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Forensic MBBS > Medical jurisprudence, identification > Flashcards

Medical jurisprudence, identification Flashcards

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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
Countries where both active and passive euthanasia is legalised
Netherlands (first country) Belgium, Sweden, Switzerland Thailand
26
Indian contract act and consent
Indian contract act was formed in 1872 | Consent is given in section 13
27
Types of consents
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
28
Exceptions to consent
1. Emergency 2. Mass immunisation 3. Examination of rape accused
29
87, 88, 89 IPC
87. A person above 18 can give consent for surgery or invasive procedure 88. Valid consent to suffer any consequence given in good faith 89. A child below 12 cannot give consent even for physical examination
30
90, 92 IPC
90. Consent not valid when given due to fear of injury | 92. In emergency (life threatening conditions consent is not required
31
351 IPC
Examination of patient without consent amounts to assault
32
Conditions in which the consent has to be obtained from both husband and wife
Contraception sterilisation artificial insemination
33
Informed refusal
Patient can refuse treatment after receiving complete information about his/her condition
34
Non fit injuria
Patient cannot claim compensation for damages when consent is given willingly
35
Borrowed servant doctrine
The person who borrowed an employee is responsible for negligence by that employee
36
In loco parentis
Consent given by police/ guardian/ principle in absence of parents
37
Medical etiquette
Courtesy of doctor towards one another
38
Medical ethics
Moral principles of a doctor towards patient, society and state Decided by MCI Self imposed
39
First centre that appears
Clavicle at 5-6 weeks
40
Appearance of ossification centre
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
41
Fusion of patella or xiphoid
Patella - 14 years | Xiphoid - 40 years
42
The bones fused between 20 and 22 years
I. Iliac crest - 20 years I. Inner end of clavicle - 21 years T. Ischial Tuberosity
43
Fusion of carpal bones | First and last
First- capitate within 1 year | Last- pisiform 12 years
44
Fusion of sternum bones
``` Manubrium+4 pieces + xiphoid Going upwards: 40y. Xiphoid fuses at 15y. The next two pieces 20y. “ ” 25y. “ ” Old age. Upper piece and manubrium ```
45
Fusion of pieces of sacrum and that of greater cornua with hyoid
All pieces of sacrum fuses between 20-25 years Greater cornua fuses with the body of hyoid between 40-60 years
46
Fusion of sutures of skull
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
47
Fusion of bones of skull other than the sutures
``` L. Lambdoid = 45y A. Asterion = 50y P. Pterion = 65y Ant fontanelle 2 years Post fontanelle at birth Basisphenoid + Basi-occiput at 18-21y ```
48
X-rays of skull used for age estimation
Oblique X-ray | Lateral skiagram
49
The halves of mandible fuse at
2 years | Anterior fontanelle also fuses at 2 years
50
Rule of Haase | Modified Morrison rule
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
``` Important events occurring in foetus Part 1 (first 4 changes) ```
2m. Limb bud appears 3m. Nail star 4m. Lanugo appears, sex differentiated 6m. Vernix caseosa 2,4,8 L
52
Important changes occurring in foetus | Part 2
7m. Testis in external inguinal ring 8m. Testis in left scrotum 9m. Testis in right scrotum 10m. Nail growth till tip
53
Qualitative methods for bone age estimation
1. Greulich Pyle atlas method (M/C) | 2. Tanner Whitehouse method (most accurate)
54
First teeth (temporary) to erupt is
Lower central incisors | Then upper then upper lateral then lower lateral
55
Sequence of eruption of temporary teeth is
I (1st lower central incisor) M. C. M. (Last molar at 2 1/2 - 3 years)
56
Sequence of eruption of permanent teeth
``` M 6 years (molar) I 7 I 8 P 9 P 10 C 11 (not in expected order) M 12 M 18-25 ```
57
Superadded and successional teeth
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
Age of temporary and mixed dentition
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
Demirjian method
Estimation of age using 3rd molar
60
Dental charting/ Formula
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
Palmar notation and Haderup formula
Palmar notation: 1➡️8 every half jaw from centre Haderup formula: Palmar notation + upper teeth +ve/ lower teeth -ve
62
Universal formal of teeth notation
1➡️16 from right upper | 17➡️32 from left lower
63
FDI and modified FDI notation for teeth notation
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
6 X-ray criteria for age determination using teeth used in Gustafson method
``` S. Secondary dentine C. Cementum apposition R. Root resorption I. attrItion P. Peridontosis T. Translucency: best >30 years ```
65
Gustafson method
Age by teeth X-ray Used when >25 years Best tooth is incisor whereas worst tooth is molar
66
Methods similar to Gustafson method for determining age using teeth
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
Stack method
Age of infant is calculated using teeth height and weight
68
Lamendin method
Age of person is calculated using: 1. Gum regression 2. Translucency/ transparency of tooth
69
Multiplication factors (for calculating stature of a person) are given by
1. Karl-Pearson 2. Trotter-Gleser 3. Dupertius-Hadden 4. Jit-Singh
70
Multiplication factors given for different bones (for calculating stature) are
``` 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
Barr body was discovered by
Bar and Bertam
72
Davidson body
Drumstick body present in 6% of neutrophils of females
73
X chromosome is identified using Y chromosome is identified using
Fuelgen reaction using acriflavine stain Fuel for next generation Quinacrine reaction is used
74
Frontal sinus X-ray is used for
Identification when age >15 years
75
Colonel Victor Barker was as case of
Concealed sex
76
For lip print , stains used are:
Aquaprint | Cyanoacrylate
77
For identification of any body, we use
1. DNA 🧬 2. Blood 🩸 group 3. Maple 🍁 method: lines on 2nd molar 4. Aspartic acid 5. Mg-Zn ratio
78
Stelle method for identification | When is it used
When fragments of bones are only available, the stature is determined by Stelle method
79
Minimum age at which a child is responsible for a crime
According to 82 IPC: 7 years | According to Railway act: 5 years
80
Minimum age at which a child is punishable for the offence
12 years according to Railway act
81
366 B IPC
Importation of a girl (<21 years of age) from foreign country for prostitution Not <18 years
82
Age of scar
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
Describe the best method for criminal identification
Fingerprint (dermatoglyphics/fingerprinting/ Galton-Henry system) Discovered in 1858 by William Herschel First fingerprint bureau in India- Kolkata (writer building)
84
Development of fingerprints and Quetelet rule
``` 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
Henry classification
``` Classification of fingerprints Loop: 70% Whorls Arches Composite: 1-3% ```
86
Permanent loss of fingerprints can be caused by
Radiation Leprosy Charring
87
For histo section of fingerprints, what depth of skin is taken
For histo section 0.6 mm depth of skin is taken
88
The best and worst finger for fingerprinting
Best finger: thumb Worst finger: little finger For comparison of fingerprints a minimum match of 10-12 corresponding points is required
89
Types of fingerprint
1. Plastic: soap, cheese 2. Latent: invisible 3. Visible: blood stain/other stain
90
Latent fingerprint is made visible through which methods
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
Major methods of identification other than fingerprinting
1. Poroscopy 2. Palatography (rugoscopy for anterior 1/3rd) 3. Cheiloscopy 4. Podoscopy 5. Superimposition technique
92
Describe poroscopy and palatography
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
Describe cheiloscopy and podoscopy
``` 3. Cheiloscopy: Use of lip print Discovered by Suzuki 7 types of lip print 4. Podoscopy: Use of footprint for identifying children ```
94
Superimposition technique
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
Anthropometry
``` Bertillion’s system/Portrait Parle Used when no biological specimen is available 1. Body marks 2. Body measurement 3. Descriptive data ```
96
Tattoo marks | types and identification
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
Dyes used for tattoo
1. Prussian blue 2. Cinnabar 3. Malachite green 4. Vermilion 5. India ink
98
Tattoos are erased by
B. Burn, beam C. Corrosive D. Dry ice (CO2) E. Enzymes (like papain) , excision, electrolysis
99
Corpus Delecti
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
Race cephalic index
``` CI=(breadth of skull/ length of skull) *100 DuMB head D: 70-74.9 M: 75-79.9 B: 80-85 ```
101
Various cephalic indices
``` 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
Indices for race
``` 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
Identification of race based on orbits
Shape of orbit is used 1. Square: Negro 2. Triangular: caucasoid 3. Round: Mongol
104
Identification of race based on the medulla of their hair
``` 1. Kidney: Negro Cuticle absent 2. Oval: caucasoid 3. Non fragmented: Mongol Round ```
105
Special features of teeth of the Caucasian and Negro races
``` 1. Caucasian race: Carabelli cusp- Maxillary molar 2. Negro race: Large teeth More cusps in molar teeth ```
106
Specific characteristics of Mongol teeth
1. Shovel shaped incisor 2. Pointed canine 3. Bull like tooth (taurodontism) 4. Enamel pearl (premolar)
107
Sequence of secondary sexual character
``` The. Testis and penis development P. Pubic hair G. Growth spurt Must. Moustache All. Axillary hair Boys. Beard ```
108
Sequence of appearance of sexual characteristics in female
``` The. Thelarche (breast bud) P. Pubarche G. Growth spurt Must. Menarche All. Axillary hair Girls ```
109
Krogman’s table
Sex determination by bones is via Krogman’s table Pelvis: 95% Skull: 92% Pelvis and skull: 98% Long bones: 80% Whole skeleton: 100%
110
Bony prominence more prominent in female is
Frontal eminence | Rest is opposite
111
Shape of pelvic inlet in respective genders
Heart shaped in males | Round shaped in females
112
Bony angles more in female
Angle of mandible | Sub pubic angle
113
Tertiary sexual character
Preauricular sulcus which is present in female pelvis (only rarely in males)
114
Best bony parameter to determine sex
Greater sciatic notch | Small, deep and narrow in males, which is opposite in females
115
Chilotic line and sex determination
Line connecting sacrum to pelvis In males, sacral part is prominent In females pelvic part is prominent
116
Best bony index to determine sex | Property of bony indices
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
Corpobasal index
The bony index which is higher in males | Breadth of 1st sacral vertebra)/ (breadth of base of sacrum
118
Ashley rule | Hyrtl’s law
Ashley rule: Sternum length is more in males Hyrtl’s law: Length of body of sternum is higher in males

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