FMT HUBs

137.Explanation Correct Answer - D Ans. is 'd' i.e., 210 days Viability means the physical ability of a foetus to lead a separate existence after birth apart from its mother, by virtue of a certain degree of development. A child is viable after 210 days (7 months) of intrauterine life, and in some cases after 180 days (6 months) but in most of these cases fetus is immature. Full term mature infant show :- Length (crown-heel length) 48-52 cm, head circumference 30-35 cm. Ossification center at lower end of femur (appears at the end of 9 months or just before birth) and Ossification center of cuboid and upper tibia may also present (Note : some ossification centers are also present, but they appear before the attainment of viability so their presence does not have importance. These are (i) Clavicle, mandible, ribs vertebra → at the end of 2nd month, (ii) Calcaneum(os calcis) and manubrium sterni → at the end of 5th month and (iii) Sternum → at the end of 6 month). Other center which appears at attainment of viability is primary ossificaion center of talus which appears at the end of 7th month Join @FMThubs

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136.Explanation Correct Answer - B Ans. is 'b' i.e., It is developed in presence of air Adipocere formation (saponification). Adipocere is a modification of putrefaction, which occurs in the absence of air. That is when there is excessive moisture (humidity) and warnth (warm temperature), but absence of air i.e. warm humid climate, normal putrefaction does not occur, rather saponification occurs. Thus adipocese formation occurs in dead bodies which are lying in water (immered in water) or burned in damp lay soil. Saponification (adipocer formation) is the conversion of dead body into soft, fatty waxy substance due to conversion of unsaturated liquid fats to saturated solid fats under the influence of intrinsic lipase and lecithinase produced by Cl. perfringens. The process involves gradual hydrolysis and hydrogenation of body fats into higher fatty acids which combine with calcium and ammonium ions to form insoluble soaps. Ultimately, palmitic, oleic, stearic and hydroxystearic acids are formed, mixture of these is known as adipocere. Adipocere formation starts in subcutaneous fat and is marked in areas having excessive fat, eg. cheeks, female breast, buttocks and abdomen. Slowly the whole body including muscles and internalviscera change into adipocere. Adipocere has offensive or sweetish smell, however in early stages, smell is ammonical. Body is converted into soft, waxy and brittle substance, it floats on water, it can be cut easily, it dissolves in alcohol and ethers, and it melts on heating. Facial features and injuries on body are well preserved, thus identfication of body and determination cause of death (in case of injury) are possible. Normally adipocere formation requires 3 weeks to upto 3 to 6 months. However shortest recorded period in india is 3 days 22 hours. In india, it has been observed to begin within 4-5 days. Adipocere may persist for years or decades. Adipocere does not occur in foetus less than 7 month's. Medicolegal importance : (i) Identification of body (facial features are preserved), (ii) cause of death (injury marks are preserved), (iii) time since death can be estimated. Join @FMThubs

135.Explanation Correct Answer - B Ans. is 'c' i.e., < 18 years Juvenile Justice Act 2000 Juvenile justice (care and protection of children Act, 2000 (now Amendment Act 2006) covers :- i. Juveniles in conflict → child who is alleged to have committed an offence. ii. Children in need of care and protection → children who are neglected, abused, or abandoned. This act defines a juvenile / child as a person who has not completed the age of 18 years. Join @FMThubs

134.Explanation Correct Answer - C Ans. is 'c' i.e., Maceration Dead born : A deadborn child is one which has died in utero and shows one of the following signs after it is completely born :? 1) Rigor mortis : Rigor mortis may occur in dead fetus before birth or at birth. 2) Maceration : Maceration is a process of aseptic autolysis. It occurs when a dead fetus remains in the uterus for 3-4 days surrounded by liquor amnii but with exclusion of air. Skin slippage is the earliest sign (occurs within 12 hours). There is gas in the great vessels and chambers of heart (Robert's sign). Except for lung and uterus, which remain unchanged for a long time, all other organs become soft, oedematous and loose there morphology. The one important radiological sign suggestive of maceration is 'Spaulding's sign' i.e. skull bones override each other. The smell is somewhat rancid. 3) Putrefaction (decomposition) : If the membranes are ruptured after death of fetus and air gains entry into liquor amnii, fetus undergoes putrefaction instead of maceration. Body is greenish, foul smelling and bloated. 4) Mummification : It results when there is deficient blood supply, scanty liquor and no air enters uterus. Body is thin, shrivelled dark brown and emitting smell like rotten cheese. Join @FMThubs

133.Explanation Correct Answer - D Ans. is 'd' i.e., Thomas Methods of removal of organs Virchow's technique - organs are removed one by one. Cranial cavity is exposed first, followed by thoracic, cervical & abdominal organs. Rokitansky's technique - It involves in situ dissection in part, combined with en block removal. Lettulle's technique - Cervical, thoracic, abdominal & pelvic organs are removed en masse & dissected as organ block. Join @FMThubs

132.Explanation Correct Answer - C Ans. is 'c' i.e., 21 years A person attains majority on completion of 18 years. However if a person is under the guardianship of court, he attains majority after 21 years (Indian Majority Act 1875). Join @FMThubs

131.Explanation Correct Answer - B Ans. is 'b' i.e., Tache noir If the eye lids are open for a few hours after death, a film of cell debris and mucous forms two yellow triangles on the sclera on either side of the iris , which become brown and then black called tache noir withing 3 - 4 hours Join @FMThubs

130.Explanation Correct Answer - C Ans. is 'c' i.e. Hyperkalemia Join @FMThubs

129.Explanation Correct Answer - A Ans. is 'a' i.e., Vagal inhibition Types of drowning Drowning is classified as (1) typical and (2) atypical. 1. Typical drowning (wet drowning) Typical drowning refers to obstruction of air passages and lungs by inhalation of water or other fluid. Therefore it is also called wet drowning and findings offluid and froth are present in PM examination. Typical drowning may be :- i. Fresh water drowning : In fresh water drowning large quantities of water cross the alveolar membrane into circulation causing hypervolaemia and hemodilution. RBCs imbibe water and burst (hemolysis) with liberation of potossium. Therefore, heart is exposed to volume overload, potassium excess, sodium deficit (hyponatremia), and anoxia. Anoxia and hyperkalemia cause ventricular fibrillation and death in 4-5 minutes. ii. Salt water drowning : Hypertonicity of inhaled water causes loss of fluid from circulation into the lungs giving rise fulminating pulmonary edema with progressive hypovolaemia, circulatary shock, and eventually cardiac standstill (asystole) with death in 8-12 minutes. 2. Atypical drowning It refers to drowning in which even after submersion of body in water, little or no water anters respiratory passages and lungs.Hence typical findings of wet drowning in the form of froth and oedema aquosum of lungs are not found. Atypical drowning may be :- i. Dry drowning : On contact with water, especially cold water, there results intense laryngospasm, so that water does not enter the lungs. Death is due to asphyxia because of laryngospasm. ii. Immersion syndrome (hydrocution/submersion inhibition/vagal inhibition) : Sudden death occurs due to vagal inhibition as a result of (a) sudden impact with cold water, (b) duck diving (falling in water with feet first), and (c) horizontal entry in water with impact on epigastrium. iii. Submersion of unconscious : If person is unconscious since before submersion in water, little or no water enters respiratory passages. It may occur in MI, cerebrovascular accident, hypertension, epilepsy, cerebral aneurysm and in drunk state. iv. Near drowning (secondary drowning syndrome/post immersion syndrome) : In this drowning is survived and death occurs at a later stage after removal from water. Either the person himself comes out of water or he is recovered alive, but due to complications of submersion, he dies at a later stage. It is due to hypoxic encephalopathy and fibrosing alveolitis. The death occurs due to combined effect of cerebral hypoxia, pulmonary edema, aspiration pneumonitis, electrolyte disturbances and metabolic acidosis. Join @FMThubs