chocolate or coffee- (methemoglobin formation) brown To join Catalyst 100 download the PrepLadder App App Storea CA TALS Teo Ea PrepLadder 4) penth 2 EE LT] ia c= Day 25 Subject A middle aged man presented with paraesthesia of hands and feet. Examination revealed presence of Mee’s lines in the nails and raindrop pigmentation in the hands. The most likely diagnosis is: A. Lead poisoning B. Arsenic poison! C. Thallium poisoning D. Mercury poiso ‘Signs and symptoms in chronic arsenic poisoning Signs and symptoms’ Nausea, vomiting, abdominal cramps, loss of appetite, constipation or diarrhea, salvation Congestion, watering of the eyes, photophobia. Cough, hoarseness of voice, bronchial catarrh, hemoptysis, dyspnea. There may be a rash resembling fading measles rash. Speckled brown pigmentation, mostly on the skin flexures, temples, shoulder, eyelids and neck (raindrop pigmentation). Macular areas of de-pigmentation may appear on normal/ hyperkeratosis of the palms and soles with irregular thickening of the nails and development of white bands of opacity in the nails of fingers end toes (called Aldrich-Mees lines). Brittle nails and alopecia are also seen. Pept) To join Catalyst 100 download the PrepLadder App orn App StoreCATALYST. Ea PrepLadder .) P= A A og) Day 25 Subject CNS Peripheral neuropathy with tingling, numbness of hands and feet, polyneuritis, anesthesia, paraesthesia with painful swelling encephalopathy. Neuritis resembles chronic alcoholism. ws Hypertension, ischemic heart disease, cardiac failure, dependent edema. Renal Chronic nephritis, urine may be red or green in color, dysuria and anuria may develop from renal tubular necrosis. Hepatic Hepatomegaly, jaundice, cirrhosis of the liver. Hematolgic | Bone, marrow suppression, hypoplasia, anemia, thrombocytopenia and leukemia. To join Catalyst 100 download the PrepLadder App orn App Store«& ATA TS Tee Ea PrepLadder 4) penth 2 LT] A => «r= Day 25 Subject Bruton’s line is seen in: B) Arsenic poisoning C) Phosphorus poisoning D) Zinc poisoning Chronic Lead Poisoning (Plumbism/ Saturnism) + It was also called colica pictorum (the colic of painters), painter's colic.) + Characteristic features are given below : Anemia: In early stages, there may be polycythemia with plychromatophilia,but later there is anemia with karyorrhexis and dyserythropoiesis (punctuate basophilia, reticulocytosis, poikilocytosis, anisocytosis), nucleated red cells and increase in mononuclear cells in peripheral blood and ringed sideroblasts in bone marrow. 2. Burton's /Burtonian Line: A stippled blue line is seen on the gingival surface in 50-70% cases. + Itis due to subepithelial deposit of granules at the juncti orera CATAL ST [)PrepLadder “LT c= Day 25 Subject especially near dirty or carious teeth of the upper jaw, within a week of exposure. + It is due to formation of lead sulphide by the H2S formed from decomposed protein in the mouth. + Asimilar blue line may be seen in cases of poisoning by: Mercury, Iron, Copper, Silver, Bismuth 3. Colic: It is usually a late symptom, involving both large and small intestines, ureters and blood vessels. + The pain is spasmodic, paroxysmal, occurs at night and may be very severe (saturnine colic), 4. Constipation: Common feature and usually precedes colic. 5, Lead palsy (Drops): it is a late and uncommon phenomenon, seen in <10% of cases. 6. Lead encephalopathy CED To join Catalyst 100 download the PrepLadder App cer Google Play App Store ar«& ATA TS Tee Ea PrepLadder 4) penth 2 EE LT] A => «r= Day 25 Subject 7. Facial pallor: Earliest sign; seen around the mouth. It is due to vasospasm and produced by contraction of the capillaries at the arterial side. 8. Optic atrophy 9, Retinal stippling is noticed by ophthalmoscope with presence of grayish glistening lead particles in the early phase of chronic lead poisoning. 10. Lead osteopathy: Laboratory Tests |. Normocytic and normochromic, a micracytic, hypchromic anemia may be seen with mixed etiology. IL. Punctate basophilia: >200 cell/cu mm. Ill. Whole blodd lead level is the most useful indicator of lead exposure. Blood lead >70 11 g/ dl (severe toxicity) and >50-70L1g/ dl (moderate toxicity). In children, >10}19/ di of lead in the bload is abnormal (some consider 2 St /dl as diagnostic). IV. Coproporphyrin in urine > 15,19/ dl. V. §-amino levulinic acid in urine > 5 mg/1 VI. Plasma lead > 0.1 mg/ml. Vil. X-ray: Radio-opaque bands ar’lead lines’ (metaphyseal sclerosis)* at the metaphyseal plate of long bones are seen in children. To join Catalyst 100 download the PrepLadder App App Store«& ATA TS Tee Ea PrepLadder aes ; FR ia c= Day 25 Subject A 28 year-old male patient is brought to casualty in comatose state with pin-point pupils, reduced respiratory rate and bradycardia. Most likely diagnosis: antidepressant poisoning C. Benzodiazepine poisoning D. Organophosphorus poisoning nical ton arornee Tonidrame Clie! features icone _| Treatment Ste of action Opate Nadouane Opiod reveptar ‘ichov neve Physostigmine Muscarine Inyo hernia acetylcholine (mild to severe), | anthistarsines receptor Pe Bympalhominet Hypertension, | Cocaine, Tensodasepines and B To join Catalyst 100 download the PrepLadder App App StoreTeac tachycardia yrexa, papllary istation, disphorosis, tered mental “amphetamines Forensic Medicine adrenergic receptors Choline (Orgzrophosshate and cartamates) radiycardin, depression, miosis, SLUDGE (caliation, Iecrimation urination, Aetecation, GIT distress, emesis) (8 Seine, 3Di, parathion, malathion, iazinon atropine Praidozime (for (0? insecticides) eatin and eetyicholine receptors Sedative hypnotic (wencodiazepines) normal vita signs, siplopia, oaxia, function siurrec ies, Lerontece amnesia, anxiety, hallucinations, delitium Alprazolam, fluritvezevem, ‘xazeparn Fomaneri Faminabunyr cid receptors en Google Play Download on the LN eseesCATALYST. Ea PrepLadder aes ; FR ia c= Day 25 Subject Dhatura poisoning is characterized by: A. Pinpoint pupil B. Dilated salivary gland D. Decreased temperature Common names: Thorn apple (fruits are spherical and have sharp spines), Jimson weed,* Hell’s bells and devil's trumpet (for their large trumpet-shaped flowers) Signs and symptoms can be summarized as 9 Ds: |. Dryness of the mouth (dry as a bone), bitter taste, burning pain in stomach and vomiting. Il. Dysphagia (difficulty in swallowing). Ill. Dysarthria (difficulty in talking) due to inhibition of salivation — mumbling in quality and is often incomprehensible. \V. Dilatation of cutaneous blood vessels (red as a beet). Face is flushed and conjunctiva congested.3 To join Catalyst 100 download the PrepLadder App ease«& ATA TS Tee Ea PrepLadder 4) penth 2 EE LT] A => «r= Day 25 Subject V. Diplopia due to dilated pupil (mydriasis) with loss of accommodation for near vision, developing into temporary blindness (blind as a bat) and photophobia .Light reflex is sluggish, and later absent. VLDry hot skin (hot as a hare) due to inhibition of sweat and stimulation of heat regulating center. There is dry mucous membrane with dry axilla. Temperature is raised by 1-2°C. Vil. Drunken gait: there is giddiness, confusion, restlessness, agitation and unsteady gait, the patient staggering like a drunken individual. VII. Delirium (mad as a wet hen): Mutters indistinct words, exhibits typical pill-rolling movements, pulls imaginary thread from fingertips, picks at clothes and tries to run away from his bed, visual and auditory hallucinations may be present. Patient cannot recognize relatives and friends. Undressing behavior is common. The changes in mental status are characteristic of delirium IX. Drowsiness: Delirium passes off and patient becomes drowsy, may progress to stupor, coma, or rarely to death from respiratory paralysis. Fatal dose + Seeds: 75-125 (stupefying dose: 40-50 seeds), + Hyoscine: 15-30 mg. Fatal period: 24 h. To join Catalyst 100 download the PrepLadder App App Store