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MCQs in Forensic Medicine...

MCQs in Forensic Medicine
and Toxicology, 6/e
By Dr KS Narayan Reddy, MD, DCP, PhD, FAMS,
FIMSA, FAFSc, FIAMS, FAFM; Retired Principal,
Professor of Forensic Medicine, Osmania Medical
College, Hyderabad
MCQs test the memory, professional skill,
capacity to diagnose or treat a disease,
understanding and comprehension abilities in
candidates. They also aim at measuring higher
level abilities like analysis, judgement and
reasoning. This multiple choice questions book
in the area of Forensic Medicine and
Toxicology is based on the above concept. All
the undergraduate medical students and also
the students preparing for various
postgraduate entrance exams will find this
book extremely useful.

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Exclusive preview MCQs in forensic medicine and toxicology 6e by reddy. To Order call +91 8527622422 Exclusive preview MCQs in forensic medicine and toxicology 6e by reddy. To Order call +91 8527622422 Document Transcript

  • III C HAPTER 13 M ECHANICAL A SPHYXIA 1. Apoplexy is the term used for (a) Jugular vein (b) Vertebral artery (a) Cerebral congestion (c) Trachea (d) Carotid (b) Cerebral ischaemia 7. In typical hanging death occurs due to (c) Cerebral anoxia (a) Blocking of jugular veins (d) Cerebral concussion (b) Blocking of carotid arteries 2. Hanging is defined as (c) Blocking of vertebral arteries (a) Suspension of body by a ligature around (d) Both and (a) and (b) the neck, body weight acting as constricting 8. In typical hanging knot is present at force (a) Occipital area (b) Mastoid area (b) Suspension of body by ligature after death (c) In front of ear (d) Any of the above (c) Obliteration of air passages by external 9. Cyanosis occurs when the concentration of re- factors duced haemoglobin exceeds (d) Mechanical interference to respiration (a) 2 g% (b) 4 g% 3. The commonest cause of death in hanging is (c) 5 g% (d) 6 g% (a) Asphyxia 10. Cyanosis is caused by (b) Cerebral venous congestion (a) An increased concentration of reduced (c) Asphyxia and cerebral venous congestion haemoglobin combined (b) A decreased concentration of haemoglobin (d) Cerebral anaemia (c) A decreased concentration of oxyhaemo- 4. Delayed death in hanging can be due to the globin following conditions, EXCEPT (d) Hypoxia (a) Hypoxic encephalopathy 11. A ligature mark on the neck directed oblique- (b) Infraction of brain ly upwards on both sides is seen in hanging (c) Oedema of lungs with a (d) Fracture of the cervical vertebrae (a) Fixed loop with a single knot in midline at 5. Weight for occluding internal jugular vein in the back of the head hanging is (b) Running noose (a) 2 kg (b) 4 kg (c) Fixed loop with a knot in the region of one (c) 8 kg (d) 12 kg ear 6. In hanging last to be occluded is (d) Low point of suspension 1. (a) 2. (a) 3. (c) 4. (d) 5. (a) 6. (b) 7. (d) 8. (a) 9. (c) 10. (a) 11. (a)Chapter-13.indd 104 7/13/2011 5:17:30 PM
  • MECHANICAL ASPHYXIA 105 12. Which one of the following statements regard- 17. In a case of hanging ligature marks in neck are ing ligature mark in hanging is NOT true? example of (a) In the case of a fixed loop with a single knot (a) Contusion (b) Pressure abrasion at the back of the head, the mark is seen (c) Laceration (d) Bruise directed obliquely upwards on both sides 18. A reliable sign of antemortem hanging is (b) In the case of fixed loop with the knot in the (a) A thin line of congestion of haemorrhage region of one ear, the mark differs on each along the edges of ligature mark side of the neck (b) Congested, livid face marked with (c) In case of running noose the mark is oblique petechiae on both sides (c) Swollen, dark coloured protruded tongue (d) If the ligature is in the form of loop, the (d) Protrusion of tongue mark is prominent on the part of the neck 19. The most important feature of antemortem to which the head has inclined hanging is 13. All of the following are characteristic of liga- (a) Fracture of hyoid bone ture mark of hanging EXCEPT (b) Ligature mark on neck (a) It is usually oblique (c) Fracture of thyroid cartilage (b) It does not completely encircles the neck (d) Dribbling of saliva (c) It is usually seen high up on the neck 20. The width of ligature mark on skin may not (d) The base is soft and reddish correspond with ligature when the ligature 14. In hanging, the groove produced by ligature used is a may be less well marked with (a) Rope (a) Loop arranged with a fixed knot (b) Woven belt (b) Low point of suspension (c) Nylon or silk fabric (c) Running noose (d) Electric wire (d) Loop 21. Hyoid fracture is common in 15. A horizontal ligature mark is seen in the neck (a) Hanging (b) Strangulation in case of hanging (c) Throttling (d) Choking (a) When a fixed loop with a fixed knot in the 22. Slow asphyxia is likely to occur in hanging region of one ear is used when (b) When a fixed loop with a single knot at the (a) Ligature exerts pressure below the chin and back of the head is used does not encircle the neck (c) When a fixed loop with a single knot at the (b) Ligature exerts pressure below the chin and chin is used encircles the neck (d) In partial hanging (c) Ligature exerts pressure at the level of thyroid 16. A ligature mark may not be seen in the neck in cartilage case of hanging (d) Ligature exerts pressure below the level of (a) In partial hanging thyroid cartilage (b) If a loop is made of soft material 23. In hanging coma occurs rapidly if ligature (c) If narrow ligature is used completely obstructs (d) When a fixed loop with a single knot at the (a) Jugular veins (b) Vertebral arteries chin is used (c) Carotid arteries (d) Pharynx 12. (c) 13. (d) 14. (b) 15. (d) 16. (b) 17. (b) 18. (a) 19. (d) 20. (c) 21. (c) 22. (a) 23. (c)Chapter-13.indd 105 7/13/2011 5:17:31 PM
  • 106 S ECTION I: FORENSIC MEDICINE 24. In hanging, asphyxial signs are slight when (c) Homicide (a) Suspension is complete (d) Suicide and homicide (b) Suspension is incomplete 31. Unequal pupils in hanging is due to pressure (c) The deceased is in a kneeling position on the (d) The deceased line prone with only the face (a) Parasympathetic chain and chest off the ground (b) Sympathetic chain 25. All of the following are characteristic of death (c) Optic pathway due to hanging EXCEPT (d) All of the above (a) Ligature mark around 32. “Le facie sympathique” is seen in (b) Ecchymosis of subcutaneous tissues under (a) Hanging (b) Strangulation the ligature mark (c) Smothering (d) Aconite poisoning (c) Trickling of saliva from the mouth 33. In a case of typical hanging, postmortem (d) Ecchymosis of the larynx or epiglottis hypostasis is seen in 26. Reflex vagal inhibition may occur in (a) Legs and feet (a) Impaction of food in larynx (b) Hands and forearms (b) Drowning (c) Both (a) and (b) (c) Hanging (d) Genitalia (d) All of the above 34. When a person has suspended himself by 27. In case of hanging, a typical ligature mark applying ligature around the neck so that the shows following characteristics EXCEPT point of suspension (knot) is situated in the (a) Oblique region of the occiput. Such hanging is called (b) High up in neck (a) Typical (b) Atypical (c) Continuous (c) Partial (d) Incomplete (d) Above the level of thyroid cartilage 35. Postmortem staining of lower parts of hands 28. Which one of the following statements regard- and feet indicates ing width of ligature mark compared to width (a) Prolonged suspension after death of ligature in hanging is NOT true? (b) Antemortem hanging (a) Equal (b) More (c) Death due to asphyxia (c) Less (d) Variable (d) Drowning 29. A ligature mark may not be seen in the neck 36. In hanging transverse splits of carotid arteries in case of hanging in the following condition may be seen in EXCEPT (a) Outer coats (a) If a portion of clothing intervenes between (b) Middle coats the ligature and the skin (c) Inner coats (b) If a loop is made of soft material (d) None of the above (c) If a narrow ligature is used 37. Intima of carotid arteries is usually ruptured (d) If the ligature is cut soon after death in 30. Scratches or nail marks on the neck in hanging (a) Hanging may be found in case of (b) Ligature strangulation (a) Suicide (c) Traumatic asphyxia (b) Accident (d) Burking 24. (a) 25. (b) 26. (d) 27. (c) 28. (b) 29. (c) 30. (d) 31. (b) 32. (a) 33. (c) 34. (a) 35. (a) 36. (c) 37. (a)Chapter-13.indd 106 7/13/2011 5:17:31 PM
  • MECHANICAL ASPHYXIA 107 38. Hanging with feet touching the ground is seen 45. In judicial hanging fracture, vertebrae are seen in at (a) Suicidal hanging (a) C1–C2 (b) C2–C3 (b) Homicidal hanging (c) C4–C5 (d) C6–C7 (c) Accidental hanging 46. In judicial hanging which position of knot is (d) Postmortem hanging more effective? 39. Dribbling of saliva is characteristic of (a) Back of neck (a) Antemortem hanging (b) Side of neck (b) Postmortem hanging (c) Below chin (c) Homicidal strangulation (d) All are equally effective (d) Suicidal strangulation 47. The ligature mark of strangulation is 40. Lynching is a form of (a) Transverse and completely encircles the (a) Sexual asphyxia (b) Homicidal hanging neck (c) Judicial hanging (d) Strangulation (b) Usually seen high up in the neck 41. Lynching is (c) Usually two or three marks are seen due to (a) Practiced in North America multiple tying of the ligature (b) Practiced by white people on Negroes (d) Oblique, incomplete (c) Hanging publicly on a tree 48. A ligature mark may NOT be seen in the neck (d) All of the above in case of strangulation by ligature 42. Which one of the statement is NOT correct (a) If the ligature is a thin rope concerning accidental hanging? (b) If the ligature is removed soon after death (a) It may be associated with abnormal sexual (c) If the body is mummified behaviour (d) If the body is embalmed (b) It may occur in workmen in falling from 49. Extensive bruising of muscles and subcutan- scaffolding and getting entangled in ropes eous tissues in neck is characteristic of (c) It may occur from suspension of the chin by (a) Hanging (b) Strangulation the steering wheel of a motor car (c) Throttling (d) Burking (d) It may occur in infant with a string attached to a toy tied to the crib 50. Horizontal ligature mark in the neck is seen in (a) Throttling 43. Postmortem hanging is characterised by the (b) Hanging following EXCEPT (c) Strangulation by ligature (a) Marks of violence on the body (d) Choking (b) No dribbling of saliva (c) Signs of dragging on the body 51. All of the following are characteristic of liga- (d) Continuous ligature mark round the neck ture mark of strangulation EXCEPT (a) The mark completely encircles the neck 44. Death in judicial hanging is due to (b) It is usually seen high up in the neck (a) Shock (c) It is transverse (b) Fracture-dislocation of upper cervical (d) Reddening and congestion is present (c) Rapid asphyxia immediately above and below the groove (d) Inhibition of the heart 38. (a) 39. (a) 40. (b) 41. (d) 42. (d) 43. (d) 44. (b) 45. (d) 46. (c) 47. (a) 48. (b) 49. (c) 50. (c) 51. (b)Chapter-13.indd 107 7/13/2011 5:17:31 PM
  • 108 S ECTION I: FORENSIC MEDICINE 52. A horizontal complete ligature mark below compressed part may be absent if ligature the level of thyroid cartilage with extensive is tightly applied on the neck until death bruising of subcutaneous tissues and muscles occurs adjacent to it indicate (d) Dislocation of cervical vertebrae may be (a) Accidental strangulation fractured (b) Homicidal hanging 59. In ligature strangulation, the lungs show all of (c) Homicidal strangulation the following changes EXCEPT (d) Suicidal hanging (a) Congestion is marked 53. Seminal emission is more common in (b) Silvery-looking spots are seen under the (a) Strangulation by ligature pleural surface (b) Hanging (c) Microscopic areas of collapse are present (c) Smothering (d) Ecchymoses and subpleural haemorrhages (d) Traumatic asphyxia do not occur 54. Maximum congestion is seen in 60. Emphysematous bullae on the surface of the (a) Choking (b) Hanging lungs are commonly seen in (c) Strangulation (d) Drowning (a) Hanging 55. Bleeding from the nostrils, mouth and ears is (b) Ligature strangulation common in (c) Drowning (d) Traumatic asphyxia (a) Hanging (b) Strangulation by ligature 61. Hanging differs from strangulation by the fol- (c) Smothering lowing features EXCEPT (d) Choking (a) Always suicidal 56. Most important sign of strangulation is (b) Ligature mark is oblique (c) Neck is elongated and stretched (a) Ligature mark around the neck (d) Subcutaneous tissue under the mark is (b) Haemorrhage under ligature mark white, hard and glistening (c) Fracture of hyoid bone (d) Dislocation of cervical vertebrae 62. All of the following findings indicate death due to ligature strangulation in putrefied body 57. Evidence of strangulation includes all EXCEPT EXCEPT (a) Ligature mark on the neck (a) Fracture of the larynx or hyoid bone (b) Subconjunctival ecchymoses (b) Bruising of the muscles of the neck (c) Dribbling of saliva from mouth (c) Ligature mark (d) Congestion of face (d) Signs of asphyxia 58. Which one of the following statements regard- 63. Holding the neck of victim in bend of elbow is ing internal findings in the neck in case of liga- known as ture strangulation is NOT true? (a) Throttling (b) Mugging (a) There is severe engorgement and (c) Bansdola (d) Garrotting haemorrhage into the tissues in and above the area compressed 64. The following are the type of homicidal stran- (b) The muscles of the neck are usually gulation EXCEPT lacerated (a) Bansdola (b) Mugging (c) Bruising of the deeper tissues in the (c) Lynching (d) Garrotting 52. (c) 53. (b) 54. (c) 55. (b) 56. (b) 57. (c) 58. (d) 59. (d) 60. (b) 61. (a) 62. (d) 63. (b) 64. (c)Chapter-13.indd 108 7/13/2011 5:17:31 PM
  • MECHANICAL ASPHYXIA 109 65. Bansdola is a form of 71. In case of throttling bruises on the neck may (a) Homicidal suffocation be seen in a completely haphazard manner (b) Homicidal strangulation (a) In frank struggle of victim (c) Homicidal hanging (b) In children (d) Homicidal choking (c) When the neck is small 66. Garrotting is a method of homicidal strangula- (d) When the assailant’s hand is large tion which is accomplished by 72. The size of the contused areas on the neck in (a) Placing one bamboo stick across the front case of throttling may be more than the size of of neck and one at the back, and tying both the digits due to ends with a rope (a) Shifting of the grip (b) Holding the neck of victim in the bend of (b) Maintaining the pressure on the neck the elbow (c) Interposing a soft material between the hand (c) Compression of the neck by the hand and throat (d) Throwing a ligature over the neck from (d) Pressure exerted by the right hand behind and quickly tightening it 67. Which of the following is used as a method of 73. Hyoid bone fracture is seen in all of the execution in some countries? following EXCEPT (a) Bansdola (b) Garrotting (a) Throttling (c) Mugging (d) Smothering (b) Hanging (c) Choking 68. Last part to be dissected during autopsy in as- (d) Strangulation by ligature phyxia death (a) Neck (b) Head 74. Fracture of hyoid bone is more common in (c) Abdomen (d) Thorax (a) Hanging 69. In a suspected case of throttling, the procedure (b) Ligature strangulation advised at autopsy is (c) Manual strangulation (a) Block removal of neck structures for (d) Traumatic asphyxia subsequent detailed examination 75. In throttling fracture of the hyoid bone is com- (b) Skull and chest are opened and examined monly seen in before in situ examination of neck structures (a) greater horn (c) In situ examination of neck structures before (b) Lesser horn opening the skull and chest (c) Body (d) It is immaterial if you follow any of the (d) Both in the body and greater horn above methods 76. Maximum congestion is seen in 70. In case of throttling the situation and extent (a) Choking of the bruised areas on the neck depend on the (b) Hanging following EXCEPT (c) Strangulation (a) Relative positions of the assailant and (d) Drowning victim (b) The manner of grasping the neck 77. In “commando punch” the injury usually (c) The degree of pressure exerted upon the occurs to throat (a) Eye (b) Neck (d) The manner of application of the ligature (c) Face (d) Chest 65. (b) 66. (d) 67. (b) 68. (c) 69. (b) 70. (d) 71. (a) 72. (a) 73. (c) 74. (c) 75. (a) 76. (c) 77. (b)Chapter-13.indd 109 7/13/2011 5:17:31 PM
  • 110 S ECTION I: FORENSIC MEDICINE 78. The following are the differences of strangula- 85. Fracture of the body of thyroid cartilage may tion from hanging EXCEPT be seen in the following conditions EXCEPT (a) Carotid arteries damage is rare (a) Throttling (b) Fracture dislocation of cervical vertebrae is (b) In a cyclist in traffic accident common (c) Hanging (c) Neck is not elongated (d) Karate blow to the front of the neck (d) External signs of asphyxia are well marked 86. Bruising of the muscles of neck and larynx with 79. Fracture of hyoid bone, thyroid cartilage and fracture of thyroid cartilage and hyoid bone is cricoid cartilage along with neck muscle bruis- seen in death due to ing suggests (a) Hanging (a) Manual strangulation (b) Throttling (b) Ligature strangulation (c) Ligature strangulation (c) Hanging (d) Traumatic asphyxia (d) Choking 87. Palmar strangulation is caused by 80. Fracture of hyoid bone with thyroid cartilage (a) Forcibly closing throat by right palm along with neck muscle bruising suggests death (b) Forcibly closing throat by both palms due to (c) Forcibly closing throat by fingers of both (a) Strangulation (b) Hanging hands (c) Choking (d) Gagging (d) Karate blow to the front of the neck 81. Bilateral comminuted fractures of the larynx 88. Swelling and protrusion of the tongue is more are usually caused by common in (a) Pressing the neck with the hands (a) Hanging (b) A blow to the neck (b) Ligature strangulation (c) Ligature strangulation (c) Traumatic asphyxia (d) Garrotting (d) Gagging 82. Anteroposterior compression fracture of the 89. Cricoid cartilage is usually fractured in- larynx is usually caused by (a) Throttling (a) Ligature strangulation (b) Ligature strangulation (b) Throttling (c) Traumatic asphyxia (c) Garrotting (d) A blow to the front of the neck (d) Hanging 90. Which one of the following regarding death 83. Adduction type of fracture of hyoid bone is due to throttling is NOT true? seen in death due to (a) Fracture of the hyoid bone (a) Ligature strangulation (b) Fracture of thyroid cartilage (b) Hanging (c) Collection of blood behind the pharynx, (c) Throttling larynx and on the front of the cervical spine (d) Motor vehicle accidents (d) Fracture of cricoid cartilage 84. A blow on the larynx may cause death from 91. Fracture of hyoid bone and larynx indicate (a) Laryngospasm (a) Accidental throttling (b) Fracture of hyoid bone (b) Suicidal throttling (c) Air embolism (c) Homicidal throttling (d) Nerve paralysis (d) All of the above 78. (b) 79. (a) 80. (a) 81. (b) 82. (d) 83. (c) 84. (a) 85. (c) 86. (b) 87. (b) 88. (b) 89. (a) 90. (c) 91. (c)Chapter-13.indd 110 7/13/2011 5:17:31 PM
  • MECHANICAL ASPHYXIA 111 92. The most common cause of suffocation is 98. The postmortem finding seen in smothering (a) Inhalation of irrespirable gases (a) Abrasion on the inner side of the upper lip (b) Closure of glottis (b) Fracture body of hyoid (c) Pressure on chest (c) Thyroid fracture (d) Deprivation of oxygen (d) Curved marks on the neck 93. Which one of the following statements regard- 99. The positive findings of burial of a living per- ing suicidal smothering is NOT true? son is (a) It can occur by closing the nose and mouth (a) Presence of moulds on the body by the hand (b) Congestion of liver and spleen (b) It is possible by burying the face in a mattress (c) Marked pulmonary oedema (c) It is possible by lying against the bed clothing (d) Earth or sand in trachea and bronchi to obstruct the nose and mouth 100. From autopsy, it is extremely difficult to de- (d) It can be effected by tying a polythene bag tect over the head (a) Homicidal smothering 94. In suffocation, petechial haemorrhages may be (b) Homicidal gagging seen in (c) Homicidal choking (a) Pericardium (b) Meninges (d) Homicidal ligature strangulation (c) Peritoneum (d) All of the above 101. Burking is a name derived from a 95. Which one of the following is NOT correct, (a) Place concerning accidental smothering? (b) Person (a) It is less common than suicidal smothering (c) Firearm (b) It can occur in a vitiated atmosphere (d) Weapon used for murder (c) It is not necessary that the mouth and nostrils 102. A method of homicidal smothering and trau- should be completely closed at the start matic asphyxia is known as (d) An intoxicated person may smother himself (a) Choking (b) Gagging by burying his face in a pillow or covering (c) Burking (d) Overlaying with bed clothes 103. A method of sitting over chest and closing 96. It is true regarding subcutaneous rupture of nostrils and mouth to cause asphyxial death is larynx and trachea that known as (a) It may produce widespread subcutaneous (a) Overlaying (b) Choking emphysema (b) It can be produced by the impaction of large (c) Burking (d) Gagging food bolus 104. Burking is combination of smothering and (c) It is only a presumption not a reality (a) Strangulation by ligature (d) None of the above (b) Throttling 97. Paleness of the face with few petechial haemor- (c) Gagging rhages in the eyelids are seen when smothering (d) Traumatic asphyxia is caused by 105. In burking the cause of death is (a) Closing the mouth and nose by the hand (a) Smothering (b) In air-tight place (b) Traumatic asphyxia (c) Inhalation of irrespirable gases (c) Smothering and traumatic asphyxia (d) Head and face enclosed in a plastic bag (d) Cerebral congestion 92. (a) 93. (a) 94. (a) 95. (a) 96. (a) 97. (d) 98. (a) 99. (d) 100. (a) 101. (b) 102. (c) 103. (c) 104. (d) 105. (c)Chapter-13.indd 111 7/13/2011 5:17:31 PM
  • 112 S ECTION I: FORENSIC MEDICINE 106. The cause of death from choking include all of 113. “Cafe coronary” is the following EXCEPT (a) A type of death due to choking (a) Asphyxia (b) Cerebral anaemia (b) Sudden death due to coronary thrombosis (c) Cardiac inhibition (d) Laryngeal spasm (c) Death due to alcoholic cardiomyopathy 107. Choking (d) Food poisoning (a) It is a form of asphyxia caused by mechanical 114. The cause of death in cafe coronary is occlusion within air passages by a solid (a) Asphyxia object (b) Coronary thrombosis (b) A twig of madar 20 cm long (c) Sudden heart attack (c) It is practised in India by dais (d) Laryngeal spasm (d) Occurs due to closure of external respiratory 115. In overlaying death occurs due to orifices (a) Smothering 108. Mode of death from obstruction of the air pas- (b) Compression of the chest sages from within is (c) Inhalation of gastric contents (a) Anaemic anoxia (b) Stagnant anoxia (d) None of the above (c) Anoxic anoxia (d) Histotoxic anoxia 116. The term overlaying implies 109. Choking due to regurgitation of food may oc- (a) Asphyxia caused by an obstruction within cur in air passages (a) Under the influence of drink (b) Homicidal smothering (b) Head injury (c) Asphyxia resulting from forcing a cloth into (c) Traumatic asphyxia mouth (d) Smothering (d) Compression suffocation 110. Death caused due to regurgitation of food and 117. Presence of mucus, saliva and oedema fluid on inhalation into the respiratory tract is called the clothing tied over mouth and is suggestive (a) Smothering of (b) Choking (a) Antemortem gagging (c) Traumatic asphyxia (b) Choking (d) Mugging (c) Struggle before death 111. Homicidal choking can be produced when a (d) Traumatic asphyxia victim is 118. Detection of buccal epithelium on the gagging (a) An infant material may help (b) Disabled (a) To establish the sex of the victim (c) Under the influence of alcohol (b) To establish the sex of the accused (d) All of the above (c) To ascertain the age of the victim 112. Cafe coronary commonly occurs in persons (d) To ascertain the age of the accused who 119. Traumatic asphyxia results from (a) Had a previous heart attack (a) Injury to the head (b) Intoxicated (b) Crushing of the chest and abdomen (c) Suffering from anginal attacks (c) Crushing of the lower limbs (d) All of the above (d) Fall from a height on the buttocks 106. (b) 107. (a) 108. (c) 109. (a) 110. (b) 111. (d) 112. (b) 113. (a) 114. (a) 115. (b) 116. (d) 117. (a) 118. (a) 119. (b)Chapter-13.indd 112 7/13/2011 5:17:32 PM
  • MECHANICAL ASPHYXIA 113 120. All of the following are causes of traumatic as- (c) Cold water entering ear drums or mucosa of phyxia EXCEPT the pharynx and larynx (a) Gross compression of the chest and (d) All of the above abdomen 127. Atypical arrest due to drowning is (b) Stampede in a crowd (a) Cardiac arrest due to drowning (c) Falls of earth or stone during tunnelling (b) Laryngospasm due to drowning (d) Gross compression of the head (c) Drowning in unconscious state 121. All the following can cause traumatic asphyxia (d) All of the above EXCEPT 128. Dry drowning is (a) Railway accident (a) When a person falls in a dry well and dies (b) Road traffic accident (b) Death occurs due to fall in water from spasm (c) Stampede in crowd of larynx (d) Accidental strangulation (c) Falls in water and die due to vagal 122. The characteristic feature of traumatic asphyxia inhibition is (d) All of the above (a) Multiple fractures of bones 129. Which is NOT a contributory cause of death (b) Deep purple colour of the head, neck and in immersion syndrome? upper chest (a) Cold water entering the pharynx and (c) Collapse of the lungs larynx (d) Abrasions and contusions around the mouth (b) Cold water stimulating the nerve endings of and nose the surface of the body 123. Which of the following is not a cause of death (c) High emotion due to suffocation? (d) Hyperkalaemia (a) Choking (b) Gagging 130. The salt concentration of seawater is about (c) Smothering (d) Throtting (a) 0.5% (b) 0.1% 124. Death is usually accidental in the following (c) 2.0% (d) 3.0% conditions EXCEPT 131. In freshwater drowning there is (a) Traumatic asphyxia (b) Choking (a) Hypernatraemia (c) Gagging (d) Overlaying (b) Hyperkalaemia 125. The term “dry drowning” is used when death (c) Hypermagnesaemia occurs (d) Hypercalcaemia (a) Within half hour to several days after 132. Hypervolaemia and hyperkalaemia are seen in resuscitation (a) Freshwater drowning (b) From immediate sustained laryngeal spasm (b) Saltwater drowning (c) From vagal inhibition (c) Dry drowning (d) From hyperkalaemia (d) Immersion syndrome 126. In immersion syndrome death results from va- 133. Haemodilution occurs in gal inhibition due to (a) Seawater drowning (a) Cold water striking the epigastrium (b) Freshwater drowning (b) Cold water stimulating the sensory nerves (c) Both seawater and freshwater drowning in the skin (d) None of the above 120. (d) 121. (d) 122. (b) 123. (d) 124. (c) 125. (b) 126. (d) 127. (d) 128. (b) 129. (d) 130. (d) 131. (b) 132. (a) 133. (b)Chapter-13.indd 113 7/13/2011 5:17:32 PM
  • 114 S ECTION I: FORENSIC MEDICINE 134. Exchange of water in drowning at alveolar level (a) Total asphyxia is produced due to fresh- depends upon water drowning (a) Quantity of the water inhaled (b) Laryngospasm causes vagal inhibition (b) Osmotic gradient between blood and water (c) Haemoconcentration of blood caused by (c) Thickness of the alveolar septa osmotic pressure effect (d) All of the above (d) Haemodilution, overloading of heart and 135. The common cause of death in freshwater haemolysis resulting in release of potassium drowning is 142. Fatal period in freshwater drowning is about (a) Asphyxia (a) 2 to 3 minutes (b) 4 to 5 minutes (b) Ventricular fibrillation (c) 4 to 8 minutes (d) 8 to 10 minutes (c) Laryngeal spasm 143. Hypernatraemia is seen in (d) Vagal inhibition (a) Freshwater drowning 136. The common cause of death in seawater (b) Saltwater drowning drowning is (c) Immersion syndrome (a) Laryngeal spasm (b) Vagal inhibition (d) All of the above (c) Exhaustion (d) Asphyxia 144. Signs of asphyxia are absent in 137. In dry drowning death is due to (a) Wet drowning (a) Laryngeal spasm (b) Dry drowning (b) Exhaustion (c) Secondary drowning (c) Ventricular fibrillation (d) Seawater drowning (d) Vagal inhibition 145. Slow death occurs from asphyxia in 138. The cause of death in immersion syndrome is (a) Freshwater drowning (a) Laryngeal spasm (b) Saltwater drowning (b) Ventricular fibrillation (c) Secondary drowning (c) Vagal inhibition (d) Immersion syndrome (d) Asphyxia 146. In drowning in unconscious state the lungs 139. The complication of drowning in freshwater is are (a) Haemodilution (a) Ballooned (b) Severe pulmonary oedema (b) Not ballooned (c) Hypokalaemia (c) Collapsed (d) Hypernatraemia (d) Show congestion and petechial haemorrhages 140. Reflex cardiac arrest is due to 147. Which of the following is not seen in sea water (a) Sudden flow of water into the nasopharynx drowning? (b) Sudden thrust of water over the abdominal (a) Hypernatraemia region (b) Hyperkalaemia (c) In both (a) and (b) (c) Fluid retention (d) Does not occur in drowning (d) Intravascular dehydration 141. In case of freshwater drowning death occurs 148. Victim of drowning in a state of suspended within 4 to 5 min of submersion due to ven- animation can be revived within tricular fibrillation. Which of the following (a) 10 to 20 minutes (b) 30 to 60 minutes reasons is responsible for this? (c) 1 to 2 hours (d) 2 to 3 hours 134. (b) 135. (b) 136. (d) 137. (a) 138. (c) 139. (a) 140. (c) 141. (d) 142. (c) 143. (b) 144. (c) 145. (b) 146. (b) 147. (b) 148. (a)Chapter-13.indd 114 7/13/2011 5:17:32 PM
  • MECHANICAL ASPHYXIA 115 149. At autopsy, a body was found to have fine froth 157. Most important sign of death due to drowning from the nose and mouth which increased on is compression of the chest. Which of the follow- (a) Washerwoman’s hands and feet ing is the most likely cause of death? (b) Weeds and grass grasped in the hands (a) Opioid poisoning (b) Hanging (c) Cutis anserina (c) Drowning (d) Cyanide poisoning (d) Cyanosis 150. Reaction phenomenon is seen in 158. Important sign of antemortem drowning is in- (a) Burns (b) Drowning dicated by (c) Poisoning (d) Gunshot injury (a) Cutis anserina 151. It is true regarding seawater and freshwater (b) Frothy fluid in mouth and nostril drowning that (c) Grass and weeds in hands (a) The mechanism of death is the same (d) Washerwomen’s hands (b) The mechanism of death is different 159. Postmortem staining is usually found on the (c) The mechanism of death is the same but the face, upper part of the chest and hands and feet time taken is different in death due to (d) All of the above (a) Choking (b) Strangulation 152. Rigor mortis in case of drowning (c) Drowning (d) Traumatic asphyxia (a) Appears late 160. The most characteristic external sign of drown- (b) Appears early ing is (c) Has no effect on appearance (a) Cutis anserina (d) Appears early in postmortem drowning (b) Washerwoman’s hands and feet 153. Which of the following is NOT true about (c) Fine, white, lathery froth at the mouth and freshwater drowning? nostrils (a) Hypovolaemia (d) Distended abdomen (b) Ventricular fibrillation (c) Hyperkalaemia 161. Specific gravity of human body is (d) Haemolysis (a) 1.08 (b) 2.01 (c) 1.05 (d) 2.35 154. Cutis anserina is seen in (a) Drowning (b) Hanging 162. Large quantity of froth is found at the mouth (c) Electrocution (d) Mummification and nose in the following, EXCEPT 155. Washerwoman’s hands and feet are usually seen (a) Strangulation in a case of drowning in (b) Electrical shock (a) 6 to 12 hours (b) 18 to 24 hours (c) Traumatic asphyxia (c) 24 to 36 hours (d) 36 to 48 hours (d) Opium poisoning 156. All of the following are features of washer- 163. A child got drowned in a pond. The most char- woman’s hands, EXCEPT acteristic finding at autopsy is (a) Soddening of the skin (a) Petechial haemorrhages (b) Thinning of the skin (b) Washerwoman’s feet (c) Wrinkling of the skin (c) Cutis anserina (d) Bleaching of the skin (d) Froth at mouth and in respiratory passage 149. (c) 150. (b) 151. (b) 152. (b) 153. (a) 154. (a) 155. (b) 156. (b) 157. (b) 158. (c) 159. (c) 160. (c) 161. (a) 162. (c) 163. (d)Chapter-13.indd 115 7/13/2011 5:17:32 PM
  • 116 S ECTION I: FORENSIC MEDICINE 164. Froth of drowning can be differentiated from (b) Froth in the trachea that due to other causes by (c) Mud and sand particles in the terminal (a) Microscopic detection of mucus bronchioles (b) Detecting excess of sodium chloride (d) Diatoms in the lungs (c) Detecting excess of potassium 171. In freshwater drowning the lungs are (d) Detecting excess of magnesium (a) Ballooned but light in weight 165. Absence of foam in drowning can be found in (b) Ballooned and heavy (a) Dry drowning (c) The shape of sectioned portion is not (b) Immersion syndrome retained (c) Both (a) and (b) (d) Copious amounts of fluid pours out of the (d) Wet drowning cut section 166. The colour of the postmortem staining may be 172. In saltwater drowning the lungs are pink or cyanotic in death due to (a) Ballooned and heavy (a) Hanging (b) Ballooned but light in weight (b) Drowning (c) Pale pink in colour (c) Traumatic asphyxia (d) On section water does not pour out (d) Throttling 173. In death due to drowning in sea difference of 167. The important finding of antemortem drown- at least --------% in chloride content in left and ing is right side of heart is significant (a) Froth in mouth and nostrils (a) 5 (b) 10 (b) Washerwoman’s hands and feet (c) 25 (d) 60 (c) Fluid and air in the bronchi 174. A person brought to casualty showing froth at (d) Haemoconcentration the mouth and nose, which increases on com- 168. All of the following are the findings in sea-wa- pression of chest, is seen in ter drowning EXCEPT (a) Secondary drowning (a) Pulmonary oedema (b) Strangulation (b) Hypernatraemia (c) Dry drowning (c) Hyperkalaemia (d) Hanging (d) Haemoconcentration 175. Petechial haemorrhages in drowning may be 169. Regurgitation of gastric contents into the lar- seen in ynx and trachea in cases of drowning is due to (a) Subpleural tissues of lung (a) Ingestion of large quantities of water (b) Submucosa of trachea (b) Medullary hypoxia (c) Bronchioles (c) Stimulation of gastric mucosa by substances (d) Alveoli in ingested water 176. Drowning can be diagnosed if there is (d) All of the above (a) Cyanosis 170. The most characteristic internal finding in (b) Fracture of hyoid bone drowning is (c) Water and diatoms in lungs and stomach (a) Emphysema aquosum (d) All of the above 164. (a) 165. (c) 166. (b) 167. (c) 168. (c) 169. (b) 170. (c) 171. (a) 172. (a) 173. (c) 174. (a) 175. (a) 176. (c)Chapter-13.indd 116 7/13/2011 5:17:32 PM
  • MECHANICAL ASPHYXIA 117 177. Drowning is characterised by the following 185. In cases of death due to drowning, water in signs EXCEPT small intestine is (a) Lungs are ballooned (a) An important finding (b) Trachea and bronchi contain froth and sand (b) Not an important finding (c) Diatoms are present (c) Helps in estimating time since death (d) Stomach is empty while lungs are full of (d) None of the above water 186. Temporal bone haemorrhages are found in 178. Bulky oedematous lungs with fine froth and (a) Throttling (b) Drowning diatoms are suggestive of (c) Cyanide poisoning (d) Arsenic poisoning (a) Antemortem drowning 187. In a putrefied body, the most important find- (b) Postmortem drowning ing indicating death due to drowning is (c) Antemortem hanging (a) Specific gravity of plasma from right side of (d) Suicidal hanging heart is more than left 179. In drowning, emphysema aquosum is seen in (b) Difference in chloride in right and left side (a) 30% (b) 50% of heart (c) 80% (d) 95% (c) Presence of water in the pleural cavities 180. Emphysema aquosum is seen in (d) Presence of diatoms in internal organs (a) Wet drowning 188. If the postmortem is delayed in a case of drown- (b) Dry drowning ing (c) Secondary drowning (a) The typical findings in the lungs may (d) Immersion syndrome disappear (b) The typical findings in the lungs are not 181. Paltauf ’s haemorrhages are seen in affected (a) Electrocution (b) Hanging (c) The diatom test becomes negative (c) Throttling (d) Drowning (d) None of the above 182. Presence of aquatic vegetation in lower respira- 189. Acid digestion technique is used for tory tract in a case of drowning (a) Detection of algae in stomach contents in (a) Is positive proof of drowning drowning (b) Not a definite sign (b) Detection of diatoms in tissues in (c) Not significant at all drowning (d) Can be seen in both antemortem and (c) Detection of metallic pieces in the muscles postmortem drowning (d) All of the above 183. Water is found in the stomach in cases of 190. One of the following is a sure sign of death due drowning in to drowning (a) 20 to 30% cases (b) 30 to 40% cases (a) Cutis anserina (c) 50 to 60% cases (d) 60 to 70% cases (b) Water in the stomach 184. Water can be absent in the stomach in cases of (c) Pulmonary oedema drowning due to (d) Diatoms detected in bone marrow (a) Immersion syndrome 191. The confirmatory laboratory test for death due (b) Putrefaction to drowning in seawater is (c) Both (a) and (b) (a) Diatom test (b) Chloride test (d) Absorption of water after death (c) Specific gravity test (d) None of the above 177. (d) 178. (a) 179. (c) 180. (a) 181. (d) 182. (a) 183. (d) 184. (c) 185. (a) 186. (b) 187. (d) 188. (a) 189. (b) 190. (d) 191. (d)Chapter-13.indd 117 7/13/2011 5:17:32 PM
  • 118 S ECTION I: FORENSIC MEDICINE 192. Commonest type of drowning is (a) Diatom test (a) Suicidal (b) Accidental (b) Chloride test (c) Homicidal (d) Undetermined (c) Magnesium estimation 193. Accidental drowning can be ruled out if (d) None of the above (a) Hands and feet are tied by a ligature 200. In faked drowning, the following signs may be (b) The body is tied up inside a gunny bag present EXCEPT (c) Heavy weights are attached to the body (a) Lungs will be normal (d) All of the above (b) Heart shows normal chloride contents in 194. Which of the following sign will indicate that both chambers the death due to drowning was antemortem? (c) Trachea will not be congested (a) Cutis anserina (d) Cutis anserina will be prominent (b) Washerwoman’s hands 201. In a person who died of drowning in seawater (c) Weeds and grass in the hands (a) Lungs are pale pink (d) Cyanosis (b) Signs of asphyxia are not seen 195. Hydrostatic lung can be seen (c) Stomach does not contain water (a) If the body is removed from water within 6 (d) The chloride content of left side of heart is hours of drowning higher (b) If the body remains in water at a depth of 2 202. Diatoms are metres for 20 hours (a) Parasites (b) Algae (c) In secondary drowning (c) Bacteria (d) Fungi (d) Drowning in shallow water 203. The conclusive postmortem finding of death 196. False negative hydrostatic test in a live born by drowning is foetus is seen in (a) Cutis anserina (a) Atelectasis (b) Artificial respiration (b) Presence of water in the middle ear (c) Emphysema (d) Putrefaction (c) Oedematous lung 197. In a suspected case of drowning diatoms can be (d) Demonstration of diatoms in the organs of looked for in the body (a) Brain (b) Bone marrow 204. Gettler’s test is used in (c) Liver (d) All of the above (a) Hanging (b) Strangulation 198. Differenciate between freshwater drowning (c) Drowning (d) Poisoning and seawater drowning 205. Bleaching of cuticle begins after (a) Frothing is seen in freshwater drowning (a) 4 to 8 hours of immersion only (b) 12 hours of immersion (b) Diatoms are found in the sternum in (c) 24 hours of immersion freshwater drowning (d) 48 hours of immersion (c) Increase in the chloride levels in the left side of heart 206. Floatation of a body in water is due to (d) Pulmonary oedema (a) Flesh being eaten by fishes 199. The following is the absolute and confirmatory (b) Presence of gases laboratory test for deaths due to drowning in (c) Water logging of body seawater (d) All of the above 192. (b) 193. (d) 194. (c) 195. (b) 196. (a) 197. (d) 198. (c) 199. (d) 200. (d) 201. (d) 202. (b) 203. (d) 204. (c) 205. (a) 206. (b)Chapter-13.indd 118 7/13/2011 5:17:32 PM
  • MECHANICAL ASPHYXIA 119 207. A dead body will float in summer after drown- (c) Can cause delayed death ing in (d) Can cause secondary drowning (a) 6 to 12 hours (b) 12 to 24 hours 211. The most fatal complication that can occur to (c) 24 to 36 hours (d) 36 to 48 hours divers (under high atmospheric pressure) is 208. Air pockets in clothing may cause (a) Pulmonary oedema (a) Early floatation of the body (b) Air embolism (b) Late floatation of the body (c) Vagal inhibition (c) No effect on floatation (d) Suffocation (d) No floatation at all 212. Sexual asphyxias are commonly associated 209. Deep inspiration above the water level may with cause (a) Sadism (b) Fetichism (a) No effect on floatation of body (c) Masochism (d) Voyeurism (b) Early floatation of body 213. The most frequent method of sexual asphyxias (c) Late floatation of body is (d) Late floatation of body only in seawater (a) Hanging 210. Hyperventilation before drowning (b) Electrical stimulation of genitals (a) Can cause immediate death (c) Enveloping the head in a plastic bag (b) Does not alter the process of drowning (d) Inhalation of stupefying substances 207. (b) 208. (a) 209. (b) 210. (c) 211. (b) 212. (c) 213. (a)Chapter-13.indd 119 7/13/2011 5:17:32 PM