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Forensic MBBS > Sexuality, Sexual Offences and infanticide > Flashcards

Sexuality, Sexual Offences and infanticide Flashcards

1
Q

Impotence

A

Inability of man to achieve erection or orgasm
M/C cause in India: psychogenic
M/C in world: vasculogenic

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2
Q

Quoad hoc

Frigid

A

Quoad hoc:
A male being impotent only to a particular female

Frigid:
Inability to initiate/maintain sexual arousal in a female

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3
Q

M/C of sterility

A

Lead intoxication

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4
Q

Supposititious child

A

Fictitious child

A female may feign pregnancy 🤰 and claim the child 👶 to be her own to extort money by blackmailing

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5
Q

Fecundation ab extra

A

Conception by deposition of semen in vulva/thigh

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6
Q

Superfetation

Superfecundation

A

Fertilisation of 2 separate ova by 2 acts of coitus in 2 different menstrual cycles ➡️ twin pregnancy

Fertilisation of 2 separate ova by 2 acts of coitus within one menstrual cycle ➡️ twin pregnancy

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7
Q

Sterilisation in India

A

Compulsory sterilisation is not practiced in India
Voluntary sterilisation is practiced in India. It requires written consent from husband and wife.
After vasectomy, abstinence is required for 3 months

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8
Q

Artificial insemination

A

Artificial introduction of semen (1ml) into female genital tract to result in pregnancy
1 donor can produce 10 children max.
Race of donor should be similar to recipient
Written consent of both husband and wife
Confidentiality
Child should be adopted

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9
Q

Indications for artificial insemination

A

Use of donor specimens in cases of:

  1. Impotent husband
  2. Sterile husband
  3. Rh incompatibility
  4. Hereditary disease
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10
Q

Methods of artificial insemination

A
  1. Artificial insemination of husband AIH
  2. Artificial insemination by donor AID
  3. Artificial insemination by husband + donor ➡️ pooled semen
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11
Q

Artificial insemination and legality of marriage

A

In case of insemination due to impotency of the husband ➡️ wife can file for divorce
But not for sterility

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12
Q

Types of surrogacy

A 
1. Commercial:
 Not practiced in India
 Surrogate mother paid for caring child
2. Altruistic:
 Practiced in India 
 Only medical expenses are covered
 Close relative with at least 1 child
The intending couple should be married for at least 5 years
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13
Q

Punishment for intending couple of surrogacy for breaking the law

A
  1. 10 lakhs penalty

2. 10 years punishment minimum

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14
Q

Adultery

A

Extra marital affair
Was punishable under 497 IPC
Decriminalised since 27th September 2018

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15
Q

Indications for MTP

A

S. Social indication (contraceptive failure)
E. Eugenic indication and environmental indication
T. Therapeutic indication
H. Humanitarian

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16
Q

Criminal abortion laws related IPC

A 
312 IPC: with mother’s consent
313 IPC: without mother’s consent
314 IPC: death of the mother
315 IPC: killing a foetus >28 weeks
316 IPC: killing the foetus on an attempt to kill mother
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17
Q

MTP amendment Bill

A

In 2014
Homeopathic and Ayurvedic doctors were allowed to conduct MTP
MTP register should be maintained for 5 years
Data should be confidential
Changes in criteria of MTP

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18
Q

Criteria for MTP

A
  1. Consent for MTP should be given only by mother
  2. Age for consent >18 years
  3. MTP < 12 weeks, requires 1 doctor
  4. MTP 12-20 weeks, requires 2 doctor
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19
Q

Abortifacients

A 
Substances that induce abortion
1. Ecbolics: eg., ergot
 uterus contraction
2. Emmenagogues:
 increased blood flow to pelvis/menstrual blood flow
3. Diachylon and utus paste
4. Abortion stick: vaginal irritation
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20
Q

Emmenagogues

A 
Abortifacient
Mechanism: increased pelvic / menstrual blood flow
Eg., 
B. Borax 
O. Oestrogen 
S. Sanguinarine
S. Senecio 
Rue, Labrunum
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21
Q

Diachylon, utus paste

A

uses as abortifacients

Diachylon: lead product
Utus paste: combination of iodide + iodine

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22
Q

Abortion stick

A 
Length 12-18 cm
Causes vaginal irritation ➡️ abortion
🌱 used:
P. Plumbago 
E. Ergot
E. Ecbolics
C. Calotropis (M/C)
O. Oleander 
L. Lead 
A. Arsenic, aconite, Abrus precatorius
S. Strychnine
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23
Q

Defloration

A

Loss of virginity
1. Hymen may be torn
2. Fourchette/posterior commissure is torn
3. Fossa Navicularis: disappeared, not intact
Vagina is dilated
Its rugosity is lost

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24
Q

Hymen

A

Does not decide virginity
M/C site of rupture: posterolateral (5’-7’o clock position)
Semilunar/crescentic in 70% of women
In children hymen is not ruptured easily because it is deep-seated
Caruncula myrtiformis- healed tag of hymen

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25
Q

Features of fimbriated hymen (natural notches of vagina) that differentiate it from vaginal tear

A
  1. Present anteriorly
  2. Symmetrical
  3. Fold of mucous membrane
  4. Do not extend to vaginal wall
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26
Q

Causes of rupture of hymen

A
  1. Sex
  2. Surgery
  3. Infection
  4. Masturbation
  5. Sanitary tampons
  6. Trauma
  7. Shola pith
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27
Q

Aptae viris

A

Shola pith is a spongy plant stem used to dilate the vagina

It is used in young girls (aptae viris) to make them fit for sexually intercourse

28
Q

False virgin

A

A female who participated in sexual intercourse but with hymen intact (elastic hymen)

29
Q

Differences between nulliparous and parous female

A 
1. Uterine cavity:
 Triangular 🆚 circular
2. Wall of uterus:
 Convex 🆚 concave
3. External os: 
 Circular 🆚 transverse slit
30
Q

Sexual offence

A
  1. Natural:
    Penovaginal sexual route
    Rape is both natural and unnatural sexual offence
  2. Unnatural:
    Any offence where this route is not used.
    Punishable under 377 IPC (10 years)
    • Incest is not a crime in India
    • Adultery is only a civil case ➡️ divorce
31
Q

Incest complex

A
  1. Electra complex:
    Sexual relationship between daughter and father
  2. Oedipus complex:
    Sexual relationships between son and mother
  3. Pharaon complex:
    Sexual relationship between brother and sister
32
Q

Lesbianism

A

The active sexual partner is Dyke/ Butch
Passive sexual partner is Femme in 2018, change in 377 IPC.
Homosexuality in adults with consent is decriminalised

33
Q

Sodomy

differences b/w habitual and non-habitual

A 
1. Non habitual passive agents:
 Tear, injury, rigidity of anal canal
2. Habitual passive agent:
 Funnel shaped anal canal
 No tear, rugosity 
 Shaved perineal hair
 Positive lateral buttock traction test
 Manual reaction of buttocks - paradoxical dilation of anal canal
34
Q

Rape

definition

A

375 IPC - defines rape
Rape is insertion of penis/penis like objects into vagina/oral/ anal/urethral parts of female
Natural or unnatural

35
Q

Rape and consent/ will

A 
Rape includes:
1. Against will
2. Without consent 
3. With consent:
• out of fear 😨 
• fraud
• intoxication
• <18 years - statutory rape
36
Q

Medical definition of rape

A

Slightest penetration of vulva - defines rape
Hymen rupture, semen discharge or complete penetration is not necessary
No age limit for committing rape
Only with females in India
Impotency is not a defence for rape
In France rape - both male and female

37
Q

Punishment for rape

A 
Under 376 IPC
A. Coma or any vegetative state: LI-☠️
B. Both 👫🏻 legally separated/divorced:
 2-7 yrs
C. Custodial rape: 5-10 years
D. Gang rape: 20 yrs-LI
E. Excessively heinous or rarest of rare crime/related gang rape:
 LI-☠️
38
Q

Examination of victim

formalities

A

164 CrPC
Minimum rank - Sub Inspector
Female SI and doctor required
Examination done with consent 53(2) CrPC

39
Q

Examination of victim

medical tools used

A
  1. Toluidine blue dye:
    detect injuries in vaginal and perianal region
  2. Glaister keen Rod:
    detect hymen rupture 5-7’o clock
  3. Four swabs from different region collected
40
Q

Examination of accused of rape

53 CrPC

A

Consent not required
Minimum rank sub inspector level
Smegma present around glans penis ➡️ no sexual intercourse in last 24 hours
Penile swabs collected: detect vagina cells by Lugol’s iodine stain or Papanicolaou stain

41
Q

Legal implications in rape

A

Disclosure of identity of rape victim: punishable under 228 IPC
For rape trial in court: camera trial or secret trial ➡️ public not allowed 327 CrPC
357 CrPC : it is mandatory for any hospital to examine/treat rape victim without any delay

42
Q

166 A and B IPC

A

166 A IPC:
If police fails to report/file FIR its punishable under 166 A IPC
166 B IPC:
If hospital fails to provide treatment to rape victim, its punishable under 166 B IPC

43
Q

Acts which impose burden of proof of a rape case on male

A

114 A IEA: Presumption of absence of consent
113 A IEA: Presumption of abetment of suicide
113 B IEA: presumption of dowry death
146 IEA: immortal character of rape victim is not questionable

44
Q

Marital rape in India

A

Old law: wife <15 years even with consent is punishable
Supreme Court changed it to 18 years
Above 18 years - no marital rape

45
Q

Juvenile rape

A

POSCO act: protection of child against sexual offences
It is for children below 18 years - both male and female
Implemented in 2012
Amendment Bill passed on 2019

46
Q 
Infanticide 
Neonaticide
Filicide
Xenocide
Uxoricide
A 
Infanticide:
 Killing a child < 1 years
Neonaticide:
 Killing a child within 24 hours of birth (not 28 days)
Filicide:
 Killing a child by parents
Xenocide:
 Killing of a whole race
Uxoricide:
 Killing of romantic partner
47
Q

Fetus deaths

A 
1. Dead born:
 Within uterus
2. Still born:
 In birth canal during delivery
3. Live born:
 Gets delivered and respires at least once
48
Q

Features seen for a viable baby i.e, >28 weeks out 7 months

A 
Length: 35 cm
Weight: 900-1200 gm
Eyelid: open at 7 months 👁
Pupillary membrane: disappears
Bony centers of sternum and talus appears 🦴
49
Q

Features in a dead born

A 
R. Rigor mortis, Robert sign
A. Aseptic autolysis
M. Mummification 
S. Spalding sign
Hyper flexion off spine + crowding of ribs
Deuel’s Halo sign
50
Q

Robert sign

Maceration

A 
Robert sign:
• air or gas in aorta
• earliest sign - within 12 hours
Maceration/aseptic autolysis :
• Fetus becomes soft and flaccid 
• fetus surrounded by aseptic amniotic fluid
• skin - red and peeled off
• sweet smell
51
Q

Mummified fetus

A

Seen when the amniotic fluid, air and blood supply to the fetus is compromised
Fetus is dehydrated and sunken
Seen in dead born

52
Q

Spalding sign

Deuel’s halo sign

A 
Both are seen in dead born
Spalding sign:
 Seen because of liquefaction of 🧠 
 Leads to overlapping of bones 🦴 
Deuel’s halo sign: 
 skull table show Deuel’s Halo because of 🔼 subcutaneous fat
53
Q

Findings in live born

A
  1. Respiratory signs are present
  2. 🫁: voluminous, inflated, soft, 🔼 weight, rounded margins and light red 🟥
  3. Position of diagram: 6-7 ribs (before 4-5 ribs)
54
Q

Tests for live born

A
  1. Wreden test: air in👂
  2. Breslau 2nd life test: air in stomach/intestine
  3. Fodere test: 🫁 weight ✖️2
    30 gm ➡️ 60 gm
  4. Plouquet’s test: 🫁:👤 in weight
    1:70 ➡️ 1:35
  5. Hydrostatic test
55
Q

Hydrostatic test

Breslau 1st life test

Raygat test

A 
Unused 🫁 :
 Sp. gravity: 0.94
 Does not sink
Respired 🫁:
 Sinks in water
 Sp. gravity 1
56
Q

False positive for tests for live born

A 
Non-respired lung showing positive test
1. Decomposition:
 Gas in lungs
 Liver is taken as control
2. Artificial respiration
57
Q

False negative for tests for live born

A

Fetus respired but test is negative

  1. Pulmonary edema
  2. Alveolar duct membrane
  3. Feeble respiratory effort
  4. Pneumonia
  5. Air absorbed by 🫁
58
Q

Umbilical structures and foramen ovale

forensics

A 
1. Umbilical artery:
• Closes by 3rd day
• forms medial umbilical fold
2. Umbilical vein:
• closes by 4th day
• forms ligamentum teres
3. Umbilical cord;
• closes by 5-6 days
• falls off
4. Ductus venosus:
• closes by 3-5 days
5. Ductus arteriosus:
• closes by 7-10 days
6. Foramen ovale:
• closes by 2-3 months
59
Q

Vagitus uterinus

Vagitus vaginalis

A
  1. Vagitus uterinus:
    Crying of baby intra-uterine
  2. Vagitus vaginalis:
    Crying of baby in vaginal canal
60
Q

Cephalohematoma

infant injuries

A

Injuries due to instrument
Present in b/w periosteum and skull
M/C in right parietal bones
It never crosses the suture lines

61
Q

Caput succedaneum

A

Edema and congestion of scalp because of pressure produced by vaginal ring

62
Q

SIDS sudden infant death syndrome

A

Crib death
Cot death
Seen as negative autopsy: no cause can be ascertained
M/C sleep apnea

63
Q

IPCs relevant to infanticide

A

312-316: criminal abortion

317: abandoning child < 12 years
318: concealment of birth (punishment of 2 years + fine)

64
Q

Battered baby syndrome

Caffey syndrome

A

Baby is abused physically by guardian or parent repeatedly
History given by parents and physical findings in the baby’s body are inconsistent
Multiple injuries of various duration are seen:
1. Multiple rib fractures:
String of beads appearance
2. Metaphyseal fractures of long bones:
Bucket 🪣 handle fracture/ Corner fracture
3. Skull fracture: Egg shell🥚 fracture

65
Q

Shaken baby syndrome

Infantile whiplash injury

A
  1. Repeated shaking ➡️ forced hyperextension ➡️ hyperextension injury of neck
  2. Intraocular bleed ➡️ Dot blot hemorrhage
  3. Periorbital hemorrhage
  4. Subdural hemorrhage
  5. Six penny bruise or 🪙 shaped bruise may be present
  6. Butterfly bruise: may be present
66
Q

Steps in examination of accused in a sexual assault

A
  1. Brought by 👮‍♂️ and signed request
  2. Consent
  3. Preliminary data
  4. Physical & mental status
  5. Signs of struggle on clothes or body
  6. General & local examination
  7. Preservation of samples
  8. Lab report and opinion
  9. Potency certificate
  10. Age estimation

Forensic MBBS (7 decks)

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