Medicozpg

Forensic medicine: is the application of medical and paramedical knowledge in the administration of law and justice. Legal medicine and state medicine are other names for it.
Medical jurisprudence: deals with the legal rights, privileges, duties and obligations of medical practitioner.
Points to remember
1. Pin – point pupils = O***m
2. Dilatation of pupils = Dhatura, Cyanide
3. Constriction of pupils = O***m, phenol, organo-phosphorus, physostigmine, chloral hydrate.
4. Cumulative poisons are: Barbiturates, and methyl alcohol
5. Habit forming poisons are: Caffeine and Ni****ne.
6. Addiction drugs are: Alcohol, Barbiturates, Coccaine, Cannabis, Chloral hydrate, O***m, Pethidine.
7. Hemodialysis is good value in: Salicylate, methanol, barbiturate, and aspirin (except kerosene oil and diazephem)
8. 1st sign of intra-uterine death: Gas shadow in aorta (as early as 12 hours).
9. Increased anion gap is seen in Salicylate poisoning, lactic acidosis, starvation.
10. Ideal su***de poison = Cyanide
11. Ideal homicide poison = Thallium, fluoride compounds.
12. Commonly used homicidal poisons: Arsenic, aconite
13. Commonly used suicidal poisons: Endrine, O***m, Barbiturates, Organo-phosphorus compounds.
14. Poison resembling cholera = Arsenic
15. Poison resembling tetanus = Strychnine
16. Poison resembling natural death = Thallium
17. Poison resembling fading measles = Arsenic
18. Poison resembling thyrotoxicosis = Bi-nitro compounds.

Tests for detecting poisons:
• Arsenic = Marsh’s test, Reinsch’s test
• O***m = Marquis test
• Alcohol = Mc’evan’s test
• Datura = Mydriatic test
• Phenol = Green urine.

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🍒 Cherry red spot – cherry red spot myoclonus syndrome.
🍒Cherry angioma – senile haemanigoma.
🍒CHERRY RED SPOTS-central retinal artery occlusion,berlins oedema,tay sachs,niemanns picks, gauchers

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Q1-Which of the following anesthetic agents does not trigger malignant hyperthermia?
a) Halothane
b) Isoflurane
c) Suxamethonium
d) Thiopentone

Answer: Thiopentone
Explanation:
Agents causing malignant hypothermia:
Inhalation agents:
Halothane (Most common inhalation agent)
Isoflurane
Enflurane
Desflurane
Sevoflurane
Methoxyflurane
Muscle relaxants:
Succinyl-choline (Most common agent)
Local Anesthetics:
Lignocaine

Q2-Which of the following intravenous induction agents is the most suitable for day care surgery?
a) Morphine
b) Ketamine
c) Propofol
d) Diazepam

Answer: Propofol
Explanation:
Agent of choice-Day care surgery
Propofol———-Intravenous induction agent
Desflurane——-Inhalation induction agent
Muscle relaxant-Mivacurium

Q3-Which of the following agents is used for the treatment of postoperative shivering?
a) Thiopentone
b) Suxamethonium
c) Atropine
d) Pethidine

Answer: Pethidine
Explanation:
Treatment of postoperative shivering:
Oxygen inhalation
Tramadol (Drug of choice)
Pethidine
Pentazocine
Most commonly shivering is seen after halothane administration.

Q4-Which of the following agents is not used to provide induced hypotension during surgery?
a) Sodium nitroprusside
b) Hydralazine
c) Mephentermine
d) Esmolol

Answer: Mephentermine
Explanation:
Mephentermine acts directly on both alfa and beta receptors to cause cardiac stimulation and vasoconstrictions.
Mephentermine increases the cardiac output and both systolic and diastolic blood pressure.
It is used to prevent hypotension.

Motor supply of the diaphragm is
a) Thoraco-dorsal nerve
b) Inter-costal nerves
c) Phrenic nerve
d) Sympathetic nerves

Answer: Phrenic nerve
Explanation:
The diaphragm is primary muscle of respiration.
It is dome shaped and consists of a peripheral muscular part and a centrally placed tendon.
On contraction, it pulls down its central tendon and increases the vertical diameter of the thorax.
Motor supply: Phrenic nerve (C3, 4 and 5) only
Sensory supply:
Phrenic nerve: Parietal pleura and peritoneum covering the central surface of diaphragm
The lower six inter-coastal nerve: The periphery of diaphragm

🍟🍟🍟LUNG TUMORS ( PAEDIATRIC AGE GROUP)🍟🍟🍟

🍕 most common tumor of the pediatric lung -METASTASIS
most commonly from
🍷 osteosarcoma
🍷 wilms tumour
🍕 most common benign tumor of the pediatric lung (both infants and children) is-INFLAMATORY MYOFIBROBLASTIC TUMOR
🍕most common benign lung tumor in infants-PLEUROPULMONARY BLASTOMA
🍕 most common primary malignant tumor of the pediatric lung is-BRONCHIAL CARCINOID
🍕intra pulmonary form of hodgkin disease in adults is-bronchovascular

🍷🍷🍷🍷🍷🍷

🍟🍟LUNG TUMORS:

🍣MC lung mass-GRANULOMA
🍣MC benign tumor of lung-HAMARTOMA
🍣MCC of pulmonary tumor embolus-GASTRIC CANCER
🍣 MC histologic type of bronchogenic carcinoma associated with cavitation : SQUAMOUS CELL CANCER
🍣MC histologic type of bronchogenic carcinoma associated with pancoast tumor :
SQUAMOUS CELL CANCER
🍣MC histologic type of bronchogenic carcinoma associated with pleural effusion : ADENOCARCINOMA
🍣MC histologic type of lung cancer associated with asbestosis exposure :BRONCHOALVEOLAR CARCINOMA
SQUAMOUS CELL CANCER
🍣 MC right cardiophrenic angle mass : Epicardial fat-pad/lipoma
🍣MC type of intrapulmonary involvement of Hodgkins disease : Bronchovascular form.
🍣 MC primary lung tumor under age 16 : Bronchial Adenoma
🍣 MC Histological Type of Lung Ca in World – Adenoca
🍣MC Histological Type of Lung Ca in Young Patient – Adenoca
🍣MC Histological Type of Lung Ca in Female Patient – Adenoca
🍣MC Histological Type of Lung Ca in Nonsmoker – Adenoca
🍣MC Histological Type of Lung Ca metastasized to Opposite Lung – Adenoca
🍣MC Histological Type of Lung Ca arising at periphery of lung – Adenoca
🍣MC Histological Type of Lung Ca arising from Bronchioles – Adenoca
🍣MC Histological Type of Lung Ca associated with Hypercalcemia – Squamous Cell Ca
🍣MC Histological Type of Lung Ca in Smoker – Squamous Cell Ca > Small Cell Ca
🍣MC Histological Type of Lung Ca in India – Squamous Cell Ca
🍣MC lung ca assosicated with scars-adenocarcinoma
🍣MC Lung Ca detected by positive sputum cytology – Squamous Cell Ca
🍣 MC Lung Ca leading to Pancoast Tumor – Squamous Cell Ca
🍣MC Lung Ca with Best Prognosis – Squamous Cell Ca
🍣MC Lung Ca with Poor Prognosis – Large Cell Ca
🍣MC Lung Ca Responding to Chemotherapy – Small Cell Ca
🍣MC Lung Ca Responding to Radiotherapy – Small Cell Ca
🍣MC Lung Ca causing SVC syndrome – Small Cell Ca
🍣 MC Lung Ca associated with Hypokalemia – Small Cell Ca
🍣 MC Lung Ca associated with Paraneoplastic Syndrome – Small Cell Ca
🍣 MC Lung Ca associated with Clubbing – Non Small Cell Ca
🍣 MC Lung Ca present at peripheral location – Non Small Cell Ca

🍣🍣🍣🍣🍣🍣

1.Hutchison freckle? Lentigo maligna✅✅

2.Hutchison sign? Periungual melanoma✅✅

3.Hutchison triad? Interstitial keratitis, snhl, notched incissors in Cong.syphilis✅✅

4.Hutchison teeth? Notched incisors in cong.syphilis✅✅

5.Hutchison rule? If tip of nose is involved, ocular involvement incidence high in herpes zoster✅✅

Fatal dose of arsenic
a) 20-30 mg
b) 50-60 mg
c) 60-80 mg
d) 120-200 mg

Answer: 120-200 mg
Explanation:
Ref: Forensic science: Reddy
Arsenic poisoning:
Fatal dose: 0.1 to 0.2 g arsenic trioxide
Fatal period: 1 to 2 days
Arsenic is teratogenic and can result in lung, skin cancers, leukemia.
Manifestations of chronic arsenic poisoning:
CNS: Polyneuritis, paresthesias, encephalitis
Skin: Rain drop type of pigmentation, Aldrich Mees Line in nails
Eyes: Watering, congestion, photophobia
GIT: Nausea, abdominal cramp, salivation and diarrhoea
CVS: Cardiac failure and dependent edema
Renal: Chronic nephritis
Hepatic: Hepatomegaly and cirrhosis
Hematologic: Bone marrow suppression
Respiratory system: Cough, hemoptysis and dyspnea

Most common cause of para-su***de
a) Drug ingestion
b) Hanging
c) Firearm
d) Cutting wrist

Answer: Drug ingestion
Explanation:
Ref: Forensic science: Reddy
Para-su***de/Attempted su***de/ Pseudocide:
It is a conscious, often impulsive, manipulative act, undertaken to get rid of an intolerable situation.
Drug ingestion is the commonest form.
Most persons are psychologically disturbed.

A male with azoospermia found to have normal FSH & testosterone levels & normal size te**es. Probable cause is
a) Vas obstruction
b) Kallman syndrome
c) Un-descended te**is
d) Klinefeltor’s syndrome

Answer: Vas obstruction
Explanation:
Obstructive azoospermia:
Normal FSH
Normal testosterone
Normal te**es
Absence seminal fructose

Concentration of adrenaline in following conditions?
1.asthma inhalation?
1:100✅

2.anaphylactic shock i.m?
1:1000✅

3.anaphylactic shock s.c?
1:1000✅

4.anaphylactic shock i.v?
1:10000✅

5.cardiac arrest i.v?
1:1000✅

6.with local s.c?
1:200000✅{2lakh}

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Tobey Ayer Test is positive in
a) Lateral sinus thrombosis
b) Petrositis
c) Cerebral abscess
d) Subarachnoid hemorrhage

Answer: Lateral sinus thrombosis
Explanation:
Tobey-Ayer-Test is used in the diagnosis of lateral sinus thrombophlebitis. This is to record CSF pressure by manometer and to see the effect of manual compression of one or both jugular veins.
In cases where the lateral sinus is obstructed on one side, compression of the jugular vein on the intact side causes a rise in CSF pressure, whereas compression of the obstructed side does not raise the CSF pressure.

Blunt injury abdomen patient was hemo-dynamically stable. Next investigation
a) X-ray abdomen
b) Barium Swallow
c) FAST
d) DPL

Answer: FAST
Explanation:
Evaluation of blunt injury abdomen:
Initially evaluated by FAST (hemo-dynamically stable patients)
CT scan in hemo-dynamically stable patients
Diagnostic peritoneal aspiration in hemo-dynamically un-stable patients

Full thickness graft can be obtained from all of the following except
a) Axilla
b) Groin
c) Supra-clavicular area
d) Elbow

Answer: Axilla
Explanation:
Donor sites for full thickness graft:
Eye lids
Post-auricular skin
Supra-clavicular skin
Ante-cubital skin
Inguinal area
Ge***al area
Sub-mammary skin
Sub-gluteal skin

A 50 yr old male presents with obstructive symptoms. Biopsy of stomach reveals gastrointestinal stromal tumor (GIST). Most appropriate marker for GIST is
a) CD 34
b) CD 117
c) CD 30
d) CD 10

Answer: CD 117
Explanation:
GISTs are the most common mesenchymal tumor of GI tract and are most frequently located in stomach.
GISTs express the Kit or CD-117 protein, a trans-membrane tyrosine kinase receptor.
Kit is used not only for diagnosis but also for targeted therapy of GISTs.
Imatinab, a tyrosine kinase inhibitor, is widely used in treatment of advanced and metastatic GISTs.

Nicoladoni sign is also known as
a) Murray sign
b) Frei sign
c) Darier's sign
d) Branham sign
-
-
-
-

Answer: Branham sign
Explanation:
Nicoladoni sign, also Branham sign is the slowing of the heart rate in response to compression on the artery proximal to an arterio-venous fistula.
Compression on the artery proximal to an arterio-venous fistula:
Swelling diminished
Thrill or bruit ceased
Pulse rate and blood pressure decreased