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1) Which of the following best describes this CT scan image of the skull?

(Image will be projected on 2) Which of the following CT scan images of the skull, labeled A to D, is most probably caused by a hammer blow? (Images A to D will be projected on LT screen) 3) For the body shown in the photograph, which of the following would NOT be useful for identification: (Image will be projected on LT screen) A) B) C) D) Fingerprints. Teeth. DNA. Presence of old fracture. 4-6) Question based on photo about wounds. (Question will be in the printed question paper). (Image will be projected on LT screen). 7) Question is left out of this handout. (Image will be projected on LT screen) 8) Question based on photo about gunshot wounds. (Question will be in the printed question paper). (Image will be projected on LT screen) 9) Question based on photo about burns. (Question will be in the printed question paper). (Image will be projected on LT screen) Burns

lightning (red) - clothes holey and tattered dry heat (eg. explosion) wet heat (eg. scald) - peeling skin/blister electrical chemical (eg acid) (greenish)

10) Question is left out of this handout 11) A 76 year old Indonesian tourist with severe heart disease was found dead by her daughter in their hotel room. There were no external injuries. Which of the following is true? (The alternatives A to D will be in the printed question paper) 12) Which of the following is not true about the Coroners system in Singapore? Coroner's system in Singapore inquire and determine when, where, how, and in what manner the deceased came by death death reportable when suspect died in sudden or unnatural manner, by violence or unknown coroners act 2011- came into force on 2Jan 2011

inquire into cause of & circumstances of death ascertain identity of the deceased ascertain how, when and where the deceased came by his death 13) Which of the following is not true regarding forensic pathologists in Singapore? Forensic Pathologists require any medical/healthcare practitioner to furnish detailed report on medical treatment or care rendered medical/healthcare records related to treatment and care failure to provide/destroy = <= 10,000 or imprison <12 months or both may appoint any pathologist as forensic pathologist 14) A 92-year-old man has advanced terminal lung cancer and only has a few days to live. He is admitted into a hospice. He is given morphine to relieve pain. While going to the toilet, he slips and falls on his buttocks. He has some pain in his hip. He is able to get up with the help of the nurses and goes back to bed. The next morning, he is found dead in bed. Which if the following is the best course of action? (The alternatives A to D will be in the printed question paper) 15 - 23) Question is left out of this handout (Question will be in the printed question paper).

24 - 26) Question regarding post mortem change (Question will be in the printed question paper). (The choices will be in the question paper). Post mortem change rigor mortis (stiffening) hypostasis (settling of blood) 1st 6 hours livor mortis - purplish red discoloration of skin due to blood settling down putrefaction (decomposition of proteins/body) marbling (superficial vein under skin) swelling/bloating skin peeling maggot infestation skeletonisation 27) Which of the following is NOT a natural cause of death? (The choices will be in the question paper). Not a natural cause = reportable deaths accident

execution homicide misadventure suicide terrorism war adverse outcome of surgery

28) Which of the following deaths need not be referred to the Coroner? (The choices will be in the question paper). Deaths need not be reported = not in reportable deaths Reportable deaths 1. person whose identity is not known 2. unnatural or violent 3. resulted on or suspected to have resulted, directly or indirectly, as a result of any medical treatment or care 4. occurred directly or indirectly, from an accident 5. while the person was in official custody, except death as a result of capital punishment 6. where person was, before his death, in official custody and where the death was related, or suspected to be related to that custody . occurrin! apparently or possibly as a conse"uence of law enforcement operations #. occurrin! at any workplace, or as a result of any accident or dan!erous occurrence at a workplace, as defined in the $orkplace %afety and &ealth 'ct ()ap 354'* +. involvin! a public vehicle or commercial transport vehicle 1,. on board a %in!apore re!istered vessel or aircraft while in fli!ht 11. was caused or suspected to have been caused by an unlawful act or omission 12. the manner or cause of which is unknown 13. occurred under suspicious circumstances

29) Which of the following injuries is NOT due to blunt force trauma? (The choices will be in the question paper). Blunt force trauma abrasion contusion (bruise) lacerations concussions

bone fracturing 30) Which of the following is NOT true regarding a laceration? (The choices will be in the question paper). Laceration irregular tear-like wound skin injury where skin is broken caused by blunt force/rolling linear (regular) or stellate (irregular) 31) Which of the following is NOT true regarding self-inflicted wounds? (The choices will be in the question paper). Self inflicted wounds abrasion o injury to superficial layers o skin not broken o caused by blunt force trauma contusion (bruise) o bleeding under skin/in organ o due to blunt force trauma laceration incised wound o skin broken and has sharp edges o by sharp edge objects (knife, razor) o includes 'stab wounds' 32) Regarding defense injury, which of the following combination of statements (from A to D) is correct? (Seven statements will be given in the printed question paper. The choices A to D will give a combination of the 7 statements. Choose the choice A to D which shows the combination of statements which are correct). Defense injury indicate: victim was conscious, partially mobile and not taken by surprise Type: blunt force o bruises are hallmarks, sometimes with abrasions o fractures of hard bones may occur sharp weapon o incised wound gunshot Location mainly forearms/hands on thighs

palm side of hands and fingers 33 - 37) Question regarding firearms/ gunshot. (Question will be in the printed question paper). Firearms/gunshot penetrating - enter an object and remain inside perforating - passes completely through the object o has exit wound Types of wounds entrance wound = surrounded by reddish brown area of abraded skin, known as abrasion ring wound looks smaller than the bullet passed through hard contact wound = muzzle held tightly against the skin, searing and powder blackening of immediate edge of wound, autopsy reveal particles of soot and unburnt powder loose contact = muzzle held lightly, soot deposited can be wiped away near contact, muzzles not in contact, powder grains leave a powder tattooing. entrance wound surrounded by wider zone of powder soot, and seared, blackened skin intermediate range = close enough to produce powder tattooing, numerous reddish brown to orange red lesions around entrance to wound distant = no marks other than bullet perforating the skin reddish brown to orange red powder tattooing = alive when shot gray or yellow marks = dead before shot Type of gun used shotgun wounds o massive tissue destruction and embedded wadding if shot within 10 feet handgun o larger and more prominent tattoo patterns than rimfire due to flake powder rimfire weapon o use ball powder = faint and extremely fine tattooing o confined to tissues and organs directly in their path center-fire rifles o can damage organs, bones, and tissues without contact o organs that are directly hit may partially or completely disintegrate o pressure powerful enough to fracture bones and rupture vessels close to the wound o can eject tissue on entrance and exit wound

Examining bullets no grooves o fired from oversized weapon such as rifle elongated grooves with deep incision o fired from undersize weapon skid marks exist o fired from revolver powder marks o often occur on lead bullets or full-metal jacketed bullets that have lead exposed at the base bullet removed from body too mutated to be useful bullet recovered from decomposed bodies likely to be partially/completely useless even if shot from the same firearm, unlikely that two bullets are similar

38) Regarding asphyxia, which combination of the following statements, from A to D, is correct? (Seven statements will be given in the printed question paper. The choices A to D will give a combination of the 7 statements. Choose the choice A to D which shows the combination of statements which are correct). Asphyxia severe deficient supply of oxygen to body Types: lack of oxygen in air smothering - covering mouth and nose with a hand, pillow or a plastic bag gagging (blocking mouth) thorax prevented from moving external neck compression hanging overlaying Signs: facial congestion cyanosis o blue or purple coloration of skin due to tissues near the surface being low in oxygen petechial hemorrhages o red or purple spots on body. caused by broken capillary blood vessels Auto-erotic asphyxia production of cerebral hypoxia to produce hallucination self applied bondage

escape mechanism 39) Question is left out of this handout (Question will be in the printed question paper). 40 - 43) Question regarding sexual assault/ sexually transmitted disease. (Question will be in the printed question paper). Sexual assault/STD Victim should be referred for Medical examination o treatment of injuries o management of possible infection, pregnancy Forensic examination o documentation of injuries o preservation of trace evidence o first 72 hours most crucial (ejaculate - seams starts to disintegrate and DNA disappear) Victims Children Adolescent girls and young women o extra genital trauma common o drugs/alcohol may be involved Older women o more prone to genital trauma Men o rarely reported and often overlooked Physical examination inside mouth - oral sex (frenulum to tear) bite marks - forensic dentist vulval bruising - ascertain penetration hymen - tear at 9 o'clock (digital penetration - where finger put into virginal) Forensic sampling blood DNA analysis - serology, drugs fingernails - nail cutting or scarping, swab for blood hair (head/pubic) - foreign hair, semen clumps plain non-genital swabs - to lift saliva, semen, lubricants oral swabs - dentures, braces for oral sex genital & anal swab

Penile examination penile papules o small saliences on the ridge of glans of penis, harmless anatomical variation phimosis o foreskin cannot be retracted = cannot be cleaned, hence red and mistaken for injury balanitis o infection of foreskin Sexually transmitted diseases herpes o by virus o blisters in a group o 1. affect genitals, 2. affect mouth o difficult to treat o can often recur viral wart o due to viral infection o black marks, spots of blisters o look like small stalks syphilis o 1st stage: chancre (firm, painless, non-itchy skin ulcer) o doctor swap ulcer to culture a grow to find syphilis o condylomata lata - lumps o wart like lesions on the genitals o symptoms of secondary phase candidiasis - fungal/yeast infection, treatable, white spot on penis kaposi's sarcoma o cancer caused by HIV, in the late stage, on the feet, only in patients with aids o dark red spots molluscum contagiotagiosum o ulcer, a virus infection, looks like a crater of a volcano asphyxiapilia - practice of using strangulation to enhance pleasure of mausturbation

44) Question regarding asphyxia. (Question will be in the printed question paper). 45 - 47) Question based on IVLE posting. (Question will be in the printed question paper). -irearm weapons smooth bore (shot!un*

.ifled hand!uns o .evolver (15, m/s* o 0istol (3,,115, m/s* .ifles (lon! barreled* (5,, 1 15,, m/s*

'mmunition .ifled o 'mmunition consists of the cartrid!e case, primer, !unpowder and bullet o 0rimer 1 explosive material at the base of the cartrid!e, detonated by the firin! pin, to i!nite the !unpowder o 2unpowder 1 !enerates !ases to force the bullet down the barrel o 3ullet 1 the pro4ectile, which separates from the cartrid!e %hot!uns o %hell (cartrid!e* contains 5shots5 or 5pellets5 instead of a bullet .iflin! refers to !rooves and lands, in a spiral fashion, in the bore (inner aspect of the barrel* imparts spin to the bullet, and makes the bullet more stable in fli!ht have 5class5 or 5individual5 characteristics )lass characteristic6 o bumbler, diameter, width, depth of lands/!rooves o direction of riflin! twist o de!ree of twist 7ndividual characteristics o due to imperfections on the lands and !rooves which are specific to that weapon )alibre refers to diameter of the bore of weapon from 5land5 to 5land5 also refer to the bore diameter from !roove to !roove or the diameter of the bullet/cartrid!e can be !iven in inches or millimeters shot!un calibre called 5!au!e5, defined as the number of lead balls which exactly fit the shot!un bore, that e"uals to one pound on wei!ht -irearms most !unshot wounds caused by small arms o firearms that are dischar!es from the hand or shoulder o hand!uns, rifles, shot!uns, machine !uns

hand!uns 1 revolvers and pistols revolvers had rotatin! cylinders with chambers into which the cartrid!es are loaded pistols, 1 cartrid!es are loaded into ma!a8ines or clips, which are placed in the pistol !rip auto loadin! pistol 1 1st cartrid!e is usually loaded by pullin! the side. $hen tri!!er is pulled, bullet moves down the barrel and the !ases !enerated e4ect the cartrid!e and load the next cartrid!e

.ifles o firearms desi!ned to be fired from shoulder o can be sin!le shot or auto loadin!, which can be semi or fully 1auto o semi auto rifles 1 tri!!er has to be pulled each time to fire a bullet o auto rifles 1 one pull of the tri!!er will fire the bullets until the ammunition is all used up, or when the tri!!er is released

$oundin! woundin! capability of a bullet depends on the amount of 9:, which depend on mass and velocity it possesses amount of ener!y released by the bullet within the body depends on several factors6 o initial ener!y in the bullet o ener!y bullet has lost in fli!ht o yaw of the bullet at the time of impact o bullet characteristics o tissue bein! impacted appearance of !unshot wound determined by the mu88le to tar!et distance o contact, near contact, intermediate and distant &ard contact wounds searin! of skin/clothes by hot !ases imprint abrasion of mu88le impre!nation of imprint and wound with soot and !unpowder splittin! of skin if the skin is very close to bone ;oose contact wounds dense deposit of soot encirclin! the !unshot hole an!led contact wounds mu88le held at an!le to skin

shape of searin! and soot deposition can is eccentric if !ap is lar!e enou!h, there may be a fan1 shaped 8one of powder tattooin! 7ntermediate tattooin! due to powder !rains strikin! the skin, and abradin! or contusin! the skin distance is about 1,mm <istant wounds absence of soot, powder tattooin!, searin!, only bullet hole hand!uns 1 powder tattooin! disappears when mu88le tar!et distance is about 6, to 12, cm test firin! of a firearm with similar ammunition at varyin! distances is essential to arrive at a more precise tar!et1mu88le distance wound appearance affected if there is any barrier between the mu88le and skin, includin! clothin!