MINISTRY OF HEALTH, COMMUNITY DEVELOPMENT,GENDER,ELDERLY AND

CHILDREN

TANGANYIKA MEDICAL TRAINING BOARD

ORDINARY DIPLOMA IN CLINICAL MEDICINE

(NTA LEVEL 6)

CONTINOUS ASSESSMENT 1

MODULE NAME: BASICS OF FORENSIC MEDICINE

MAY 2018

ANSWER GUIDE

TIME: 2:30 HOURS DATE:.................................................

GENERAL INSTRUCTIONS:

1. Read all instructions carefully

2. Write your examination number on each page of the answer sheet you use
3. Attempt all questions
4. Cellular phones are NOT allowed in the examination room
5. Each essay question to be answered on not more than 3 hand written papers
6. This paper consist of five(5) sections
7. The table below is for OFFICIAL USE ONLY

SECTION TYPES OF QUESTIONS MARKS SCORED

ALLOCATION MARKS
A MULTIPLE CHOICE 20
B MULTIPLE TRUE/FALSE 20
C MATCHING 10
D SHORT ANSWER 20
E GUIDED ESSAY 30
TOTAL 100

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SECTION A: MULTIPLE CHOICE ( 20 Marks)

INSTRUCTION
 Answer all questions
 Each question carries one mark
 Encircle the most correct response

1 The branch of forensic medicine that deals with the study of DNA analyses of bodily
(physiological) fluids for the purpose of identification and individualization is called:
A Forensic serology
B Forensic toxicology
C Forensic pathology
D Forensic anthropology
E Clinical Forensic Medicine

2 Dr X, was called to the crime scene, and he decided to take samples for DNA with an aim of
indentifying the perpetuator of crime . In this case Dr X is identifying the principle of:
A Individuality and exchange
B Exchange and progressive change
C Exchange and circumstantial facts
D Individuality and progressive change
E Individuality and circumstantial facts

3 Dr RR was called to the crime scene, While in the crime scene he didnot condon the area,
wear PPE and allowed suspected victims to enter the crime scene, In the medical legal
aspect this is called:
A Consent
B Autonomy
C Negligence
D Medical Error
E Confidentiality

4 During Documentation of blunt force injuries the following is important to note:

A Not necessary to fill in PF3 form
B Never describe the direction of force
C Never conclude if is contusion injury
D Never use the words possibly or unlikely
E Never use the names of specific objects
5 Mr. X 46 years old was found dead at the road side in Mama John, On postmortem
examination he was found with area of echymosis on the scalp, The most likely type of
trauma is:

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 A Tear
B Abrasion
C Laceration
D Contusion
E Concussion

6 The most common symptoms and signs of sharp force injuries DOESNOT include:
A Pain
B Fever
C Redness
D Bleeding
E Tenderness

7 Local examinations of sharp force injury wounds focuses on:

A Areas of necrosis
B Type of the margins
C Timing of the wound
D Circumferential diameter
E Description of the wound in terms of its direction.

8 One of the following is an example of Rifled firearm:

A Shotgun
B Handgun
C Plastic Bullets
D Rubber bullets
E Homemade guns

9 A dead body was presented to you for forensic examination, the victim has been shot once
at the chest, On examination there was burn area noted, soot in shape of a muzzle, small
sized entry wound and irregular large sized exit wound, The most likely type of wound in
the client is:
A Contact wound
B Short range wound
C Distant range wound
D Either Short range or Distant range wound
E None of the above

10 Treatment of non- fatal burn injuries involves application of:

A Tetanus Toxoid vaccine when necessary
B Oral antibiotics to all types of burn wounds
C Wound dressing to all types of burn wounds
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 D Anti-inflammatory to all types of burn wounds
E Antipain injectables regardless of the type of burn

11 Victims of firearm non-fatal injuries cannot be linked one of the following authorities :
A Police
B Social Welfare
C Close relatives
D Medical Facility
E Government Chemist(for DNA)

12 The mechanism of death by electrocution will involve one of the following

pathophysiology:
A Tissue Hypoxia
B Vagal Inhibition
C Tissue Infarction
D Vagal stimulation
E Tissue Coagulation

13 Mr. X 55 years old was found dead in the water, on postmortem examination NO any
symtomatology was noted. On the lung examination there was a clear airway. The cause of
death for Mr X is most likely:
A Dry Drowning
B Wet Drowning
C Salt water drowning
D Fresh water drowning
E Secondary Drowning

14 Mr RR, 35 years old was found dead hanging in a rope. On examination the body was fully
suspended from the ground, on examination he had no bruises or cut wounds, but had
conjuctival and Petechiae haemorrhage on the face. The ligature mark was seen passing the
thyroid gland to the occipitus and below it was a reddish discoloration of skin. The most
likely diagnosis is:
A Partial Hanging
B Complete Hanging
C Manual Strangulation
D Dead body suspended
E Ligature strangulation

15 A 43 years old man was found dead in a guest house, the housekeeper says he was having
sexual intercourse with a girl whom happens to be around. The girl confirms of being asked

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 by the victim to cover his mouth and nose using a pillow as part of raising sexual arousal.
The most likely cause of death is:
A Stroke
B Smothering
C Strangulation
D Cardiac Arrest
E Vagal Stimulation

16 Mr X, 35 years was hit by a lightening while at home, The mechanism of death for the
victim could be:
A Tissue Atrophy
B Tissue Hypoxia
C Tissue Ischaemia
D Tissue liquefaction
E Tissue Coagulation

17 Positional asphyxia is virtually always an accident and is always associated with:

A Stress
B Strangulation
C Drug intoxication
D Sleep disturbance
E Hypertensive disorders e.g. Stroke

18 The mechanism of death in manual strangulation is:

A Stimulation of vagal nerve
B Fracture of the hyoid bone
C Rupture of the cerebral arteries
D Occlusion of the carotid arteries
E Fracture of the c2 cervical vertebrate

19 In making forensic conclusion, the Istanbul Protocol offers five categories of conclusions,
Which of the following is not included in the protocol;
A Consistent
B Diagnostic of
C Very Probable
D Not Consistent
E Highly Consistent

20 A female X, adult was brought to the hospital dead as she was trying to abort in a local
dispensary, The doctor explains he had just started to dilate the cervix using metal dilators,
and then the patient lost consciousness, on examination you noticed a laceration at the
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cervix. Cervical OS was closed and the pregnancy is intact. what could be the probable
cause of death:
A Vagal Stimulation
B Anaphylactic Shock
C Vagal inhibition
D Cardiac Arrythmia
E Stroke

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SECTION B: MULTIPLE TRUE/FALSE (20 Marks)

INSTRUCTIONS

 Answer all questions

 Write the word TRUE for a true statement and FALSE for a false statement in the space
provided
 Do not use the letters T/F. These will not be awarded any marks

1. The following are the aim of torture:

A ____________ To get confession
B ____________ To ascertain the truth
C ____________ To destroy personality
D ____________ For sexual gratification
E ____________ To spread terror in the community

2. The psychological sequalae of torture involves:

A ____________ Anxiety
B ____________ Depression
C ____________ Increased libido
D ____________ Low self esteem
E ____________ High self- esteem

3. The classical signs of asphyxia are:

A ____________ Cyanosis
B ____________ Eccymosis
C ____________ Visceral congestion
D ____________ Petechiae haemorrhage
E ____________ Lack of fluidity of blood

4. You are called to examine the dead body of a victim who was shot by a hand gun in
Close range about 40cm away. The most likely features to be obtained from the victim
includes
A ____________ Ragged lacerations are seen
B ____________ Muzzle marking will be seen
C ____________ Soot formation on the wound
D ____________ Tattooing by unburnt powder granules.
E ____________ Size of the entry wound is equal to the bore of weapon

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5. The following are branches of forensic medicine:
A ____________ Forensic Geology
B ____________ Forensic pathology
C ____________ Forensic toxicology
D ____________ Forensic criminology
E ____________ Clinical forensic medicine

6. Mechanical Asphyxia can be subdivided into the following types:

A ____________ Riot-Crush
B ____________ Strangulation
C ____________ Smoothering
D ____________ Positional Asyphxia
E ____________ Traumatic Asyphxia

7. In writtin a report of a tortured victim, The following are important steps to be

considered:
A ____________ The report should indicate the purpose
B ____________ The report should show the resume of a doctor
C ____________ The report should document the presenting history
D ____________ The report should document the psychological assessment
E ____________ The report should be focused only on the local examination

8. The purpose of autopsy and inquiry in death associated with a fire includes:
A ____________ To determine the nature of death
B ____________ To affirm the death as being accidental
C ____________ To determine the identity of the deceased or the remains in
multiple fatalities.
D ____________ To determine whether the deceased person was dead or alive at the
time of fire.
E ____________ To determine whether the death was accidental, the result of
criminal or negligent acts, homicidal, suicidal or natural.

9.

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SECTION C: MATCHING ITEMS (10 MARKS)

Instructions

 Answer all questions

 The section carries 10 marks
 All answer should be written in CAPITAL LETTERS and placed in the space provided
1. Match the description of the asphyxia in column B with their corresponding types of
asphyxia in column A and put the answer in the ANS space provided

sn COLUMN A ANS SN COLUMN B

1 Entrapment A. Pressure on the neck is applied by a constricting band
(e.g., belt, electric cord, rope etc.)
2 Smothering B. heavy weight presses down on an individual’s chest or
upper abdomen, making respiration impossible
3 Chocking C. A form of violent mechanical asphyxial death caused
by closing the external respiratory orifices
4 Traumatic Asphyxia D. Asphyxia caused by inadequate oxygen in the
environment.
5 Ligature Strangulation E. sudden swallowing of an object, goes down the wrong
way, and lodges in the windpipe.
F. chest compressed by stampeding people piling on top
of each other.

2. Match the description of the principles of forensic medicine in column B with their
corresponding principles in column A and put the answer in the ANS space provided

sn COLUMN A ANS SN COLUMN B

1 Principle of individuality A This principle emphasizes on the necessity of
providing like samples and specimen for comparison.

2 Principle of exchange B The principle emphasizes the necessity of (early

3 Principle of progressive
change
4 Principle of comparison
5 Principle of analysis
detection, minimal/none interference) correct packing
and sampling for effective use of experts
C Every individual is unique
D Everything changes with passage of time. Its impact in
forensic medicine is immense.
E All the identifications, definite or indefinite are made
consciously or unconsciously on the basis of
probability
F when a criminal or his instrument of crime comes into
contact with a victim or the object surrounding him,
they leave traces, and the criminal or his instrument
picks up traces from the same contact. .

Page 9
SECTION D: SHORT ANSWER (20 marks)

Instructions
 Answer all question
 All answers must be written in a space provided
 Bad handwriting will lead to loss of marks

1. Outline seven (7) methods of torture:

________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________

2. A three years old boy was brought to you in the OPD, The parent complain he had put a
round object in the nose and was unable to breath. On examination he had central
cyanosis and was dyspnoec.

A: What is the diagnosis for this patient

_______________________________________________________________________

B: Describe the management of the patient

________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________

3. Outline the steps occurring in the mechanism of death by hanging:

___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________

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4. Differentiate typical entry from exit gunshot wounds
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________

5.

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SECTION E: ESSAY QUESTIONS (30 MARKS)

 Answer all questions

 Each question carries 15 marks
 Answers should be in a narrative format
 The will be a penalty of 2 marks for essay that have been outlined
 Bad handwritting is highly discouraged

1. A 16 years old boy was rescued by the fishermen as he was drowning in the indian
ocean. He was brought to the hospital and on examination he was semiconscious and
dsypnoec. Describe the management of this patient.

2. A 10 years old young girl was brought to you by the parents claiming she was raped by
the neighbor. Discuss the concepts in medical legal issues you would take in
consideration when managing the client:

**** ALL THE BEST****

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