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Forensic MBBS > Medical jurisprudence, identification > Flashcards

Medical jurisprudence, identification Flashcards

1
Q

Parts of MCI act

A

The MCI act 1956 has three schedules

  1. Doctors from India
  2. Doctors outside India
  3. Two parts: those not included in schedule 1 and those not included in schedule 2
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2
Q

Functions of MCI

A
  1. Medical education
  2. Medical register
  3. Disciplinary control
  4. Qualification exam for FMG for their recognition
  5. Appellate tribunal
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3
Q

Members of IMC

A

Number of members elected from various states and universities of India, and some members nominated by the government of India
They hold office for 5 years
They elect a President and Vice President among themselves
They appoint a Registrar and a Secretary four day to day functioning

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4
Q

Functions of SMC State medical Council

A
  1. Medical register
  2. Disciplinary control
  3. Warning notice
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5
Q

Functions of the SMC with respect to infamous conduct or serious professional misconduct

A

The SMC can:

  1. Issue a warning notice
  2. penal erasure or professional death sentence (erasure of name of the doctor from the medical register) which has to be confirmed by the MCI and can be appealed to the health ministry
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6
Q

Making of a false document by a doctor is punishable

A

197 IPC

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7
Q

Examples of professional misconduct

A 
A. Alcoholism addiction
adultery abortion
advertisement association
B. Bribe
C. Covering
D. Dichotomy
F. False document (197 IPC)
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8
Q

Examples of privileged communication

A 
C. Crime-police/ magistrate 39 CRPC
I. Infectious disease relative
V. veneral disease 
I. interest of patient-eg.,suicide
C. court of law
S. Servant life endangering  
I. Interest of self
N. negligence 
notifiable disease
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9
Q

Therapeutic privilege

A

Exception to full disclosure

Example suicidal tendencies

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10
Q

COPRA act is of which year

A

Consumer protection act of 1986

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11
Q

Compensation for various redressal forums

A

District level: 20 lakh
State level: 20 lakh-one crore
National level: more than one crore
Only paid patients get compensation

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12
Q

351 IPC

A

Examining a patient without consent

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13
Q

Negligence comes under the IPC section

A

336: life in danger
337: simple hurt
338: grievous hurt

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14
Q

Abortion with consent of mother comes under the IPC

A

312 IPC

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15
Q

Burden of proof in cases of civil negligence falls on

The punishment in these cases is

A

The patient

The punishment is only money as a compensation unlike criminal negligence where 304A IPC is also considered

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16
Q

Res ipsa loquitor

A

Cases which speaks for itself and proves negligence by doctor
No contributory evidence is required
It is applicable for both civil and criminal negligence

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17
Q

Novus actus intervieniences

A

Cases where both the doctor and the accused are responsible for the death of the patient or victim

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18
Q

Res judicata

A

In civil negligence the same case cannot be discussed twice in the same court

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19
Q

Res indicata

A

The patient can file a negligence case within only two years of the incident

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20
Q

Defenses for the doctor against medical negligence case if civil

A
  1. Informed consent
  2. Res indicata
  3. Res judicata
  4. Therapeutic misadventure
  5. Contributory negligence and corporate negligence
  6. Error of judgement
  7. Products liability
  8. Calculated risk doctrine
  9. Vicarious liability
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21
Q

Exceptions of contributory negligence

A
  1. Last clear chance doctrine:
    If doctor misses the last chance to inform the patient
  2. Avoidable consequence doctrine
    Patient not following doctors instructions adequately leading to damage. Patient is held more responsible
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22
Q

Vicarious liability

A

Respondent superior
Let the master answer
Employer is responsible for negligence by the employee
Only applicable in civil cases involving monetary compensation.

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23
Q

Common drugs used for active euthanasia

A
  1. Phenobarbitone
  2. Thiopentone
  3. Insulin
  4. Opium
  5. KCl
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24
Q

Euthanasia in India

A

In India, only passive euthanasia is legalised (first in Maharashtra in 2015)
It can be conducted with the permission of Supreme Court(by a panel of doctors)

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25
Q

Countries where both active and passive euthanasia is legalised

A

Netherlands (first country)
Belgium, Sweden, Switzerland
Thailand

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26
Q

Indian contract act and consent

A

Indian contract act was formed in 1872

Consent is given in section 13

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27
Q

Types of consents

A
  1. Expressed consent (written or oral)
  2. Implied consent
  3. Informed consent :
    bidirectional
    Medical procedure then surgery is informed
  4. (Blanket/ Blind/ Open consent)
  5. Substituted consent
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28
Q

Exceptions to consent

A
  1. Emergency
  2. Mass immunisation
  3. Examination of rape accused
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29
Q

87, 88, 89 IPC

A
  1. A person above 18 can give consent for surgery or invasive procedure
  2. Valid consent to suffer any consequence given in good faith
  3. A child below 12 cannot give consent even for physical examination
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30
Q

90, 92 IPC

A
  1. Consent not valid when given due to fear of injury

92. In emergency (life threatening conditions consent is not required

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31
Q

351 IPC

A

Examination of patient without consent amounts to assault

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32
Q

Conditions in which the consent has to be obtained from both husband and wife

A

Contraception sterilisation artificial insemination

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33
Q

Informed refusal

A

Patient can refuse treatment after receiving complete information about his/her condition

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34
Q

Non fit injuria

A

Patient cannot claim compensation for damages when consent is given willingly

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35
Q

Borrowed servant doctrine

A

The person who borrowed an employee is responsible for negligence by that employee

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36
Q

In loco parentis

A

Consent given by police/ guardian/ principle in absence of parents

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37
Q

Medical etiquette

A

Courtesy of doctor towards one another

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38
Q

Medical ethics

A

Moral principles of a doctor towards patient, society and state
Decided by MCI
Self imposed

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39
Q

First centre that appears

A

Clavicle at 5-6 weeks

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40
Q

Appearance of ossification centre

A

Clavicle 5-6 weeks
5m - Calcaneum
7m - Talus, (2nd and 3rd pieces of sternum)
9m - Lower end of femur, cuboid, capitate bones
10m - upper end of tibia

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41
Q

Fusion of patella or xiphoid

A

Patella - 14 years

Xiphoid - 40 years

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42
Q

The bones fused between 20 and 22 years

A

I. Iliac crest - 20 years
I. Inner end of clavicle - 21 years
T. Ischial Tuberosity

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43
Q

Fusion of carpal bones

First and last

A

First- capitate within 1 year

Last- pisiform 12 years

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44
Q

Fusion of sternum bones

A 
Manubrium+4 pieces + xiphoid 
Going upwards:
40y. Xiphoid fuses at
15y. The next two pieces
20y. “ ”
25y. “ ”
Old age. Upper piece and manubrium
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45
Q

Fusion of pieces of sacrum and that of greater cornua with hyoid

A

All pieces of sacrum fuses between 20-25 years

Greater cornua fuses with the body of hyoid between 40-60 years

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46
Q

Fusion of sutures of skull

A

1y. Metopic / frontal suture
80y. Masto-occipital suture

Coronal suture 25-40y
Sagittal suture 25-(40-50)y (best)
Inner table of skull bone fuses 5-10y earlier than outer table

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47
Q

Fusion of bones of skull other than the sutures

A 
L. Lambdoid = 45y
A. Asterion = 50y
P. Pterion = 65y
Ant fontanelle 2 years
Post fontanelle at birth
Basisphenoid + Basi-occiput at 18-21y
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48
Q

X-rays of skull used for age estimation

A

Oblique X-ray

Lateral skiagram

49
Q

The halves of mandible fuse at

A

2 years

Anterior fontanelle also fuses at 2 years

50
Q

Rule of Haase

Modified Morrison rule

A

Age of foetus in first 5 months= square root of length of foetus in cm
(Modified Morrison rule - part 2 of rule of Haase):
Next 5 months, age of foetus in months = length of foetus/5

51
Q 
Important events occurring in foetus
Part 1 (first 4 changes)
A

2m. Limb bud appears
3m. Nail star
4m. Lanugo appears, sex differentiated
6m. Vernix caseosa
2,4,8 L

52
Q

Important changes occurring in foetus

Part 2

A

7m. Testis in external inguinal ring
8m. Testis in left scrotum
9m. Testis in right scrotum
10m. Nail growth till tip

53
Q

Qualitative methods for bone age estimation

A
  1. Greulich Pyle atlas method (M/C)

2. Tanner Whitehouse method (most accurate)

54
Q

First teeth (temporary) to erupt is

A

Lower central incisors

Then upper then upper lateral then lower lateral

55
Q

Sequence of eruption of temporary teeth is

A

I (1st lower central incisor)
M.
C.
M. (Last molar at 2 1/2 - 3 years)

56
Q

Sequence of eruption of permanent teeth

A 
M 6 years (molar)
I 7
I 8
P 9
P 10
C 11 (not in expected order)
M 12 
M 18-25
57
Q

Superadded and successional teeth

A

Superadded:
3 permanent molars in every quadrant (not the premolars)
Successional teeth:
Erupt in place of predecessor teeth
All other permanent teeth
The temporary molars are replaced by premolars

58
Q

Age of temporary and mixed dentition

A

Age of temporary dentition: 6-7 years
Age of mixed dentition: 6-12 years
Permanent teeth = (age-5)*4 where age is 7-12

59
Q

Demirjian method

A

Estimation of age using 3rd molar

60
Q

Dental charting/ Formula

A
  1. Palmar notation
  2. Universal formula
  3. FDI
  4. Modified FDI method
  5. Zsigmondy method: Roman numeral
  6. Anatomical charting marks
  7. Haderup formula
61
Q

Palmar notation and Haderup formula

A

Palmar notation: 1➡️8 every half jaw from centre

Haderup formula:
Palmar notation + upper teeth +ve/ lower teeth -ve

62
Q

Universal formal of teeth notation

A

1➡️16 from right upper

17➡️32 from left lower

63
Q

FDI and modified FDI notation for teeth notation

A

FDI :
quadrant number (from right upper ➡️ lu ➡️ ll ➡️ right lower) + palmar notation (1➡️8)
Example 11,…18,21,…
Modified FDI:
Quadrant numbers for lower jaw are replaced by the reverse (4➡️3 and 3 ➡️4)
Right ➡️ odd 1,3
Left ➡️ even 2,4

64
Q

6 X-ray criteria for age determination using teeth used in Gustafson method

A 
S. Secondary dentine
C. Cementum apposition
R. Root resorption
I. attrItion
P. Peridontosis 
T. Translucency: best >30 years
65
Q

Gustafson method

A

Age by teeth X-ray
Used when >25 years
Best tooth is incisor whereas worst tooth is molar

66
Q

Methods similar to Gustafson method for determining age using teeth

A
  1. Daliz method: modification of Gustafson method
  2. Stack method: for infant
  3. Boyd method:
    For neonates
    Incremental lines on teeth
  4. Lamendin method
  5. Miles method: wear and tear of tooth
67
Q

Stack method

A

Age of infant is calculated using teeth height and weight

68
Q

Lamendin method

A

Age of person is calculated using:

  1. Gum regression
  2. Translucency/ transparency of tooth
69
Q

Multiplication factors (for calculating stature of a person) are given by

A
  1. Karl-Pearson
  2. Trotter-Gleser
  3. Dupertius-Hadden
  4. Jit-Singh
70
Q

Multiplication factors given for different bones (for calculating stature) are

A 
Femur: 3.7
\+0.8
Tibia/ fibula: 4.5
\+0.8
H. Humerus: 5.3
\+0.8
U. Ulna: 6.1
\+0.4
R. Radius: 6.5
Bone length is measured using Hepburn osteometric board
71
Q

Barr body was discovered by

A

Bar and Bertam

72
Q

Davidson body

A

Drumstick body present in 6% of neutrophils of females

73
Q

X chromosome is identified using

Y chromosome is identified using

A

Fuelgen reaction using acriflavine stain
Fuel for next generation

Quinacrine reaction is used

74
Q

Frontal sinus X-ray is used for

A

Identification when age >15 years

75
Q

Colonel Victor Barker was as case of

A

Concealed sex

76
Q

For lip print , stains used are:

A

Aquaprint

Cyanoacrylate

77
Q

For identification of any body, we use

A
  1. DNA 🧬
  2. Blood 🩸 group
  3. Maple 🍁 method: lines on 2nd molar
  4. Aspartic acid
  5. Mg-Zn ratio
78
Q

Stelle method for identification

When is it used

A

When fragments of bones are only available, the stature is determined by Stelle method

79
Q

Minimum age at which a child is responsible for a crime

A

According to 82 IPC: 7 years

According to Railway act: 5 years

80
Q

Minimum age at which a child is punishable for the offence

A

12 years according to Railway act

81
Q

366 B IPC

A

Importation of a girl (<21 years of age) from foreign country for prostitution
Not <18 years

82
Q

Age of scar

A

5-6 days: red blue (angry) scar
2 weeks - 2 months: pale (tender and soft)
2 month - 6 month: brown (tender and tough)
> 6 months: white (non tender)
Scar is vascular/ soft till 2 months

83
Q

Describe the best method for criminal identification

A

Fingerprint (dermatoglyphics/fingerprinting/ Galton-Henry system)
Discovered in 1858 by William Herschel
First fingerprint bureau in India- Kolkata (writer building)

84
Q

Development of fingerprints and Quetelet rule

A 
Starts developing in foetus- 12-16 weeks
Completes by 24 weeks
Fingerprints are papillary ridges
Quetelet rule:
 Fingerprints are not identical even in identical twins
85
Q

Henry classification

A 
Classification of fingerprints
Loop: 70%
Whorls 
Arches
Composite: 1-3%
86
Q

Permanent loss of fingerprints can be caused by

A

Radiation
Leprosy
Charring

87
Q

For histo section of fingerprints, what depth of skin is taken

A

For histo section 0.6 mm depth of skin is taken

88
Q

The best and worst finger for fingerprinting

A

Best finger: thumb
Worst finger: little finger
For comparison of fingerprints a minimum match of 10-12 corresponding points is required

89
Q

Types of fingerprint

A
  1. Plastic: soap, cheese
  2. Latent: invisible
  3. Visible: blood stain/other stain
90
Q

Latent fingerprint is made visible through which methods

A
  1. Fabric: AgNO3
  2. Paper: iodine/osmium tetra oxide
  3. Glass: scanning e- microscope
    Other chemical used are:
    Barium products
    Ninhydrin
    Cyanoacrylate
    Best method: OFTIR (Optical frustrated total internal reflection)
91
Q

Major methods of identification other than fingerprinting

A
  1. Poroscopy
  2. Palatography (rugoscopy for anterior 1/3rd)
  3. Cheiloscopy
  4. Podoscopy
  5. Superimposition technique
92
Q

Describe poroscopy and palatography

A
  1. Poroscopy:
    Discovered by Edmund Locard (exchange principle)
    Pores are found in skin tissue with 1mm ridge having 9-18 pores
  2. Palatography:
    Discovered by Allen
    Hard palate specimen is taken from decomposed bodies
    Anterior 1/3rd is important-rugoscopy
93
Q

Describe cheiloscopy and podoscopy

A 
3. Cheiloscopy:
 Use of lip print
 Discovered by Suzuki 
 7 types of lip print
4. Podoscopy:
 Use of footprint for identifying children
94
Q

Superimposition technique

A

Skull X-ray is used for identification
Screening test (not confirmatory)
Discovered by Glaister
Skull X-ray is compared to corresponding points in negative of a photograph
Difference in corresponding points suggests that both don’t belong to the same person

95
Q

Anthropometry

A 
Bertillion’s system/Portrait Parle
Used when no biological specimen is available
1. Body marks
2. Body measurement
3. Descriptive data
96
Q

Tattoo marks

types and identification

A
  1. Live
  2. Dead
  3. Decomposed
    Can be detected upto lymph node level
    Made visible via UV lamp
    For old tattoo, infrared photography is used
    Famous case: Sydney Shark arm case
97
Q

Dyes used for tattoo

A
  1. Prussian blue
  2. Cinnabar
  3. Malachite green
  4. Vermilion
  5. India ink
98
Q

Tattoos are erased by

A

B. Burn, beam
C. Corrosive
D. Dry ice (CO2)
E. Enzymes (like papain) , excision, electrolysis

99
Q

Corpus Delecti

A

Body of offence
aka essence of crime
When there is a crime, identification of the body is most important
Other evidences are clothes, traces of evidences, weapons,…

100
Q

Race cephalic index

A 
CI=(breadth of skull/ length of skull) *100
DuMB head
D: 70-74.9
M: 75-79.9
B: 80-85
101
Q

Various cephalic indices

A 
1. Dolicocephalic: 
 Negro, pure Aryan 
 70-74.9
2. Mesaticephalic: 
 Indian
 75-79.9
3. Brachycephalic: 
 American, Japan, Mongol
 80-85
 Due to early fusion of coronal suture
102
Q

Indices for race

A 
B. Brachial= (radius length/ humerus)*100
C. Cephalic
C. Crural= (tibia length/femur)*100
I. Intermembranal= (H+R)/(T+F)*100
Humo-femoral index
103
Q

Identification of race based on orbits

A

Shape of orbit is used

  1. Square: Negro
  2. Triangular: caucasoid
  3. Round: Mongol
104
Q

Identification of race based on the medulla of their hair

A 
1. Kidney: 
 Negro
 Cuticle absent
2. Oval: caucasoid 
3. Non fragmented:
 Mongol
 Round
105
Q

Special features of teeth of the Caucasian and Negro races

A 
1. Caucasian race:
 Carabelli cusp- Maxillary molar 
2. Negro race:
 Large teeth
 More cusps in molar teeth
106
Q

Specific characteristics of Mongol teeth

A
  1. Shovel shaped incisor
  2. Pointed canine
  3. Bull like tooth (taurodontism)
  4. Enamel pearl (premolar)
107
Q

Sequence of secondary sexual character

A 
The. Testis and penis development
P. Pubic hair
G. Growth spurt
Must. Moustache
All. Axillary hair
Boys. Beard
108
Q

Sequence of appearance of sexual characteristics in female

A 
The. Thelarche (breast bud)
P. Pubarche
G. Growth spurt
Must. Menarche 
All. Axillary hair
Girls
109
Q

Krogman’s table

A

Sex determination by bones is via Krogman’s table
Pelvis: 95%
Skull: 92%
Pelvis and skull: 98%

Long bones: 80%
Whole skeleton: 100%

110
Q

Bony prominence more prominent in female is

A

Frontal eminence

Rest is opposite

111
Q

Shape of pelvic inlet in respective genders

A

Heart shaped in males

Round shaped in females

112
Q

Bony angles more in female

A

Angle of mandible

Sub pubic angle

113
Q

Tertiary sexual character

A

Preauricular sulcus which is present in female pelvis (only rarely in males)

114
Q

Best bony parameter to determine sex

A

Greater sciatic notch

Small, deep and narrow in males, which is opposite in females

115
Q

Chilotic line and sex determination

A

Line connecting sacrum to pelvis
In males, sacral part is prominent
In females pelvic part is prominent

116
Q

Best bony index to determine sex

Property of bony indices

A

Sciatic notch index
4-5 in males, 5-6 in females
Bony indices are usually higher in female (like Washburn index (ischiopubic index))except corpobasal index

117
Q

Corpobasal index

A

The bony index which is higher in males

Breadth of 1st sacral vertebra)/ (breadth of base of sacrum

118
Q

Ashley rule

Hyrtl’s law

A

Ashley rule:
Sternum length is more in males
Hyrtl’s law:
Length of body of sternum is higher in males

Forensic MBBS (7 decks)

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