Chapter Topics Page

Special Problem Based

Ques section (Including ans) 64 107

Forensic Medicine
(Contains Tricky Sections) 108 167

24 Introduction to Forensic Medicine 108

25 Legal Procedure 110

26 DMDC & Medical Ethics 113

27 Mechanical Injury 115

28 Fire arm & Bomb blast injury 118

29 Trace evidence 129

30 Regional & Road traffic accidents 120

Conte
31 Autopsy 120

32 Death & Post mortem changes 124

33 Violent Asphyxial Deaths 127

34 Starvation & Anesthetic Death 132

35 Thermal Injury 133

36 Electrocution, Lightning 134

37 Identification 135

38 Sexual Offences 139

39 Irritant poisons Impotency, Sterility, 142

Artificial Insemination, virginity, Defloration & hymen

40 Pregnancy, Delivery & Abortion 144

41 Infanticide 146

42 Forensic Psychiatry 147

43 General Toxicology 149

44 Organo Phosphorus Compound(OPC) 151

45 Kerosene Oil 152

46 Corrosive Poisoning 152

47 Sulphuric Acid Poisoning 153

48 Nitric Acid 154

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 1

’ V/ ' I

49 Hydrochloric Acid
’54
SO Oxalic Acid
’54
SI Carbolic Acid
’55
52 Metalic Poisoning
155
53 Arsenic Poisoning
156
54 Lead Poisoning
158
55 Phosphorus Poisoning
159
56 Snake Bite
159
57 Deliriant Poison
160
58 Datura
160
59 Cannabis
161
60 Alcohol
162
61 Opium
163
62 Barbiturates
164
63 Asphyxiants
165
64 Carbon Monoxide
165
65 War Gas
165
66 Paracetamol Poisoning
166
67 Drug Dependence & Abuse
166

Covid 19 at a Glance
168-176
Diseases at a Glance
177-18'
68 Communicable Diseases:
177
69 Non communicable
Diseases: 181
Differences at a glance 185-224
70 Community Medicine:
185
71 Forensic Medicine:
205
Weapons & Poisons at a glance:
225-232
72 Weapons:
225
73 Poisons:
229

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 Chapter Topics Page

Opinions at a glance: 224-236

OSPE: 237-267

74 Community Medicine: 237

75 Forensic Medicine: 256

Color plate: 268 296

76 Models (Community Medicine): 268

77 Weapons & Poisons: 285

MH Box Questions: 297-332

78 Community Medicine: 297

79 Forensic Medicine: 307

t - 1 Viva Section: 333 357

(Prof scenario* Introductory Questions with Answers)

80 Community Medicine
i. Board I: 333
ii. Board II: 341

Con
81 Forensic Medicine:
i. Weapon Board: 347
ii. Poison Board: 352

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any book published bj’ Axis Medical School

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 Forensic Medicine ITEM Book

Introduction to Forensic Medicine

1. Define Forensic Medicine. ***

2. What is the name of this department? ***

3. Tell me the name of your Forensic Medicine Text book. ***

4. Tell me the name of the writer of the Text Book. ***

5. What is the edition of your text book? ***
6. Tell me the other name of Forensic Medicine book. ***
7. What are the branches of Forensic Medicine? ***
8. What is Forensic Pathology?
9. What is Forensic Dactylography? *
10. What is Clinical Forensic Medicine? *
1 1 . Who is the father of Forensic Medicine? ***
12. Tell me the scopes of Forensic Medicine.
13. Tell me the aims of Forensic Medicine.
14. Tell me the goals of Forensic Medicine. **
15. Why you should study Forensic Medicine? ***
16. Tell me the differences between Forensic Medicine & Clinical Forensic Medicine. **
17. Define Medical Jurisprudence. ***
18. When can you apply the knowledge of studying medical jurisprudence?
19. Tell me the differences between Forensic Medicine & Medical Jurisprudence. ***
20. What are the aspects of Law-Medicine relationship?
21. Define Medical Ethics.
22. What do you mean by Medical Etiquette?
23. Why doctors of all categories should have fair knowledge in Forensic Medicine? ***

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 Forensic Medicine
ITEM Book

Tricky Question:

Answer: The word Forensic has come from

the Latin Word Forensis & is related
lawyers did their business in ancient
to “Forum", The Roman market place where
times.

2. Father
Answer: Father of Forensic Toxicology- Mathieu Joseph Bonaventure Orfila
(Spanish)

3. Radiology <^r fa?

Answer: Role of Radiology in Forensic Medicine:
Z Determination of Age
J Detection of foreign bodies
Examination of bone fracture
Z Diagnosis of live birth
It is done in some autopsies(virtual autopsy)

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Forensic Medicine ITEM Book
Legal Proceihire

1. WhatisBPC?
2. Define crime.
3. Define Criminal.
4. What arc the types of criminal?
5. What is criminology?
6. What are the conditions to be fulfilled defining a
crime?
7. Why there is difficulty in detection of crime
in Bangladesh?
8. What is case? What are the types of cases?
9. Tell me some examples of civil & criminal
cases. ***
10. What is Warrant?
1 1. What is Summon? ***
12. Define Inquest. ***
13. Who does the inquest? ***
1 4. What are the places where coroners inquest &
continental system applied? ***
1 5. What type of Inquest is done in Bangladesh? ***
1 6. What is Police Inquest?
1 7. What is Magistrate Inquest? ***
1 8. Where magistrate inquest is required? ***
19. Who is a coroner?
20. Tell me about medical examiner system.
21. Define Inquest report. *
22. What are the parts of Inquest? **
23. What are the contents of Inquest? ***
24. What is Challan? ***
25. Tell me the number of Challan. ***
26. What is more important between Inquest & Challan and why so? ***
27. Define Offence.
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 -N v\ hat are the types of offence? *
29. W hat do you mean by cognizable offence? *

30. What do you mean by non-cognizablc offence? *

31. Tell me the example of cognizable/non cognizable offence.
32. What is Warrant?
33. Define summon/subpoena. ***
34. Who serves summon? ***
35. What is the punishment if anyone fails to attend the summon? ***
36. What is regarding summon?
37. What are the Punishments authorized by law in our country?
38. What is conduct money? *
39. What do you mean by capital punishment? ***
40. What are the methods of capital punishment?
41. Define witness. **
42. What are the types of witness? ***
43. Who is a common witness?
44. Who is an expert witness? ***
45. Define hostile witness. **
46. What is petjury? **
47. Can you act as common & expert witness at
the same time? If yes, how can you
act as both? ***
48. Who can act as both common & expert
witness? ***
49. Define Evidence. *
50. UTiat are the types of evidence? *
51. What are the types of oral evidence?
52. What is hearsay? *
53. Tell me about circumstantial
evidence.
54. What do you mean by
Medical Documentaty Evidence?
55. Have you ever seen any
Medical Documentaty Evidence?
--
Tellmetheexample of Medical Documentaty
Evidence.
al
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 51. What do you mean by Medicolegal? ***
58. Tell me the difference bctw een medical certificate & medicolegal reports. M‘
59. Define Dying Declaration.
60. Tell me the procedure of giving dying declaration. **
6 1. What is dying deposition? ***
62. Tell me the procedure of giving dying deposition? **

63. Tell me the difference between dying declaration & dvmg deposition ***

64. Which one is more important between dying deposition & dying
declaration?
65. What is bed side court? ***
66. Which one between the dying declaration & dying deposition has a
value if the
patient survives? ***
67. What are the pans of deposition? **
68. Tell me the procedure of giving evidence in the court.
69. Wliat do you mean by cross examination?
70. When judge can quest ion the witness?
7 1. What is leading question? **
72. Can you tell me an example of leading question?
73. Tell me about the judicial system of Bangladesh.
74. Define Court. ***
75. Tell me the classification of court.
76. What is civil & criminal court? ***
77. Tell me the function of civil & criminal court.
78. What are the punishments magistrate court can give?
79. Tell me the power of district & session judge court.
80. WTio can give death sentence? (Session & aditional session judge) *•*
81. What is constrictive liability ?
82. What is command certificate? ***
83. What is mass disaster?
84. Where is your home town? What type of court is running there? Tell me the
function of that court. ***
85. What is jury?*
86. What is plaintiff? *
87. What is defendant? *

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 BMDC & Medical Ethics

1. What is BMDC? ***

2. What is the full form of BMDC? ***
3. Tell me the location of BMDC. **
4. Tell me about establishment of BMDC.
5. Tell me the function of BMDC. ***
6. Do you know the structure of BMDC?
7. What is BMA? **
8. Tell me the difference between BMDC & BMA. ***
9. What do you mean by medical ethics? ***
1 0. Tell me the type of violation of medical ethics.
1 1. After being a doctor when you can discontinue the treatment of your patient? ♦*
12. Tell me how BMDC acts on judicial procedure.
13. Tell me when & how a doctor’s name is erased from the register of MDC. *♦*
14. What do you mean by penal eraser?
15. What is professional death sentence? ***
16. Define PIC (Professional Infamous Conduct). ***
1 7. What are the common PICs? ***
1 8. What do you mean by adultery? ***
19. What is Dichotomoy?
20. What is fee sharing & fee splitting? **
2 1 . Which one between fee sharing & fee splitting is ethical & why?
22. What is Professional negligence? ***
23. Tell me the types of professional negligence. ***
24. What are the other names of professional negligence? ***
25. Tell me some example of civil professional negligence. **
26. Tell me some example of criminal professional negligence. **
27. Tell me the difference between PIC & Professional negligence. ***
28. Who will give punishment in PIC? ***
29. What is Professional secrecy? ***
30. If due to some valid reason professional secrecy is broken,
what is it called then?
31. Define Privileged communication. ***
32. Tell me the aspects of privileged
communication. ***
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 f ^ic
M«dicin« *11M Book
^^^Ti**'**
< I dl n* mh*m«l consent •••
\\ hat snr ll* conditions of an informed convent • •••
, w hai sre the conditions when consent is invalid 1

ig \\ hal is product liability ’

14 Define Euthanasia.
.Ki What arc the types Euthanasia’’
of
41 1 ell me about each types of Euthanasia.
42 What is the first country that practiced Euthanasia .’
43 Define Res Ipsa Loquitor.
44 Tell me the examples of Res Ipsa Loquitor.
45. What is vicarious liability?
a
Tricky Question:
BMDCCSfto^ C^?
Answer: Prof. Dr. Mohammad Shahidullah

*IBMA C^?
Answer: Mostofa Jalal Mohiuddin
UI BMDC & BM A C^T^TRI?
Answer:
BMDC: Syed Nazrul Islam Sarani, Bijoynagar (Opposite the ovchead water
tank)
BMA: Topkhana road.
81 CXFbPld tow WEFT Contributory
negligence^ XWI Negligence
Answer: Contributory negligence from doctor’s side: (Mainly Civil malpraxis)
z Failure to obtain informed consent
Failure to obtain proper history of the patient
Making wrong Diagnosis
Failure to give post-operative care, to attend the patient in time

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 I
Mechanical Injury

I. Define Injury.
What are the types of Injury?
3. What arc the injuries that are caused by blunt force? ***
4. What arc the injuries that are caused by sharp cutting force? ***
5. What are the injuries that arc caused by pointed weapon?
6. Tell me the medicolegal importance of Injury.
7. Define Hurt. ***
8. Tell me the types of hurt. **
9. What is simple hurt?
10. Define grievous hurt. ***
11. Tell me the BPC 320.
12. Tell me the 8th point of BPC 320.
13. What is the punishment of Grievous hurt?
14. What is emasculation? ***
15. What is the procedure of emasculation?
16. Define Assault.
17. Define Battery.
18. Define Wound. ***
19. What are the causes of
death due to wound? ***
20. Define surgical wound.
21. Define Abrasion. ***
22. What are the types of
Abrasion? ***

25.
26.
27.
28.
29. What are
the types of
Bruise?
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 Forensic Medicine ITEM Book
30. Tell me about shifting bruise.
31 . Tell me the age & color change of bruise.
32. Tell me the medicolegal importance of bruise. ***
33. Tell me the difference between Hypostasis & Bruise. ***
34. Tell me the difference between Artificial & true Bruise.
35. Define laceration.
36. Tell me the types of laceration?
37. What is split laceration? ***
38. What are the other name of split laceration? ***
39. Tell me the common site of split laceration. ***
40. Define incised looking wound. ***
4 1. Can you determine incised looking wound in open eyes? ***
42. Tell me the character of incised looking wound.
43. Tell me the medicolegal importance of incised looking wound.
44. What is incised wound?
45. Tell me the types of incised wound.
46. Tell me the character of incised wound. ***
47. An incised wound over the throat- what will you name it?
48. What are the sites where the incised looking wound is inverted? **
49. What arc the sites of concealed punctured wound?
50. Tell me the cause of death in suicidal & homicidal cut throat wound. **
51. Tell me the difference between suicidal & homicidal cut throat wound. ***
52. Tell me the difference between Incised & chop wound.
53. What is hesitation cut?
54. What is tentative cut?
55. What is defense cut?
56. Tell me the level of suicidal & homicidal cut throat wound. **
57. Define weapon.
58. What are the types of weapon?
59. Show me natural weapon in your body.
60. Define homicide.
61 . What are the types of homicide?
62. What is justifiable homicide?
63. What is excusable homicide?

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 Tricky Questions

Answer:
Head (Blunt wound)
.•
Nail (concealed puncture wound
Hands (blunt wound, Asphyxial
in infant, abrasion)
injury)
•
injury)
• Feet (blunt wound, Asphyxial
. Bends of knee and elbow (Asphyxial
injury)

• Hair (in case of female)

Dangerous & Why?
Bruise & Hypostasis^
due to
because death may occur from butse
Answer: Bruise is more dangerous
blood loss. Minimum one third of total blood loss may lead to death.
to I True abrasion dM ^ic^?
formation, simple in nature.
Answer: Bleeds little, heals rapidly, no scar
8 1 Incised wound ?

Answer: By drawing, sawing & striking.

I Incised & stab wound tWfb Basic difference I

Answer: . ...
... stab, wound, depth
In Incised wound length is greater than the depth, in is

deeper than length that’s why it is more dangerous.

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Forensic Mecncine
••’em tool<

Define forensic ballistics

Define firearm ***
3. Classify firearmguns
4. What is choking? ***
5. Define rifling. ***
6. What is the importance of rifling? ***
7. Tell me the M/E of rifling.
8. Tell me the parts of shot gun cartridge.
9 Tell me the parts of rifle cartridge
10. What is Primer?
1 1. Tell me the composition of primer. ***
12. Can you tell me the mechanism of Primer?
13. Tell me the medicolegal importance of primer.
14. What is the other name of gun powder?
15. What is gun powder?
16. Tell me the types of gun powder. ***
17. What is projectile
18. Tell me the difference between bullet & pellet. ***
19. What is abrasion collar?
20. Differentiate entry & exit wound. ***
21. What is ricochet bullet? **♦
22. What is the medicolegal importance of ricochet bullet?
23. What is tandem bullet?
24. What is souvenir bullet?
25. What is kennedy phenomenon? ***
26. What is dumdum bullet?
.
27. Tell me the difference between suicidal & homicidal gunshot injury
28. Tell me the effects of bomb blast explosion.
29. What is Marshal triad? ***
30. What is blast lung? ***
31. Tell me the features & findings of blast lung. ***

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 Trace
Evidence

2.
3.
Te"
xyhatisthem ^"7^™ ^nen>
for blood
ae (
#♦

4.
5.
6.
7.
8.
9.
10.

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 Regional & Road traffic accidents (Mainly for written)

are aclua,,y (Blunt force injury)

I. Whn! ‘yPe of inJurics
7 Classify RTA according to type of victim.

3. Who arc the common victims of RTA?

4. Who arc the main victim of RTA in our country & in developed countries?
5. Tell me about steering wheel injury.
6. What is whiplash injury? ***
7. Tell me the opinion of death due to RTA. ***

Autopsy (for Written & Viva Both)

1. How many autopsy cases you have witnessed by yourself? ***

(10 SCaseGf1^ ^*^151)
2. Where have you witnessed autopsy? *** location.
Morgue^
3. Tell me the name of the cases you have witnessed by yourself. ***
4. Have you written autopsy report of those cases? Tell me how an autopsy report look like? ***
5. Where is the box for opinion writing in autopsy report? ***
6. An autopsy report contains how many signatures? And what are they? ♦**
7. What are the medicolegal examinations done in our country? ***
8. What are the other name of autopsy?
9. Define autopsy. ***
10. What are the information you can obtain from autopsy? *
1 1 . What are the types of autopsy? *
12. What is medicolegal/Forensic autopsy?
13. Why medicolegal/Forensic autopsy is needed?
14. Is consent needed for clinical autopsy? (Yes)
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 •e
15 What type of autopsy is done in morgue?
16 Which autopsy is complete & which one is incomplete
autopsy? (Clin'
incomplete, medicolegal autopsy is complete)
17. What are the objective of autopsy?
18. Tell me some conditions where nature/manncr of death
is not given
m autnn<.
report. *** W
19. Who can carry/perform autopsy in BD? ♦**
20. Suppose you are a great private practitioner,
can you perform autopsy?
21. What are the parts of an autopsy report?
*
22 Tell me the pre-requisite of medicolegal
autopsy. ***
23. What are the criteria of an ideal
mortuary? **
24. Mat are the conditions when you
can refuse to perform an
What is second autopsy? autopsy.'
26. What are the pre-requisite
of second autopsy?
27. Tell me the medicolegal importance
of second autopsy
28- Can you tell me a renowned
case of second autopsy?
29. Define Negative autopsy.
3«. What are the causes of negative
autopsy?
3 1. What is
embalming?
32. What is obscure
autopsy?

” What are the reasons of

34. Define
Exhumation.
35. What are the procedure
obscure autopsy?

of exhumation?
36. What are the objectives
of exhumation?
37.
38. ^'^of'^r^^i^
Tell me the procedure
in exhumation?
of exhumation.
39. Tell me the

"-T
function of Mo Mo„-
40. What are the &
rules of performina eXhUma,ion-
8 mcdlco|egal autopsy?
41. W
What> are th
the parts of
medicoiega! autopsy?
42. TeHne about
inremal examiners of
43. W
^re'heprimaryincis^or
44. What are the
-
incisions made for i„lmial
Or,ntemal
examination?
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 the procedure of circularil/Y/Modified
Y shaped cruciate incision.
45- Tell me
What are the incisions for scalp?
46.
Why umbilicus
is avoided during incision? **
47.
of hanging what type of incision you will go for? (Modified)
48. In case
bone is removed? / How skull bone is removed in BD?
49. How skull
the causes of viscera preservation
50. Tell me
the commonly preserved viscera?
51- What are
commonly used preservatives for viscera preservation?
52. What are the
advantage of using NaCl as preservatives?
53. What is the
disadvantage of using NaCl as preservatives? (Not useful for
54. What is the
chlorinated viscera)
55. In case of alcohol poisoning, from where blood is collected? (Large Peripheral
vein, eg- Subclavian vein)

56. Why formalin is not used as preservatives for viscera preservation?

57. Why rectified spirit is not used for viscera preservation now?
58. Where will you send the viscera after labelling? I Where will you send the viscera
for examination?
59. Tell me the procedure of viscera preservation.
60. How many containers are used for viscera preservation?
61. Tell me the container & amount of viscera taken for preservation.
62. How much of each container is kept empty & why?
63. Why stomach, liver & kidneys are kept separate?
64. Why stomach with its full content is taken?
65. Why liver not less than 500gm is taken?
66. Why longitudinal half of each kidney is taken?
67. How can you differentiate Antemortem or postmortem poisoning from viscera
preservation?
68. What are the cases where full liver is taken for viscera preservation?
69. What is the difference between the opinion of hanging & the opinion of OPC
poisoning?
70. Why detection of crime is difficult in BD?
71. What is virtual, psychological autopsy? (NTK)

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 " hat are the iMswmalmn sou san (mm

"*•"
1
hat are the v,n
nx- the l„„„ „t autop.) ()n H|>
No hnw< m। |(| (

ricky Question:
Ik'Jil Nkh Identify ♦««
Answer: Police Constable
1 What are the
systems of autopsy
A.«er: Medtcolegal Medical Lxammcr
System
Coronal Sysytem
Conventional System Continental Sysytem (BD)
Fiscal System
WWW Clinical Autopsy asm
Answer: Amted Forces Medical
College (AFMC)
^^^^Cavity^^open^r
Answer: cr Cavity w |njuiy
«"^«5Skull
-I What does the chain of custody

.
means?
Answer:
[Link]^[Link]
Toxicology Department.
ldine
^^Fotenstc Medicine & F

5. Which is the ideal

incision?
Answer: Modified Y shape (In foreign
Country)
6 When the 1st Medicolegal
autopsy was done & who have
Answer. Bartolomo De Varignana done it?
in 1302 AD.
? What is the Pnnsloo & Gordon
incision’
Answer: Modified Y shape incision
is called Prinsloo &
Gordon incision.
Why ngltt lobe of liver is taken
for viscera preservation?
A».wer: bright
lob.^BwtaBWww|y^^i

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 ITEM Book
Forensic Medicine
Changes
Death & Post Mortem

Thanatology.*
1. Define Forensic
I What is the medicolegal
[Link] of death.
2. Define death.
What is Bishop’s
Tripod of life?
3.
4. What are the types of death?
of death?
5. What are the clinical types
of death?
6. What are the medicolegal types
declaring death.
7. Tell me the procedure of
somatic & molecular death.
8. Tell me the differences between
of somatic death?
9. What are the medicolegal importance
death?
10. What are the types of brain
11. What is whole brain death?
of brain death.
12. Tell me the diagnostic criteria
death?
13. How can you diagnose a brain stem
14. Which tissue is most vulnerable to
hypoxia? (Nervous Tissue)

15. What are the mode of death? ***

16. What are the manner of death? ***
17. What are the stages of death?
18. What is natural death?
19. What are the causes of syncope?
20. Define suspended animation/Apparent death/Death trance *
21. What are the types of suspended animation?
22. Tell me an example of voluntary suspended animation.
23. Tell me some example of involuntary suspended animation.
24. What do you mean by presumption of death?
25. What do you mean by presumption of survivorship?
26. What are the changes after death? ***
27. How can you estimate time since death?
28. Tell me about the immediate change of death. ***

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 death.
29. Tell me about the early change of
♦**
30. Tell me about the late change of death.
***
31 . What is algor mortis/post mortem cool ing?
32. What is livor mortis? ***
33. What are the sites of livor mortis?
34. Tell me about the timing of livor mortis.
35. Tell me about the color of hypostasis. *
36. What is rigor mortis?
37. Tell me the medicolegal importance of rigor mortis.
38. What are the differences between hypostasis & bruise?
39. Tell me the criteria of issuing a death certificate.
40. Suppose, you are a medical student of a renowned medical college, can you issue
a death certificate?
41. Suppose, you are a fresh intern doctor of a renowned medical
college hospital, can
you issue a death certificate?
42. What is cadaveric spasm?
43. Tell me the differences between rigor
mortis & cadaveric spasm
44. What are the other form, of stiffenening?
(Heat, cold, gas stiffening, Cadevenc spasm)
45. What is putrefaction?
46. What are the stages of putrefaction?
47. Tell me about the color change
of the skin during putrefaction.
4«. What is modified putrefaction?
49. What is adipocere formation?
50. What is mummification?
5 1 . Tell me the medicolegal importance
of mummification
52. What is murbling of skin?
53. Define sudden death.
54. What are the causes of sudden
death?
55. What is PVS? (A condition where
but there is no awareness)
there i, some degree of ar . , (®ye«
are open

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 have a patient with
cortical death & another patient with brain stem
56.
SUPPOS^^ actually? Who is suitable for organ donation?
(Brain stem

dea,h) who is actually in reproductive

caseof sudden death of female
57-
-ost likely the cause ofher sudden death?

^on anesthetic criminal

abortion)

Tricky Question:
transplanted after deat .
What are the organ
Answer:
Autograph
Holograph

/ Formalin- 1.5 L
Sodium borate- 600 gm
/
Sodium citrate- 900 gm
/ Glycerin- 600 ml
mg
Sodium chloride- 800
Eosin-30 ml
ml
Soluble wintergreen- 90
Water- upto 10L
3. What is catalepsy?
Answer: Synonym of
4. Brain death dx
Deathtmnce^ ?jtW?

a. Critical medicine
b. Neuromedicine
e. Ward in charge
5. Conscious level Grading

a. Grade 0- Fully Conscious

state minimum stun
b. Grade 1- Drowsy
c. Grade 2- M^^msponse to maximum sunu
resp
d. Grade 3- Minimum
e. Grade 4-No_response_
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6. Tell me the rule of thumb.
Answer:
Respiratory system stops within 20sec after cardiac arrest
Cardiac system stops within 20 minutes after respiratory system.
7. Algor mortis JI Temperature loss/hour
Answer: 1\1.5° loss per hour.
8. W Internal Organ JI SOT Rigor Mortis appear
Answer:
a. Cardiac Muscle

Violent Asphyxia! Deaths

Define asphyxia.
2. What do you mean by violent asphyxia?
3. What are the means of violent asphyxia?
4. Tell me the classification of
violent
asphyxia.
5. Tell me some example of
6.
Pathological & Mechanical asphyxia S
Hemorrhage/Tardteu’s spot. Congestion,
7. What is cyanosis?
Edema) •••
8. What are the deoxygenated
Hb that transmit through
Intense dark blue or purple) rough skin during
d • cyanosis?
9.
W^at do you mean by petechial
hemorrht
•TdlmetheP/Mfindingsofasphyxiadeath...
>age?

are the causes of

death in si01eMasph
'
a-opsy? (Vagal
,he ^ieal
/features of asoh
inhibition, highly decom
'

be found ^ng
“[Link]^^^
^-ddendea^
the vagus nerve runs)
14. Define hanging.
n s Placed
on the neck where

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ForenSic Medicine ITEM Book
commonly used ligature for hanging?
l5. What arc the (Rope. McuUk
chains, wires. Bed sheet, scarf. Sarcc. Held, Neck tic)
of
16. What are the types hanging?
17. What arc the types of hanging according to suspesion? •••
18. What are the types of hanging according to mode of death?
19. Tell me the factor causing of death in ease of complete hanging (Weight of the
whole body)
20. Tell me the medicolegal importance of complete hanging. •••(It is always
suicidal unless otherwise proved)
21. Which type of hanging is more common? (Atypical)
22. Which type of hanging is more suicidal? *** (Partial hanging- CTOI
CT
More
Suicidal)
23. Tell me the position of knot in case of typical hanging. ***
24. Tell me the position of knot in case of atypical hanging.
25. Show me the nape of the neck. ***
26. What is accidental hanging?
27. What are the factors causing accidental hanging in infants, children, adults?
28. Infants- Umbillical cord causing constriction around the neck
29. Children- During play by acting judicial hanging.
30. Adult- Sexual asphyxia(Autoerotic)
31 . Tell me the cause of death in case of hanging. **
32. What are the treatment of hanging case? (Artificial respiration, stimulus
should be given)
33. What are the cause of delayed death in case of hanging?
34. What do you mean by judicial hanging?
35. Tell me the fractured/dislocatcd vertebrae in case of judicial hanging. (C2<3.
C3-C4) •*
hanging. (Beneath the chin,
36. Tell me the position of the knot in case of judicial
properly seen injudicial hanging) •«
sign of asphyxia are not
of hanging.
37. Tell me the forces require for death in case
38. Tell me the P/M findings of hanging.
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39 Tell
n*e‘he‘’Pin'onorh,n8ing'
neck findings of hanging.-
40len me -he
41 what do ym.
mean by glistening?-
4J What do you
4J Ten me tbe
me"" hy •ubconjunC,ival pe,'climl hcm°tThagc?
confirmatory sign of antimortem hanging.

from the angle of

mouth)
-
(Dribbling

dribbling of saliva from the angle of mouth.

44 Tell me the cause of
of asphyxia where the ligature mark is absent.
45. Tell me some condition
case of male)
(Scarf, long hair(fcmalc), long beard in
importance of hanging.
46. Tell me the medicolegal
47. What is post mortem suspension?
Hanging & strangulation. ***
48. Tell me the differences between
49. Define strangulation. ***
50. What arc the types of strangulation?
51. What arc the other names of manual strangulation? (Throttling/palmar
strangulation)
52. What are the mechanical strangulation? (Bansdola, Mugging, Garroting)
53. Tell me the causes of death in case of strangulation. ***
54. Tell me the P/M findings in case of strangulation. (NO DRIBBLING OF
SALIVA)
55. What is Parchmentization? ***
56. Why the ligature mark of strangulation is not obliterated by putrefaction?
Because compression of underlying blood vessels in the neck causing lack of
blood supply in that area by preventing access of bacteria & the tissue underlying
structure becomes hard & parchment like.
57. What is mugging?
58. Show me how to do mugging? ***
59. Why there is no ligature mark in mugging?
Because the constricting force is the soft tissue of elbow (Arm lock). Bid there i
presence of external sign of
struggle.

—
60. What is Bansdola?
61. What is garroting?
..

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 Because of sudden unconsciousness. Hut a transverse circular ligature mark n
found.
throttling. *
63 Define
(4 What arc the post
mortem appearance of throttling?
throttling is possible?
65 Tell me suicidal
No. because the compression of the neck as larynx & trac hea produces rapid
unconsciousness, thereby fingers will be relaxed.

66. Define Drowning. ***

67. What are the classification of drowning?
68. What do you mean by dry drowning? ***
69. What do you mean by wet drowning? ***
70. What is immersion syndrome?
71. What is secondary drowning?
72. Tell me the causes of death in case of drowning.
73. Tell me the mechanism of drowning.
74. Tell me the pathphysiology of drowning. *
75. Tell me the pathophysiology of fresh water drowning.
76. Tell me the pathophysiology of fresh salt drowning. *
77. What are the difference between antemortem & postmortem drowning?
78. Tell me the difference between fresh water & salt water drowning.
79. Tell me the P/M findings of drowning. ***
80. Tell me the importance of froth in drowning.
81. What is Diatom?
82. Define suffocation.
83. What arc the types of suffocation? *
84. Tell me the cause of death in case of suffocation.
85. What is choking? ***
86. Tell me the cause of choking.
the word choking? / What else the
87. Where else you have heard
meaning of choking? *
choking.
What arc the causes of death
in
88.
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89. Define cafe coronary. ***
90. What are the causes of cafe coronary? ***
91. Tell me the clinical features of cafe coronary. *
92. Tell me the autopsy findings of cafe coronary. **
93. What is gagging?
94. What are the gagging material? (Cloth, paper ball)
95. Tell me the cause of death in case of gagging.
96. What is traumatic asphyxia?
97. What are the causes of traumatic asphyxia?
98. What is overlying?
It is a form of traumatic asphyxia in which compression of the chest wall
prevents respiratory movement.

99. Tell me the medicolegal importance of overlying.

Usually young children or infant becomes victim by compressed under mother
or any adult bed partner.
100. What is barking?
It is a form of violent asphyxia combination of smothering, palmar
strangulation & traumatic asphyxia.

————————
I

1. Hanging
T ricky Question:
P

Dependent part for hypostasis

Answer:
Hand
Foot
Genitalia
Upper Part of Ligature Mark
2. What is la facie sympatheque?
Answer:
Pupil dilation & conjunctiva congestion in the same side where
the sympathetic
trunk is constricted
3. What are the reliable sign of drowning?

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 j Fine, white froth the mouth &no?ic
Presence of weeds. stones firmly gtllSped in the hand.
Presence of fine froth in the lungs & air passages
Voluminous waterlogged lungs
Presence of water in stomach & intestine
/ Findings of Diatoms in the tissues

Starvation & Anesthetic Death

I, Define starvation. ***

2. What are the type of starvation?
3. What is acute/complete starvation?
4. What is chronic/partial starvation?
5. Tell me the causes of acute starvation.
6. Tell me the causes of chronic starvation.
7. Tell me the s/s of starvation. ***
8. What are the causes of death in case of
starvation(Acute & chronic both
separately) ***
9. What are the factors influencing fatal period of
starvation?
10. Tell me the P/M findings of satarvation.
***
11. atrophy ^T? ***
12. Gall bladder Distended * **
13. Inspissated Bile wt f^?
14. What are the D/D of starvation? **
Tell me the medicolegal aspect of starvation.

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 Thermal Injury

I. Define Thermal injury.

2. What are the types of
thermal injury?
3. What is hypothermia?
4. What are the effects of cold?
S What are the effects of heat?

6. Define bum. ***

7. What is scald?***
8. What is the differences between bum & scald? ***
9. Tell me the classifications of bum.
1 0. What is Wilson’s formula?
11. What is rule of nine? / Classify bumaccording to surface area. ***
12. What are the factors affecting bum?
13. Tell me the causes of death due to bum. ***
14. Tell me the differences between heat rupture & incised wound.
15. Tell me the age of the bum.
1 6. Tell me the management of bum.
1 7. Tell me the management regarding open & close method.
18. What do you mean by puzzlistic attitude? ***
19. Tell me the differences between Antemortem & postmortem bum. ***
20. Tell me the differences between Antemortem & postmortem lightning.
21. What is heat stroke? ***
22. What is heat exhaustion? *♦*
23. What is Heat cramps? ***
24. Tell me the s/s of heat cramps.
25 What are the effects of cold to body?
a. General effect
b. Local effect
c. Localized effect
26. What is trench fool & emersion foot?
**
27. What is frost bite?

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 Electrocution, Lightning

I Define ligh^^*
lightening.
fell me the effects of
Where do we not take shelter in lightning & why?
J.
Lightning is attracted by highest points hence it is dangerous to stand near any tall
s
establishment or trees during thunder storm.
4. me about precautionary steps to avoid lightning stroke.
Tell
5. Tell me the DT) of lightning.
6. Define electrocution.
7. Tell me the sources of electrocution.
8. WTiy A/C current is more dangerous than D/C current?
it destroys whole tissue of the Mr
Because A/C current attracts full body until
9. Tell me the effects of electrocution.
10. What is spark bum?
11. What is contact bum?
12. What is flash bum? ***
13. What are the delayed effects
of electrocution .
bum?
14. Tell me the characteristic of electric
of antemortem & postmortem bum
15. Tel! me the characteristics

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 Identification

1. Define identification.
2. Tell me the medicolegal importance of identification.
3. Tell me different data/traits for identification. ***
4. Tell me the traits of primary identification.
5. Tell me the traits of secondary identification.
6. Tell me the comparative data of identification.
7. Tell me the traits of identification only applicable for living person.
8. Tell me the medicolegal importance of identification.
9. What is corpus delicti?
10. Tell me some example of corpus delicti.
11. Define Race.
12. What are the types of race?
13. Tell me the race of Bangladeshi people. / tell me your race.
14. How will you determine race?
15. What is cephalic index? ***
16. What do you mean by maximum length of skull?
17. What are the types of cephalic index? ***
18. Tell me the prominent race with their cephalic index.
19. How can you distinguish between Muslim male & Hindu male?
20. How can you distinguish between Muslim female & Hindu female?
21. How can you determine the age of a person? I Tell me the procedure of
determination age of a person?
22. How can you determine age in post natal life?
23. How can you determine age in pre natal life?
24. Tell me the medicolegal importance of age.
25. Tell me the radiological findings while determining age of a person. **
26. Tell me the medicolegal importance of
different age/ tell me the medicolegal
importance of age 07, 12, 13, 14, 15, 16, years.***
18, 21,25, 32, 35,60
27. Tell me the importance of
1 8 years age. ***
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Forensic Medicine ITEM Book
of 21 years old. (
2g Tdl me the importance । *

30 Define majority.
31 Tell me the age of majority. **
the medicolegal importance of majority.
32 Tell me
33 Tell me the medicolegal importance of sex.
34 How can you determine sex in living body?
35 How can you determine sex in dead body?
36 How can you determine sex in highly decomposed body?
37. What is bar body?
38. Where is barr body found? *** '^
importance of barr body.
39. Tell me the
40. What is Davidson’s body?
41. Davidson’s body ’TbSUT ^ll^?
42. What is Intersex?
43. What are the types of intersex?
44. Tell me some example of gonadal dysgenesis.
45. What is true hermaphroditism?
46. What is pseudo hermaphroditism?
47. What is male pseudo hermaphroditism?
48. What is female pseudo hermaphroditism?
49. Tell me the anatomical structure of Klinefelter syndrome.
50. Tell me the nuclear sex of Klinefelter syndrome. ***
51. Tell me the nuclear sex chromosome pattern of Klinefelter syndrome.
52. Tell me the anatomical structure of turner syndrome.
53. Tell me the nuclear sex of turner syndrome.
turner syndrome.
54. Tell me the nuclear sex chromosome pattern of
55. Tell me the count of human teeth.
56. Tell me the medicolegal importance of teeth.
57. What are the types of teeth with number.
58. What are the developmental types of
teeth?

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59. Tell me the age of eruption of teeth. (Not asked in Viva frequently)
60. Tell me teeth count before 6 months (No tooth)
61. Tell me teeth count at 9 months (06)
62. Tell me teeth count at 6-7th year. (20 Temporary+4 first permanent teeth)
63. Tell me teeth count at 9th year. (12 Temporary+12 permanent teeth)
64. Tell me teeth count at 1 Oth year
65. Tell me teeth count at 1 1th year
66. Tell me teeth count at 12th year
67. Tell me teeth count at 14th year
68. Tell me teeth count at 14-17th year
69. Tell me teeth count at 1 7-25th year
70. Tell me differences between permanent & temporary teeth. **
71. What is tattoo mark?
72. What are the pigments used in tattoo marks?
73. How can you erase tattoo mark?
74. What are the sites of tattoo mark?
75. Tell me the complications of tattoo marks.
76. Tell me the medicolegal importance of tattoo marks. ***
77. Tell me how you can confirm a tattoo mark?
78. Tell me what you know about “Sydney Shark? *
79. Define Forensic dacty lography.
80. What is dactylography Finger print 'Henry Galton Sysytem Dactyloscopy?
81. What are the types of dactylography?
82 . Tell me the methods of dactylography.
83. What are the medicolegal importance of dacty lography?
84. What is concealed sex?
85. What can be the motive of concealed sex?
86. What are the types of occupational mark?
87. Tell me some example of temporary & permanent occupational mark.
88. Define scar.
89. What is keloid?
90. What are the complications of scar mark?
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 medicolegal importance of scar mark.
9j Tell me the
medicolegal importance of bite mark.
mark in case of assault.
Tell me the site of bite
bites.
94 Tell me the sites of sexual
95' What are the sites of
inflicted bite mark?
What is Superimposition?
96
97 What is stature?
the stature? ***
98. How can you determine
99. Define anthropometry.

Tricky Section:
X?
1 What are the proofs that you are
which has my
Answer: I have an Id card
> Name
> Photo
> Sign of the college principal
> Sign of the Dean of the University
> Attested copy
hospital.
2 Tell me about anti switch technique in
using tag in the
of babies: By Foot print,
Answer: To prevent the interchange
hand
3. How can you differentiate between a
muslim & hindu girl?

Answer:
. In Muslim girl: Hairs of the private parts
are shaved.
. In Hindu girl: Hairs are not shaved, that’s
why foul smell is also found.

4. What is dentition?
in a particular species or
Answer: The arrangement or condition of the teeth
individual.

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 Sexual Offences

I Mme sexual alienees.

I ell me the classification of sexual offences.

'
4.
What
What
aie

aie
the natural sexual olTeuees?
the unnatural sexual olTeuees?
s What aie the sexual paraphilias?
6 What are the sex linked offences?
A Define sexual pci versions.
1 some example ol sexual perversions.
9 Define Rape. ***
10. I ell me the procedure of rape victim
examination.
I I . What are the pre-requisite of rape victim
examination? ***
12. 3 passport size photograph is taken during rape victim
examination. Wra
« ft? •“
13. Who identifies (he victim?
14. Why presence of a 3rd person female attendance is
mandatory? ***
1 5. I ell me the procedure of examining the private
parts.
16.
onto
1 7. What do you mean by Lithotomy position?
i x. aiW onto ,
1 9. What are the private parts to be examined during
examination?
20. Why high vaginal swab is taken?
**
2 1 . Where do the high vaginal swab is sent?
22. I ell me the complication of rape.
***
23. What is rape trauma syndrome? *
**
24. What are the stages of rape trauma syndrome?
25. De fine incest.
26. I ell me the varieties of incest.
27. I ell me the medicolegal importance of incest.

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Forensic Medicine ITEM took
Define adultery. •••
19 What i' buccal coituV’
10 What is bestiality?
31 What is leshianisnVTrihtdisin?
jl
JJ
34
Define sodomyl.n.1 coiiu^)uggny/f |tcd
Who .re the moat frequent people
Who arc Eunuch*?
fw ..
35 Who arc Zinana? (Genitalia intact)
36 Tell me the sign of sodomy in
[Link].1 passive went
37. Define sadism. ♦*
38. Define masochism. **
39. What is necrophilia?
40. What is nccrophagia?
41. What is undinism?
42. What do you mean by Lust murder? ♦*
43. What is scoptophilia?
44. What is fetichism?
45. What is voyeurism?
46. Define exhibitionism.
47. Define transvestism.
48. What is mastuerbation?
49. Tell me the circumstances where consent given for sexual intercourse
becomes
invalid.
50. What is indecent assault?
5 1 . Tell me some example of indecent assault.

Work for a cause, not for applause.

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 1 . What is statuatory rape?
Answer:
n is sexual intercourse with a girl below 1 6 years of age even with her
is neither violent nor physically consent 1
coerced.
2- What is spousal rape?
Answer:
is forceful sexual intercourse with
wife who is living separately from him
under a degree of separation, or any
custom or usage without her consent It
is
Punishable.
3‘ What is gerontophilia?
Answer:
In case of Sodomy ,if the passive
agent is adult than the active agent
4' Lesb,an'sm^ few
tsrai sexual Gratification W
Answer:
Simple lip kissing, deep kissing
Generalized body contact
Massaging the breasts & private parts
Genital Apposition
Friction of external genital organs
Mutual rubbing of private parts
Use of artificial phallus or something similar.
5. What is sexual oralism? What are the types
of it?
Answer:
Sexual oralism: It is the obtaining of sexual pleasure from the
application of the mouth
to the sexual organs. It is seen in heterosexuals &
homosexuals.
Types:
• Anilingus (Rimming): Kissing, licking &sucking of the anus by a sexual
partner.
• Cunnilingus (Mouth job): kissing, licking & sucking of a female’s genitals by
her partner.
• Fellatio (Irrumation/blow job): The stimulation of penis by the partner’s
mouth.

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Forensic Medicine ITEM took

J
|
Impotency, Sterility, Artificial Insemination,
virginity, Defloration & hymen

I. Define virginity.
2. Tell me the medicolegal importance of virginity.
3. W hat are the features of virginity in private parts? •••
4. Define hymen. *•*
5. W hat are the most common type of hymen? •*•
6. W hich type of hymen is more common?
7. Hymen perforated "5^ incision faus
8. Wrhat are the features of defloration?
9. Tell me the usual rupture poition of hymen. * * *
10. WTien the hymen can still be intact in deflorated woman? ***

11. Tell me the changes in private parts of woman after repeated sexual intercourse.
12. Tell me the extra genital sign of virginity.
13. Tell me the cuses of ruptured hymen in virgin.
14. WTiat is false/pseudo virgin. ** *
15. Why does false virgin occur?
16. Define impotence. ***
17. Define sterility. ***
18. What are the types of sterility?
19. Tell me the causes of sterility & impotence in male. ***
20. Which one is ground of divorce between sterility & impotence? ***
21. Define artificial insemination. ***
22. What are the types of artificial insemination? ***
23. Which one is more convenient between AIH & AID? ( A1P) ***
24. Tell me the criteria of donor for artificial insemination.
25. Tell me the procedure of artificial insemination.
26. What are the pre-requisite of artificial insemination? / Tell me the duty of a
doctor for artificial insemination. *
27. What do you mean by surrogacy?
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 ITEM Book Forensic Medicine

28. Define surrogate mother.

29. Tell me the medicolegal importance of surrogate mother.

. What is Aptoc viris?

Answer:
Introduction Of foreign body; e.g. sola pith into vagina for rendering very young
girls fit for sexual intercourse is called aptoe viris .It is one of the causes of
rupture of hymen even without sexual intercourse.
2. What is “Quoad hoc"?
Answer:
Quoad hoc is an individual, who is impotent with one particular woman, but not
with others. Psychological factors are supposed to be associated.

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 Pregnancy, Delivery & Abortion

1 . Define Pregnancy. **
2. Tell me the different types of pregnancy.
3. Tell me the normal period of pregnancy.
4. What do you mean by viable age?
5. Tell me the medicolegal importance of pregnancy. ***
6. Tell me about the diagniosis of pregnancy?
7. What are the presumptive sign? **
8. What are the changes in breast during pregnancy?
9. Define quickening. **
10. What is jackquemier’s sign?
11. What are the probable sign of pregnancy? ***
12. What is the confirmatory sign of pregnancy? * * *
13. Tell me the height of uterus.
14. What is Heager’s sign?
15. What is Goodell’s sign?
16. What is Braxton-hick’s sign? **
17. What are the positive sign of pregnancy? ***
18. Tell me about surest signs of pregnancy. (Positive signs) ***
19. What are the tests done to assess pregnancy?
20. When (weeks) can you listen the heart sound? (10th week)
21. Define superfoetation. ***
22. Define super fecundation. ***
23. What is pseudocyasis? ***
24. Define delivery.
25. What are the legal issues related with delivery?
26. Tell me the signs of recent delivery. ***
27. Tell me the remote signs of delivery.
28. What is suppositious child? ***
29. Tell me the legal issues of suppositious child.

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 30. What do you mean by af Illation case? **
3 1 . Tell me the different measurement of uterus after delivery.
32. Tell me about concealment of birth.
33. Define posthumous child. **
34. Tell me a renowned example of posthumous child. ***
35. Define legitimacy.
36. When do the question of legitimacy arise?
37. Tell me the conditions of presumptive illegitimacy.
38. Define abortion. **
39. What are the types of abortion?
40. Tell me the difference between natural & criminal abortion.***
41. Tell me the medicolegal importance of abortion. ***
42. What are the causes of natural abortion? *
43. What is justifiable abortion? ***
44. Tell me the indication of justifiable abortion.
***
45. What are the other names of justifiable
abortion? *
46. What are the precaution taken berfore therapeutic
abortion?
47. What is criminal abortion?
48. What are the methods of criminal
abortion?
49. Tell me the complications of criminal
abortion. •*»
50. Tell me the causes of criminal
abortion. ***
51. Tell me the dutie of a doctor in
case of criminal abortion.
What is fabricated abortion?
53. What is amniotic fluid embolism?

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I
5

mfanlicide...
3
4 What arc the WurB| in
cou^
5. Wt“ the
unnatural “
6.
7.
Tell me the
mcdicolegI11
What are the modes
of
lm" of
“'"h?
infanticide. ..
8. What ts act of ’
9.
omission?...
What is act of
10.
commission?...
11.
12.
^‘^^^entofinf^
What ts battered baby
What is Munchausen’s
syndrome?..
syndrome?
13.
14.
15.
W^M^^
Watare the Rosenberg
What are the injuries
criteria ofMSbP?
caused by batted k u
16.
17.
What is SIDS (Sudden
Infant
What are the main features of
Death s
* / ”*
cot deatM
18. Tell me the P/M findings
ofcrib death.
19. Tell me some accidental
cause of infant death.*
20. What is precipitated labor? *
21. What are the features of precipitated labor?
22. Tell me the stages of precipitated labor.
23. What are the causes of precipitated labor?
24. Tell me about concealment of birth.
25. Define still birth. ***
26. Tell me the P/M findings of still birth.
27. Define dead birth/bom. ***
28. What are the P/M findings of dead born?
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 29. Tell me the importance of dead born & Mill born. *
30. Define live birth. ***
31 . What arc the signs of live birth?
32. Tell me about hydrostatic test.
33. Tell me the interpretation of hydrostatic test.

Forensic Psychiatry

33 Delusion- False belief.

33 Hallucination- False perception without external object.
33 Illusion- False interpretation with external object.
1. What is Psychiatry?
2. What is Forensic Psychiatry?
3. Define mental illness. (More appropriate term is Mental impairment)
4. What is Delusion?
5. What are the types of delusion? ***
6. Tell me about each type of delusion. (C^T d!4>UI ^1^^ Describe
TOFs 5R 'SUTl Ijl^f TO
TO)**
7. Tell me the medicolegal importance of Delusion.
8. What is Hallucination? ** *
9. Tell me the types of hallucination. **
10. Tell me about each type of hallucination. (C^I Describe
‘to to
TO)**
1 1. Tell me the medicolegal importance of Hallucination.
12. What is illusion? ***
13. Tell me the medicolegal importance of illusion.
14. What is Phobia?

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 pcfinc Impulse.
15.
What arc the types of impulse?
16- (NTK)
17. What is obsession?
IS. What is somnambulism? *
19. What is lucid interval? **
20. Define insanity.
21- What arc the types of insanity?
22. Tell me the causes of insanity.
23. Tell me the difference between true & false insanity.
24. Tell me about insanity & civil responsibility.
25. Tell me about insanity & criminal responsibility. **
26. What is McNaughten Rule? ***

Tricky Question: ।

1 How will you test a person is insane or not?

Answer:
In the presence of-
/ Psychiatrist
/ Forensic expert
An order from magistrate court.
Psychiatric patient bo examine Time
Magistrate Permission I]

The difference between you & who you want to be is

the work you put in it.

T 1 148 Axis Medical School

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 General Toxicology

I IkliiK loxuologx
' Iklinc I otvnMc Toxicology
' [Link] is clinical toxicology'*
J Define Poison Poixomng ••
5 What is toxin *
6 What do you mean by lethal dose, ratal dose & fatal period?
?. Classify poison
S. lassify poison medicolegally/modc of action.
(.

Tell me the characteristics of an ideal homicidal potion. •••

10 Tell me the characteristics of an ideal suicidal
poison •••
II Tell me some names of ideal suicidal poisons. •••
12 Tell me some names of ideal homicidal poisons.
13. W hat are the sources of poison?
14 What are the route of administration of poison?
1 5. \\ hat are the types of poisoning?
16. What is parasuicide?
1 7. Tell me the common poisoning in Bangladesh.
1 8. What is rural & urban poison?
1 9. Tell me the fate of poison in the body
20. What are the routes of elimination of poison from the
body?
21. Tell me how you can diagnose a poison in living
& dead body.
22. Tell me the eye changes of different poisons(Pin
point /ConstrictedDilated pupil)
23 Tell me your duty as a doctor in a suspected ••
case of poisoning. ***
24. Tell me the management of poisoning.

Axis Medical School

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 Stomach Wash Tube

flexible, non collapsing, elongated rubber tube I

This is soil 5 meter length. 1 cm
tunnel, rubber tube, suction bulb, mouth gag Ac 2 openings- one
diameter having a
central & one lateral. So, my identification this is a stomach wash tube.

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 1. What arc the other names of Stomach wash tunc .
2. What is the name of the tube in case of children?
3. Tell me the parts of the stomach wash tube. * * *
4. Tell me the function of stomach wash tube.
5. Why mouth gag is used for? * * *
6. Tell me the procedure of gastric lavage. *
7. Tell me the indication of stomach wash tube. *
8. Tell me the contraindication of stomach wash tube. * * *
9. Tell me the complications of stomach wash tube.
1 0. Define chelating agent. Tell me some example of chelating agent.
11. Define antidot. * *
12. What are the types of antidote?
13. Tell me the antidots of Opium, OPC, Paracetamol, Benzodiazepine & Datura.
14. What is universal antidote? * *
15. Tell me the composition of universal antidote. ***
1 6. What are the poisons you can diagnose by smell?

Organo Phosphorus Compound

1. What is the full form of OPC?

2. Tell me the clasification of OPC.
3. What is the mechanism of action of OPC poisoning? **
4. Tell me the sign symptoms of OPC poisoning. ** *
5. What is chromo chryorrhoea?
6. Define atropinazation. ***
7. How will you manage a patient of OPC poisoning? * * *
8. Tell me the fatal dose & fatal period of OPC poisoning.
9. Tell me the post mortem findings of OPC poisoning. * *
1 0. What are the preaution you will take for OPC poisoning?

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 Kerosene Oil

I. What type of poison kerosene oil is tncdicolcgally?

2. Tell me the use of kerosene oil.
3. Why kerosene oil is blue? * *

4. Tell me how kerosene oil is obtained? * * *

5. What is rock oil?
6. What are the products obtained at high temperature?
7. What are the products obtained at low temperature?
8. What is the final products obtained at low temperature?
9. Tell me the fatal dose & fatal period of kerosene oil. * * *
10. What are the clinical features of kerosene oil? * * *
11. Tell me the sign symptoms of kerosene oil poisoning in case of children.
12. What do you mean by crawling baby & toddler babdy? * *

13. Why stomach wash is contrindicated in kerosene oil Poisonong? ***

14. Tell me the complications of kerosene oil Poisoning.

15. How will you manage a case of kerosene oil Poisoning?

Corrosive poisoning

1. Define corrosive poison.

2. Tell me the classification of corrosive poison
3. What is the mechanism of action of corrosive acids?
4. Why alkali is more dangerous than acids? ***
5. What is the mechanism of action of corrosive alkalis?

152 Axis Medical School

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 ITEM Book Forenilc Medicine

Sulphuric acid poisoning

I \\ [Link] aic the oihcc [Link]* <»l Milphunc acid ’

2 Whs Milphunc acid i* known a* oil ol sitnol? *
3 Iell iik the pio|KrtiV' ol sulphuric avid
4 What it the colour ol lommcri’ial sulphuric avid?
5 W hat i' the volour ol pure sulphuric avid?
o Whj commercial sulphuric avid is dark in color? ••
7. \\ hai do vou mean by hygroscopic substance?
S Tell me name of some hygroscopic substances
9. What are the uses of sulphuric acids?
10 How sulphuric acid exert its action?
11 Tell me the sign symptoms of sulphuric acid poisoning. **
12. How will jou manage a case of sulphuric acid poisoning?
13 Why gastric lavage should be avoided in sulphuric acid poisoning?
14. Why prednisolone is used in sulphuric acid poisoning?
1 5. Which substances are used to neutralize the ingested sulphuric acid?
1 6. What are the complications of sulphuric acid poisoning?
1 7. What is the fatal dose of sulphuric acid? ***
1 8. What is the fatal period of sulphuric acid?
1 9. Tell me the cause of death by sulphuric acid poisoning.
20. Tell me the postmortem findings of sulphuric acid poisoning.
2 1. Tell me the features you get by examining a stomach after sulphuric Acid
Poisoning. ***
22. What are the medicolegal uses of sulphuric acid poisoning? **
23. Define vitriolage. ***
24. What are the causes of vitriolage?
25. What are the complications of vitriolage?
26. How w ill you treat a patient of vitriolage?
27. What can be the cause of death by vitriolage?
28. What is the medicolegal importance of vitriolage?
29. What are the punishments of vitriolage?
***

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 Nitric Acid

1. What are the other names of nitric acid?

2 Tell me the properties of nitric acid.
3. Tell me some important sign symptoms of nitric acid poisoning.
4. What is xanthoproteic reaction?
5. What is aqua regia?

6 What is the fatal dose of nitic acid?

7. What is the fatal period of nitric acid?
X. What can be the cause of death by nitric acid poisoning?

Hydrochloric acid

| Other names of HCI

2. What are the important features of HCI poisoning? *
1 What is the fatal dose of HCI? ••
4 What is the fatal period of HCI?

Oxalic acid

Tell me the other names of oxalic acid

What are the properties of oxalic acid?
Tell me some important sign sy mptoms of oxalic acid poisoning
W hat is the fatal dose and fatal period of oxalic acid poisoning.

i 154 Axis Medical School

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 Carbolic add

• U hu is the other name of carbolic

acid?
- 1 ell me the properties of pure
carbolic acid.
'
4
1 ell me the properties of commercial
carbolic acid.
•
What are the uses of phenol? ••
W hat are the routes of
administration of carbolic acid?
6 1 ell me some important sign symptoms
of carbolic acid poisoning
Tell me the features of stomach in carbolic
acid poisoning. ***
8. What is carboluria?
9 Tell me the colour of urine in carboluria.
1 0. Which substances are responsible
for the urine in carboluria?
11 What are the complications of carboluria?
1 2. What is phenol marasmus?
13. What is oochronosis?
14. How will you manage a case of carbolic
acid poisoning? •»»
1 5. Mat are the causes of death by
carbolic acid poisoning?
1 6. Tell me the medicolegal use of
carbolic acid poisoning.
1 7. What are important post mortem findings you
will get in catholic acid poisoning?
1 8. What is the fatal dose of carbolic acid
poisoning? ***
1 9. What is the fatal period of carbolic acid
poisoning?

Metallic Poisoning

1 What do you mean by irritant poison?

2. I ell me name of some irritant poison
3. Classify irritant poisons
4. Tell me name of some metallic poisons

Axis Medical School 155

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 Arsenic Poisoning

! What is the medicolegal name of arsenic?

2. What arc the commercial uses of arsenic?
3. What are the natural sources of arsenic?
4 What are the forms of arsenic?
5. Classify the poisonous forms of arsenic.
6 How will you convert poisonous arsenic from nonpoisonous arsenic? **
7. What is the most commonly used poisonous form of arsenic? **
8. Tell me the properties of arsenic
9. Why arsenic floats in water? **
10. What is the characteristic sound produce by arsenic? **
11. Tell me the mechanism of action of arsenic.
12. What is the target tissue of arsenic?
13. What do you mean by tolerance of arsenic?
14. Tell me about Marsh’s test.
15. Define arsenicosis.
16. What are the types of arsenic poisoning?
17. What is the fatal dose of arsenic?
18. What is the fatal period of arsenic?
19. Tell me the medicolegal uses of arsenic. ***
poison? ***
20. Why arsenic is called ideal homicidal
as ideal homicidal poison? *
21 What are the draw backs of arsenic
in a dead body?
22. How will you ensure arsenic poisoning
Tell me some historical cases related to
arsenic poisoning
23.

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 Acute Arsenic Poisoning

I• What arc the types of acute arsenic poisoning?

W hat is the mechanism of action of fulminant type of arsenic
poisoning?
3. \\ hat is the cause of death by fulminant type of acute arsenic
poisoning? **
4. What arc sign symptoms of narcotic type acute arsenic poisoning?
5. What are the sign symptoms of gastric type of arsenic poisoning?
6. Tell me the difference between acute arsenic poisoning and cholera.
7. How will you manage a case of acute arsenic poisoning?
8. What is the antidote of arsenic poisoning? ***
9. Why ferric oxide is used in acute arsenic poisoning? **
1 0. Tell me the dose at which BAL is given in acute arsenic poisoning.
1 1. Tell me some important post mortem findings of acute arsenic poisoning.
1 2. What are the causes of death by acute arsenic poisoning?

Chronic arsenic poisoning

1. What are the causes of chronic arsenic poisoning?

2. What are the sign symptoms of chronic arsenic poisoning?
3. What are skin changes observed in chronic arsenic poisoning? ***
4. How will you manage a case of chronic arsenic poisoning?
5. What is arsenic neuritis?
6. What is the cause of death by chronic arsenic poisoning?

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 Lead poisoning

। What are the uses of lead?

i What are the sources of lead?
3 Tell me name or some different forms of lead with their sources. ••
4 What is fatal dose of lead?
5 What is the fatal period of lead?
6. What is the medicolegal importance of lead?
7. How will you manage a case of acute lead poisoning?
8. What is the antidote used in lead poisoning? *♦
9. What is the cause of death by lead poisoning?
10. What are the sources of chronic lead poisoning? **
1 1. What are the sign symptoms of chronic lead poisoning?
12. What is lead palsy? **
1 3. What s lead line? ***
14. What is the other name of lead line?
15. How lead line is formed?
1 6. What is the medicolegal importance of lead line?
1 7. Why lead line never occurs in lower jaw?
1 8. What is the location of lead line? **
1 9. What is lead encephalopathy?
20. Who are the common sufferers of lead encephalopathy? **
21 . How will you manage a case of chronic lead poisoning?
22. What is the cause of death by chronic lead poisoning?
23. What are the postmortem findings of chronic lead poisoning?

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 Phosphorus Poisoning

1. Tell me the sign symptoms of phosphors poisoning

2. What is phossy jaw? **
3. What id phossy tooth?
4. Tell me the properties of phosphorus,

Snake Bite

1. What is Jacobson’s organ?

2. What is the function of Jacobson’s organ?
3. Who are the common victims of snake bite?
4. Tell me the classification of poisonous snake.
5. Tell me name of some common poisonous snake in bd. ***
6. Tell me the difference between poisonous and nonpoisonous snake. **
7. What are the confirmatory signs of poisonous snake bite?
8. Define snake venom. **
9. WTiat are the types of snake venom?
1 0. Tell me the composition of snake venom. *
11 . What is the function of snake venom? ***
12. What is the cause of death due to snake bite?
1 3. Tell me the sign symptoms of cobra bite.
14. How will you manage a case of snake bite? ***
1 5. Tell me the medicolegal importance of snake bite?
16. Define anti-venom. **
17. What are the other names of antivenom?
18. What are the types of anti-venom?
19. Which type of antivenom is commonly used? ***
20. Which type of antivenom is better and why? **

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 What is stupor?
1.
What are the stupefying agents?*
2
Tell me some examples of stupefying agents. ***
3.
pefme delirium.
4.
5. What is deliriant poison?
of deliriant poison.
6. Tell me some examples

Datura

1. What are the other names of datura?

2. Why datura is known as traveler’s poison? ***

3. Tell me the properties of datura.

4. Which part of datura is poisonous?
5. What is thom apple?
6. Why datura apple is known as thom apple? **
7. What are the varieties of datura plants?
country?
8. Which variety of datura is most common in our
9. Why intact seeds of datura do not produce delirium?
10. Tell me the shape of datura seeds.
seeds?
11. What are the differences between datura seeds and capsicum
12. What are the active principles of datura? **
13. Tell me some important sign symptoms of datura poisoning
14. What is ludicrous movement? ***
15. What are the Morton signs of datura poisoning? _

Axis Medical School

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 OUUK
Forensic Medicine
Hv I low w ill you manage a caw of datura poisoning?
7. \\ hat arc the common sites of
datura poisoning?
*$ \\ hat are the antidotes of datum poisoning? *•*
19. Tell me the fatal dose of datura poisoning
*0. Tell me the fatal period of datura poisoning.
- 1• Tell me some important postmortem findings of datura poisoning.
22. What is the cause of death due to datura poisoning? **
23. What is the medicolegal importance of datura poisoning?

Cannabis

1. What are the other names of cannabis?

2. Which part of cannabis is poisonous?
3. What are the active principles of cannabis? ***
4. Tell me the properties of cannabis indica.
5. What are the common preparations of cannabis?
6. What is the effect of majoon?
7. Tell me some sign symptoms of acute ganja poisoning.
8. Tell me some important sign symptoms of chronic ganja poisoning.
9. What is ganja psychosis? **
10. What are the clinical features you will find in a patient with ganja psychosis?
11. What is running amok? ***
1 2. What are the events of running amok?
13. What is hashish insanity?
14. Tell me the treatment of chronic ganja poisoning.
15. Tell me the fatal dose of different cannabis preparation.
16. What is the medicolegal importance of cannabis?
17. What is speedball?
18. What is cocaine bug?

Axis Medical School 161|

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 Albin uuvk
Forenslc Medicine
Alcohol

Tell me the properties of ethyl alcohol.

2. What are the types of alcohol?
3. What are the uses of alcohol?
4. What are the types of drinks of alcohol?
5. Tell me percentage of different preparations of alcohol.
6. What is congener?
7. How much alcohol can be consumed by man and woman without any harm?
8. What are the types of alcohol poisoning?
9. What is the fatal dose of ethyl and methyl alcohol?
10. What is the fatal period of methyl and ethyl alcohol?
11. Tell me name of some hazards which are related to alcohol.
12. What is Saturday night palsy? **
13. What are stages of acute alcohol poisoning? ***
14. What are the important signs symptoms of each stage?
15. What is Me Ewan’s sign? **
16. Tell me some important sign symptoms of acute methyl poisoning.
17 How will you manage a case of acute methyl poisoning?
18. What are the complications of acute methyl poisoning?
19. What are the causes of death if acute methyl poisoning?
20. What is Munich beer heart? *
21 What are the common sign symptoms of chronic alcohol poisoning?
22. How will you treat a case of chronic alcohol poisoning?
23. What is Antabuse? *
24. Define delirium tremens. ***
25. Tell me some causes of delirium tremens
26. What is the medicolegal importance of delirium tremens? ***
27. Define Wemeck’s encephalopathy. *
28. Define Korsakoff psychosis. *
29. What are the features of Korsakoff psychosis?

162 Axis Medical School

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 ITEM took Forensic Medicine

30 What i' alcoholic blackout/

31 What are the feature* of alcoholic blackout I
blackout /
32. What iv the medicolegal importance of alcoholic
33 Define drunkennen ***
34. Ilow will you diagnose a case ol drunkenness I
35. What is the punishment of drunkenness?
♦*♦
36 What are the relations between traffic accident and alcohol ?

1. Define narcotics.
2. Define somniferous agent.
3. What is opium? *
4. Tell me the source of opium.
5. What is golden triangle ang golden wedge? ***
6. Which countries are included in golden triangle and golden wedge? ***
7. Which is the preferable time to collect poppy seeds and why? ***
8. Which part of poppy plant is poisonous? ***
9. How will you obtain opium from poppy plant?
1 0. What are the active principles of opium? ***
11. Why narcotics are now called opioid?
1 2. What are the stages of opioid poisoning? ***
13. Tell me some important sign symptoms of opium poisoning.
14. What is the triad of opium poisoning?
1 5. What are the differential diagnosis of opium poisoning? ***
1 6. How will you manage a case of acute opium poisoning?
17. What are the specific antidotes of opium poisoning? With dose **
*
18. What is the treatment of chronic opium poisoning?
1 9. What is the fatal dose and fatal period of morphine?

—— What are the causesof death of opium poisoning?

Axis Medical School
***
163

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 Medicine ITEM Book
Forensic
me some important postmortem findings you will get from a case of opium
21- Tell
poisoning. *
22. Why
rectified spirit is not used in opium poisoning as a preservative for
chemical examination? ***
the medicolegal importance of opium poisoning.
23. Tell me
is known as ideal suicidal poison? ***
24. Why opium
the accidental causes of opium poisoning?
25. What are

Barbiturates

I Tell me the properties of barbiturate

2. Classify barbiturate
acting barbiturates.
3 Tell me name of some ultra-short acting and short
4. What is the medical use of thiopental sodium?
5 Which form of barbiturate can cross blood brain barrier?
6. 1 ell me some sign symptoms of barbiturate poisoning.
7. What is the first symptoms of barbiturate poisoning ’ **
g. How w ill you manage a case of barbiturate overdose?
9. What is Scandinav lan methos?
10. What are the complications related to barbiturate poisoning?
II. What is barbiturate blister?
12. How a barbiturate blister is formed?
I J. W hat are the common sites of barbiturate blister formation? **
14. W hat are the causes of death due to barbiturate poisoning?
15. Tell me the medicolegal uses of barbiturate poisoning. **
16. In which region barbiturate is mostly use as a suicidal substance? ***
17. Tell me some important post mortem findings of barbiturate poisoning.
18 What is barbiturate automatism? ♦**
19. w ho are the common victims of barbiturate automatism?
20. W hat is the medicolegal importance of barbiturate automatism?

nJ 164 Ans Medical School

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 21 What is the fatal dose and fatal period ol barhiiuratc poisoning,
22 Docs barbiturate have any antidote? *
23 Which barbiturate is used in anesthesia?

Asphyxiants

I . Define asphyxiants
2. What are the types of asphyxiants?

Carbon Monoxide

1. Tell me the properties of CO

2. What are the sources of CO?
3. How CO is formed?
4. How CO can produce anemic anoxia?
5. Tell me some important sign symptoms of CO poisoning.
6. How will you treat a case of CO poisoning? **
7. What are the causes of death by CO poisoning?
8. Tell me some important postmortem findings of CO poisoning.
9. Which colour will you observe in peripheral blood in CO poisoning? ***
1 0. What is the medicolegal importance of CO poisoning?

War gas

1. Tell me name of some war gas

2. What is tear gas?

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 Medicine ITEM Book
Forensic

i. What is the chemical name of paracetamol?

2. What are the sign symptoms of paracetamol poisoning?
3. What is the fatal dose and fatal period of paracetamol poisoning? ***
4. How will
you treat a case of paracetamol poisoning?
5 What is the antidote of paracetamol? ***
g What are the causes of death by paracetamol poisoning? ***
What is the medicolegal importance of paracetamol poisoning?

Drug dependence and Abuse

1. What is drug abuse? **

2. Which drug are commonly used by drug abusers?
3. What is drug addiction? **
4. Which drugs are commonly used for drug addiction?
5. What is drug habituation? **
6. Tell me the difference between drug habituation and drug addiction. **
7. What is drug dependence? **
8. What are the types of drug dependence?
9. What is withdrawal symptom?
10. What is body packer and body stuffer? *

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 communitv Medicine ITEM Book

Covid 19 (Corona virus is the disease caused by a new corona virus called SARS-
19)

Cov-2. WHO first learned the new virus on 31st December, 2019 following a report of a
cluster of cases of viral pneumonia in Wuhan, People’s Republic of China. It was declared
a public health emergency of international concern at the end of January, and a Pandemic
on 11 March, by the WHO.

Virus info-

Name- SARS Corona Virus-2, Firstly known as nCov 19(novel corona virus 2019)

Details- SARS-CoV-2 is an enveloped p-coronavirus, with a genetic sequence very

similar to SARS-CoV-1 (80%) and bat coronavirus RaTG13 (96.2%). The viral envelope
is coated by spike (S) glycoprotein, envelope (E), and membrane (M) proteins. Host cell
binding and entry are mediated by the S protein. The first step in infection is virus binding
to a host cell through its target receptor. The SI sub-unit of the S protein contains the

_
receptor binding domain that binds to the peptidase domain of angiotensin-converting
enzyme 2 (ACE 2).

Type of the virus- RNA virus (Single stranded enveloped RNA Virus)

Other viruses of corona virus family-

1. SARS (China 2002)

MM 168 Axis Medical School

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 2. MARS (Middle east 2012)
Why the virus is called corona?

The word Corona means Crown. It looks like a crown under mcroscopc. That is why
it
is calle corona virus.

Zoonosis
Covid 19 is transmitted from bat to an intermediate host(Though not proved) to human
That is why it is a zoonotic virus.

Time tlnct lymptom onnt (tayi)

Patho^enesis-
The spike protein(Sl) of the SARS Cov2 binds with the ACE 2 receptor of mucosal
surface of the respiratory tract. It destroys the type 2 pneumocytes in the alveoli which
leads to pneumonia & ARDS. Also immune response occurs & a high rise
of cytokines
like IL(1, 6, 8), TNF. TNF is noted. This is called Cytokine storm.

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(The vino can also be ,
tranimin
’• Fcvcr
2. Dry Cough
"‘“Womaticn,
3. Fatigue
4. Vomiting
5. Diarrhea
6. Nausea
7. Loss of taste or
smell
8. Difficulty in breathing,
talking,
moving, and chest pain

1. Nasal congestion
2. Conjunctivitis (Redeyes)
3. Sore throat
4. Muscle or joint pain
5. Skin rash
6. Nausea & vomiting
7. Diarrhoea
8. Chills & Dizziness

Symptoms of severe COVII) |<) include.

1. Shortness of breath
2. Loss of appetite
3. Confusion
4. Persistent pain in chest
5. High Temperature

Other less common symptoms

1. Irritability
2. Confusion
17Q Axis Medical School

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 1 RoiHVdoMBi hHBIh'U
4 Anvicts
5
Sleep IhwHUcn
Complex [Link] problems like strokes, brain inflammation, delirium A nerve
damage

What happens to people when one affected with Covid 19-

COVID-19 affects different people in different ways, Most infected people will develop
mild to moderate illness and recover without hospitalization.

Among those who develop symptoms, most people recover from the disease
without needng hospital management. About 15% become seriously ill &
require 0?& 5% become critically ill & need intensive care.

Risk factors associated with the development of severe disease, admission to

intensive care unit, and mortality
Cnderlving condition
Presentation Laboratory markers

1 Older age Higher fever (>39°C on

admission) Neutrophilia/lymphopenia

Hypertension Dyspnoea on admission Raised lactate and lactate

dehydrogenase

Cardiovascular disease Higher qSOFA score Raised C reactive protein

Chronic obstructive
pulmonary disease Raised ferritin

Obesity Raised IL-6

Diabetes Raised ACE2

Malignancy D-dimer>l pg/mL

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 Failure
। pespimtory
2, aR1^
Septi Shock
3 Sepsis &
4 Thromboembolism
5, Multiorgan failure

5 Post Covid pneumonia

7 Neurological symptoms

Epidemiology of Covid 19
Occurrence- Worldwide (Global Pandemic)

Epidemiological determinants:
Agent- SARS COV 2
Reservoir- Bat, Pangoline
/3 Source of infection- Secretions of respiratory tract, saliva.
J3 Period of communicability- From day of infection to 7 days after
recovery.
Incubation period- 2-14 days

Host Factors:
/ Age- All ages
Sex- All
DM, COPD)
Predisposing factors patients with comorbidity (HTN,

Axis Medical School

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Environmental factors-
I Travelling
2. Lack of healthy sneezing & coughing practice
3. Lack of wearing mask
4. Lack of interest in social distancing
5. Lack of hand hygiene

Mode of transmission-
1. Infected respiratory droplets, with viral infection occurring by direct
or indirect
contact with nasal, conjunctival, or oral mucosa, when respiratory particles
are
inhaled or deposited on these mucous membranes.
2. Fomites- Surface substance contaminated by respiratory droplets. Most
transmission
occurs through close range contact (such as 15 minutes face to face and
within 2 m)
and spread is especially efficient within households and through gatherings
of family
and friends. Both SARS-CoV-2 and SARS-CoV-1 remain viable for many
days on
smooth surfaces (stainless steel, plastic, and glass) and at lower temperature
and
humidity (eg, air-conditioned environments). Thus, transferring
infection from
contaminated surfaces to the mucosa of eyes, nose, and mouth via
unwashed hands
is a possible route of transmission. This route of
transmission may contribute
especially in facilities with communal areas, with increased
likelihood of
environmental contamination.
3. To some extent, virus can be shredded by feces.

Diagnosis-
1. RTPCR
2. Rapid antigen test
3. Antibody test
4. X ray
5. HRCT

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 •rt'und l,K nH ,0 and develop IrealmeMs for ( OVID l’>

! optima* supportive cure includes oxygen lot severely ill patients and ihox who
arc at ri^k lot severe disease and more advanced respiratory support such a*
ventilation lor patients who arc critically ill
2 Dexamethasone is a corticosteroid that can help reduce the length of time on a
ventilator and save lives ol patients with severe and critical illness
i Mostly supportive treatment

4 Remdesivir (Antiviral drug)

5 Convalescent plasma therapy

Control Measures
Both Isolation & Quarantine are methods of preventing the spread of Covid 19-
/ Quarantine- At home/separately for 14 days
Isolation- 10 days isolation from the days you are Covid 19 positive (+).

Preventive Measures
1. Get vaccinated when a vaccine is available.
2. Stay at least 1 meter apart from others, even if they don't appear to be sick.
3. Wear a properly fitted mask when physical distancing is not possible or when in
poorly ventilated settings.
4. Choose open, well-ventilated spaces over closed ones. Open a window if indoors.
5. Wash hands regularly with soap and water or clean them with alcohol -based hand
rub.
6. Cover mouth and nose when coughing or sneezing.
7. If feeling unwell, stay home and self-isolate until recovery’.

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W hat Ivpcs of masks should people near?

There arc three types of masks that WHO recommend for the public:

I. Reusable non-medieal masks which comply with the ASTM I 3502

standard ("CEn
Working Agreement 17553, or n Onon-mcdical mask meeting Wilf)
c"cntu|
parameters;
2. Disposable medical masks which comply with medical mask
standards EN 14683
Type I. ASTM F2I00 Level I, YY/T 0969, YY 0469 (or equivalent);
3. Other types of well-fitting non-medical masks, including homemade
multi-layered
masks are an acceptable option, when other options arc not available.

Disposable medical masks are also recommended for;

1. Anyone who is feeling unwell, including people with mild symptoms,
such as
muscle aches, slight cough, sore throat or fatigue.
2. Anyone awaiting COVID-19 test results or who has recently tested positive.
A respirator or a medical mask should be worn by to caregivers at any setting
where
care is provided to patients with suspected or confirmed COVID-19, including home
care, long-term care facilities and community care settings.

Covid 19 in Bangladesh-
O First case- 8th March, 2020.
O IEDCR & DGHS took the major role in covid pandemic.
O [Link] is working for social awareness in Bangladesh
O 1 6263 is the emergency health care service of Bangladesh and working for social
awareness

Role of IEDCR Role of DGHS

1 . Lab testing (RT-PCR) 1. Formulating guidelines
2. Formulating of strategy
2. Report & recording
3. Recording & reporting
3. Training program. 4. Telemedicine
5. Online training program for doctors & general
population
6. Monitoring vaccination program.

175
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 GO*

(iii bi»

rn/cr Modern*
1 J Inlinson A
Johnson
1
% Inopharm 1 AsIra/enee* ovavas I
(Janssen) |
NVX-
BNTU2b2 mRNA-1273 3ullMOUS 1 iiimr-< orv
1
* hAdOtl
fl( oV-19 < 0V2U2 I
mi* "4
1 ( ’Uni) I
2,21 !, 28 days apart 1 dose 1 I।ven 1 2, 412 1 2. 21 days I
0.5ml) 1 ( 0.5ml) 1 *irifflu* uUrly 1 rek s apart I ap art
apart (0
dose*
1 X years and 1 8 years and 1 X years and 1 । < years and | 1 < years and I
12 years older 1 sldcr >lder I oIder | <> dcr
«kd
Yes Yes Yes Yes 1 Yes Yrs 1
fffrctl'*"'”
,[Link] deUlU
j Yes Yes Yes Yes 1 Yes 1
Yes
carrto*
ttriauQ 70%
95% ' 94.1% 72% 95 6% (UK I
Effectiveness 100% for
against 86% in 65 1 86% in 65 and 86% against 1 1
severe trials)
disease In U.S. and older older severe disease
i disease
clinical tri*1*
Vector 1 inactivated I Inactivated Recombinant 1
(modified 1 virus common protein adjuv 1
Type of mRNA mRNA
Vaccine
common cold cold virus | ants 1
1 virus)
1 injection site 1 Fatigue, 1 Fatigue,
Fatigue, Fatigue, 1 Fatigue, 1 pain, fatigue
headache, headache, 1 headache, 1 headache, 1 headache, 1
Most common 1 and
I chills, 1 chills, 1
side effects chills, muscle chills, muscle 1 chills, muscle 1 headache,
pain 1 pain 1 muscle pain 1 muscle pain 1
pain 1 tenderness
Testing for
I Yes, ages 12-15 1 Yes, ages 12-17 1 TBD 1 TBD 1 TBD |
children? Individuals with
History of History of a history of
allergic reaction 1 allergic reaction 1 History of anaphylaxis,
to polyethylene 1 to polyethylene I severe reactior body temperatu re 1
glycol, 1 glycol, 1 to vaccine over 38.5°C
Who should polysorbate or 1 ingredients, ri sk should postpon e 1 TBD 1 TBD
not get the 1 polysorbate or
other vaccine other vaccine 1 of rare blood vaccination until
vaccine?
1 ingredient’s ingredient’s clot in womer they no longer
Allergic under age 50 have a fever
Allergic reactioii
reaction to first to first dose
dose

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 Diseases at a glance

Communicable Diseases
Disease Occurrence Ecological Triad Natural History ( llnlcal Features/
Complications
Diphtheria Developing Atcnk Source of Infection- Clinical Features-
A Cory neb jetenum Case (Sub-clinical,
underdevclo dipthcnac frank clinical), earner. / Sore throat
ped country Host- Both sexes ( I -5 Mode of transmission- Difficulty in swallowing
years). Infant are Droplet infection / Low grade fever
immune for 6 weeks (Mainly), From infected Mild erythema, localized
after birth. cutaneous lesion exudate
Fnsironmental factor- Portal of entry- / Hoarseness of voice &
All seasons, especially Respiratory route croupy cough
in winter season Non respiratory route.
Incubation period:
2-6 days.
Enteric Worldwide Agent- S. Typhi Source of infection: Complications- ~
Fever
(Typhoid & Host- Male>Female Primary source- 7 Intestinal Hemorrhage
Paratyphoid) (5-19 years) Feces/Urine /
(Complicatio Intestinal perforations
Secondary Source- / Urinary Retentions
ns 'QWT Environmental factor- Contaminated water, / Pneumonia
Ww High in rainy season. food, fingers & flies. / Myocarditis
Moreover, / Psychosis
J Poor socioeconomic Mode of transmission: / Cholecystitis
conditions Fecal oral route V Nephritis
/ Low standard of Urine oral route
personal hygiene
Osteomylitis
/ Non availability of Thrombophlebitis
Incubation Period:
safe water 10-14 days
J In adequate disposal
of excreta
Chicken Pox Mainly Agent: Varicella Zoster Source of infection: Clinical features or
among the Virus Oropharyngeal secretion
children of a case of chickenpox
characteristics:
Host: 7 They are superficial and
Children <10 years are unilocular
Mode of transmission:
usually affected. Dew drop in appearance
Droplet infection
One attack give long / At first abundantly on the
term immunity. / Droplet nuclei
trunk, then less abundantly e
/ Direct contact in the face and arms including
Environmental mucous membrane
Factors: Incubation period: (Centripetal distribution)
Mostly occurs in spring 7-21 days 'Z Axilla are usually affected
Overcrowding also Sole and Palm are usually
favours its transmission free
J Appear in crops for 4 to 5
days
All stages at one time
(pleomorphism: macule,
papule, vesicle, scab at a time)
/ Scabbing begins 4 to 7 days
after first appearance.

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 Children of tgenl Mvunnuh souter nt Infection ( implication*
5-9 year* ol 1 'arwtiditis *hv a of mump* case J Pune realms
«ge
( hiphtiCIfl*
lost y lode of transmission:
j t hi hili*
/ Children of 5-9 yvais 1 hoplct infection
d age Mcnirigrwnc cpl> iliti*
/ Children below 6 । ncuhatinn period: IX Mymardiiis
nonths are immune lays (2-5 weeks) 7 Ihyroxhiis
wausc maternal 4 Neuritis
antibody
7 One attack gives
lifelong immunity

Environmental
Factors:
•J Mostly occurs in
Winter & spring
•J Overcrowding also
favours its transmission
Rubella All are Agent: Rubella virus Source of infection: Complications of Rubella
susceptible Host: All are Nasal or throat droplets • Congenital Rubella
susceptible of clinical & subclimcal syndrome. Deafness,
One attack gives cases cardiac malformations,
lifelong immunity cataract, glaucoma,
Maternal antibody Mode of transmission; retinopathy
protects infant for 4-6 Droplet infection • Cerebral palsy
Microcephalus
months after birth Droplet nuclei • Intrauterine growth
Environmental
Transplacental
transmission
• retardation
Factors: • Hcpatosplcnomegaly
Mostly occurs in late
winter and spring
Incubation period: 18
days (2-3weeks)
• Mental retardation
Prevention.
MR vaccine
MMR vaccine
Poliomyelitis Primarily in Agent: polio virus Source of infection: Clinical features:
children Feces and Flaccid type of paralysis and 1
between Host: Can occur in any oropharyngeal secretion laboratory isolation of polio 1
6months to 3 age group but primarily of cases. virus in stool
years in children between
6months to 3 years Incubation period:
7-14 days
Environment: More
likely in rainy season. Mode of transmission:
Others favours: Feco oral route
Unsanitary disposal of
excreta & unsafe water
Hepatitis B High-risk Agent: Hepatitis B Source of infection: 1 Prevention:
group; virus Contaminated blood, Active immunization: j
Doctors, serum, body secretion ol Pentavalent vaccine
nurses, Host: all are susceptible vase or carrier Passive immunization: HB1G
dentists, Take protective measures
hospital Environment: Incubation period:
staff, High risk group are 1 -6 months
laboratory more prone to develop
workers, Mode of transmission:
prostitutes, Blood borne,
homosexuals transplacental, sexual
.drug transmission
addicts.
Rabies Zoonotic Agent: Rabis Virus Source of Infection:
disease (lyssavirus type /) saliva of the rabid
animal
Host: All are
susceptible

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 High ynwip Inriihalhm pnlml
\mnud handler' 1 fatally M weeks, may
V< tcnnanan vary from in day* to
1hmlcr* 1 10 dais
1 it Id nalmnhata
Hones hunt< i Mode id transmission:
Hiles, sctaklu s or In ks
1 in Ironmen): phuco id tabid animal*
where inler ted mhid
animals me inAilablc
Iknguc 1 ndemic lot Agent: 1 hni Sourer of Infect Inn
Dhaka city
vims
IcRtiiresofehulfRldengii,
BIimhI id n case id Sudden onset of fever wh*
Host: All me dengue h
continuous for 5 to 7 day,
Susceptible continuous or Mddfauicli
One attack gives Incubation period: 5-6 temperature with a hrcik on
immunity against that days the fourth and fifth days
particular serotype Back ache, arthralgias,
Mode of transmission: headache, generalized pa)n
Environment: more Propagative type of retro orbital pain
common during rainy biological transmission Maculopapular rashes over
reason where abundant (through bite of Female face neck and chest 3 to 4
places breeding of Aedes Mosquito) days after the onset of
Aedcs Mosquito fever

Vector: Adult female

aedcs mosquito
tuberculosis Developing Agent: Mycobacterium Source of infection: Clinical features: '
Countries tuberculosis Sputum positive cases, Cough persisting for more
infected milk than 3 weeks fever evening
Host: All are rise of temperature anorexia
susceptible Incubation period: weight loss hemoptysis
Males> females 3-6 weeks
Complications:
Environment: Mode of transmission: Pleural effusion spinal pain
Overcrowding Droplet infection back pain
Poor housing Droplet nuclei stiffness joint damage
Poor nutrition favours Milk bome meningitis
transmission of the liver damage
disease renal damage
Pertussis heart disorder
Usually Agent: Bordetella Source of infection:
occur in Stages:
pertussis nasopharyngeal and z Catarrhal stage
infants and bronchial secretion of a z Paroxysmal stage
preschool Host: All are
children
case z Convalescent stage
susceptible
Incubation period: 7- Complications:
Environment: 14 days
Overcrowding Bronchitis
Poor sanitation
z Bronchopneumonia
Mode of transmission: Bronchiectasis
Droplet infection Sub conjunctival
Direct contact hemorrhage
Tetanus Agent: Clostridium Source of infection: Clinical features:
tetani Soil, dust, animal dung. Trismus or lock jaw
Host: All arc Spasm of facial muscle or
Incubation period: risus Sardonicus
susceptible 6-10 days
Agricultural workers are Spasms of muscle of the
at special risk. back and neck or
Mode of transmission: opisthotonos
Through contaminated
Environment: wound with tetanus
Spores of Clostridium Prevention:
spore Active immunization: by
tetani arc present in soil,
dust and animal dung. Pentavalent and TT
vaccine

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 1/I/"
/ |'«<M«r Um' >«'' '■ by
lift and Al’.

hn«te '(genl: Sourer of Infection! ( ardlnal 1 eahires

Bl'1'’0 1 tedious ' f/»w MmiI mi n turn of (>)«>» • r i'’’
a Partial or Mil (•m of
d iaea* InU. All ate Incubation period 15 (Utanrinis vr m.«i in d'
mueptihle years affreted arras
ICO vaccine gives • PrcuiKeofllKkconl
some protection against Mode of transmission: nerve wi’h altered
cprosy Droplet infection function
Direct contact (in case • Presence of «■<! h”
Environment: of lepromatouv 1 cprosy) bacilli in the skin or n। d
* Overcrowding smears
« Poor ventilation
• Humidity
Favours transmission

in: Agent: Lcishmania Source of Infection: Clinical features:

'
KalaA^ 1 •Endemic
Trishal donovani Blood of infected man • Fever
Splenomegaly
• Mynien or animal •
singh Host: people of Incubation period: 1-4 • Hepatomegaly
Tangail endemic area Months • Anemia
• Muktag
Mode of transmission: • Loss of weight
• Environment: cyclopropagativc type
• Darkening of the skin of
acha of biological
Valuka Cracks and crevices of face, hand, abdomen
• the houses of endemic transmission
• Fulbari area
a
Vector: Sandfly

1 Protozoal Agent: plasmodium Source of Infection:

" Malaria species Blood of infected
disease
Plasmodium Vivax person
Endemic Plasmodium falciparum
area: Plasmodium malariae Incubation period:
Hilly tracts Plasmodium ovale About 10 days
of Host: People of
endemic area Mode of transmission:
• Chittagong Cyclopropagative type
• Khagrachori
Environment: presence of biological
• Bandorban
of vector and infectious transmission or vector
• Sylhet agent in the indirect
environment. transmission

Vector: Adult female

anopheles mosquito
Source of infection: Clinical features.
Filariasis Endemic Agent: Wuchereria
area: Bancrofti Blood of case • Lymphangitis
• Lymphadenitis
• North Host: People of Incubation period: 8- • Elephantiasis of legs,
Bengal genitalias and arms
endemic area 16 months
• Rangpur • Hypersensitivity state
• Dinajpur Environment: presence Mode of transmission:
of vector and infectious Cyclodevelopmental
agent in the type of biological
environment. transmission

Vector: Adult female

culex mosquito

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 ITEM Book Community Medlc|ne

Disease Risk Factors Dingnosls Prevention &

Treatment ^thcr»
< «1W 1 Aon-modifiahlc 1.1 CG
Heart Primary pretention m the
Disease • Age- inctcjse with age [Link] x-ray absence of clinical
• sex- more in male manifestation of disease • Angina pectori,
• Family history Ipulse oximetry
• Genetie factors
• Personality: Type A •Llcocardiogrnm A POPULATION, strategy;
1. Prevention in whole
"^""•‘[Link]
• ™diac fa»JUre
personality [Link] populations- based on mass • Sudden death
echocardiogram approach focusing on control
2. Modifiable: underlying causc/risk factors
• Cigarette smoking (•cardiac CT scan
‘Dietary changes
• High BP &MR1 ‘Prevention of smoking
• Ele\ ated scrum ‘Maintenance of BP within
cholesterol normal level
(Hyperlipidemia)
• Diabetes ‘Regular physical activity
• Obesity 2. Primordial prevention in
• Sedentary Habits whole population
• Stress B HIGH RISK strategy:
1. Identify the risk by
estimation of serum
Cholesterol
2. Specific advice e.g.
treatment of HTN,
avoidance of smoking

Secondary prevention:
• cessation of smoking
• control of HTN &
Diabetes
• Healthy nutrition
• Exercise promotion
• clinical trial with-
-Beta blocker
-Anticoagulants
-Lipid lower agent
-Anti-thrombotic agent

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 Medicine ITEM Book
communitv
"j^vrnodinablc: formal: Systolic- I Prlmmary prevention- Co mplicallonv
with age <130mmllg /I. POPULATION strategy. 1 Hypertensive cardiovascular
Age- rises (
Diastolic «"8510011 Ig •Nutrition (Reduction of salt disease
Sex- both Left ventricular hypertrophy
evidence intake, moderate fat intake,
Genetic factors-Theis based on High Normal- avoidance of alcohol coronary heart disease
of genetic factors Systolic (130-139) Congestive cardiac failure
twin & family studies the
Bap
Diastolic (85-90)
• Weight reduction
Ventricular arrythmias
value of monozygotic are •exercise promotion Myocardial Ischemia
usually more than those of • Health education
Sudden death
Hypertension
zygotic twins. ♦Stage 1- •Self care I. Hypertensive
Family history- the children of cerebrovascular disease
Systolic (140-159),
normotensive parents have 3% Diastolic (90-99)
B. HIGH RISK strategy:
Intracranial hemorrhage
possibility of developing HTN According to presence of risk
[Link] Infarction
whereas this possibility is 45% ♦Stage 2-
actor
1 1 .Hypertensive renal disease 1
in children of two hypertensive Systolic [Link] failure
parents j [Link] prevention
(160-179), [Link]
-Early case detection
Diastolic (100-109) 14. Atherosclerotic
Modifiable- । -Treatment complications:
15. peripheral vascular disease 1
-Patient compliance
• obesity salt intake 1 ♦Stage 3-
• Excess Systolic > 1 80, 16. Aortic dissection:
fat intake
• Saturatedtaking Diastolic >100 Extravasation of blood into 1
• Alcohol & along the wall of the
• less physical activity aorta 1
stress [Link] emergencies: 1
• EnvironmentalOCP, I
• Vibration, temperature,
other factors- Noise, • encephalopathy
• Nephropathy
humidity • Retinopathy
• unstable Angina
• MI
• Heart failure
1
Pulmonary Edema
• Eclampsia i
« Malignant Hypertension I
CT scan 1. control of arterial 9. DVT
Stroke 1 .Hypertension 10. Aphasia
•MRI hypertension
•Swallow test 2. Early detection &treatment of 11. Involuntary muscle
[Link]- tightening or spasticity
•Heart & blood transient Ischemic attack
vessel's test 3. Control of Diabetes 12. Mood change
- Cardiac abnormalities •Carotid ultrasound 4. Elimination of smoking 13. Chronic headaches
- Diabetes mellitus •Echocardiography 5. Prevention & management of
-Obesity
Elevated Blood Lipids other risk factors
6. Treatment of acute stroke to
control complications
- Smoking 7. Facilities for long term follow
- Glucose intolerance up of patients are essential
- Oral
Blood clotting & viscosity 8. Education Straining of health
personnel S of the public
- contraceptives 1 Primary prevention: C/F:
Rheumatic Agent- Streptococcus | Major criteria:
1 .Carditis Improvement of environment,
Fever
Host¬ [Link] Prophylactic antibiotic in sore - Fever
age: childhood & adolescence
polyarthritis
[Link]'s cholera
throat-Phenylmethyl penicillin
260mg 6 hourly - Poly arthritis in large joints
1
(5-15) years 4,Subcuteneous Secondary prevention: - Carditis (valves also involved)
nodule Prophylactic antibiotic to preven - Nodules
Sex -both sexes 5. Erythema
marginatum
further attack
‘♦♦It should be continued at
- Brain (abnormal jerky
purposeless movement)
Immunity: Group A Minor criteria: least 5 years after last attack/ up involvement
Clinical: to 18 years of age (which one is
streptococcal products have
some toxic products & host has -Fever longer) - Skin
-Arthralgia ’♦If carditis (mild mitral
an antigenic cross relationship.
-Previous rheumatic regurgitation) should be
Socioeconomic status: poverty, fever continued at least 10 years after
overcrowding, poor housing Laboratory findings: last attack up to 25 years of age
-Raised ESR/C- *’ more severe/ valvular disease-
High risk group: school going reactive protein lifelong
children, slum dwellers -Leukocytosis Non-Medical measures
-Prolonged PR Evaluation
interval in ECG
-Positive throat
culture
| -Recent scarlet fever

'

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 •'•me
( ancer 1 nvlinnmrnul
•1ohm i o
( a <<ixn Pxp <
•mrat
I’Hmarv ptrirnllon
1 He style mndifu attain
I
1
1» mgj —
***< '*s<rwt,^
•Alcohol Ca breast Tuhaccn. al. nhol, diet 2
DkImv lav ton Mammography -( hemo prevention ViHmins
-thv upaliotMl etpi^Um ( a lung dint X- (antiocid mtc). NS AIDS 4
MiumsIAc Hepatitis BAC. ray, iputum
(binary,^,
-Screening lest pap ameer,
HIV infections. Cytomegalo¬ cytology mammography
virus. HPV, 1 yrnphoma
Parasites: Svhisloaomiaais
( amcr oftil trait
stool examination
Secondary prevention:
I at ly Diagnosis by observalmn.
J pressure
( Hstoms, habits Colorectal earner palpation A teat
Genetic factors Sigmoidoscopy • Treatment Surgery, radiation,
1 aryngcal cancer chemotherapy
Indirect
1 aryngoxcopy
( arcinoma 1 arlt Marriage •Di: Primary prevention: time No
of emit Multiple pregnancies Papanicolaou prospect before the appearance J
- early child bearing
•Multiple sex partners
cytologic test (pap of »igns Asymploms, improved
smear) personal hygiene & birth control
-I ally sex -cervical biopsy & play important role
(XP
Histopathology
•Poor sanitation -Colposcopy Secondary prevention:
•low socio-economic -Schiler's test -Cancer registration
condition 'Investigation: -Early detection
-Genital warts -Pap smear -Early treatment
-HPV -VIA (Visual
•Premalignant condition inspection with acetic
acid) test
-HPV DNA testing
-Liquid based
cytology
- Age: incidence increasing V Breast self- Primary prevention:
of breast between 35-50 years of age
-Family history
examination by
the patient - Elimination of risk factors
-Parity: Those w hose 1’ Palpation by a - Promotion of cancer
pregnancy is delayed to their physician education
late thirties are at high risk
than multiparous women.
Thermography - Reduction of childhood
Mammography obesity
- Age at menarche
&menopause: Early menarche - Strenuous physical activity
&late menopause - Reduction of fat intake
-Increased Estrogen
&progesterone level Secondary prevention:
- Prior breast biopsy - treatment
Early Diagnosis
-Diet - Follow up
-Socio economic state: in -
higher group
-Others: Radiation, OCP
Oral cancer -Tobacco Primary prevention:
-High intake of alcohol Elimination of tobacco
-Pre cancerous lesions e.g., Secondary prevention:
Leukoplakia, erythroplakia -Early Diagnosis
-High risk group -Treatment
Lung cancer [Link] 1 .Chest radiograph 1 . Primary prevention:
[Link] factors: 2. Sputum cytology To control smoking
-Air pollution 2. Secondary prevention:
-Radiology -Early detection of cases
-Occupational exposure -treatment
Diabetes -Family history Fasting blood Primary prevention: Complications:
-High saturated glucose: 1 -Population strategy: Healthy A. Acute complications:
-Excessive alcohol intake 7.0 mmoVL in nutritional habits &physical
-Less physical activity -Hypoglycemic coma
symptomatic patients exercise -Diabetic
-Obesity & on two separate 2. High risk strategy:
-Heart disease, valvular disease occasions in -Avoidance of sedentary lifestyle
- Retinopathy
-Lactic Acidosis
-Viral infections: Rubella, asymptomatic -Avoidance of alcohol B. Chronic complications:
mumps patients. I. Ocular
--Low
Malnutrition RBG: Secondary prevention: - Diabetic cataract
socio-economic >1 [Link]/L
condition In an individual with
-Early Diagnosis - Diabetic retinopathy
-treatment -Glaucoma
-Maternal Diabetes classic -Proper management [Link] nephropathy
-Genetic syndrome sign/symptoms of
-Stress Diabetes.
-Self care -Micro albuminemia
Tertiary prevention -progressive nephropathy
2 hours OGTT:
>11.1 mmol/Lafiera
-Photocoagulalion
-Renal transplant for end stage
3. Diabetics neuropathy
4. Gangrene of foot
75gn load of glucose. renal failure

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 '^mpmodifiable: Diagnosis: Primary prevention: Complications:
'Obesit? .Age- increases with age Measurement of BMI -Health education -Hypertension
-Sex- high risk in female -Management of risk factors -CHD
-Family history -Management of weight -Hyperlipidemia
-Genetic factors Secondary prevention: -Stroke
-Ethnicity -Appetite -Type II DM
-Surgery -Fatty liver
Modifiable: -Gall stone
-Physical inactivity -cancer
--Eating
low socio-economic status
habit
-osteoarthritis
-low back pain
-psychosocial factors:
depression
-Endocrine factor: Cushing
syndrome
-Alcohol
-Drug: Corticosteroids, OCP
-Smoking: inverse relationship

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F’
Differences at a glance

Community Medicine

DJUcrt m ( S community medicine ;ind cliniiul medicine:

Community medicine Clinical medicine
1 It is a system of delivery of 1 . It deals with removal of disease
comprehensive health care to the from the patient through provision of
people by health team in order to diagnosis and treatment.
improve the health of the community.
2. It is a preventive, promotive, 2. It is the curative treatment of
curative and rehabilitative health care. diseased individual.
3. It serves the individuals and 3. It serves the individual at his
1ami lies at the community level. personal level.
4. Participation: Community 4. Participation: Doctor, nurse, and
participation. allied health workers.
5. Professionals go to the community. 5. Patients go to the phys ic ian.
6. It is field oriented. 6. It is hospital oriented.
7. Community diagnosis is done. 7. Clinical diagnosis is done.
8. Teamwork is extremely necessary. 8. Teamwork is needed only in few
occasions, e.g. in an operation or in
emergency management.
9. Field trial and surveys arc very 9. Only clinical trial is important.
important.
10. Skill: Epidemiological skills are 10. Here technical skills are required.
required.
1 1. Surveillance is needed for the 1 1 . Surveillance is not required.
control of disease.
12. Treatment is done as part of 12. Preventive care depends upon the
prevention. good will of
13. Monitoring condition is poor. 13. Monitoring condition is rich.
14. Special activities: During 14. Highest possible qualities of
epidemic. medical services to the patients.

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 - MHIIIIIU mi 5 med
"
Traits Public health I Community medicine
'jyDcfinition 1 he science and art of preventing
A system of delivery of
disease, prolonging life, and comprehensive health
promoting health and efficiency care to the people by a
through organized community health team in order to ”
efforts. improve the health of the
community.
2) Objective To control environment to To provide
promote the health, e.g. water comprehensive health
supply, sanitation. care.
3) Part It is a part of the community It includes public health.
medicine.
4) Community Is not essential. Is essential.
participation

Differences between public health & community health:

Traits Public health Community health 1
1) Definition It is the science and art of A EURO symposium (1966) 1
preventing disease, defined community health as
prolonging life, including ‘all the personal health
promoting health and & environmental services in any
efficiency through human community, irrespective
organized community of whether such services were
effort. public or private ones'.
2) Part It is a part of community It covers all the aspects of public
health health, preventive medicine and
social medicine.
3) Components In practice public health Its components are curative,
components are preventive, promotive and
community water supply, rehabilitative services.
proper sewage disposal,
| good housing etc.

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4) Main To control physical To promote physical and social
object he environment and wellbeing of the people.
communicable diseases.
5) Community Not needed. Essential.
participation

Differences between disease control & disease eradication;

Traits Disease control Disease eradicationi
1) Definition It is the reducing the It is the termination of "
incidence of disease; the all transmission of
duration & risk of infection by
transmission; the effects extermination of the
of infection; and the infectious agent through
financial burden of the surveillance &
community. containment.
2) Area of operation Only where All areas where
transmission is intense. transmission occurs.
3) Step The first step in the The final step in the
conquest of disease. conquest of
disease.
4) Aim To reduce the incidence, To tear out of disease by
prevalence and outcome roots.
of disease.
5) Operational Good. Perfect.
standard
6) Disease agent Permitted to persist Absolutely eradicated.
7) All or none phenomenon Not so. Yes.

8) Example Malaria control. Small pox eradication.

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 communitv Medicine ITEM Book
^^^^piffcrencc between cpidcmiologx and clinical ni< dicinc:

Traits Epidemiology Clinical medicine

D Unit of study Defined population or I asc or cases
population at risk 1
"^Concerned > Disease pattern in entire Only sick, not healthy.
with population.
> Both sick and health
ITDoctor The investigator goes out The patient comes to the
patient into the community. doctor.
relation
4) Identify > Source of infection. Seek a diagnosis &
> Mode of spread. prescribe specific treatment.
> Future trend.
> Specific control
measures.
5) Evaluation Prevention and therapeutic No such responsibility.
measure.
6) Idea 'Conceptual’-symbolized on Perceived by clinical
the forms of table and diagnosis, lab diagnosis &
graphs. post-mortem reports.

7) Services Epidemiologist give Physician gives only

comprehensive health care; curative health care
e.g. preventive, primitive,
curative, rehabilitative.
t

studies:
Differences between crosssectional and longitudinal
Longitudinal studies
Cross sectional studies
1) Simplest form of observational 1) It is an observational study.
study.
2) Observations are repeated in the
2) A single observation of a cross¬
section of population at one point in same population over prolonged
time is done by survey method.
period of time by follow up
examination.
3) Useful for both acute and chronic
3) Useful for chronic diseases.
diseases.

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4) It is also known as prevalence 4) Incidence rate can be determined.
study.
5) It gives distribution of disease in 5) It identifies the risk factors of
the population. disease.
6) Usually less time is needed. 6) It is time consuming.
7) Less expensive 7) More expensive.
8) Gives little information about 8) Gives good information about
natural history of disease. natural history of
disease.

Differences between case control and cohort studies:

Traits Case control study Cohort study
1) Proceeds from Effect to cause. Cause to effect.
2) Starts with Starts with the disease. Starts with people
exposed to risk factors
or suspected cause.
3) Formulation of Usually the first Reversed for testing of
hypothesis approach to the testing previously formulated
of a hypothesis. hypothesis.
4) Number of subject Fewer. Larger.
5) Duration Short. Long.
6) Result Quick. Delayed.
7) Study of rare disease Suitable. Not suitable.
8) Yielding rate Odds ratio. Incidence rates, relative
risk (RR) & attributable
risk (AR).
9) Information about Cannot yield. Can yield information
disease about more than one
disease outcome.
10) Expense Relatively inexpensive. Expensive.

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 Community Medicine ITEM Book
^^gHTerences between case control study, cohortstud\ cross sectional Much
" Traits Case control Cohort study Cross sectional
study study
5)Sampling Outcome based. Exposure based. Without regard to
exposure or
outcome.
2) Exposure Elicited. Known. Elicited.
3) Outcome Known. Elicited. Elicited.
"4) Case With outcome. With exposure. Anybody in a
definition definite
population.
5) Control Without Without No control
definition outcome. exposure. needed.
6) Temporal Usually Usually Contemporary.
sequence retrospective. prospective.
7) Sample size Small. Large. Large.
needed
8) Classification Population with Population free Population
of Population outcome& from outcome; without
without outcome. but with & identification of
without outcome or
exposure. exposure.

9) Risk measure Odds ratio (OR). Relative risk Odds ratio (OR).
(RR).

10) Function Compare Compare Describe

prevalence of incidence rates association
exposure between of outcome in between exposure
cases & control. exposed & & outcome
unexposed. simultaneously.

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 Differences between sporadic, endemic, epidemic unci pandemic:

Traits Sporadic Endemic Epidemic Pandemic 1

1. Number Small Low small Unusual Unusually
of persons High number large
largc(but
involved
within
average
fluctuation)

2. Period Short(Intcrmittent) Long Short drawn Short

for w hich (continuous) (usually
mass communicable
disease disease) or
exists long drawn
(usually non
communicable
disease).
3. Scattered Localized Localized Spread
Territorial regional or from
extent of extensive country to
disease another
outbreak country in
a short
time

Differences between screening and diagnostic tests:

Screening test Diagnostic test
1 ) Done on apparently healthy 1) Done with those with indication or sick.
individual.
2) Applied to groups. 2) Applied to single patients, all disease
are considered.
3) Test results are arbitrary and final. 3) Diagnosis is not final but modified in
light of new evidence, diagnosis is the sum
of all evidence.

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 "^Based on one criterion or cut off 4) Based on involvement of a number of
point. symptoms, signs and laboratory findings
"^Less accurate. 5) More accurate.

6) Less expensive. 6) More expensive.

Not a basis of treatment. 7) Used as a basis of treatment.
8) The initiative comes from the 8) The initiative comes from a patient with
investigator or agency providing care. a complaint.

Distinguish between isolation quarantine:

Traits Isolation 1 Quarantine '
1) Definition It is the limitation of I t is the separation, for the
freedom of communicability jperiod of movement of such
of infected persons or 1well persons or domestic

animals from others in such ianimals exposed to

places and under such communicable disease for a

conditions, as to prevent or period of time not longer
limit the direct or indirect than the longest usual
transmission of the incubation period of the 1
infectious agent from those disease, in such manner as
infected to those who are to prevent effective contact
susceptible or who may those not so exposed.
spread the agent to others.
2) Purpose To limit the spread of the To prevent the transport of 1
disease in the community. infection across national
boundaries

3) Period As long as the disease The longest usual

remains communicable i.e. it incubation period for that
may be short same or more specific disease.
than of incubation period.
4) Popularity Popular method. Out-dated method.

5) Restrictions Infected persons. Healthy contacts of an

for infectious disease.

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Pilh It mo bchyc* n piiudbiulIlHijjmd mullibmlllMi} JvPL”M
Train Paucibacillary leprosy M ultlbacillary leprosy
1) Prevalence More common Less common
2) —Body’s resistance
I — — — A- Fairly good
,

Poor.
to the disease

3) Number of skin 1 to 5. More than 5.

lesion
4) Number of bacilli Extremely few. Enormous numbers.
5) Distribution Asymmetrical. Mostly symmetrical.
6) Description of a Usually well- Shiny, reddish, poorly
lesion demarcated, non¬ demarcated areas, papules,
itching, pale or reddish, nodules, tumours and
flat or raised patches raised patches with
with distinct margin. slopping edge.

7) Surface Rough, dry and hairless. Smooth and shiny.

8) Sensory loss in Marked sensory loss. Slight or no sensory loss.
lesions Patient does not feel
touch, temperature or
pain in affected area.
9) Infectivity' Nil or negligible. Highly infectious.

10) Outlook Good. Poor, if untreated.

Differences between IPV (Salk vaccine) and OPV (Sabin vaccine):

IPV (Salk type) OPV (Sabin type)

Killed formulized virus. Live attenuated virus.
Given subcutaneously or IM Given orally.
Induces circulating antibody, but no Immunity is both humoral and intestinal.
local (intestinal) immunity. Induces antibody quickly.
Prevents paralysis, but dose not Prevents not only paralysis, but also
prevent intestinal reinfection.

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Communitv Medicine ITEM Book
| Can be effectively used in controlling
1
"^tuscful in controlling epidemics
epidemics. Even a single dose elicits
substantial immunity (Except in tropical i

countries)
difficult to manufacture. Easy to manufacture.
"Thevirus content is 1 0,000 times Cheaper.
mOre than QPV. Hence costlier. i

"D^senot require stringent Requires to be stored and transported at

subzero temperatures, unless stabilized.
conditions during strong and
transportation. Has a longer shelf¬
life. J
:
Differences between hepatitis-A & E and Hepatitis- B
Traits Hepatitis-A & E Hepatitis-B & C 1
Faeco-oral. Parenteral (e.g needle 1
1. Transmission
prick, blood, sexual
etc.) 1
2. Chronicity No Yes 1
3. Chronic No Yes i

complications (e.g. liver

cirrhosis &
hepatocellular cancer)
4. Anti-viral therapy Not needed. Needed. j

Differences between chicken pox and measles.

Traits Chicken pox Measles |
[Link] Varicella zoster virus Measles virus (RNA 1
paramyxo virus) j
Usually mild. Mild.
2. Prodromal
syndrome
3. Fever Temperature rises with Fever appear on the 1st 1
each fresh crop of rash. day. |
Rash
Appear On 1st day to 7th day
Distribution Ccntripentally At first profuse or
distributed, extensive in | abundant on face |

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 covered areas of the particularly forehead and
body e.g trunk, axilla is behind the cars, then in
also affected. extremities (hand and
feet)
Appearance • Appears in • At first reddish
successive crops maculo-popular
for 3- 4 days and rash eruption.
whenever • By the 5th or 6,h
examined, rash 1 day the rash
found in the begins to undergo
different stages. desquamation
• Mostly leaving a
superficial. brownish
• Unilocular. discoloration.
• Vesicles raised
centrally (dew
drop like)

Difference between small pox & chicken pox:

Traits Small pox Chicken pox
1. incubation period About 12 days (range: About 15 days (range:
7-17 days) 7-21 days)
2. Prodromal Severe Usually mild
symptoms
3. Distribution of rash. a. Centrifugal a. Centripetal
b. palms and soles b. Seldom affected,
frequently involved, c. Axilla affected.
c. Axilla usually free d. Rash mostly on
d. Rash predominant on flexor surfaces.
extensor surfaces and
bony prominences.
4. Characteristics of a. Deep- seated. a. Superficial.
rash b. Vesicles multilocular b. Unilocular, dew-drop
and umbilicated. like appearance.
c. Only one stage of c. Rash pleomorphic.
rash may be seen at one
time.
.
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 d- No area of
d. An area of
inflammation is seen inflammation is see
around the vesicles. around the vesicles. |
5. Evolution of rash a. Evolution of rash is a. Evolution of rash
slow, deliberated and very rapid.
majestic, passing
through definite stages b. Scabs begin to from
of macule, papule, 4-7 days after the rash
vesicle and pustule appears.
b. Scabs begin ti frim
10-14 days after the
rash appears.
6. Fever Fever subsides with the Temperature rise with
appearance of rash, but each fresh crop of rash.
may rise again in the
pustular stage (2ndary
rise of fever)

Difference between cholera and food poisoning:

Traits Cholera ]Foodpoisoning 1

1 . Epidemiology Occur often in epidemic Often a single group of 1
form associated with persons who shared a 1
other cases in the common meal I
neighborhood secondary
case occur No secondary cases I
2. Incubation From a few hours up to 1 to 24 hours
5 days
3. Onset With purging | With vomiting 1
4. Nausea and retching None | Present
5. Vomiting Projectile, effortless, 1 Often single, severe 1
watery and continuous vomit, mucus and 1
|blood streaked
6. Stools Copious rice watery, 1 Frequently, may
inoffensive contain mucus and I
blood offensive
7. Tenesmus None Yes j
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 ITEM Book Community Medicine
1
8. Abdominal None Yes
tenderness
9. Dehydration Very marked Distinct
JO. Muscular cramps Constant and severe Less constant
11. Surface Subnormal Often up to 1 00-102~~
temperature
deg F
12. Headache None Often
13. Urine Suppressed Seldom suppressed
14. Blood Lcucocytosis Normal

Ihltvrcnccs between communicable & non-communicable disease:

Traits Communicable disease Non-communicable
disease
1. Transmission Transmitted from person Not transmitted person
to person to person
2. Agent/ risk factor Agent responsible There are some risk
factor
3. Causative agent Usually single Multifactorial
4. Disease cycle Yes No
5. Cellular alteration Usually short Long
~

6. Cellular alteration Usually reversible Irreversible pathological

alteration occurs.

Differences between the clinical presentations of IDDM & NIDDM:

Clinical features Type-1 DM (IDDM) Type-2 DM (NIDDM)
1. Age of onset Usually <30 years of Commonly middle aged
age and elderly
2. Onset Abrupt onset. Gradual (insidious)
onset.
3. Severity More server form if not Frequently mild in
diagnosed. severity.
4. Fate Becomes lethal if Slow ketosis and long
treatment is late compatible survival.
5. HLA association HLA related HLA relation yet to
find.

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Community Medicine
ITEM Book
s between mosquito and sand lh;

— Traits
Large.
Mosquito
*Small
Sand fly 1
1

L Size 1 Jpright & lanceolate

2. Wings
Dorsal ly
(;ompared with body- ,
Fly Hopping.
JHaving
[Link]/hopping a pair of large
Semi-globular having a 1
^4. Head eye, a proboscis, a pair
pair of large eye, a 1

proboscis, a pair of of palpi and pair of

palpi and a pair of antennae.
antennae.
Rounded, having a pair Not rounded Having a
5. Thorax pair of wings and 3
of wings and 3 pairs of
legs. pairs of legs.
IS not a ndiry maevu Is a hairy insect.
6. Hair
Legs are short. Are long compared with
7. Leg the size of body.

developing and developed countryi

Differences of age-sex pyramidbetween
Developing country Developed country
Traits
(like Bangladesh) (like japan)
The pyramid has a wide The pyramid has bulge
1. Shape of pyramid
base and narrow apex. in the middle &
narrower both base and
apex
Base of the pyramid Middle portion of the
2. Cause of this shape
represents children pyramid represents the
population and as birth middle-aged population
rate is very high in and as in the developed
developing countries the countries population
age pyramid takes this mainly consists of
shape. middle aged or elderly
people so the age
pyramid takes the
shape/

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3. Interpretation Indicate rapid growth of Indicate high rate of
population population in younger
age.

Dillcrence between breast (Mother ’s) milk and cow’s milk:

Composition Breast milk Cow’s milk

1. Protein 1 I gm/litre 33 gm/ litre
2. Carbohydrate 70 gm/litre 50 gm/ litre
3. Fat 35 gm/ litre 35gm/litrc
4. Non protein 0.32 gm/ litre 0.32 gm /liter
5. Minerals 2 gm/ litre 8gm/ litre
6. Ca 0.33 gm/ litre 1 gm / litre
7.p 0.15 gm/ litre 1 gm / litre
8. Fc 0.4- 1.5 mg/ litre 0.3-0.5mg/ litre
9. Vitamin C 60 mg / litre 20 gm/litre
10. Vitamin-D 50 1U 25 IUE
11. Water 80 gm /litre 7 gm / litre
12. Energy 640-720 Kcal 650

Difference between acthe & Passive immunity:

Traits Active Immunity Passive

Immunity
1. Active Participation by Yes. No.
the host
2. Onset of action Immunity starts to develop Start
after a considerable latent immediately.
period.
3. Duration of action Long-lasting. Short-lasting.

4. Immunological memory Present. Not present.

5. Secondary immune Occurs. Not occurs.
response
6. Risk of hypersensitivity No risk of type-1 and Type- There is risk of
reaction 3 hypersensitivity. type-1 and
Type-3
hypersensitivity.
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 Communitv Medicine ITEM Book
"iTUse Prevention of disease. Prevention and
treatment of
disease.

Comparison between primary & secondary immune response:.

Features Primary response Secondary response
1. Latent Period Long Short
2. Rate of antibody Low High
production
3. peak antibody titer Low High
4. Persistence of Ab titer Short Long
5. Affinity of Ab Low High
6. Memory cells Absent Present
7. Cross reactive Low High
antibody
8. Predominant 1g class IgM IgG
9. Dose of antigen Large Small

Differences between vaccine and antisera:

Traits Vaccine Antisera
Immuno-biological They contain
1. Preparation
substance prepared form immunoglobulins
live modified, inactivate prepared in animals such
or killed organisms, as horses.
extracted cellular
fractions, toxoids or
combination of these.
Active. Passive.
2. Types of
immunization
For prevention of For treatment of
3. Uses
infectious diseases. infectious and non-
infectious conditions.
4. Complications Post-vaccine encephalitis Serum sickness,
& encephalopathy, anaphylactic reaction etc.

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 i Guillain Barre syndrome
(GBS)elc
5. Contraindications in Some liv e v necines arc Antisera have no
pregnancy contraindicated in contraindication in
Pregnancy pregnancy
6. Herd immunity Possible Dose not possible.

Differences between attenuated saccine and killed saccinc;

Traits Killed vaccine Live attenuated vaccine
1. X umber of doses Multiple Single
[
2. Need for adjuvant Yes No
3. Duration of Shorter Longer
immunity
4. Effectiveness of Lower Greater
protection
5. Immunoglobulins IgG IgA and IgG
produced
6. Mucosal immunity Poor Yes
produced
7. Cell-mediated Poor Yes
immunity prod uced
8. Residual virulent Possible No
virus in vaccine
9. Reversion to
Possible
virulence
10. Excretion of vaccine No
NO
virus and transmission
to non-immunc contacts
1 1. Interference by No
other viruses in host
Possible
12. Stability at room High Low
temperature

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Differences between antiseptics and disinfectant:
Traits Antiseptic Disinfectant
1. Strength of chemicals Mild chemicals. Used in Strong chemicals. Used in
lower concentration. higher concentration.
2. Used for Living surface. Example: Non-living surface/objects 1
skin and mucous Example: Floor, bed, pan
membrane. etc.
3. Mode of action Prevent the growth or kill Kill the microorganisms
the microorganisms. except spore.
4. Irritant or Harmful Not irritant to living
surface. It is not harmful to
1
the body.
5. Example Cresol (Lysol), Acids & alkalis,
Chlorhexidine, Dettol, Formaldehyde,
Savlon, Povidone iodine Gluteraldehyde, Bleaching
etc. powder etc.

Differences between disinfection and sterilization:

Traits Sterilization Disinfection 1

1. Definition Absolute freeing of an Disinfection is a process 1
article from all of reduction of number
microbial burden of contaminating
including spore . organisms to a level that
cannot cause infection.
2. Effectiveness Sterilization is an Some organisms and
absolute term i. e. the bacterial spores may
article must be sterile. survive.

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 Difference hdwwn kwashiorkor & marasmus:
Marasmus Kwashiorkor
Traits
None Lower legs sometimes
1 . Oedema
face or generalized

Marked Less obvious often

2. Wasting
masked by oedema
Severe Less Severe
3. Muscle wasting

4. Growth retardation Severe Sometimes

Usually nil Usually Present
4. Mental changes
Usually good Usually Poor Common
1. Appetite
2. Diarrhoea Common Common
3. Skin changes Usually none Often diffuse
pigmentation
4. Hair changes Texture may be Often sparse straight and
modified silky
5. Moon face None Often
6. Hepatic enlargement None Frequent

Differences between health education & propaganda:

Health Education Propaganda / Publicity
1) Knowledge & skills actively required. 1 . Knowledge instilled in the minds of
people.
2. Makes people think for themselves. 2. Prevents or discourages thinking by
readymade
3. Disciplines primitive desires. 3. Arouses & stimulates primitives desires.

4. Develops reflective behavior. Trains 4. Develops reflexive behavior; aims at

people to use judgment before action. impulsive actions.
5. Appeals to reason. 5. Appeals to emotion.

6. Develops individuality, personality & 6. Develops a standard pattern of attitude

self- expression. and behaviors according to the mould used.
7. Knowledge acquired through self-reliant 7. Knowledge is spoon-fed and passively
activity received.

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8. The process is behavior centred aims at 8. The process is information centred-no
developing favourable attitudes and habits change of attitude or behavior designed
& skills.

Differences between street virus and fixed virus:

Traits Street virus Fixed virus
1. Definition Virus in naturally Serial brain-to-brain passage of i

occurring cases of rabies. street virus produces fixed

virus.
2. Incubation period Long and variable. Short and fixed.
Usually does not produce.
’
3. Negri bodies Produce
4. Multiplication in Multiply Lost power of multiplication
salivary gland
5. Pathogenicity Pathogenic. Non-pathogenic.
6. Vaccine preparation It is not used to prepare It is used to prepare anti-rabies
anti- rabies vaccine. vaccine. |

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 b'oreiisic Medicine
Pith lent hue Imuivn pi oh-wlomd mgllgcm i A pi okwhimil mist midm i

Traits Professional negligence Infamous mlsconduc t

Offense Absence of care & skill Violation of code of
or willful negligence medical ethics
Duly of care Should be present Need not be present
Damage to person Should be present Need not be present
Trail Cavil or Criminal court State medical council fc
BMDC
Punishment Fine or imprisonment Erasure of name from
registration or wami ng
Appeal To Higher court To Government

Difference between male & female;

Trait Male Female
Gonads A functioning testis. A functioning ovary.
Penis, prostate etc. arc Uterus, vagina etc. are
appendages appendages
Build Larger with greater Smaller with less muscular
muscular development development
Shoulders Broader than hips Narrower than hips
Waist 3-defined Well defined
Trunk Abdominal segment:Smaller Abdominal segment:
Longer
Thorax Dimensions more Shorter & rounded
Limbs Longer Shorter
Arms Flat on section Cylindrical on section
Thighs Cylindrical Conical (Due to shorter
femur& greater deposition
of fat)
Gluteal region Flatter Full & rounded
Wrists & ankles Not delicate Delicate
Breast Not developed Developed

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Forensic Medicine ITEM Book
Pubic Hair Thick & rhomboidal 1 hin, horizontal &
(extends upward to
triangular (covers mons
umbilicus) veneris only)
Body Hair Present on~facc& chest Absent on face & chest
Head Hair Shorter, thicker & coarser Longer, thinner & finer
Larynx Prominent (Length: 4.8cm) Non-promincnt
(Lcngth:3.8cm)

Differences Between male & female In nuclear sexing:

Trait Male Female
Chromatin pattern 46, XY 46, XX
Barr Body 0-4% cases 20-80% cases
Davidson body Absent Upto 6% cases

Difference between temporary & permanent teeth:

Traits Temporary teeth Permanent teeth
Size & weight Smaller & lighter Larger & heavier
Color China white Ivory white
Incisors Vertical Slightly project forward
Neck More constricted Less constricted
Ridge Present between neck & Absent
body
Roots of molars More divergent but Less divergent but
smaller larger
Replacement By permanent teeth Not replaced by any
Total number 20 32(28-31)
Difference in teeth No premolars, 8 molars 8 premolars, 12 molars
types

Differences between somatic death & molecular death:

I Trait I Somatic death Molecular death

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 Complete & irreversible Death
of cells & tissues
Definition individually, which
stoppage of the
circulation, respiration takes place usually 1-2
& brain functions hours after the stoppage
of the vital functions
Immediately after 2-6 hours after somatic
Time
stoppage of life death
Muscles response to No response to stimuli
Reaction to stimuli
electrical stimuli
Possible Not possible
Organ transplantation

Similarity Occurs in whole body Different cell die at

at a time different period
Death trance/ apparent May simulate with Dose not simulate
death/ suspended somatic death
animation
Confirmation Unreliable sign of death Reliable sign
Medicolegal Indicates clinical death Indicates surest sign of
importance death

Differences between cortical brain death and brainstem death:

Traits Cortical brain death Brain stem death
Cerebrum Damaged Intact
Brain stem Intact Damaged
Circulation & Continues Interrupted
reparation
Persistent Vegetative Persists Absent
State
Recovery Rare Irreversible
Causes Cerebral hypoxia, Increased intracranial
widespread brain injury pressure, cerebral
etc. edema

Differences between death & death trance:

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forensic Medicine ITEM Book
Trait 1 Death Death trance
Definition Permanent & Condition in which 1
irreversible cessation of signs of life seem to be
functions of 3 absent because of 1
interlinked vital interruption in function
systems of body of 3 vital systems but 1
life still remains
Types 2 types: Somatic, 2 types: Voluntary,
molecular involuntary
Reversibility Irreversible Reversible
Done Can’t be done Can be done voluntarily
voluntarily
Interpretation Confirmed Wrong interpretation

Differences between post-mortem staining congestion:

Trait Postmortem staining Congestion I

Situation Dependent part of the Whole or any part of the 1
organ organ |
Cut surface Oozing of blood from Exudation of fluid, I
distended capillaries mixed with blood from 1
the cut surface. 1
Swelling or edema Nil May be present \
In case of stomach & There will be lines and Uniform hyperemia
intestine, xvhen areas of discoloration &
stretched paleness
Cause Passive capillo-venous Duc to some pathology
distension in the organ
Nature of change Postmortem Antemortem

Differences between priman & sccondnn relaxation;

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 ITEM Book Forensic Medicine

Trait Primary relaxation Secondary relaxation

Time of occurrence Immediately after death After rigor mortis passes
of & decomposition
occurs
Death of muscle tissue Has not occurred Has occurred
Response to stimuli Responds Dose not respond
Other external Nothing particular Signs of decomposition
features are there
Body temperature Nearer to normal Low

Differences between putrefaction & maceration:

Trait Putrefaction Maceration

Definition Process by which Condition of autolytic
Complex organic body decomposition of dead
tissues break down to fetus
simpler inorganic
compounds or elements
Occurs in In all deaths Only in “dead birth”
Mechanism Action of micro¬ Aseptic autolysis
organism & autolysis
Site Outside the uterus Intrauterine
Odor Foul smell Sweetish & disagreeable
| Color of skin Green Deep red or greenish

Differences between true bruise & artificial bruise:

Trait True bruise Artificial bruise

Cause Mechanical force-Blunt Irritant chemical or
trauma plant juice e.g. juice of
marking nut, calotropis
or plumbago rosea
Site Anywhere Exposed, accessible
parts
Color Typical color changes Dark brown (No
change)
Shape Regular (Usually round) Irregular

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Forensic Medicine ITEM Book
Margin 3 defined; Diffuse &' Well defined, regular
irregular
Redness & See in the site Sec in the surrounding
inflammation skin
Contents Extravasated bold Acrid serum
Itching Absent Present
Similar lesions May be present May be present only on
elsewhere in the body nail bed (Due to
itching)
Nailed vesicles Absent May be found around
nail beds due to itching
Chemical tests Negative Positive for the
chemical
Small blisters Absent May be present on the
margin
Swelling Slight swelling Absent
Extravasation of blood Present Absent

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Ihlh (« ih « In i"< • n iin im <1 non ml A bn IM «1 hHikiiiU woiinil

Trait Incised wound Inched looking wound

Nature of injury 1 nily an incised wound 1 I ruly a laceration

Manner of production By sharp cutting weapon By blunt weapon

Mode of production By drawing, sawing or By friction, stretching

striking the sharp edge & compression

Site Anywhere Usually over body

prominences c.g scalp,
eye brow, check bonsc
etc.
Shape Usually spindle shaped Irregular
Dimension Length is greater than Length & breadth is
breadth & depth greater than depth
Margin Well defined, cleanly cut In naked eye: may
& sharp appear smooth &
sharp.
With hand lens:
Irregular, uneven &
ragged
Bleeding Extensive bleeding Less bleeding
Tissue bridging Totally absent Remains in some
extent
Hair bulbs Clean-cute Crushed
Beveling May be present Absent
Marginal abrasion & Absent Present
bruise
Foreign matter Absent Usually present
Bones May be cut May be fractured
Clothes May be cut May be tom
Medicolegal Mostly homicidal Mostly accidental
importance

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Forensic Medicine ITEM Book
rcncci between suiddnl cut tin oat and hmnk Idal j ill tin '«.1» injut '

Trait Suicidal cut throat Homicidal cut throat

Situation Mostly on left side Ac lostly in Iron! At partly
front and partly on right on either or both sides of
1
side of neck ( in right ncck
handed pci son)
Level High up the thyroid 1 ,ow; on or below
cartilage thyroid cartilage
Wounds Multiple, superficial .
fd u111p1c deep ।

Slope Upward 1Mo slop or downward

Edges Usually ragged Sharp Ac. clean-cut
Direction From left to right & Transverse
above downwards (in
right-handed person)
Tailing Present Absent
Hesitation cuts Present Absent
Severity of wound Less severe More severe
Defense wounds Absent Present
Marks of resistance Absent Present
Secondary wounds Self-inflicted incised Other homicidal
wounds may be present wounds, defence cuts,
on other approachable marks or resistance
parts of the body present on other parts of
the body 1
Hands Weapon may be firmly Fragments of clothing,
grasped (due to hair etc. may be grasped
cadaveric spasm)
Weapon Held in cadaveric Usually absent
spasm of the hand or
present nearby
Bleeding Less More
Large blood Vessels Carotid arteries arc Carotid arteries are cut
spared
Blood stains Blood trickles down in Blood trickles down by
front of chest & sides of neck (As victim
abdomen (As victim is is mostly in lying
mostly in standing or position)
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 sitting position); maybe
in the mirror; face-
bleeding may be found
Absent (As victim is mostly in
Foreign material e.g
hair lying position)
Corresponding cuts on Absent May be present
clothes
Circumstance Quiet place e.g. Disturbed e.g.
bedroom or locked disarrangement of
bath-room; usually in furnitures in room
front of a mirror
Cause of death Air embolism Hemorrhage & shock
Suicidal note May be present Absent

I utlerences between ante-mortem wound A post-mortem wound:

Trait | Antemortem wound Postmortem wound

Nature Before death After death
Edges(Gaping) There is gap between Edges do not gape
edges: edges are (closely approximated);
swollen, everted. No swelling or
retracted retraction
Hemorrhage Abundant: usually Slight or none: always
arterial venous
Spurting Marks of spurting of No spurting (Oozing
arterial blood occurs)
Extravasation Deep staining of edges No deeply stained (Stain
& extravasation in can be washed out)
neighboring tissue (
Stains can’t be washed
out)
Coagulation Firm clot present No clotting (or soft.
friable clot)
Vital reaction Present e.g. No signs
Inflammation & repair
Enzyme histo- Activity of several Diminished or no
chemistry enzymes e.g. esterase. enzyme activity
ATPase. amino-
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 peptidase. nt id
phosphatase, alkaline
*phosphatase, elastase
Ikilling & repair I < inmulntion tissue A 1
Absent
। fibrous tissue present

Difference Iktwcn luat stiokc A [Link] exhaustion

Traits Heat stroke Heat exhaustion
Body temperature More than 41” K( Normal b<xly
temperature
Sweating Absent lixccssivc
Skin Red, hot, dry Cool, pale, clammy
Pulse Rapid, strong Rapid, weak
Other features Throbbing headache, Faint or Di//y, muscle
unconsciousness cramp

Differences among name burn, sc ah Il_A.chen y cnHwrn:

~

Traits Burn Scald Chemical burn ,

Cause Dry heat injury Moist heat injury Corrosive
e.g. Flame, e.g. Liquid or chemicals
heated solid steam at boiling
substance or X- point
rays
At& above the At & below the At & below the
Site
site of site of contact site of contact
application of
heat
Dry & shriveled; Sodden & May be
Skin
may be charred bleached destroyed
Absent Present Absent
Splashing
More Less More or less
Depth of injury
Present Present Absent
Red line
Black Bleached Distinctive
Color
Present Absent Usually present
Charring

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 I)vcr brunt area Very rare
\ nicatlon 1 Kindly al
margin ol burnt
area
Absent Singeing present
Hair Singeing present
Not burnt May be burnt
( lothcs Burnt
Think Ac less Thick A
Scar 1 hick A more
( (Xili.K led
contracted contracted
Present in upper Absent Absent
Soot particles
respiratory tract -

Absent Present Present

Ulceration
r
Healing Delay larly Delay
May be present Absent Present; ugly
Contracture
bum
Severity More Less More or less

Differences between ante-mortem hums & post-mortem burn:

Traits Ante-Mortem burn Post-mortem burn

.7
Line ofr redness
j
Present Absent
(Around the injury)
Blister Contents: Serous fluid Contents: Air & thin
with proteins, Cl, Br; F clear
Base: Red & inflamed Fluid
Base: Dry, hard &
yellow
Internal organs Congested Not so
Soot particles Present in respiratory Absent
tract
Blood Cherry red color Not so
Carboxy meth- Present in RBC Absent
hcmoglobin
Signs of inflammation Present Absent
Vital reaction Marked cellular Absent
exudation & reactive
changes in tissue cells
Enzymatic activity Increased No change
Healing & repair Present Absent

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 Forensic Medicine
^^^^jfferences between antemortem & postmortem sc;ild:

Postmortem

i1
Traits
tne of redness
jillv vi

"Content
Antcmortm scald
Exudative Fluid
Present
Absent
Gas or air
___ 1
J
Absent -
"Si^TofTnflammation
healing
Present
Present Absent 1
Process of
Infection Present | Absent

true virgin & false virgin:

True virgin False virgin

Traits
The woman has no experience The woman is
Basic difference experienced with sexual
of sexual intercourse
intercourse
Not ruptured: Not ruptured; thick,
Hymen
It is a thin flap of tissue of fleshy or fibrous, elastic
regular shape & experience with folds
Apposed to each other Not apposed
Labia majora
In contact Not in contact
Labia minora
Narrow, rugae more folded & Rugae are less obious
Vagina
vault more conical
Intact Disappears
Fossa
navicularis
Intact Tom or intact
Fourchette
a. Size: Small a. Size: Variable
Breast
b. Shape: Hemispherical b. Maybe flabby or
c. Consistency: Firm pendulous
d. Areolas: Smaller & c. Areolas: Wider
pinkish d. Nipples: Large,
e. Nipples: Small raised

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Dilh। ( in ia hi h>i i n i olnsli mu A 111 Wilf UlHIU
Traits Colostrum Breast milk
Secretion From 3d month of After product ionof
pregnancy lo 1 0 days colostrum and secreted
1—
। Appearance
after delivery
Thin yellowish fluid
2 years after delivery
Thick whitish fluid
Consists of Free fat globules & Large fat globules*
large phagocytic cells only a few phagocytic
filled with fat droplets cells
Trypsin inhibitor Present Absent
Water 86% 88.5%
Lactose (g)
Carbohydrate
5.3 6.8 —
Protein (g) 2.7 1.2 ~
LFat (g) 2.9 3.8

Differences between parous u terus& millioarous uterus:

Traits Parous uterus
Size Nullinarous ntornc
I***" vzuo Ultl
US
9 cm long, 6.5 cm wide; 7 cm long ,
4.5 cm wide
larger & thicker ; smaller & thinner
Weight 80-120 g on
40-80 g
Ratio between body & Body is twice the length Body & the
cervix cervix have
of cervix the same length.
Fundus Upper surface of fundus Upper
surface offunduT”
is convex & on a higher
less convex & on same
level than the line of level of broad ligament
broad ligament
v^dviiy Walls are concave from Walls
are convex from
inside forming a wider inside
& rounded cavity
forming a smaller
Cervix & triangular cavity
h regular & edges show
Regular, no scars.
scars. External os:
External os: Rounded &
Rounded & appears as a appears
as a small
small hollow in center
hollow in center of
of cervix. Mucous
cervix. Mucous

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 membrane is smooth & membrane is smooth &
intact & orifice closed. intact At orifice closed.
Internal os: Circular, Internal os: ( ircular.
well-defined. Well-defined.

Differences between natural abortion & criminal a hot lion

Traits Natural abortion Criminal abortion ]
Predisposing factor Diseases of uterus, Usually no predisposing
placenta, abnormality of factor is related
fetus may be found
Motive Absent Pregnancy of
unmarried, widow is
common
Infection Rare Frequent
Marks of violence Absent Present in abdomen &
genitalia
Genital organs Injuries are absent Injuries e.g. Contusions,
lacerations, abrasion,
perforations etc. may be
seen
Toxic effect Absent Local or systemic toxic
effects are found
Foreign bodies Absent in genital tract May be present in
genital tract
Fetus Wounds absent Wounds may be present
(Rarely)

Difference between still born & dead born:

Traits Dead birth Still birth
Site of death Inside the uterus During birth process
Time of death Ante-partum/intra- Ante-partum
partum
Age of fetus Any period of gestation Fetus must attain
viable agc(28lh week)
Rigor mortis May be present Absent

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 M •«< ••tkm Mo h»- p* rar nt \Mrnt
Mummlfh M«S I* |H« »• »lf \Mrnf
Spalding'* »lgn Mo hr prarnl \harnt

IMh KUO hi l»ii n nub and f« Hl ah ld'M»d

1 rails Mair la male

Set chromatin 44. XY n XX
Da* idwn bods (in Absent Present in ufto 6*
neutrophil) neutrophils

|)|fl<l<n«i l>. f n , . n m din .n \ Mond A Dll list I 11.1 1 blood:

Traits Ordinary Blood Menstrual BIihmI

( olor bright red [Link] red
(Mor Sally odor fishy odor; disagreeable
Reaction Alkaline present
Clot formation C lot is formed not formed
Microscopic Nothing Characteristic endometrial Ik vaginal
Examination epithelial cells,
L. microorganism present
Anywhere
* usually found on female
garments, diapers of
pieces of clot

Difference between antemortem & postmortem colt:

Traits Antemortem Clot Postmortem ( lot

Color Yellow Dark red
Consistency Einn Gelatinous
Wash out Not wash out Easily washes away
Composition Formed by platelet & Fibrin absent
fibrin
Attachment to vessel Attached Not attached
wall
On drying Get broken into scales Becomes powder

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Forensic Medicine ITEM Book
Difference between psychosis & neurosis:
Traits Psychosis Neurosis
Nature A disease entity with a A reaction to stressful
physical basis which is circumstances due to
determined genetically adverse childhood
experiences
Severity Major Minor
Empathy Absent Present
Contact with reality Absent Present
Insight Absent Present

Difference between lucid interval in insanits & head injun :

Traits Insanity Head Injury'
History h/o insanity present h/o injury to the head
Preceding symptoms of insanity of concussion
Following symptoms of insanity of cerebral irritation &
compression of brain
Occurrence frequent only once

insanity
Difference between true insanity & feigned
Traits True Insanity Feigned Insanity
Onset Gradual or insidious Sudden
Absent Present e. G. Past
Motive
history of crime
Predisposing Usually present. E. G. Absent
factors History of insanity of parents
or of sudden momentary loss,
grief etc.
Uniform, specific; present Not specific; present
Sign & symptom
whether the patient is being only when person is
observed or not conscious of being
observed
Continues irrespective of Noticeable mostly in
Existence of presence of others
fpqfnres presence or absence of others
Excited, agitated, depressed Not so; may overact ( to
Mood show abnormality in
fluctuated
mood)

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Facial eiprctMon Peculiar e <, Vacant l«>k or । No peculiarity; variable.
1 fixed look of excitement
I voluntary

1 rails Arsenic poisoning

Pain in throat Cholera
Before vomiting Aller vomiting
Purging follows vomiting
Stool Before vomiting
Al early siage;'dark Rice watery, not bloody
colored, bloody & passed tn continuous
Later: rice watery involuntary jet
1 cncsmus & anal
Present Absent
irritation
omited matter Contains mucus, bile & Watery withouTmu^"
blood bile and blood.
X oice
Not affected
Conjunctivae Rough & whistling"
Inflamed Not inflamnH '

.\nal\sis of excreta
Arsenic present
C ircu ms tun till Vibrio cholera present
Of arsenic poisoning may
Othcr case of
be present
locality

Dl10!>nhn„...
Trait White phosphorus
Color
4
Wbiteoryellow --^jljphospW^
Appearance
Translucent; waxy Reddish-brown
Smell
cylinders "^Whous^
Lu n minosity
garlicky'
Odorless "

Exposure toair —Lum i nounrTthA^Ti

ne a ark
hi i
bl on-luminous
fumes; ignites at 34° c
and
~^oxidi^dT^
fuming; non-
Use -^^P^u^
Fertll^rM^^^ inflammable
Toxicity box
Highly toxic “

Non-toxic

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 Difference Iwlwccn poisonous & non-pois,,,,,,^ s„|,n:
Traits Poisonous snakes Non- poisonous snakes
Head scales a. Small Large ( Generally)
b. Large; an opening/ pit
between eye& nostril (pit
viper)
c. 3rd labial scale touching
eye & nasal shields
(cobra, king cobra, coral
snake)
d. No pit & 3rd labial scale;
eye & central row of
scales on back: enlarged;
undersurface of mouth
has only 4 infra-labial
scales, the 4,h being the
largest (kraits)
Belly Scales / Large; cover the entire Small ( like those on
ventral scales breadth back or moderately
large); do not cover the
entire breadth
Poison Has poison apparatus Dies not have
Apparatus
Fangs Hollow-like hypodermic Short & solid
needles
Fang marks 2 deep faint impressions A number of small
impressions in a row
Teeth 2 long fangs 4 longitudinal; rows in
upper jaw; 2 rows in
lower jaw
Tail Compressed Not much compressed
Bite Deep Shallow, superficial,
multiple elliptical
impressions
Habit Nocturnal Not so

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mihuuhcs neluccn electrocution & lightning:

Traits Electrocution Lightning

Burn marks Joule burn, flash burn, Filigree bum
crocodile bum
Volt Average 220 V; may be upto Millions of volt
310 V
Medicolegal Mostly domestic, industrial, Always natural
importance natural
Diagnostic criteria of Absent Present
lightning

Different Between antemortem & post mortem hanging:

Traits Ante-mortem hanging Post mortem hanging

Ligature mark Oblique, non-continuous, circular, Continuous,
high up low- down
Dribbling of saliva Present Absent
Knot Usually single Multiple
Abrasion & bruise Present around the knot Usually absent
Vital reaction Present Absent
Neck Stretched & elongated not stretched or
elongated
Signs of asphyxia Markedly present Absent
Parchmentization Present Absent
Post mortem staining Present above the ligature Absent above the
ligature
Petechial hemorrhage Present above the ligature Absent above the
ligature

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Forensic Medicine ITEM Book
Piffcrcncc between hanging & Mrsinmdatioii
Points Hanging Strangulation
External finding
Ligature mark Oblique, non-contmuous, Continuous, circular, at
high up the thyroid or below thyroid
cartilage cartilage which
completely encircles the I
neck transversely
Abrasion & bruise Less common More common
Neck Stretched & elongated Not so 1
Face Pale & placid Cyanosed, swollen,
congested
Protrusion of Less marked More marked
tongue
Saliva stain Often present Usually absent
Bleeding from nose, Not common Common
mouth & ears
Signs of asphyxia Les marked More marked
Seminal fluid at More common Less common
glans
Involuntary Less common More common
discharge e. G feces,
urine

Internal findings
Subcutaneous tissue Parchmentized i. E. Dry, Ecchymosed
hard, white, glistening
Fracture of hyoid May occur Uncommon
bone
Fracture of thyroid Less common More common
cartilage
Fracture of larynx Less common More common
& trachea
Carotid artery Rupture is common No common

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 Medicis
°1Sons at a glance
ill
I

——
instrument
—/-Weapon^ injuries
Rope Mcdic^
'“Abrasion
^•ramline appearance.' -Strangulation
-Whipping
^^medi^^-
cause:
-Grievous hurt (face, eyes)
(Homicidal) -Asphyxia
-Venous
-Throwing into fire c°ngestion
(Homicidal) -combined
«hyxia&ven
congestion
-Cerebralanemia
or ischemia
;Reflex vagal
inhibition
-Fracture or
Electric dislocation of
-Strangulation cervical VAHak
wire vertebrae
-Whipping -Ventricular""
-Rape fibrillation
-Throwing into fire -Asphyxia
Rollar By blunt ends:
-Bruise -Homicide -Shock &intemal
-Abrasion - Grievous hurt hemorrhage
-Laceration - Assault - Gangrene
-Fracture & dislocation -Infection
By body
-Fracture & dislocation
- Bruise
~ -Asphyxia
Paper -Bruise -Homicide -Shock &intemal
weight -Abrasion - Grievous hurt
-Laceration hemorrhage
-Assault - Gangrene
_ -Fracture & dislocation -TnFprtinn
in mu iiuii
,Shfety By edges -All the Grievous hurt -Hemorrhage
Razor -Incised wound -Homicide -Infection
Blade -Abrasion -Suicide -Septic
By pointed corner edge: -Assault pneumonia
- Incised wound -Air embolism
- Scratch abrasion -Fat embolism

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Forensic Medicine ITEM Book

Pin
By blunt irregular edge:
-Abrasion
-Scratch
— -Shock

-Punctured, penetrating
- Infanticide -severe internal
-concealed wound hemorrhage
& perforating wounds
Jitiife By sharp cutting edge: -Hemorrhage
-incised wound -Infection
-Abrasion -Septic
By sharp pointed end pneumonia
-punctured wound -Air embolism
-perforating -Fat embolism
- Penetrating wound -Shock
-Abrasion
By blunt edge:
-Bruise
-Laceration
- Fracture &dislocation
By handle:
-Bruise
-Laceration
- Fracture &
Dislocation
Razor By sharp cutting edge: -Grievous hurt
-Incised wound
-cut throat wound
By blunt edge:
-Abrasion
- Bruise
Dagger By pointed end: -Homicide -Hemorrhage
Penetrating wound - Grievous hurt -Infection
By sharp cutting edge: -Assault -Septic
-Incised wound pneumonia
- Cut throat -Air embolism
-Fat embolism
By handle:
-Abrasion -Shock
-Bruise -Perforation
-Laceration
Dao By pointed end: -Homicide -Hemorrhage
-penetrating wound -Grievous hurt -Infection
-Punctured wound -Septic
-perforating wound pneumonia
By sharp cutting wound -Air embolism
-Incised wound -Fat embolism
- chop wound -Shock
By blunt end: -Perforation
-Fracture & dislocation -Gangrene
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 -laceration
By handle :
-Fracture & dislocation
-laceration
/Rain da By sharp end: Homicide Hemorrhage
-Chop wound hurt Infection
-Abrasion Septic
by pointed end: Imeumonia
-perforating embolism
-penetrating -Fat embolism
-punctured -Shock
-Abrasion -Perforation
By blunt edge: -Gangrene
-Laceration
-Fracture & dislocation
By Handle:
-Fracture & dislocation
-Laceration
Sickle By pointed end: -Homicide
-penetrating wound Domestic use:
-perforating wound -Cutting of cultivated
By sharp serrated edges: crops
-Incised wound
-Lacerated wound
-Cut throat wound
By blunt edges &handle:
-Abrasion
-Bruise
-Laceration
Sword By pointed wound: Domestic: Self defense -Shock
Penetrating wound Homicide -Hemorrhage
By sharp cutting edge: -perforating -Infection
-Incised wound -penetrating wound
-Cut throat
-Chop wound
By blunt edge:
-Abrasion
-Bruise
-Laceration
Electric By pointed end: -Homicidal -Hemorrhage
saw/Saw -Abrasion -Grievous hurt -Infection
-Bruise
-Incised wound
By sharp cutting edge:
-Incised wound
-Bruise
J
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 •Laceration
-Abrasion
Chinese By sharp culling edge: Domestic use Io cut trees 1 lemorrhage
Axe/Axc / -Chop wound Ml
Chapati -Penetrating -Homicide -Gangrene
By blunt edges: - ( inevous hurt
-Bruise
-Laceration
-Fracture & dislocation
with handle:
-Abrasion
-Bruise
-Laceration
-Fracture &dislocation
Shabol / By sharp flattened end: Domestic use : i
Crowbar -Incised wound -Digging of soil
-penetrating wound -Breaking of wall
By blunt end &body:
-Abrasion
-Bruise
-Laceration
-Fracture & dislocation
of bones
Bollom / By pointed end: Domestic use:
Spear -Penetrating wound -Hunting wild animals
-perforating wound -Self defense
By sharp edges:
-Incised wound
-Lacerated wound
By blunt handle:
-Abrasion !
-Bruise
-Laceration
- Fracture &dislocation
xJeta/Kotc By sharp pointed Domestic use:
h projections of weapon: -Fishing
-penetrating -Hunting of snakes,
-perforating wound crocodiles
By blunt handle:
-Fracture &dislocation
-Abrasion
-Bruise
-Laceration

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 Poisons

Poisons Medicolegal Cause of death

Importance
- Suicidal poison in rural - Early cause : Respiratory failure
area. due to asphyxia
t s
- Accidental poisoning - Late cause: Ventricular arrhythmia.
s/iPC occurs in manufacturers,
farmers & their children.
- Homicidal poisoning
doesn’t occur
- Ideal suicidal poison. - Asphyxia
- Accidental poison is also - Cardiac failure.
common.
Opium - Rarely homicidal &
cattle poison.
- Used to steady nerves
for doing some bold.
- Accidental poison - Depression of respiratory center.
yXlcohol - Homicidal poison - Aspiration of vomit.
- Intermittent infections.
- Road poison. Respiratory failure
-Country liquor
Datura - Accidental in children.
- Rarely homicidal.
- Not taken by suicide
- May be accidental. Respiratory failure
- Sometimes road poison.
Cannabis - Used as aphrodisiac & to
strengthen nerve to
commit criminal act.
- Accidental cases occurs - Respiratory failure
from addiction. - Cardiac arrest.
Cocaine - Believed to be an
aphrodisiac.
- Rarely homicidal or
suicidal
- Suicidal mostly. -Circulatory collapse.
Sulphuric - Accidental sometimes. - Oedema of glottis.
'■
acid - Used as abortifacient. -Hypostatic Pneumonia.
- Renal failure.
- Suicidal mostly. -Inhalation of fumes in the larynx,
Nitric acid
- Accidental sometimes. trachea & bronchus causing
- Used as abortifacient. congestion, edema, choking &
suffocation

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 Ingestion mas cause sImh k.
perforation . [Link]
peritonitis
•Most case* arc mik [Link] Inhalation of fumes in the larynx,
A few arc Accidental or trachea A bronchus c aming
Homicidal congestion, edema, choking A
Hydrochloric -Rarely, if it is injected suffocation
acid into the vagina causes •Ingestion may cause shock,
abortion perforation, toxemia, chemical
peritonitis
1 J
-Maybe used as suicidal | -Asphyxia due to
agent Failure of respiration
-may
Accidental poisoning
also occur when
Oedema of glottis
Complications! bronchopneumonia)
taken by a child or if
Carboloc acid taken by mistake for some
other liquid
-May be used as an
abortifacient agent
-
Homicidal use is rare

-Accidental due to -shock

mistaken with Mg -Tachycardia! ventricular
sulphate , Zn sulphate, or fibrillation)
sodium bicarbonate
-Suicidal is rare
-Homicidal poisoning is
Oxalic acid rare due to sour , acrid
taste
- Rarely used as
abortifacient
-Used ti erase the
signature illegally.
-If the victim survives, the -Shock
act may amount to -Severe bum
Vitriolage Grievous hurt. -Toxemia
-Homicide
-Ideal Homicidal poison Acute:
-May be Accidental agent -Dehydration & circulatory collapse
-Potassium &other electrolyte loss
-Hepatic failure
- Toxic encephalopathy
^Arsenic Chronic:
-Hepatic failure
- Damage to the kidneys
-Toxic encephalopathy
-Intercurrent infection
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 •Ac utc poisoning nue J Acute poisoning
•( Inonn pusoninp 1 Gastroenteritis
common j Scptn shock
-Homicidal poisoning is < hromc poisoning
rare Malnutrition
Zcad -Il is not used lot Inicrcurrcnl infections
suicide liver failure
Diachylon pastel lead •Respiratory failure
paste ) or red lead is used -Renal failure
lot abort ion -1 nccphalopathy
•('attic poison
-Suicidal -Metabolic acidosis
-Accidental in case of •Uremia
Salicylic acid
idiosyncrasy patient •Acute circulatory shock
-Respiratory failure
-Usually an accidental -Asphyxia
poison, common victims -Respiratory centre depression
are crawling -Sudden Cardiac arrest
Kerosene
baby,Toddler baby, adult
by drinking by mistake it
- Aspiration Pneumonia

for country liquor

- Suicidal poison is rare
-not used for homicide.
- Accidental sometimes. Respiratory arrest
C olC 02 - Suicidal rare
- Homicide is
uncommon.
-Almost always -CNS depression
Accidental, specially on -Respiratory depression
H2S sewer workers -Cardiac depression
- Chronic exposure may
occur in industries
- Accidental mainly -depression of spinal cord
- Occasionally &medulla
Snake homicidal. -Respiratory paralysis
-Rarely suicidal -Paralysis of nerves
(Cleopatra) -Hypotension
- Accidental more Asphyxia
common
- Homicidal & suicidal is
Nux vomica rare
/strychnine - Sometimes as
abortifacicnt &
aphrodisiacs
Yellow Suicidal or homicidal Peripheral circulatort failure
oleander/Cerhcra - Used in criminal
thevetia abortion

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Forensic Medicine ITEM Book

- Accidental Ventricular fibrillation

- Often suicidal
Aconite - Cattle poison
- Arrow poison
- used as abortifacient.
-Commonly suicidal Early stage:
- Rarely homicidal -Respiratory failure
- Accidental may occu -ventricular fibrillation
Barbiturate Later stage:
-Bronchopneumonia
-Irreversible anoxia with pulmonary
edema
-Accidental in - Renal failure due to acute tubular
idiosyncratic patient necrosis
Paracetamol -Suicidal poison in -Cerebral edema
western countries

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 Opinions

Hanging-
In my opinion death was due to asphyxia as a result of hanging which was antemortem &
suicidal in nature.

Strangulation-
In my opinion death was due to asphyxia as a result of strangulation which was
antemortem & homicidal in nature.

Drowning-
In my opinion death was due to asphyxia as a result of drowning which was
antemortem.

Burn- (3 opinions according to the cause of death)

1. In my opinion death was due to asphyxia as a result of above-mentioned bum
injuries which was antemortem.

2. In my opinion death was due to hypovolemic shock as a result of

above-mentioned
bum injuries which was antemortem.

3. In my opinion death was due to septicemic shock as a result of complication of

above-mentioned bum injuries which was antemortem.

RTA/Raihvay accident-
In my opinion death was due to hemorrhage & shock as a result of above mentioned
injuries which was antemortem and accidental in nature.

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Elec! rocution-
ln my opinion death was due to asphyxia as a result of electrocution which was
antemortem.

Fall from heigh I -

1 . In my opinion death was due to hemorrhage & shock as a result of above-mentioned
injuries which was antemortem and consistent with fall from height.

2. In my opinion death was due to hemorrhage & shock as a result of above-mentioned

injuries which was antemortem and consistent with fall from height.

Poisoning- (OPC)
Z Primary Opinion- Opinion as to the cause of death is kept pending till the receipt
of the chemical analysis report of the viscera.
Second/Final Opinion- Considering autopsy findings & chemical analysis report
of the viscera I am of the opinion that death was due to asphyxia as a result of
ingestion of Organophosphorus compound poison which was antemortem.

Stab/Cut throat wound

1. In my opinion death was due to hemorrhage & shock as a result of above-mentioned
stab wound which was Antemortem & homicidal in nature produced by sharp cutting
& pointed weapon.
2. In my opinion death was due to hemorrhage & shock as a result of above-mentioned
cut throat wound which was Antemortem & homicidal in nature produced by sharp
cutting weapon.

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Bullet luiury-
1. In my opinion death was due to hemorrhage & shock as a result of above mentioned
bullet injury from rifled fire arm which was antemortem & homicidal in nature.
2. In my opinion death was due to hemorrhage & shock as a result of above mentioned
pillet injury from shot gun which was antemortem & homicidal in nature.

Natural Death-
analysis report
Primary Opinion- Opinion is kept pending till the receipt of chemical
)W
of the viscera & histopathological examination report of Hcart/Liver/Brain.

examination, post mortem

Second/Final Opinion- Considering physical
examination, chemical analysis & histopathological report
of the viscera, I am of the
as a result of acute cardiac
opinionthat death was due to coronary insufficiency
Heart cause
failure which was antemortem & natural in
nature.

Negative /Obscure autopsy

pending till the receipt of chemical analysis report
Primary Opinion- Opinion is kept
of the viscera. analysis report
Opinion- Considering the autopsy findings, chemical
Second/Final
to be the cause of death could be given as the body was highly
no definite opinion as
decomposed.

[Link] the cause of death.

NO opinion could be ascertained

Injury Reports
Opinion of injury report
should include-
i) Nature of the
injury

ii) Type ofthe

weapon used
jjj) Age ofthe injury
at the time of
examination^
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Injury 1 & 2 were grievous in nature & caused by heavy sharp cutting weapon & injury
no-3 was simple in nature caused by hard blunt weapon. Age of all injury were about 6
hours at the time of examination.

Rape-
Considering the physical, microbiological & radiological examination findings 1 am
of the opinion that the age of the victim X/Y was 1 5 years old & findings of forceful
sexual intercourse was found on her body.
Considering the physical, microbiological & radiological examination findings I am
of the opinion that the age of the victim X/Y was 15 years old & no findings of
forceful sexual intercourse was found on her body.

All progress takes place outside the comfort zone.

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 OSPE

Community Medicine

Model & Specimen

1. Question:
A. Identify the model
B. Give its identifying points in favour
of
your answer
C Write down its public health
importance.
Answer:
A- Identification: This is the model of
adult anopheles mosquito.

B- Identifying points;
o
[Link] is inclines at an angle to the
o Wings are spotted. surface.

° as long as proboscis.

c.
o Female adult anopheles
mosquito is a
o Community people must be vector for
protected bv
y ddoPtmg
mosquito. various measures against
o °ne
Sh°uld ad°Pt chemoprophylaxis
before into malaria
endemic area.

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2. Question:
A. Identify the model
B. Give its identifying points in favour of your
answer
C. Write down its public health importance.
Answer:
A. Identification: This is a model of egg of
anopheles mosquito.
B. Identifying points:
Fig. Egg of anopheles mosquito
o Eggs are laid in single.
o Boat shaped.
o Provided with lateral floats.
C. Public health importance:
o Anopheles mosquito lays eggs in clean water.
o Breeding place must be eliminated otherwise egg will undergo developmental
stages to become adult and act as vector of malaria parasite.

3. Question:
A. Identify the model
B. Give its identifying points in
favour of your answer
C. Write down its public health
importance.
Answer: Fig. Larva of anopheles mosquito
A. Identification: This is the model
of larva of anopheles mosquito.
B. Identifying points:
o Elongated in shape.
o Rest parallel to the water surface.
o No siphon tube.
o Palmate hairs present on abdominal segment.
C. Public health importance:

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 Anti-lanal measures must be taken to control malaria
If not taken larva will undergo developmental changes to become adult and will
act as a vector for malaria

4. Question:
A Identify the model
B. Give its identifying points in favour of
your answer
C. Write down its public health importance.
Answer:
A. Identification: This is a model of human
trunk showing rashes of chickenpox
B. Identifying point:

• Rashes a superficial
• They are polymorphic,
• Centripetal
_Rashes
,
in distribution
. Fig. Rashes of chickenpox
• are unilocular dew drop appearance

C. Public health importance:

• Chicken pox is an acute infections viral disease

• That may or cause for sporadically, endemically
in a community
• It must be kept under control by early diagnosis
and treatment

• Isolation of the patient with chickenpox for one

we prevent spread to other in the community.

Fig. Rashes of chickenpox

1
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Community Medicine ITEM Book
5. Question:
A. Identify the model
B Give its identifying points in favour of
your answer
C. Write down its public health importance.
Answer:
A. Identification: This is a model of human
face and trunk showing rashes of measles.

B. Identifying points:
•Rashes arc pink coloured pinhead.
•Rashes arc maculopapular in nature.
•Rashes are available in trunk and face Fig. Human face and trunk showing rashes of measles

C. Public health importance:

• Measles is an acute infectious viral disease
• That may occur either sporadic or endemic in nature
• Transmission of measles can be prevented by early diagnosis and isolation
• Measles vaccine is included in EPI schedule
• Complications of measles can be prevented by proper management with Vitamin A
supplementation breastfeeding and complementary feeding

6. Question:
A. Identify the model
B. Give its identifying points in favour of your
answer
C. Write down its public health importance.
Answer:
A. Identification: This is a model of human face
showing koplik's spot
B. Identification points:

Fig. Human face showing koplik's spot

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 • Small white spots like a grain of salt surrounded by an area of redness
smaller than pinhead innumerable in number.
• Spots appear on buccal mucosa membrane inside the cheek opposite
the
second molar tooth one or two days before the rash appear.
• The spot disappears after 3 to 4 days.

Public health importance:

• Kophk s spot appears in patients suffering from
measles in prodromal stage,
• It is pathognomonic for measles.
• MR vaccine is included in EPI program.
• If children arc vaccinated properly measles can
be prevented.

7. Question:
A. Identify the specimen
B. Give its identifying points in favour of your
answer
C. Write down its public health importance.
Answer:
A. Identification: This is a packet containing
oral rehydration salt.

B. Identifying points: As it is labelled.

C. Public health importance: Fig. Packet containing ORS

• Considerable number of lives can be saved by using the ORS
in Bangladesh
when the people suffer from diarrhea) disease.
• It is used in no sign or some sign of dehydration
respectively.
• For prevention and correction of dehydration.

• Severity and mortality can be reduced through proper

management

8. Question:

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 Identih the specimen
B Give its identihmg points in favour ol your answer
C \\ nte down its public health impoitance
\nswer:
\ Identification: It is a specimen ol lubricated
condom made ol latex, one of the spacing
contraceptiv e methods
B. Identification point: as it is labelled.
C. Public health importance:
It is used by men for contraception. Fig Packet containing condom
It is cheap and available everywhere.
Non contraceptive benefits are like prevention of sexually transmitted disease, pelvic
inflammatory disease, can be used in premature ejaculation, balloon catheterization,
as glove for rectal examination and for urinary drainage in urinary incontinence.

9. Question:
A. Identify the specimen
B. Give its identifying points in favour of your answer
C. Write down its public health importance.
Answer:
A. Identification: It is a strip containing combined oral
hormonal contraceptive pill for female.
B. Identifying points:
• It has 21 white hormonal pill and 7 red iron tablets.
Fig. Strip containing combined oral hormonal
• It is composed of ethinyl estradiol and levonorgestrel. contraceptive pill for female
C. Public health importance:
•
It is used by women for contraception.
•
It is used in treatment of dysfunctional uterine
bleeding, endometriosis, dysmenorrhea, and
fibrocystic disease of breast.

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10. Question:
A. Identify the specimen
B Give its identifying points in favour of your
answer
C Write dow n its public health importance.
Answ er:
A. Identification: This is a vial containing tetanus
toxoid v accine.
B. Identifying point: as it is labeled.
C. Public health importance:
• It is used for primary prevention of tetanus, neonatal tetanus
in particular.
• 5 doses are taken by women of reproductive age at interval of
1 month, 6-
month, I year, 1 year.

• It is given intramuscular injection in upper arm left and right side

alternatively.

Short Questions for OSPE

1 . Define [Link] are the types of epidemic?
What are the features of
point source epidemic?

Answer:
Egidem’e:occurrence of a disease, health related states, events or behavior
community clearly in excess of expected occurrence. Based
in a
on past experience
Types:
• Common source epidemic
• Propagated epidemic
• Slow or modem epidemic
Features:
• Sharp rise and sharp fall, with no secondary waves.
• Explosive in nature, there is clustering of cases within a narrow
interval of time.
• All cases develop within one incubation period of disease.
• Has a common on point of exposure.

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 2. What is sample? Name different sampling techniques.
Answer:
Sample: Sample is the representative part of population selected for the study from
whole population.

Types of sampling:
A. Probability sampling:
a. Simple Random Sampling (SRS)
b. Systematic Random Sampling
c. Stratified Sampling
d. Multistage Sampling
e. Cluster Sampling
B) Nom-Probability Sampling:
• Purposive Sampling
• Convenient Sampling
• Quota Sampling
• Accidental sampling
3. What are the measures of dispersion? Calculate the range from the following
data 68 80 60 90 72
Answer:
Measures of dispersion-:
a. Range
b. Mean deviation
c. Standard Deviations (SD)
Range= Highest value - Lowest value = (90 - 60) = 30

4. What are the measures of Central tendency?

find out the mean median and mode of the observations 3 2 8 4 5 3 3
Answer:
Measures of central tendency:
a) Mean
b) Median
c) Mode
Mean (X)= x/n=28/7=4
number), so
If we arrange the observations in ascending order, then- (The series is odd
the formula to find out the median of this series is (n+l)/2 th

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 Median (n + 1 ) 2 th 8/2 4,h value i.e., 3 is the Median of the observation

3
3
3
4
5
8
Median= (n+ 1 )/2 th = 8/2 = 4th value i.e., 3 is the Median of the observation
Mode=3 (Most Frequent value)

5. Define MMR. Mention the important causes of maternal mortality.

Calculate MMR from the following data of an area in a given year.
a. total population 2,00,000
b. number of life birth 1 0,000
c. total number of maternal deaths due to pregnancy and related causes 30]

Answer:
a) MMR= Death of women during pregnancy, delivery or within
42 days of termination
of pregnancy, irrespective of the duration and site of the pregnancy, from any
cause
related to or aggravated by the pregnancy or it management but not from accident
or
incidental causes in an area during a given year per 1000 live births in the same area and
year.
Three important causes of MMR:
• Post-partum hemorrhage (PPH)
• Toxemia of pregnancy
• Obstructed labour.
• Abortion
• Infection (Puerperal Sepsis)

Calculation:
No of maternal death
MMR = X 100
Total no of live birth

= 30X 1000/10000
= 3 per thousand live births.

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6. Give the nutritive value of potato (100 gram) give the energy value of I gram
carbohydrate
Answer:
Nutrients Amount

Protein 1 .6gm

Fat 0.1 gm

Carbohydrate 22.6gm

Mineral 0.6gm

Energy 97k cal

Energy value of 1 gm CHO = 4cal

7. Give the nutritive value of an egg. give the energy value of 1 gram fat. what
nutrients are absent in egg
Answer:
Nutritive value of egg (60gm)

Nutrients Amount
Protein 6gm
Fat 6gm
Calcium 30mgm
Iron 1.5
Energy 70k Cal

Energy value of 1 gm fat= 9 cal

Nutrient absent in egg= Carbohydrate and vitamin C.

8. Give the nutritive value of pulse (lOOgm) give the energy value of 1 gram
protein, give daily requirement
Answer:
Nutritive value of pulse (lOOgm)

Nutrients Amount
Protein 22.3gm
AC
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 Fat 1 -7gm

Calcium 73gm

Iron 2.7gm

Thiamin 0.73gm

Riboflavin 0.39gm

Niacin 3.2mg

Energy 335 Kcal

• Energy value of protein ( 1 gm) =4 cal

• Daily requirement = Igm/kg/day

9. Give the nutritive value of rice 100 gram, give the value of 1 gram
carbohydrate
Answer:
Nutritive value of rice ( lOOgm)

Nutrients Amount

Carbohydrate 78.2gm

Protein 6.8gm

Fat 0.5gm

Minerals 0.6gm

10. Write the stages of demographic cycles.

Draw and level the population pyramid of developing country, give its
important characteristics point.
Answer:
Stages of demographic cycle:
High stationary stage
Early expanding stage
Late expanding stage
Low stationary stages
Declining
Population pyramid of a developing country
Characteristics points:
Broad base

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 Narrow apex

CBR was > °R

n. According to BBS 2003 of Bangladesh, 125 million, a ui a
5/1000 population and total population was
its rating
a. growth rate of population and what is
b. population doubling time
Answer:
a) CBR=25/1000 population
CDR=5/1000 population
Population^ 25 million
GR= CBR-CDR= 25-5/10-2%
Rate: Explosive growth
b) Doubling time: 70/GR
70/2=35 yrs.

morbidity?
12. What are the measures of
What is the incidence rate?
following data of a village in a gw
Calculate the incidence rate front the
of tuberculosis 50
media population 5000 number of new cases
their
Answer:
A) Measurement of morbidity:
1 . for measurement of frequency
I. Incidence rate
II. Prevalence rate
2. for measurement of duration-
Disability
3. for measurement of severity
Case fatality rate
is the number of new cases occurring in a defined population tn a spectai penod
B) IR-lt
of time.
No. of new cases
Incidence= 1000
Population at risk

= 10/thousand/Year

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13. A. \\ hat Iv prevalence rale? Calculate the prevalence rate of leprosy from the
following data of a village in a given year
I. t otal number of populations 50000
II. total number of leprosy cases old plus new 50
B. \\ hat is the relationship between Incidence rate and prevalence rate?
Answer:
1 otal no of cases (new and old)
A) Prevalence rate xlOO
Mid-year population
50
= xlOO
5000
= 0.1%
B) Relation between Incidence Rate and Prevalence Rate
P= I x D (here, 1= Incidence, P= Prevalence, D= Mean Duration)

14. A. What do you mean by disease cycle?

B. Give the importance of incubation period
Answer:
A) Disease cycle: These are the stages through which most of the communicable
diseases passes.
The stages are:
1 -Incubation period
2-Prodromal stage
3-Fastigium stage
4-Defervescence
5-Convalescence

B) Importance of Incubation period:

a. Tracing the source of infection
b. It governs the Period of surveillance
c. Determine the method of Immunization (active or passive)
d. Prognosis of a disease can be determined.
e. Identifying the duration of quarantine

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15. A. XX rite down four differences between Street xirus and fixed xirus
B. Name the zoonotic diseases
Answer:

Street virus Fixed

I. Virus in naturally occurring cases of I . Serial brain to bram passages of

rabies street virus produces fixed virus

2. Pathogenic 2. Non-pathogenic

3. IP —Variable and long ( 1 0-2 1 0 day) 3. Fixed (4-6 day)

4. Forms Negri body. 4. No Negri body is formed

5. It is not used in vaccine preparation. 5. Used in vaccine preparation.

6. It multiplies in extra neural tissues. 6. No longer multiplies in extra neural

। tissue.

B) Zoonotic disease:
1. Bovine tuberculosis 4. Leishmaniasis
2. Rabies 5. Hydatid cyst
6. Yellow fever
3. Plague

16.
A. Define data
B. Classify data
C. What are the methods
of data collection?
may be defined
observation or measurement. Data
Answer; ,

B) Types:
According to source:
1. Primary data
2. Secondary data
3 Tertiary data
According to grouping to characteristics:
Qualitative data -
•Ordinal &
• Nominal
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[Link]\ e data
• Discrete
• ( ontinuous
According to grouping -
• Grouped data
• Ungrouped data
C) Methods of data Collection:
Observation
Asking question I Interviewing
Measurements or examinations.
z Review of document.
z Combination of all.
17.
A. Define IMR
B. Mention the important
C Calculate IMR
causes of IMR
from given data
-total number of populations
-death of infant 28 20000

Answer:^0*3'

• Kwashiorkor. Marasmus
•

C) Infant
dcaUt" 28
Live
Per thousand
like birth in a
birth=500
population=20,000
|MR=J"_fanl death
Total no of live
28 birt? X 1000

X,00°
500
= 56/1000
live birth

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 Community Medicine
ITEM Book
18. In the last census, EPl coverage in a village was
recorded as 1)1 I 75 /<>
Measles 85%. OPV 70%, TT 90%.
How can you present this information?
Answer:

age, among
19. In a rural community, there are 5000 women of reproductive
them, live birth is 2500 in 2019. 30 women died by poisoning,
25 died of

pregnancy related complication, 10 due to post parts Hemorrhage.

Calculate MMR.
25 (From pregnancy related complication) + 10 (from PPH)
Answer: MMR
X 100
2500

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 Procedure station

L Prepare homemade ORS in half Liter water

Personal hygiene \i first. I wash my hands and all of my equipment (glass. jar. spoon)
I lake 2 glasses ot waler
1 hen add one pinch of salt and 1 fist sugar
r the solution
I mpty the glass before leaving
I tomenude saline o hours 3m 3TU3 I b hours dH XHCT WHT 333^ suear
fermentation bacteria grow ^T3I

Related Question:
Indications ot ORS
a Dehy drat ion due to dianluva
b. I\'hydration due to bum
c. Dehydration due to vomiting

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Community Medicine ITEM Book
2. Collect data from the person to be examined to determine BMI:
5TWSJ f^TI
^C«7 ^<7 HF5H)
Steps:
weight (Wl
,£333 height C7^T37i

BMI = Weight in kg Height in nr = 60

(1.65)- = 22.03 kg nr

Interpretation: Nutritional status of this

person is normal.

Related Question:
BMI W73 measurement?
a. Anthropometric measurement.

3. Examine the patient to assess the dehydration status

Steps:
First 4 >1131^^31 i
fa’PTT £3>X* f&C^ I
( c^^?)

Search for dehydration on his

eyes, tongue and by skin pinch
test on his abdomen. Say
Thank you & Salam before
leaving.

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Forensic Medicine
ITEM Book

OSPE

Forensic Medicine

a. Identify the specimen

b. Write down the Medicolegal use of it.
C. Describe the ligature mark in case of
typical hanging.
d. Pressure is needed to cause venous
congestionobstruction.
zSnsvver:

a. This is a light, soft, flexible, blunt, twisted

& elongated weapon made of juite fibre/nilon. So my identification, this is rope.
b. Medicolegal use of rope:
i. Hanging
ii. Strangulation
iii. Drowning
iv. Rape/Bum
C. Ligature mark in case of typical hanging- Oblique, non continuous high up above
the thyroid cartilage.
d. 2 kg.

2.
a. Identify the specimen
b. Mention the injuries caused by blunt part.
C. What is bruise & the age of bruise?

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\n\wer:

C' This is moderately heavy sharp cutting sharp pointed weapon. So, my
identification,
this is kitchen knife.
f. Injuries caused by blunt part.
i. Fracture & dislocation of small joints
ii. Lacerations
g. Infiltration of extravasated blood into the subcutaneous or submucous spaces due
to
rupture of capillary by blunt force.
h. Age of bruise is given below -

Color Change Time Since Injury

Red Immediately/Fresh
Blue Few hours-3 days
Bluish black to brown 4th Day
Greenish 5-6 days
Yellow 7-12 days
Normal 14 days

3.
a. Identify the specimen.
b. What are the injuries caused by it?
c. What do you mean by incised looking wound?
d. Write down its medicolegal importance.

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 i

1 1”* motlcialeh hcflw hard blunt wrapm having a

[Link] lush [Link]' b\ wood

\ Iniuncs x amed by it

i Bruise
it I lucialums
hi ti.u line HI dishu alioti
i\ Incised looking wound
\ Head injury

B. I his is a blunt loice injury characlert/cd by linear

splitting ol tissue without cuessive skin damage. o\ci bony prominence appearing
like incised wound

C. Medicolegal importance
i Bruise
ii Laceration
in Fracture & dislocation

a. Identify the poison.

b Who are the common victim?

C. What are the sign symptoms produce by it?

[Link] are Us complications?

\nswcr:

l. Medium si/ed Glass bottle having a stopper containing blue color oily liquid.
identification, this is kerosene oil
having a characteristic smell. So my

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 h <[Link] I okller hubs
C s » pn^hiwd In kerosene «»il poisoning are

i Continuous crving
ii ( mitinuous coughing
in Respiratory Failure
i\ Kerosene like smell
d. Complications
i Early- Aspiration pneumonia
ii Late- Degenerative changes in the kidney,
liver.

a Identity the specimen

b Mention its fatal dose
c \\ hat are the sign symptoms produce by it?
d Mention the medicolegal importance of it.

\nswer:

a. Amber color glass bottle containing colourless, tasteless, liquid

having a
characteristic kerosene like smell. So my identification, this is Organophosphorus
Compound(OPC).

b. Fatal dose

OPC Fatal Dose

| TEPP 50mg l/M or lOOmg orally.
1 OMPA SOmg l/M or 175mg orally.
1 Parathion KOmg l/M or I75mg orally.
HETP 60mg l/M or 350mg orally.
Malathion & Diazinon Igm orally

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Forensic Medicine ITEM Book
c, S s of Organophosphorus Compound- /SICDGI <C [Link]

i. Salivation viii. Urination

ii. Lacrimation ix. Miosis
iii. Urination X. Bronchospasm

iv. Defecation xi. Lacrimation

V. G1 Disturbance xii. Emesis
vi. Ememsis xiii. Salivation
Diarrhoea

d. Medicolegal Importance: Ideal Suicidal Poison

6. Question: (Safety Razor Blade)

a) Describe the weapon
b) Mention the injuries caused by it
c) Write down criteria of suicidal cut

throat wound
d) What is tentative cut?

Answer:

a. This is light metallic weapon having two

sharp cutting edges and 2 irregular blunt
edge and an irregular gap in the middle
for fixation of razor so my identification
is safety razor blade,
b. Incised wound
Cut throat wound
Scratch wound
c. Criteria:
From left to right in case of right-handed person
Hesitation cut is present
Direction: from upward to downward

•
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 d. These are multiple superficial cut present are the beginning part of the main
wound in case of suicidal wound

7- Question (Datura)
a) Identify the specimen
b) What are its active principles?
c) Mention its total dose
d) W rite down its medicolegal importance

\nswer:

a. Glass bottle containing spherical fruit has mg

multiple spikes on the surface Seeds are odorless
and yellowish brossn hasing multiple depression
and are kidney shape So. my identification is
datura fruit and seeds
b Attis e Principles

• Hyocine
• Hyocinamtne
• f race of atropine
c 1 atal dose |(X). 1 25 crushed seeds
d Medicolegal importance Stupefying agent

K- Question ( Mpin)
a) Identify the specimen
h> W rite doss n its medicolegal importance
V I U hat type of mjury ean |t >
d) Mention the sites of concealed puncture
wound

J. This is light sharp pointing metallic

weapon
so my identification is alpin

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 b. Infanticide
c. Injury:
• Scratch abrasion
• Punctured and perforating wound
d. Sites:

• Anterior fontanelle
• Nasal aperture
• Nape of the neck
• Middle canthus of eye
• Natural orifice

9. Question (Alcohol)
a) Identify the specimen
b) What are the alcoholic beverages?
c) Fatal dose of ethyl alcohol

Answer:

a. The glass bottle containing transparent,

colorless, volatile liquid having a spiritus
odor and burning taste, so my identification
is alcohol

b. Absolute alcohol 99.99%

Rectified spirit 90%
Vodka 60-65%
Rum, liquor 50-60%
Wisky, brandy, gin 40-45%
Pot, sherry 20%
Wine Champaign 10-15%
Beer 2-8%

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 c. 1 50-250 ml consumed in I hour

10. Question
a) What is BMDC?
b) What arc the functions of BMDC".’

c) Who gives registration and who give certificate?

\nswcr:

a. Bangladesh medical and dental council. It is a statutory govt body who

adopt an ethical code for the registered medical practitioner in Bangladesh
b. Function:
• Recognition

• I rasure

• I ntrustment

• Warning notice

• Standardization and modification

• Negotiation

c. Registration BMI)(. Certificate 1)1

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 Some other OSPE question#:(or answers)
colleac lecture#

QurMkm Nt»: 1 1

a) Define death
bl Fjpe of death
death
c) Dificrvnce between somatic and molecular

Question No: 12
of m«hc0 legal
jt Define autopsy What are the [Link]
b> Who can perform it?
lor autopsy"
e, How the viscera ate taken & preserved

Question No: 13

a) Define rigor mortis.

importance of rigor mortis
b) Write down the medico legal
time of death from it ’
c> How can you calculate the

Question No: 14

a) Define hurt & assault.

b) What are the components of grievous
hurt ’
c) Write down the criteria of abrasion

Question No: 15

a) Define somatic death.

of somatic death
b) Write down the medicolegal importance

c) Ilow can you diagnose a brain stem

death ?

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 Qiicslhm Xo: 16

.1* Ik line .uilop>v \\ hul .tic Ihc incisions given ’

hl \\ [Link] is [Link] autopsy ' What arc Ihc causes ol if*
v ) \\ hat .tic ihc conditions in which .in aiilhon/cd medical officer can refuse to hold

auiopsx ’

Quest ion Xu: 17

a) Define putrefaction.
bl \\ hat ate the factors modifying it?
c) \\ hat arc the changes in the eye after death?

Question No: 18

a) Define thanato logy.

b) What are the criminal malpraxis?

c) Differentiate between dying declaration and dying deposition.

Question No: 19

a) What is it?
b) Mention the medicolegal importance of its.
c) Write down the clinical features of arsen icosis.
d) What is the normal value of arsenic in drinking water?
Question No: 20

a) Define disputed paternity.

b) I low can you diagnose paternity?
c) When a child is considered as illegitimate?

Question No: 21

a)What is sudden infant death syndrome?

b) Write down the sign symptoms of still birth.
c) Define battered baby syndrome. Enumerate the factors.

Question No: 22
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 a) What is infanticide?
b) Mention the sign of live birth.
c) Difference between respirated & unrespirated lungs.

Question No: 23

a) Define DNA fingerprint.

b) Information obtain form a drop of blood.

Question No: 24

a) Identity the specimen.

b) Name the source of it.
c) According to the boiling point in relation to it’s which the other product is?
d) Write down its medicolegal importance.

Question No: 25

a) Define antidote.
b) Name the antidote of:
i. Paracetamol
ii. OPC
iii. Opium
iv. Arsenic
v. Atropine

Question No: 26

a) Define weapon.
b) Medicolegal classification of weapon.
c) Mention five grevious hurt.

Question No: 27

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 a) Define rigor mortis.
b) Write down the medico legal importance of rigor mortis.
c) How can \ou calculate the time of death from it?

Question No: 28

a) Define hurt & assault.

b) \\ hat are the components of grie\
ous hurt?
c) \\ rite dow n the criteria of abrasion.

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 Color Plate

Community Medicine
\dult Culex mosquito
A. Identification: This is the model of adult culcx mosquito.
B. Identifying points:
• When at rest, it lies parallel to the
surface with a hunchback position.
• Wings are not spotted.

• Palpi are shorter than proboscis in

females.

C. Public health importance:

Female culex mosquito is the vector for filaria and viral encephalitis
encephalitis
Mosquito control measures must be taken to protect filariasis and

Egg of culcx mosquito

A. Identification: This is a model of egg of
culex mosquito

B. Identifying points:
• Eggs are laid in groups or clusters

• Has no lateral floats

C. Public health importance:
. Culcx mosquito lay eggs
on the surface of

>68
dirty or polluted water

encephalitis
-- -
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I .11 \ .1 III <11 Ic X IIIOMpiitO
\ Identification: litis is « model of larva
B. Idcntlh lay points
• l longatcd in shape
• Remains suspended with head
downwards making an angle to the
surface siphon lube is present
• Palmate hairs absent in abdominal
segments

C. Public health importance

• Anti-larval measures must be taken to control filariasis and encephalitis
• If not taken lava will undergo developmental changes to become adult and will
act as a vector for filaria and viral encephalitis
I HU of louse (Nils)
A. Identification: This is a model of egg of
louse
B. Identifying points
• Laid in single or groups
• Eggs are white over body attached with hair
pointed at one end the other end is truncated
and pitted.
C. Public health importance
• If control measures arc not taken by maintaining personal
hygiene or by using
insecticides eggs will develop into larva with sucks blood
• Disease like pediculosis typhus relapsing fever etc. arc transmitted by louse

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Community Medicine ITEM Book
Incinerator
\ Identification: This is a model of incinerator
B. Identification points:

• It is rectangular concrete chamber hav mg two

compartments being separated by a porous
partition.

• The lower one is for placing fuel for burning at

the top there is a rectangular chimney for
escape of smokes or fumes.

Public health importance:

• This is one method of refuse disposal.
Hospital refuses are disposed by this method to kill all the microorganisms
present.

>quatting plate of water seal latrine

A. Identification: This is a model of squatting
plate of water seal latrine with trap made of
plastic.

B. Identification points:

• It has a plastic slab having footrest.

• It has a pen for reception of night soil.
• Beneath the pen there is a water trap

C. Public health importance:

• It is most suitable for proper disposal of human excreta in rural area

• Foul odor cannot escape
• Insects and rodents cannot enter into the drainage
• If properly used Feco-oral transmission of diseases can be prevented

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Patch ol diphtheria
A. Identification: This is a model of human lace
showing patches of diphtheria in the oral
cav ity.

B. Identifying points:

• Grayish white membrane is present over

the tonsils.
• Clinically it is firmly adherent to the
underlying mucous membrane and when
try to remove bleeding occurs.
C. Public health importance:

• It is found in patients suffering from diphtheria.

• Diphtheria is an acute infectious disease which may occur in endemic, sporadic,
epidemic in a country.
• Early diagnosis and treatment of the disease prevents complication and isolation
of the patient for two to four weeks to prevent spread.
• The disease is included among the EPI disease and if the children are
vaccinated properly, it can be prevented.

Cu- 1 3X0 \
Identification: This is a specimen of copper T 380A with
applicator which is one of the spacing methods of
contraception.
A. Identifying points:

• This is T-shaped and wrapped with copper

• At the tail it has a long nylon thread

• It has an applicator to insert the device into uterine

cavity.

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Community Medicine ITEMt-k
1' I’mHu h» alth tmpmt an* a

It ««<w of |l < M anti an t fit's lis« «|m* inj ox th«*l id tontr i« rpTion
*
b I m>I hw women who have al IcnM o**C lit in|f thlM
* Il gOs * *<MlU4t«'|MhH> 1.4 |O)raf*
*1 < lx ap ami atailahk

|’< nt .th nt
.
% at t lilt

A hhnlifh aliuii Ihisis s ial oMitjininp pentavalent

v a* vine
H Idt nlilh ahmi point* \* it i> labeled
< . Public health importance:
• It I* pfophv laetn. vaccine against
' diseases such as

diphtheria pertussis tetanus, hepatitis B.

hacmophiles intluen/ae tv pc h

• This vaccine is shifted al the ape of 6 weeks 3

dose* are given al 4 weeks interval

Safdv kit
Identification: It is a satetv kit

( (imposition:
a I.'mhihtal tord clump
h Lmhiht al cord cutter
c Plastic sheet
d Thread
c Cotton
f Soap
I w: for sale delivery

Am M»dird Set um*1

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 communitv meaicme
ITEM Book
( .1 on III ( h:ii • |M”
Idcntillcntion: h '
Use:
a I o identify high-risk chikhcn.
making.
b. Planning & policy
c. Heath education for mother.
Upper line:
50"' percentile of the boys
Middle line:
3rd percentile ol the girls
Lower line:
60% of 50"’ percentile

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Community Medicine ITEM took

C1WCM4 «»•’ 'jfM

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I u \ meter

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 Community Medicine
ITEM Book
Mumps
Identification: It is mumps baby.
Show ing swelling of both parotid,
submandibular and sublingual
gland.
Complications:
a. Orchitis
b. Ovaritis
c. Pancreatitis

Measles
Identification: It is a measles baby.
Maculo-papular rash, Koplik's spot.
Complication:
a. Diarrhoea
b. Pneumonia
c. Otitis media

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Anthrax
Identification: Black eschar.
Agent: Bacillus anthracis

BCG \ accinc
Site: Upper and outer part of left arm.
Route: Intra dermal.

MR Vaccine
Site: Antero-lateral part of mid-thigh.
Dose: 0.5 ml.
Time: At the end of 9th and 15th month.

:
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Community Medicine
ITEM Book
Specimen of Rickets bain
Cause: Deficiency of vitamin D.

X ial containing injectable contraceptive

Dose: 3 months interval.
Side effects:
a. Ectopic pregnancy.
b. Bleeding.
c. Abdominal pain.

Sand Ih
Identification: It is a sand fly.
Egg: Oval or torpedo shape.
Lana: Caterpillar like.
Pupa: Convex dorsally.
\dult: Smaller than mosquito, hairy fly.
Disease transmits:
a. Kala-azar
b. Sand fly fever
c. Oriental sore

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House fix
Identification: Il is a house lly.
I pg Glistening white in colour.
Larva while, segmented
Pupa Dark brown
Adult: Head bear pair of antenna.
Disease transmits:
a typhoid
b ( holera
c. Dysentery

Syphilis b;ihv
Identification:
a. Saddle nose
b. High arch palate
c. Huchinson’s incisor
d. Mulbery molar
Agent: Treponema pallidum

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Community Medicine ITEM Book
Itch mite
Identification point:
I I he body is rounded above and
flattened below
2 It has two pairs of legs in front, two
pairs behind
1 Ihe body is covered with short
bristles.

\erles Mosquito
Identification points
I . White stripes on black body
2. Black and while band in their legs.
3. The body lies low and parallel to the
ground.

Rat fleas
Identification points
I It has no wings.
2 onical shaped head attached to
(

thorax without a neck.

; The mouth projects downwards from

the head.

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( oihiiiou bed lint’s 1
Identification points
I . Il has no w ings.
2. Bods has 3 parts; among them abdomen is largest.
I he head pointed forward has one pair of antenna.

Head louse
Identification points:
I II has no wings
1
I he [Link] is pointed lorwaid ha\ mg 5
|<»inlcd antennae

3 I horax has 3 pan cd legs.

I ii bercii In i Dru^:
Identification: \nii lubeiculat drug
First line drugs:
Isoniazid
Rifampiein
1 thambuiol
Pyrazinamide

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Community Medicine ITEM B..k
Open case: Patient with at least one initial sputum smears positive for AFB is called an
open case of TB
Closed case: Patient with at least two negative
smears but tuberculosis suggestive svmptoms
and \ray are called closed case
Open cases .ire more dangerous because open
case patients are infectious to others

( Ira I polio v actino

Identification: ( >ral polio vaccine
I ype: live attenuated
Dose schedule: 3 doses (h . in and
14’ week I
Route of administration < Irai

\ ial ot \| R y atone

Identification: \ ial ot MR vaccine

Dose schedule: 2 doses (after completion ot month and I 5'

month)

site: outer portion ot right mid-thigh

Route of administration Subcutaneous

MR vyi in^v
Identification MR syringe

Parts:
Barrel
Plunge
Barrel flange
Plunge flange
J Seal

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Pulse
Identification: Pulse
Name of essential amino acids:
Phenylalanine
Valine
Threonine
Tryptophane
Isoleucinc
Methionine
Leucine
V Lysine

\ itaniiu \ capsule
Identification: Vitamin A capsule
Name of water-soluble vitamin: B complex, C
Name of fat-soluble vitamin: Vitamin A, D, E, K
Prevention of night blindness:
II MR
I Icalth education
Administration of vitamin A capsule
Intake of vitamin A rich foods
Reducing risk factors

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Community Medicine ITEM Book

Fig: Different Types of vaccine

If opportunity doesn’t knock, build a door

yourself.

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 Color Plate

Forensic Medicine

I. Sulphuric Void
a) Glass boule containing colourless, odorless,
non-fuming oily liquid, hygroscopic. So. my
identification is sulphuric acid.
b) Fatal dose: 5-20 ml
c) Medicolegal Importance:

• Vitriolage
• Suicidal:
• Rarely homicidal and accidental
d) Throwing of sulphuric acid on another

individual is called \ itriolagc

2. Arsenic
a) White crystalline powder, makes a gritty sound
when shaking, tasteless, odour, 3 & 4 times
heavier than water, so this is Arsenic.
b) 1-2 gm (Arsenic tri oxide)
c) ideal homicidal poison:
• Tasteless, colorless

• Easily mixed with food and drink

• Symptoms mimics natural disease like
cholera

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3. Stomach \> ash tube

Hus is a soli lle\ible non collapsing rubber lube I Smeter length, km diameter having
a funnel, rubber lube, suction bulb, mouth gag Ac 2 openings- one central & one lateral
So. im identification this is a stomach wash tube

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 Gastric lavage

Removal of.

• Unabsorbed nonvolatile poison

• Removal of narcotic poison
• Stupefying poison
• Inebriant poison
• Vegetable poison
• Metallic poison
• Carbolic acid poison
b) Parts:

• Upper end: funnel

• Lower end
• Rubber tube
• Mouth gag
• Hand pump or suction bulb
4. Dao
a. It is moderately heavy, sharp cutting,
sharp pointed weapon called dao.
b. It has 2 parts
i. Weapon proper: It has 2 surfaces,
one sharp border & another blunt
edge.
ii. Handle: In which the weapon •

proper attached.
c. Injury Caused by it- Chop wound,
Laceration, Abrasion.

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5. Dagger
a. The supplied weapon is a dagger.
b. It is a moderately heavy sharp cutting metallic weapon with Iwo sharp edges ol
a handle.
C. Wounds: punctured, penetrating, perforating, laceration, incised wound.

6. Carbolic Acid

a. The supplied specimen is carbolic acid. Fatal dose:

1-2 gm.

b. Properties: It is colourless, prismatic needle-

shaped crystals, turns pink on exposure to air, have
a burning sweetish taste and has a characteristic
carbolic smell.

c. Mode of action: It has both local & remote action.

• Local: Act as a corrosive in concentrated
form.
• Remote: Act as a narcotic poisoning.
d. Carboluria: after carbolic acid poisoning urine is
suppressed or scanty. Urine may be normal in

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 colour 01 greenish at lust but becomes daik 01 olive giccn on cxposinc to the ait
t his sxmptom is known as caibohina
7. Cannabis Indica
a. 1 he supplied specimen is a reagent bottle
containing seeds A. plant extiacts ol
cannabis indica
b McdicolcgalK it is dclniani poison

c. Active principle: Primarv active pnnciplc-

tctia hvdrocannabinols Sccondaiv active

pnnciplc- canabmol (inert) A. canabidol

(mcit)

d Running amok: 11 a psvchic disturbance in

chiomc uscis ol cannabis indica marked b\

.i period ol dcpiession followed bv violent
attempts to kill people

Rifle, Handgun, and Shotgun Bores

Rifle or Handgun Barrel
The bore of a rifle or handgun is
grooved which puts a spiral spin
on the bullet for greater accuracy

lands. The
ridges of metal
between the Shotgun
grooves in a The bore of the shotgun barrel is
rifled bore smooth because nflmg would
spread the shot pattern too soon

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Forensic Medicine ITEM flock
X. Rifling
.1 1 he supplied weapon is rilling
h Rilling parallel, iw isied spinal grooving on the inner [Link] e ol barrel ol a
lireann Iron, bicach Io muzzle is called tilling
c. I nit x and exit wound by bullel
Traits Entry wound Exit wound

Size Smaller than Ihe diameter of Larger than the bullel

Ihe bullel
Shape Circular or oval usually Stellate-like
Edges Inverted Everted
Bleeding Less More
Abrasion collar Present Absent

9. Female Pelvis
a. The supplied sample is female pelvis
b. Difference between male and female pelvis:

Traits Male Female

i) General pelvic shape Deep funnel Flat bowl

ii) Subpubic arch Acute Obtuse

ii) Obturator foramen Oval Triangular

iv) Sciatic notch Acute Obtuse

v) Sacrum Long and curved Short and flat

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 C*r*»*atlo»

10. Sickle
The supplied sample ts a moderately
*
h It hit T
heavy, sharp cutting pointed
weapon

I. Weapon proper Made of metal. (It has

2 surfaces’ 2 edges & 1 pointed
end.
II Handle: Made of wood.

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Forensic Medicine ITEM Book

11. Chopper/Chapati
a. The supplied sample is heavy sharp cutting
weapon.
b. It has 2 parts
i. Weapon Proper (It has 2 surfaces, 4
edges, 1 pointed tip)
ii. Handle (Made of iron)

12. Revolver
a. The supplied sample is a firearm having revolv ing chamber So it is a rev olv er

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14 Hulld

a I he supplied sample I* a build

IS. S*«h slick

a. The supplied sample is an abortion stiek.

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 Forensic Medicine
ITEM Boole
17.

a. Medium sized glass boule

having a stopper containing cl«r. yeliowsh.
heavy
liquid with a peculiar choking odor.
So. this is a nitric acid.
18. Oxalic acid
a. Medium sized glass bottle having a
stopper containing white prismatic needle
like crystals.

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iv. Lead

a. Lead Carbonate: This supplied sample is a (small/

medium sized) glass jar/ bottle containing steel grey
coloured powder. So this is lead carbonate.

b. Lead Tetraoxide: This supplied sample is a (small/

medium sized) glass jar/ bottle containing red
coloured powder. So this is lead tetraoxide.

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Forensic Medicine
ITEM Book
20. Copper sulphate
a. Medium sized glass boule having a
stopper
containing blue color crystalline salt. So,
this is copper sulphate.

21. Capsicum seeds

a. Small sized plastic bottle having a cap
containing multiple large, thick, kidney
shaped, dark or yellowish brown, double edged
convexo-concave surface,
odourless seeds. So, these are capsicum seeds, odourless seeds. So,
these arc
capsicum seeds.

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 Box Questions

Community Medicine
g^^ 57
c^ 3% w 3^ 33 ©^
wcv, c^h 3^ ^3^ ^r 3R%3 c^ 3^3 c^, 3fc*r
w ^r ^3313 3x^3 mm 33 3^31 m,< 43X3 <^- cww
f^f33W wfkcy uNoo 3lflG<W I

4$ ^Tl^X3 33^^31 4GellGWll vX3 3lf$X3 63^31 ^IG^, C33 ^G^ 4^

^3f3 f3GSX^ <MWI 3333 3G3^3 G^G^ G<t>l3 3G^ C333 33 W ^131 ^T, ^1^*1
QjlfliWl ^I^G^ IG^fi >llG^ C^J^ I 0®<p/i/*y/ I)

What is behavioral science?

What is behavior? What are the types of behavior?
Define community medicine? Difference between community & clinical
science?
Mention the error of perception?
What is BMI? Classify the nutritional status according to BMI.
Distinguish between marasmus & kwashiorkor.
Q What are the manifestations of Vit-A disorder? How will you prevent it?
$ What is hallucination & illusion?
Q What do you mean by comprehensive health care?
Q \\ hai is personality? What are the types & components of personality?
0 Define family. What are the types?
G Define learning. What arc the factors influencing learning? Method of learning.
Q What is monitoring & surveillance?
What are the stages of development of personality?
What are the contents of health education?
P What do you mean by risk approach?
/9 Classify the media of health education? Name some mass media.
What arc the indicators of health?
Identify the aims & objectives of health education.

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 G What arc the pi i net plcs of health education?
G Define communication. What arc the harriers of communication?
JI Define health according to Wl l( )
G Classih arthropods. Mode ol iransmission of diseases by arthropods
G Culex is the most common nuiscence mosquitoes & ae4dcs arc the tiger
mosquitoes- Explain.
G Define elimination & eradication with example.
.G Sandflics arc painful troublesome nocturnal pests- Explain.
G Describe in brief the principles of arthropod control. What do you mean by
integrated approach?
.G Enlist the determinants of health.
G What are the functions of a physician?
<G How can you differentiate the pathogenic phase from pre-pathogcnic
phase?
JI What are the anti-larval measures for mosquito control?
JI What are the different diseases caused by mosquito? Differentiate between
mosquito & sand fly.
JI What is blocked flea? Why partial blocked flea is more dangerous?
JI What are the different methods of data/qualitative data pre4sentation?
JI What is risk factor? Classify it.
JI Define & classify agent.
JI What is society & community?
JB What are the criteria of a normally distributed curve?
G Tell me the procedure of calculation of median odd number.
G Enumerate the different types of sampling technique.
Q Classify the water borne disease.
9 Difference between polluted & contaminated water.
9 Mention the criteria of safe & wholesome water.
What are the bacteriological standards of safe water recommended by WHO?
What is community treatment?
What is community diagnosis?
9 Describe the purification of water on large/small scale.

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 Q Iku'nbc the nKthod nt estimation of chlorine demand of water
G Wh.o is meant by break point chlorination ’
G How waler can he purified in a H<hhI ullecled area *
G How will you purity waler al home ’
G What is iceberg phenomenon’’
Q Mention the difierent dimension of health
Q How air pollution ol Dhaka city can be minimized ’

Q What are the indications of air pollution’’ Preventive measures of it?

Q What are the important properties of noise? Adverse effects if noise’’

Mention the elTeets of noise on health. Prevention of noise?

Q What are the criteria of healthful housing?
G Mention the effects of poor housing on health. What are the criteria for good
lighting?
Q Mention the difference between shallow well & deep well.
G W hat is the concept of control of a disease?
G What are the different theories of disease causation?
Q Vital layer is the heart of slow- sand filter- Explain.

G Define refuse. What are the sources of refuse?

G What are the hazards of improper excreta disposal? How diseases can be
transmitted by excreta?
Q W'hat is sanitation barrier? Mention the different parts of water seal latrine.
I G What are the sources of radiation exposure? How X-ray technician can be
protected from radiation hazard? How radiation hazard can be prevented by
radiology department?
Q W hat do you mean by communicable & non communicable disease?
P W'hat do you mean by health spectrum?
“P A considerable amount of water purification takes place by storage- Explain.
& Coliform organism is chosen as indicator of fecal contamination of water-
Explain.
P Controlled tipping is the most satisfactory method of refuse disposal- Explain.
P Explain the importance of ‘trap’ in sanitary latrine.

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 I low will you sterilized or disinfect thermometer, utensils, feces, urine, sputum
& room'? How can you choose an ideal disinfect to kill microorganisms'?
p fell me what arc the level of prevention with their interpretation in short'?
J® Classify sterilizing agent. What do you know about pasteurization'?
Classify immunity. What arc the elements of herd immunity?"’
What are the differences between active & passive immunity?
/9 Define head immunity. What is herd structure?
What is cold chain? What are the components of cold chain?
State the immunizing schedule under EPI program.
Classify immunizing agent with examples.
What arc the criteria of an ideal health indicator?
& What is the importance of health indicator?
All vaccines are immunizing agent but all immunizing agent are not vaccine-
Examplc.
& Explain positive health & PQLI.
& What are the changing concepts of public health?
& How an individual will response to an antigen when introduced fir the first
time? What will be the result of subsequent exposure?
A If measles vaccine is given to a child before 9 months what will happen?
What is NID? How many NID tool place in Bangladesh?
£ State the calorie requirements of a normal women, pregnant women & lactating
mother.
& Classify food with examples. Mention the supplementary action of protein with
example.
What is meant by reference protein? Biologically complete protein? Essential
amino acid?
Classify food borne diseases.
What is food adulteration, fortification & additives? Give examples.
What are the dietary fibers? State the advantages of dietary fibers.
What is essential fatty acid? State the functions. ~

^What arc the common nutritional problems in BD? What is the micro & macro
nutrients?

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 Q Classify PFM What are the preventive measures?
P Lead time is the advantage gained by screening- Explain.
Q What is incidence & prevalence'.’ 1 low will you calculate it?
P Enumerate the steps in case control study? Advantages of case control study?
P What are the sources of thiamine? What is its deficiency disorder?
P What are the roles of Vit-K in blood coagulation?
P Explain epidemiological triad.
<.P What do you mean by NRR= 1 ? What is its importance?
.P What advice should be given to a mother during ante natal visit?
-P Enlist the complication that may arise during the post-natal period?
I <P Define epidemiology. What are the basic components of epidemiology?
' cP What is lathyrism? What is the cause & what are the preventive measures?
‘P Treatment of a disease that prevents death but does not produce recovery may
increases the prevalence of disease- Explain.
Ji What arc the manifestations of IDD? How will you prevent IDD?
cP Although coconut oil is vegetable oil but it is not beneficial to health- Explain.
cP Linolenic acid is the most essential fatty acid- Explain.
cP Explain the effect of HDL & LDL?
cP Define source & reservoir with example.
cP What do you mean by case & carrier?
cP Define incubation period? Tell me its importance. Why incubation period of a
disease is variable?
cP What are the risk factors for hypertension? Hypertension/Diabetes is an iceberg
disease- Explain.
<P What are the types of epidemics with example?
cP What is cohort? What arc the indications of cohort study? "

<P Differentiate between cohort & case control study. “

cP Why cross-sectional study is the most common form in research?

cP Prevalence may be compared with a photograph whereas incidence with a film-
Explain.
cP Enumerate the Jones criteria for diagnosis of rheumatic fever? Prevention of
RF?

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Community Medicine ITEM Book
* transmission
(he
Enlist types
of plague.
A A relative risk of 1 indicates no association- Explain.
How epidemic disease differs from endemic disease?
Ji Classify STDs according to viral origin. "

Ji Illustrate the clinical features of rashes of chicken pox.

Ji Complications of chicken pox? Prevention of it?
Ji Mention the complications of measles.
Ji Mention the spread of AIDS. Who are the high-risk groups?
Ji Mention the objectives of multi-drug chemotherapy of leprosy?
Ji Carriers are more dangerous than cases- justify.
Ji How isolation differs from quarantine?
Ji Classify leprosy. Mention the cardinal features of leprosy.
$ Mention the types of rabies vaccine. What factors should be considered before
starting anti-rabies treatment?
Ji What intervention strategies are to be taken to control STDs?
Ji Classify ARI according to WHO case management.
Ji Mention the cardinal features of ver}' severe pneumonia in 2 years old children.
Ji What are the approaches of hookworm control & prevention?
Ji What is DOTS? What are the objectives of DOTS?
Ji What is congenital rubella syndrome?
Ji Mention the clinical surveillance of leprosy.
Ji What are the steps for investigation of an epidemic?
Ji Mention the tools of measurement in epidemiology with example.
Ji Classify cancer according to ranking order by site.
Ji State the danger signals of cancer.
Ji Illustrate the consequences of Hepatitis-B? Differentiate between Hepatitis-A &
C?
Ji What are the modes of transmission & complications of mumps?
Ji Why tetanus can’t be eradicated?
Ji Why poliomyelitis is an eradicable disease? Explain.
Ji How can you prevent an industrial accident?

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| ® What is offensive trades? Tell me some examples.
® Ankylostomiasis can cause pneumonia- Explain.
® Stress may bring out diabetes- Explain.
Leprosy is called a social disease- Explain.
How kala-azar is endemic in some areas of BD- Explain.
What are the causes of resurgence of malaria in BD?
Enumerate pre/post exposure prophylaxis of rabies.
How Ca cervix can be prevented?
Classify accident.
Diabetes is a raising public health problem in BD- Explain.
DOTS has been recognized as the best cost effective approach to control
tuberculosis?
AFP surveillance is conducted to eradicate poliomyelitis- Explain.
Mention the duties of MO of school health program.
Mention the types & importance of school desk. Explain the importance of
minus desk. How can you prevent & manage swine flu?
How STD can be controlled? How AIDS can be prevented?
How diphtheria can be controlled?
How will you assess different stages of dehydration? What treatment & advice
you will give a child with normal dehydration?
& Enumerate the uses & objectives of epidemiology.
What are the types of epidemiological studies?
What are the types of leishmeniasis with their causative agent?
£ Mention the control measures of leishmeniasis.
Illustrate the natural history of stroke.
& Contact tracing is the best method of prevention of infection of STD- Explain.
How population strategy can prevent CHD in developing country?
& Tell me the appropriate & effective measures to reduce the incidence of RTA.
Classify IUD. State the complications of IUD.
State the mechanism of IUD.
Define & classify disaster with examples. What are the effect of disasters?
Discuss disaster preparedness.

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 Community Medicine ITEM Book
Q Discuss the merits & demerits of safe period.

.<8 Mention the hormonal contraceptive method' M/A of OC I’.

Ji State the difference between MR & abortion.
Q How can you prevent an industrial accident?
Ji What is arsenicosis? Describe the features of arsenicosis. Hou u ill you manage
arsenicosis?
Ji Rabies is a zoonotic disease- Explain.
.Q Distinguish between street & fixed virus.

Ji What steps should you suggest for the control of cholera in a village?
Define demography. What is the demographic process?
Ji Discuss demographic transition? Define & classify census.
Ji What is the position of Bangladesh in demographic transition?
Ji How to screen out open & closed cases of pulmonary TB?
° How you will investigate an outbreak of dengue in a locality?
Ji What are the links between TB & AIDS?
Ji What will be our target to reach the next stage? How zero population can be
achieved? What is population exploitation?
Ji Who are the eligible couple & who are the target couple? What is couple
protection rate?
Ji What precaution should be taken during intra natal care?
Enlist the stages of maternity cycle? Enumerate the determinants of growth &
development?
Ji Who are the high risk baby & high risk mother?
Ji Mother & child one unit- Explain.
Ji What are the warning signs of pregnancy? What is rooming in & weaning?
Ji Classify contraceptive method.
Ji Classify barrier method of contraceptive.
Ji State the contraindication & timing of insertion of IUD.
Ji Equitable distribution is essential part of PHC- Explain.
Ji Community participation at all level- Explain.
Ji Who are the ideal candidates for IUD?
Ji What is safe period? What is emergency contraceptive pill?

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 ITEM Book Forensic Medicine

Box Questions

Forensic Medicine
WK ^im^K
C9^ 2^ 5JT»i>l<!fi> ^KG^, $K K wwsr
wK d/^T C^K G^ ^CHl^ G^ , KW Wf^
W^T WIGS’, Wf^PK WG^fGW WT G^Pf ^fTW W, CPWf G^- C^G^H
f^l<i^ I

w&tk whg^t »iw ’flta d*w , ww w ok ^k fax

yMfa f^fG^ w ’Md^ W $dW fl»^T C^H C^H W ^PU W G^
^mi^i c^i kk ^r i)

Define Abortion Mcdico-legally.

Classify abortion medico-legally.
How circle of wills is formed?
Name the common regional head injury.
Name the common regional head injury of
head/neck/chest/abdomen/extremities.
Tell me the medicolegal importance of extradural subdural & subarachnoid
hemorrhage.
J? What are the injuries of front seat passengers?
What is crush syndrome?
What is alcoholic anonymous?
What is solvent abuse?
Q What are the causes of death due to abortion?
G What are the ways procuring criminal abortion?
Q What arc the signs of recent delivery?
Q What are the signs of remote delivery?
_Q What is lochia? Tell the medicolegal importance of it.

G Define incest. What is the medicolegal importance of it?

.G Define rape.
-G Tell me the procedure of rape victim examination.

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 G> Tell me the opinion of positive forceful sex.
“
What is voyeurism?
Mention the findings of habitual lesbian.
.Q Tell me the duties of a doctor during examination of rape victim examination i
Q What are the probable signs of rape?

J3 Why spermatozoa does not found in recent rape victim examination?

jQ Mention the characteristic findings in torture victims.

Define syncope. What are the causes of syncope?

.Q Mention the causes of natural abortion.

Tell the indications of therapeutic abortion.

jQ Define Justifiable or therapeutic abortion.

Tell the methods for Justifiable abortion.

Mention the procedure used as local violence in criminal abortion.
.Q Mention some abortifacient drugs use in criminal abortion.

& Mention the methods of criminal abortion.

& Tell about consent for abortion.
What are the criteria of MTP Act?
.Q What is Hasse’s Rule?

Tell the Advantages of Therapeutic Abortion.

.Q Tell About Abortion Stick.
.Q MI of Abortion.

J9 Complications of criminal abortion.

jQ Tell the causes of death due to criminal abortion.

J® Mentions the Poisonous compound of Arsenic.

Tell the use of Arsenic.
.Q Mention the medico-legal use of arsenic.
.Q Tell the domestic use of Arsenic.

& Classify with example of inorganic arsenic. Which one is more toxic?
& Tell the synonyms of Arsenic.
& Fatal dose & fatal period of Arsenic.
' £ Tell the normal value of Arsenic in case of daily intake, food value & drinking
i water.
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 ® I ell the *oukc» ol \wnk
G Which one ’* ^ikhIh (mivilv is more Wilk of Water’
1
Whs Wm'iiic Ihwls on Mater
0 I ell the ukhIc of action ol Arsenti
0 I hough the s|HMlic gravity ol Arsenti is more (han witter
but it floats in water. W h\ ’
0 W hat an the causes of i hiomc Arsenti poisoning '
0 S S ot acute \rscnic Poisoning
0 Mention the I uMtment plan lot Arsenic poisoning
0 Tell the procedure of Arsenu lest
0 Mention the Kits test done toi Arsenic detection
0 fell the tests done for Arsenic detection
Q I ell the disadi antages of Arsenic as homicidal poison.

0 Tell the advantages A disadvantages ol Arsenic as homicidal poison

Q W hat is \ldnch mee’shne?
0 W hat is Ram drop pigmentation'.’ Mentions it s site.
5 Mention the stages of Chronic Arsenic Poisoning.
© Define Arsenicosis.
Active principle Alkaloids ol C annabis.
Tell about Cannabis plant.
© W hich parts of the plants are poisonous?
© ( lassify Cannabis plant.
"
6-| atal dose & Fatal period of Barbiturates.
© Classify Barbiturates.
© W hat ate the causes of death due to Arsenic poisoning?
© W’hat is running amok?
“> Tell the S S ol acute Cannabis poisoning.
i © What is Hashish insanity?
© What is ganja?
_
’

J 9 Mentions the forms of Cannabis.

0 I atal dose A I atal peiiod ot ( aibohc acid.
© What are the derivatives ol phenol?

30
Axi'i Medical School

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.•“Mention physical properties of phenol.
A Ml of Cannabis.
A Fatal dose & period of C annabis?
A What is Ganja psychosis?~
MI of Oxalic Acid.
•fl Use of Oxalic Acid.
~
A MI of Carbolic acid.
Tell the Treatment of carbolic acid poisoning.

• Mention the use of Carbolic acid.

A What is Carbolism & Carboluria?
fl What are war gases? Tell the example of chemical &
Biological warfare.
fl Tell the PM findings of Co-poisoning.
~
fl Sources of CO & CO2.
fl Tell the mode of action of CO.
fl Mention the properties of CO & CO2.
fl Tell some irrespirable gases.
fl Mention two special findings in chronic Cocaine poisoning.
What is Body packer & stupor syndrome?
fl Define Cocaine bug?
fl Route of administration of Cocaine.
fl What are the properties of Cocaine?
fl Tell the example of Tear gas.
fl Describe the datura flower, fruit & seeds.
fl What is Alkaloid?
fl Name the alkaloids of Datura.
fl Classify datura plant.
fl Define stupefying agent with example.
fl Define dcliriant with example.
fl How many seeds contain a average size fruits?
fl Which parts of the datura plant poisonous?
fl Fatal dose & Fatal period of Datura.

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 How many Datura seeds required to create stupefying '
JI Tell the S/S of Datura poisoning.
JI What is Ludicrous movement?
JI Tell the Differences of Datura seeds & Capsicum seeds.
MI of Datura.
JI Tell the Mydriatic test in Datura poisoning.
JI Tell the Treatment plan of Datura poisoning.
JI Mention the Antidote of Datura poisoning.
JI Morton’s sign of Datura poisoning.
JI Define Forensic psychiatry.
JI What is Botulism?
JI What is Lathyrism?
JI Name three poisonous mushrooms with their active principle.
JI What are the causes of food poisoning?
JI Define Food poisoning.
JI What is delusion of grandeur & persecution?
JI What is hypochondriacal delusion?
JI Define & classify Delusion.
JI Define Compulsion.
JI Classify mental illness.
JI What are the causes of insanity?
JI What is claustrophobia & Acrophobia?
JI Define Kleptomania.
JI Define Impulse.
JI MI of Illusion.
JI Define Illusion with example.
JI Define & classify Hallucination with example.
$ Define Somnambulism.
JI What are the differences between true & false insanity?
JI Tell the history of Me Naughten Rule.
JI What is Me Naughten Rule?

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Forensic Medicine ITEM Book
Q What arc the civil responsibilities of an Insane person
’
Classify Corrosive poison.
$ What arc the action of Corrosive poison?

Define Corrosive poison.

Define lucid interval.
Define Obsession.
Define Drunkenness. ’

Properties of HCL. "

—
Properties of HN03.
Tell the properties of Sulphuric acid.
What are the complication of Sulphuric acid poison? '

What are the causes of death due to Sulphuric acid poison? “

Mention the causes of death due to Corrosive poison. “

MIofH2SO4.
& Tell the treatment of H2SO4 poisoning. “
—
"

& Fatal dose of H2SO4, HNO3, & HCL.

How you differentiate between H2SO4, HNO3 ,Hcl? '

Tell the PM findings of CO-poisoning.

& S/S of Sulphuric acid.
& Medico-legal important of HNO3. ” 4
"
MIofH2SO4. 1

& What is Vitriolage? -J

MIofHNO3. 1
& Fatal dose of H2SO4. 1

Treatment of vitriolage.
& Define Xanthophoric reaction.
& Punishment of Vitriolage.
'
Complications of Vitriolage.
What are the motives of Vitriolage?
& What is chasing the dragon? " “

”
What is speed ball?

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 Q What is street Heroin?
.Q How Heroin is derived?
Q What is Heroin?
,Q What is the other names of H2SO4?

How alcohol is obtained?

J® Tell the physical properties of Alcohol.
J® Name some CNS depressants.
J® What is Heroin adulteration?
J® Fatal dose of Heroin.
J® What is shooting gallery?
J® What is alcoholic black out?
J® What are factors influencing alcohol absorption?
^® Name some alcoholic beverages with their percentage.
J® Use of Alcohol.
J® What is surgical spirit?
J® What is absolute alcohol and rectified spirit?
J® Tell the alcohol concentration (%) in Beer, Rum, Vodka, Wine.
J® What is Congeners? Give example?
J® What is alcoholic beverage & congeners? Name some congeners.
J® What is micturation syncope?
Tell the hazards of alcohol poisoning.
J® What is Korsakoffs syndrome?
J® Fatal dose of absolute alcohol.
J® Tell the blood alcohol concentration.
J® What is “IN VINO VERITAS”'!
Metabolism of alcohol.
J® Tell the safe limit for drinking of alcohol to avoid liver damage.
J® What is arrak? Tell it’s percentage.
J® Why ethanol is use as antidote in methanol poisoning?
J® What is Mac’Ewan sign?
J® What is methelated spirit?

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I orcnslc Mcdlclnt ITEM took
A Who i* Iklimim hvim n* '
J| What is Drunkenness ’ Ml n| u
.ft What is Munich Ikvt In .m ’
J| Saturday night [Link]\
JI How long dose alcohol May in your unm ’
.P Name the methods done for alcohol »kkx non in blood
"

JI Define Still Birth

.ft Define Infanticide, I coticuk . I du uk
j| Define Infanticide
.ft Hydrostatic Test.
.ft Spalding’s Sign
J| S/S of Maceration.
.ft What is Maceration?
A Define dead bom. What are the common signs of Death birth ’
A What arc the causes of Still birth?
JI Define NAIC.
.ft Mention the synonyms of Battered baby syndrome.
Ji What are the natural causes of infanticide?
.ft Mention the causes of infanticide.
.ft What are the changes occurs in umbilical cord after birth1’
JI What is vagitus utcrines & vagitus vaginalis?
.ft Mention the fatal dose and fatal period of Kerosene.
Ji According to the boiling point of Kerosene, mention the lighter products and
heavier products of petroleum.
.ft How kerosene is obtained?
JI Name some common petroleum products.
A Define Hydrocarbon.
A Feature of Battered baby syndrome.
Ji Fatal dose and fatal period of lead.
A Name some toxic salt of lead.
P I ell the complication of Kerosene oil poisoning

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 Q Treatment of Kerosene oil Poisoning.

^Whyl^roseneis blue in color?

Tell the properties, source and uses of Kerosene
oil.

~Ji What are the types of Phosphorus?

~^^WhaTare the effects of chronic lead poisoning on reproductive system?
Ji What is lead palsy?
Ji Criteria of pain in chronic lead poisoning.
Ji What is burtonium line? D/D of it.
Ji What is saturnism? What are the causes of it.
Ji Why OPC smells like Kerosene?
Ji Classify OPC with example.
Ji What is Phossyjaw?
red phosphorus?
Ji Mention the difference between white phosphorus and
Ji What are the uses of red phosphorus?
Ji What are the uses of white & red phosphorus?
Ji Tell the treatment of OPC Poisoning.
Ji Fatal dose of OPC.
Ji What do you mean by SLUDGE? “

Ji What are the S/S of OPC poisoning?

$ Tell the muscarinic effects of OPC poisoning.
Ji Mode of action of OPC.
Ji Medico legal importance of OPC-
Jj Tell the primary opinion of a poisoning case.
-gr^T^Ti^^ in OPC^oisoningjuri^
OPC spray?

Ji What is atropinisation?
&
OPC poisoning. Which one is specific [Link]
why?
Ji Tell the criteria of crude opium.
"

"Ji How opium is obtained?

Tell the use of opium.
"^Mention the active principles of opium.

Axis Medical School

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 Forensic Medicine ITEM Book
\
"^What is plant penicillin?
"^Wliat is Chromolachryorrhoca/Red tear?
'jg'Tcll the treatment plan of Morphine Poisoning.
"j^-properties of Morphine.
S/S of Morphine Poisoning.
Still Birth?
dose of Morphine.
'ft'Classify alkaloid of opium.
Tell the chemical group contain of crude opium.
Define Forensic Toxicology.
'^ Toxicology & toxinology?

JO What is “Black”?
D/D of Opium Poisoning.
^Medico-legal importance of Opium.
"ft Tell the antidote use in Opium Poisoning.
j§ Classify poison medico legally.
of poison?
What are the route of administration
of Poison
What arc the factors modify action
7B What are the actions of Poison?
ft What is Toxinology?
JO Define Poison.

~>~Tarti^^^
J§ Name some ideal suicidal poison.

.0 What is physiological antidote?

_—
£
.

——
Tell the
Define & classify Antidote.^^
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 19 How unabsorbed poisons are removed from the
Q Tell the Principal management of suspected poisoning case.
P What are the function of mouth gag. funnel & opening of stomach wash tube?
& What arc the parts of stomach wash tube? Tell the function of mouth gag.
~~
ft What are the criteria of stomach wash tube?
ft What arc the other names of stomach wash tube?
& Define chelating agent with example.
ft What is universal antidote? Tell its Composition.
ft Complication of stomach wash.
ft What arc the solution used for stomach wash?
ft How long time you should continue stomach wash?
& What are the precautions taken while introducing of stomach wash tube?
£ Tell the procedure of stomach wash.
£ What are the contraindications of stomach wash?
ft Medico-legal importance of pregnancy.
£ Define viable age.
Normal & maximum duration of pregnancy.
Ji Define Delivery.
ft Define Pregnancy.
ft Define emetics with example.
£ What is striae gravidarum?
ft What is Montgomery’s tubercle?
ft Define colostrums with it’s composition.
& Tell the changes in the breast occurred during pregnancy.
Ji What are the presumptive signs of pregnancy?
J® What are the signs of pregnancy?
Ji Define Uterine shuffle.
Ji What is Hegar’s sign?
Ji Tell the height of the uterus during pregnancy in different months.
Ji What are the probable sign of pregnancy?
Ji What is Jackquemier’s sign?

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 )j What ts quickening?
J| Tdl the laboratory mvertigalMMi done for pregnancy
ft When foetal heart wound iv not heard''
"j|'"WhM are the positive sign of pregnancy"
J| I ell the biological test done for pregnancy
"ft Ubat is braxtonhick's contraction?
~
J| What is baHottement test?
J| U bat are the sign & symptom of recent delivery?
”
J| What are the confirmatory sign of recent delivery?
~~A When the questions of delivery arise?
Jl Define Delivery.
JI Pseudocyasis.
A What is superfoetation & superfecundation?
ft When question of legitimacy arise?
JI Define Legitimacy.
Define posthumous child.
ft Define supposititious child.
Jl Lochial discharge.
£ Tell the size and position of uterus after recent delivers'.
JI Tell the route of elimination of poison.
Jl What is atavism?
jl How disputed paternity detected?
Jl When question of paternity arise?
ft Define disputed paternity?
Tell the rout of elimination of poison.
Jl What are the differences between hypostasis & bruise?
ft What are the causes of death due to bum?
ft Define Forensic Medicine & Medical Jurisprudence?
ft ^Vhcn magistrate inquest is required?
Jl Define somatic death and molecular death? Which one occurs first?
ft Define grievous hurt. Mention its components.

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< Ikfinc mhim SV hat arc the u»mnx»n i hum * »»1 (oma '
Q W hat i* the medico legal importance of hnn*c’’

G Hou you will My that the hanging wn* tuicidal?

Q Name the condition* influencing rigor morn*
Q Define Medical ethic*
Q Mention the court* ol Bangladc*h?
Q Define privileged communication with example.
Q What arc the medico-legal a*pect of age?
Q What arc the sign* of death?
Q Ik tine abrasion? What are the types?

Q Classify violent asphyxial deaths

Q Define laceration What arc the types'*
Q What are the medico-legal questions will arise from a fire
arm injury
$ Define autopsy. Name the incisions given during autopsy.
Q Define Forensic Medicine. What is Forensic Pathology?
Q Define & classify evidences.
Q What includes documentary evidences?
Q Mention the duties of a patient to doctor.
What is the procedurcfor determination of age?
Q Define Post mortem lividity.
$ Mention its medico-legal importance?
7T Define hanging. Diffcrentialc between typical and atypical hanging.

. Gi\c the differences between entrance and exit

wound of fire arm ininrv
injury.
Name the incisions given at autopsy.
A Define Forensic Medicine.
& What arc the branches of Forensic Medicine?
A When a doctor may refuse to attend apatient?
A Define professional negligence.

A Define Finger print A classify it with p^Xge^

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 .Q Classify autopsy.
o What arc the causes of death due to bum?
© How a person can be injured by an explosion?
o What arc the causes of death from wounds?
What arc the differences between suicidal and homicidal cut throat wound
When a doctor may be called to testify?
’
What is dying declaration? What is its procedure?
’

ft Define Medical Jurisprudence. WIiaHiTmedical etiqueUe?

JI Tell the mechanism of rigor mortis.
ft What are the factors necessary for mummification?
What is dying deposition?
What are the difference between dying declaration and dying deposition?
ft What is air blast? What is its mechanism?
ft What is chop wound?
Tell the character of ligature marks in suicidal hanging.
Ji Define incised wound?
Ji Mention its characteristic features?
Ji Mention the characteristic feature of stab wound.
Ji Tell the order of appearance of rigor mortis?
Ji What is the medico-legal importance of incised wound?
Ji How will you differentiate between human hair and animal hair?
Ji Define privileged communication? Give its example.
Ji What are the differences between Homicidal and Suicidal hanging?
Ji Name the steps of record of evidences in court of law.
Ji Define chalan & inquest.
ft Who wrote the first book of Forensic medicine & which year it was published?
Ji Define strangulation. Mention the post mortem findings of strangulation.
Ji What are the other name of PM staining?
Ji How can you differentiate between Hindu and Muslim female?
Ji Define cut throat wound.
Ji What are the causes of death due to cut throat wound?
Mention the criteria of true abrasion.

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 ** Define defense wound? What arc the site of defense wound?'
What arc the medico-legal importance of hair?
What arc the Pre-requisite of medico-legal autopsy?
$ How Forensic Odontology helps in detection
crime & criminal?
M Define suffocation. What arc the causes of suffocation?
& Mention the D/D of rigor mortis.
& Define cadaveric spasm.
Define Forensic Medicine and Medical Jurisprudence.
What arc the medico-legal importances of hair?
& Define hanging. What arc its types?
& Describe the parts of an autopsy report.
What are the characteristic features of exit wound in fire arm injury?
Define drowning.
Mention the post mortem findings of drowning.
What is hesitation cut?
What is its medico-legal importance?
Mention the medico-legal importance of age.
Define identification. Classify it. Mention its data.
What are the difference between Hanging & strangulation?
J® Define sudden death. What are the causes of sudden death?
& What is syncope? What are the causes of syncope?
Define bum and scald.
J® How scalds differ from bum?
J® Define negative autopsy. What are the causes?
& Tell the complications of bruise.
J® Define asphyxia. Name the asphyxial death
What is rule of nine?
J® Define bum and scald.
Tell 10 types of Hanging
J® Tell the causes of death due to cut throat wound.
j Which one has medico-legally less value Bruise or Abrasion, & Why?

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H Whatnrclhcdillviuk<shdw(1Il|IVp,st.(S| ,l(1| |,ru(

JI Mention the Inuts I hi.i s of i<h unlit .mon

I What it Doctrine ol Res Ip,। | oqimur *
IF Define Dactylography
0 Mention its medico-legal important e
JI Classify fire arms? What is iillmp *
0 Define putrefaction? Mention its stapes ’
H WhatisBMDC & BMA?
V Define forensic Medicine. [Link] me the [Link] . nl I '.1 ’

> What are the post mortem findings of chronic starvation*

JI What is perforating & penetrating wound?
JI Define death trance. Classify it with examples.
JI Can finger prints of two persons be similar?
JI Why left thumb impression is taken?
How will you differentiate male from female?
J® Define corporate negligence?
J® What are the differences between ante-mortem and post mortem clot?
How will you ascertain the close distance of short gun wounds (2-5 cmf
What do you mean by heat cramps? Mention its synonyms.
J® Define witness. What arc the types of witness?
JI Define contributory negligence & corporate negligence?
J® What arc the tests done for detection of blood?
A Define diatom.
What arc the causes of death due to drowning?
J® Define Drowning. Classify if
What type of wounds can be caused by bomb explosion ?
J® What arc the post mortem findings of Ante-mortem drowning?
% Mention the post mortem findings of drowning.
41 Name the micro-organism involved for putrefaction.
® What information will you get from a sample of blood stain!
$ Define inquest. When magistrate inquest is required?^
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 .Q How you will differentiate human hair & animal hair?

& What is BMDC? What is its function?

Define inquest. Classify it.
J? How you will preserve & dispatch the viscera?
Mention the signs of hanging.
I Tell the procedure of giving evidence in the court.
What is product liability?
I What are the medico-legal importance of bite marks?
I Tell the eruption of temporary teeth.
Mention the medico-legal importance of Forensic Radiology.
I Tell the criteria of froth in case of ante-mortem drowning.
J® Define tattoo mark.
What arc the medico-legal importance of tattoo marks?
I Classify skull fracture.
Ji What is vicarious liability?
Ji Medico-legal importance of finger print?
& Which fingers impression is taken usually?
Ji What are the tests done for detection of seminal fluid?

(
JiName the dye used in Tattoo marks?
£ Mention the complication of tattoo marks.
Ji What is tattoo mark? Are tattoo marks permanent?
Ji What is the importance of X-ray in age verification?
I Define consent, classify consent
F How tattoo mark can be erased?
I £ Define forensic Thanatology.
1 & Define semen. What are the medico-legal importance of it?
Ji Define strangulation, throttling, mugging?
Ji Can homicide be lawful?
What arc the parts of a post mortem report?
Tell the medico-legal importance of abrasion in different ’

parts of the body.

Axis Medical School 323

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Forensic Medicine ITEM Book
-jg~fjefine & classify wound.
Mention the types ol skull fracture.
What is KM/ wnat aie the medico legal importance of it?
Delinc autopsy, vv iidi aic Ilie papers required for autopsy?
£ What are the signs of ante mortem drowning? i
What are the advantages of acid phosphates test lor detection of seminal
fluid?
What are the codes of medical ethics?
£ Mention five examples of criminal malpraxis.
What are the conditions when magistrate inquest is required? i
& Define starvation. Name the causes of acute starvation.
A What is putrefaction? Name the conditions affecting putrefaction. j
A Define hanging. Mention the cause of death from hanging.
What is incised wound? Name the medico legal importance of incised wound.
& What is the medico legal importance of death trance?
What is the information you can get from hair?
Define malpraxis. Classify it with examples.
Define inquest. What are the types of inquest?
Name the circumstances when magistrate inquest is required.
Define abrasion. What are the types of abrasion?
What are the complications of bum?
& Define injury. Classify injury.
Name the period of eruption of permanent teeth.
What are the medico-legal importance’s of tattoo mark?
What is R.M? How can you differentiate R.M. from cadaveric spasm?
What are the objectives of autopsy?
What are the medico legal importance’s of teeth?
Define evidence. Classify it.
Define professional misconduct, with examples.
M What is mummification? What are the factors required for mummification?
What are the differences between menstrual blood & normal blood?
What is BMDC? State its 4 functions.
What are the causes of death due to bum?
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39 Difference between incised wounds & incised looking wounds?
What is hurt? What are the types?
What are the components of grievous hurt?
39 Mention the early post mortem changes.
& What are the changes occurs during putrefaction?
39 Name the putrefactive gases.
& Medico-legal importance of abrasion on different parts of the body.
39 How can you differentiate suicidal cut throat wound from homicidal cut throat
wound?
39 Mention the causes of death due to cut throat wound.
39 What is starvation? Mention its types?
39 How can you differentiate between death from starvation and cholera?
39 What is BMA? Mention the functions of BMA.
39 What is the medico legal importance's of post mortem hypostasis?
39 Define bruise. What are the factors influencing bruise?
What are the professional infamous conduct?
39 What are the pre-requisite of autopsy?
39 What is black eye?
39 What is dumdum bullet?
39 Define abrasion with its type.
39 What is sudden death? What are the causes of sudden death?
39 What is negative autopsy? What are the causes of negative autopsy?
What are the causes of erasure of name of a registered physician by BMDC?
39 Define court. Name the courts of Bangladesh.
39 Define bum & scald. State 3 differences between them.
®
What are the function of District & session judge court?
39 What do you mean by cephalic index?
39 Classify wounds according to weapon used.
39 What are the effects of bomb blast? '

3® How peijury & hostile witness differs?

39 Define warrant case & summon case?
39 Define conduct money & summon.
—————————
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 ^jch one have more value challan or inquest ? Why'.J
p^n?^uct money.
g^u^tcThc components of grievous hurts.
medicine.

-jj-p^7^7you determine sex of a decomposed body?

autopsy? What are the causes of negative autopsy?

--^PH^Tcan you sure that the person is dead?

-^pp^Tcan you differentiate entry wound from exit wound of bullet njury?
'^D^cribe a typical ligature mark of suicidal hanging.
-^""ftefine wound.
will you differentiate ante mortem wound from postmortem wound?
fire arms.

T Mention the causes of sudden death.

IT What are the importance’s of dying deposition?
Mention the factors affecting putrefaction.
& How can you estimate the time passed after death?
M What are the power of 1st, 2nd & 3rd class magistrate?
'

£ What are the sentences authorized by the law?

& What is self inflicted and fabricated wound?
M Define death. What are the changes occur after death?
its indications.
Ji What do you mean by informed written consent? Mention
How you differ from inquest report & chalan?
M What is rifling? Name the composition of rifled bullet.
What is strangulation? Mention its ligature marks.
What is hypostasis? Tell the Mechanism of hypostasis.
Tell the function of district & session judge court.
Name the court that can give death sentence.
~
& Name 2 books with authors, of Forensic Medicine.
define Forensic Pathology, Forensic Ballistics &
Dactylography?
Define Forensic Criminology & Odontology?
Define Forensic Criminology & Thanatology?

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 & Define Forensic Radiology. What are the medico-legal importance ot
it.

Define Forensic Serology & Osteology.

£ What is syncope? What are causes of syncope? _
& What are the differences between hostile witness & perjury?
& What are the causes of death due to dry drowning?
Define & classify suffocation.
Define cafe coronary.
first?
What is somatic death and molecular death? Which one occurs
£ Mention the importance 15 & 16 years of age.
What is sexual asphyxia?
How you will say that the hanging was suicidal?
Name the conditions simulating rigor mortis.
Define Ethics. What is Medical ethics?
What arc the criminal courts of Bangladesh?
Define privileged communication & professional secracy?
$ What is medico-legal aspect of age?
3 What arc the signs of death?
? What is incised looking wound? What are its sites?
I What are the violent asphyxia deaths?
Define laceration. What are the types?
What medico-legal questions will arise from a fire arm injury?
’

Define autopsy. Name the incisions given during autopsy.

Mention the medical documentary evidences.
Define Forensic Medicine. What is Forensic Pathology?
I £ What includes medico-legal reports?
Mention the rights of a patient & doctor.
I What is the procedure for determination of age?
What is post mortem lividity? What is its mcdico-lcgal importance?

I & Define hanging. Differentiate between typical and atypical hanging.

। What are the differences between incised wound and incised looking wound?
I Gh e the differences between entrance and exit wound in fire arm injury^

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 Name the incisions given ai autopsy? 1
-^p^fine professional negligence.
'Tf'Whcna question of civil negligence will arise? —
will you differentiate between post mortem stain and bruise?
many papers are required for autopsy?
"JpWhat are the effects of putrefactive gases?
J5 What facts are to be mentioned in age verification report?
£ Define Medical jurisprudence & medical etiquette.
Q How a person can be injured by an explosion?
What are the causes of death from wounds?
JI What are the differences between suicidal and homicidal cut throat wound?
Ji Mention the rights & privileges of a medical practitioner.
J5 What is dying declaration? What is its procedure?
Q Describe the character of ligature marks in suicidal hanging.
Q Define incised wound?
Q What are its characteristic features?
Q Tell the Patho-physiology of Fresh water drowning.
JI What arc the Ml of mummification?
Q What is flying missiles?
Q What is hesitation cut wound?
Q Define privileged communication. Give its example.

$ What is dying deposition?

JS Mention the procedure of dying deposition. 1
Q Mention the characteristic feature of stab wound.

Ji Define strangulation. Mention the post mortem findings of strangulation.

What is the medico-legal importance of incised wound?
What is the order of appearance & disappearance of rigor mortis?
How will you differentiate between human hair and animal hair?
What is cadaveric spasm?
What types of medical evidences are produced before court*
Name the steps of recording evidences in court of law .

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 Q What is an inquest? Who will make an inquest?
Ji Define Forensic Medicine. How a Forensic specialist can help the police?
G What are differences between hypostasis and bruise?

I G How Forensic Odontology helps to detect crime?

i G How w ill you differentiate carrier and victim of bomb explosion?
Ji What is defense wound?
I .G Define suffocation. What are the causes of suffocation?
G What are the medico-legal importance of hair?
Ji What are the informations you will get from a sample of blood?
Q What includes documentary evidence?
.Q What is examination in chief?
G Define drowning.
Mention post mortem findings of drowning.
Ji What is hesitation cut? What is its medico-legal importance?
Ji What is an inquest? Who will make an inquest?
Ji Define dichotomy.
Ji What are the medico-legal importances of hair?
Ji Define hanging. What are the types?
& Mention the MI of rifling.
What is ricochet bullet & tandem bullet?
Ji Describe post mortem appearance of strangulation.
Ji What is vaginismus?
Ji Define & classify gun powder.
Ji What is maggots?
Ji Mention the importance of 1 8 years of age.
Ji How deformities help in identification?
Ji Mention the importance of age 21 years.
Ji Define & classify Homicide.
Ji What are the cardinal sign of asphyxia?
Ji What are the points in favour of homicidal drowning?
Ji Define & classify Euthanasia.

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 1
'^Define murder.
'q' Define immersion syndrome.
cTWhaTis shot gun? What is rifling?
"^""What is putrefaction? How it develops?
"q"What is BMDC? What is its function?
cases identification is needed?
is the Doctrine of Res Ipsa Loquitur?
How will differentiate male from female?
'p Define wound medico-legally & surgically.
Q What are the conditions of preserving the dead body?
What are the post mortem findings of chr. starvation?
Q What is shallow water drowning?
Define concealed punctured wound with their site.
JQ Tell the age of bruise.
What is the difference between ante-mortem and post mortem bum?
How will you ascertain the close distance of short gun wounds (2-5 cm)?
J§ What do you mean by heat cramp?
& What are the tests for detection of blood?
JI What is witness? What are the types of witness?
Ji What is contributory negligence?
Ji What are the methods of finger printing?
Ji What is the utility of finger print?
What are the causes of black eye?
Ji Define Scar. Tell its MI.
Ji Define cognizable offence with example.
Ji Define Hurt, Injury, Assault & Battery.
-
Ji What type of wounds can be caused by bomb explosion ?
Ji What is vicarious liability?
Ji What information will you get from blood stain?
How you will differentiate sex?
What is the importance of foot and shoe prints?
J b
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 \\ hat are the difficulties for detection of crime in BD?
$ I ell the points of Genes a declaration
G Classify race according to Cl.
G 1 ell the changes of eyes alict death.
G Who are the expert witness?
G Mention the common \ iscera preserved in suspected case of poisoning.
G How you will preserve this viscera?
G What is Karl Pearson's formula?
G How you will assess the age of a person with the help of teeth?
G When consent becomes invalid?
G Where & when first autopsy was performed?
G Mention the types of blood group.
G How blood group can be determined?
G What are the ways to preserve body?
G Describe post mortem findings of lungs in a case of drowning.
G Medico-legal importance of bite mark.
G What is Locard’s principle of exchange?
G Define Whiplash injury.
G How race can be determined?
G How you differ Hindu male & Muslim male?
G Define concealed sex.
G How you differ temporary teeth from permanent teeth?
G What are the criteria of valid consent?

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 Viva Section

Community Medicine

(Board 01 d RIST X Study Tour .34 Report 1-0 Hr* J]

report CVI4- question 4*41 4141 «34*14 wniW 4TTT1 Q / OiBl box W* «31^

question an^rer 4^^ 4T4 1 )

RFST or Survey Report

HR f^?

-This is survey report.

Topic f^?
-Basic Sanitation & hygiene behavior among the schools of Dhaka city.
Content 1
Chapter 1- Introduction
Justification of the study
/ Objectives
/ Variables
/ Operational definition
/ Limitations of the study

Chapter 2- Literature Review

Chapter 3- Research Methodology
Chapter 4- Results
Chapter 5- Discussions
Chapter 6- Conclusion & Recommendation
/ Conclusion

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 7
J
Rccommcndation^^^^
Reference XTCM^k
Abstract- Total report
pun
summary
sn.
Justification- 4?^^»
Objectives-

Variable- Objectives

^PendentVaHabie-c^^
Definite Rese

Scope of Anemia in
the reproductive
age wom •

Study Design
Study Period- Work schedule (Dec
2019-Feb 2020)
Study Place- Among the Schools of
Dhaka City (Badda, Shahjdpur, Demra)
Study Population-
(Class 6-10, Secondary
Population ,
High School)
Sampling Technique- Non Probability—* Convenient sampling technique
(Probability sampling technique ‘’IlfdA
whole population )
Sample size- 250
Research Instrument- Research tool—*
334 Axis Medical School

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 to my topic depending on variaoic.
> Questionnaire- List of questions related
y C heck list- Observation JI I

> White Paper- W Rm I

/ Data Collection Procedure- Asking Question

y Data Processing & Analysis
SPSS- Statistical Package for Social Sciences, v 24
Data Present TO^?

-Frequency Table & % JI

Table Benefit f^?

-Fast clear concept I

Discussion- m CsJVSlIH? C^TC^ C^iblC^ ^TT^ I

Recommendation- m TOTO WTO,

W33 oFT <P$1Co “TOT 1*10 1

Annexure- attach TO<I 1

Study Tour

(Cilf^C^d CoUT ijTOT WW WTO WTO TOI TO

JR^T TOCo TO “^mT ^KTO ^TO, ofel CTO^-o^ JI
^ifvb JT^’ RFST report I Study Tour mm^ Atal'S’ oTH 2PSf
W537T ^1 Jl^ ^ll*TO
£|$[o Mm ^IK^ *[( '341^1^)

I Study Tour J]
-CRP Headquarter, Savar J] ^JN/^IJN I
^ICRPJI^ ^Tl
- Centre for the Rehabilitation of the Paralyzed
o i v3 wr Rm otto tot
^mRci?
Axis Medical School 335

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Community Medicine ITEM Book
^/■snra [Link] 41 4H.
fRP7T**TPp ^^i i

81 s*ncH W
. William & Maric Taylor School
4 1 CRp JR Reception desk 41 W9iH rsmi ft
V5JHT UI'S?

.sna/’nnt wnra wram^.,

"«» 'oifii Handicappedi

W reception desk dm WK HWIRIICRPP5 Wm I .vel.h...!

4H ^5 WCT Rm CWI 4FK sra^ (^
^1
\b I CRP Activity 'QUIT ^fUof

- CRP Treatment & Rehabilitation services

- Academic Activity
And it has also some income source like Real state. Rental, Press wood, Metal
Workshop, Nursery, Recycled paper technology etc.
I CRP Treatment & Rehabilitation services^ X5JR^ ^IUdII
Medical Services
Physiotherapy
Occupational therapy Speech & language therapy
Special seating
Prosthetics & orthotics
Wheeled mobility aids & assistive devices
*1 wfj cx5i <uwi[X\9<\b vra, wr

W/WI 'SWT TOT

^IW C^TTO TO1^ TOTTI J1^5T
^3^1 TOTS’ TOhd TOTTI
^l^n^jCRPic^ TO33 CHIT'S
336 Axis Medical School

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 •n 'hin Win ur^M ft' w * ft'
1 K 1' Vn.w. Hh tka (llcaik|U4f1rf)
• ( RI’, Mirput
\k Khan ( RI’. ( hiitapmg

\k« Husum- ( RI’, RajUuhi

( \RS \ I ouikkumn- ( RI’, Barnhal
• 4 RI'- (ianakban. Moult iba/ar
( RI'- Nattabganj

(‘RP-<iobindapur, Mouhiba/ar
Wjrpur. ( hiiLi^inn: Raishalu. Hari\hiil. Mt>ul\iba:ar. Na^ubgani ^rU^TT
'SMTGS
\.K.: Rh ST. Study Tour SHJ (?O
Pius sra ftsiuspj i

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 Box Question

-$/6 boxes which can be vary' from college to college, hut one box must
^phere way be
include problem-based questions.)

Board I
IklFWl&Wtaiiiijni
[Link] programs
X. Wife;& Ihlumatihnall aagamratitrnft

[Link]
[Link]^hahi^&Kmainlhrnaiitadhlhg^

Si. CimmmnidaWltdla«aw»
91.N>niaomimuiiaalHltdifl«afias; J

HQ). DmmimhA & irnmuniEatiom j

to college.)
(Topics of board I can vary from college

338 Axis Medical School

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Demo Questions:
Sir: HI’S JKW first box CTO5 question ^11C^?
You: (First box C^IH5 Jl^l card
BCG is given just after birth why?
Prexalance of TB is high in Bangladesh. To prevent childhood TB and tubercular
meningitis BCG is given.
Sir: dl^M next box C^K^5 d|<Pbl ^l^ Sil'S I
You: What do you mean by reference protein?
Protein which would produce 1 gm of tissue for each gram of consumption and it has a
biological value of 100.
Sir: Next Box
You: Name the local and foreign NGOs working on Health and family planning.
WHO, UNFPA, ICDDR, B, CARE
Sir: Next Box CTOI5 'SilS I
You: Why fertility rate is high in Bangladesh?
Marriage at early stage.
Illiteracy
Unwilling to accept contraceptive methods.
Less recreational facility
Sir: CTO5 I
You: Mention about Koplik’s spot.
They are pathognomonic feature of measles, characterized by-
Small bluish, white spot on a red base.
z Smaller than head of pin
z Found on buccal mucosa opposite the 1 st & 2nd molar tooth
Sir: Problem box C^TC^5 d|<t»bl GST I
You: A person, who sustained lacerated wounds in different parts of his body from a
road traffic accident, has been brought to the emergency department of a hospital. You
are a medical officer there. How will you proceed to prevent tetanus in that case?
The wounds should be cleaned thoroughly first.
Axis Medical School 339

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 DOOM
immunization history is not given. n
Since the person's should he know,, (,,,, h>
him or his attendants.
If he was immunized w,th 5 dose ,
। vaetm<. „„ |llr||iw
vaccination is needed. If not immunized fully by 5
doses of TT vaccme. one dose „1 1 1
vaccine should be given. In addition, a dose of tetanus immune globulin f IK„ should he
given for immediate protection. Subsequently the patient should receive the remaining
doses of TT (out of total 5 doses) according to schedule.
teocher^f different topic W questioners ^|,

340 Axis Medical School

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 (Board 02 4] day visit J14 Report f^LU | hirst J) report

question W | rt^C?I W (1 vbUl box C^s question

^1*1 an \ wer 11

Day Visits

1 . Institute of Public Health

Institutes may vary from
2. EPI Headquarter
college to college.
3. Infectious Disease Hospital
4. National Institute of Cancer Research & Hospital
5. National Institute of Disease of the Chest & Hospital
6. Leprosy Control Institute & Hospital
7. Radda MCH-FP Centre

b I 05 C^TWT CNWJ

I fWrf^T?
-^Gs^^TCJTI

<MC<H)

« I Radda MCH-FP Centre ^1 fWlf^T?

si

-W/W io CWT W*T I

GI fa CW CHW W

Axis Medical School 341

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 '7 Antenatal care
Postnatal care
wi|h (

and
7
household,^ fam"y
Treatment and mana„ '
""^rs «t the
n’
eligible couples. ^selling and
°f
' treatment to the (T.T)vacc-^00
Tetanus Toxoid .
°f w°men
aged
“"'^ve to ltw
15
7 W°men of all
age groups
7
"““^monito^^
safe
home ned
„
Traditional Birth An
/
n .. . Attendants (Tb A) for

7 AdV0cacy refreSherS
&amp;
Prornotion of breastfeeding
"rOViSiOn Of Adolescent Reproductive
’
7 Health (ARH1
RH) crare services.
Treatment of general ailments.

Antenatal care has 6 components:

1• Antenatal visits
2. Prenatal advice
3- Specific health protection
4. Mental preparation
5. Family planning
6. Paediatric components
explain ^^5 I

I 'Sth?! Supportive Service

342 Axis Medical School

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 a) Diagnostic Sen ices.
b) Ultrasonography
e) Non-EPI vaccines.
d) Pharmacy.
e) Radda Physiotherapy Services.

0 Health Educations.

This chart is used to

monitor the growth of the
Use: child.

To identify high-risk
b.
children
Planning & policy making.
c. Heath education for
Upper line: 50lh mother
'Percentile of the boys
Middle line: 3rd
^entile of the gir|s
Lower line: 60° <
•°W percentile

^Medical School
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 Box Question of Board 2

boxes which can he vary from college to

(There mV be 5/6 college, hot one box most
include problem-based questions.)

(Topics of board 2 can vary from college to college.)

344 Axis Medical School

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 Demo Question*:
Su : TO Jl^ first box question

\ on: (First box CW card ^T) Mention levels of prevention

with thei
mtencntion.
There are four levels of prevention: Primordial, primary, secondary &
tertiary|
Sir: primordial level prevention oT
on: Sir, from the childhood
Sir: Next Box
You: State the life cycle of mosquito.
Egg: Laid in single lasts for I -2 days
Larva: Stage lasts for 5-7 days
Pupa: lasts for 1-2 days.
Adult: 2weeks from egg stage
Sir: IjT I
You: Define personality. State the types of personality.
It implies certain physical and mental traits which
arc characteristic of a given
individual.
Types:
Type A or extrovert
Type B or introvert
3. Type C or mixed.
Sir: Next Box

' oikMention the warning signs of pregnancy.

z Swelling of feet.
Fits.
z Headache.
Blurring of vision.
' Ceding or discharge per vagina.

tL 01
““ guardingMedical
Axis
health.
345
School

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 Medicine
ITEM Book
Co^iW of all those factors in man’s phy steal
||ation is the control
development, health and
exercise may affect on his physical

methods
sir: Pn*>enl COUp|e has come to you for advice of family planning
yH! a family planning method would
you advise for them and * hv

H** pills (OCPs) can be advised for them

i oral contraceptive
The couple can have c ni d
n ocPs is an effective spacing method.
Yho •* tine
method and the
(Condom) can also be advised, since it is also a spacing
at the desired time.
haw child later on
C
shows unwillingness to use condom then <M I aie
s
। , Y one of the couples

^choice for them.

I™™™* ’W

* Success is wulkinu from failure to failure with no loss

I
of enthusiasm. / __ _

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r
Board I (Weapon Board) Associated TopiCs

Forensic Medicine

Weapon Board
1 . Weapons
2. Mechanical injury
3. Fire arm
4. Regional injury & RTA
5. Autopsy
6. Death
7. Post mortem changes
8. Asphyxial Death
9. Thermal injury
10. Starvation

(Topics of board 2 can vary from college to

college.)

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 ITEM Book
Forensic Medicine

Examination on Oral, Practical & viva of Forensic Medicine &

2nd professional
of Dhaka. (Respective University 3
Toxicology under the University

2.

3. Forensic Medicine JU
& Toxicology written by K. S Narayan reddy
The Essentials of Forensic Medicine
4.
Nandy
Principles of Forensic Medicine: Including Toxicology by Apurba
5, cS C®
-These arc various type of mechanical weapons.
device/lnstrument >1113/^1*11
6.
7. 4*^ Weapon G5MI
(Weapon

Identification Points '^l

hW'S Ws

W/W HI

This is heavy, sharp cutting,

sharp pointed metallic weapon
called butchers knife.

8. XSJK^?
- Sir/Ma’am "Tl^
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 • Weapon Proper
edge & a sharp pointed end.
It has a sharp cutting edge, a curved blunt Another
end is fixed with handle. There arc also 2 smooth
surface.

• Handle
• Handle is wooden. It has 2 smooth surface, 2 blunt edge & I blunt end.

- fa fa ’fO 4^1 faw?

- W'W Injuries caused by it-

By sharp cutting edge-
o Chop wound, Incised wound.
By blunt edge
o Abrasion, bruise, laceration, fracture & dislocation of bones & joints.
By pointed end
o Scratch abrasion, Punctured, penetrating & perforating wound.
By handle
o Bruise, Lacerations, fracture & dislocation of bones
9. <Pl<ll
1 0. |

11. Medicolegal importance I

- Homicide
-Griveous Hurt
-Suicide & Accidental (Not so common)

13.
(?TSW 'IISmsA fa®?

14.

What are the types of skull fracture?

Answer: Skull fractures are several types

including
• Linear fracture,
• Depressed fracture,
• Elevated fracture,
• Pond fracture,
Axis Medical School 349

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Forensic Medicine ITEM Book
.
,
,
Gutter fracture,
Ring fracture,
Perforating fracture,
• Blowout fracture,
• Sutural fracture etc.
[Link] CWT I

. Define autopsy. What are the types of autopsies?

-Autopsy may be defined as examination of dead both

externally and tntemally for
academic purpose or to find out the cause of death and ns'
death related quest..,
-Types of autopsy:

• Medicolegal autopsy

• Clinical or pathological autopsy

• Academic or anatomical autopsy

15. Next card.

-What is tripod of life?

-It means interlinked vital systems of the body. Nervous system, circulatory system
and respiratory system.

16. Next box C^TC^ CWT

- What is postmortem interval? How will you estimate post mortem interval?
-It is the interval between the death and time of examination of the body.

-Methods of postmortem interval estimation are:

• Cooling of the body,
• Postmortem lividity,
• Rigor mortis,
• Progress of decomposition,
• Adipocere formation,
• Mummification

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 1 7. Next card W

- \\ hat is heat stroke and heat exhaustion?

- Heat stroke is a condition eharaeteri/ed by temperature grater than 41 degree
Celsius & neurological disturbances.

- Heat exhaustion is a condition of collapse without increase in body temperature

which follows exposure to excessixe heat.

IS Last box $1

-Tell me some factors affecting starvation.

• Age,

• State of the body,

• Temperature
• Phxsical exertion.

19. sex J] starvation JM sign symptoms ^ll^f K||C<?

- male JI
20.

male JI female GM’ ^«1*11^ body fat <PX| ?IK^ I

(JN*^ >ON blXcsl RGosi topic 'AIM'S question

£1
© An arrow is only shot pulling it backwards,
so when life is pulling you backwards there’s obviously
something good coming up.

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1.

- These are various type of chemical substance & vcgitablc origin. (Different type of
Poison *IT 'SFT)

2. Poison <«1^ HF?

- W WW C^T CW Poisoning
Poison Rl>1L<1 Poison
^Tl
3. Define Posion.

Poison is a substance (Solid, Liquid or Gaseous) which if

introduced in the living
body or brought into contact with any part thereof,
its constitutional or local effects or both.
will produce ill-health or
deal b

4. '5||b^| JRsfr Poison/bottle GWfl

ation Points

Www nr nwi
The glass bottle having a stopper
contains
spherical fruit having
multiple spike on the
surface & multiple seeds inside.
Seeds are
colourless, odourless, yellowish
brown
having multiple depression
on the surface &
k'dney shape. So, my
identification this is
datura fruits & seeds.

^'"t
Poison?
'
Slr'Ma'am^De|]riant
Poison/Stupefyingagent
' Delirium
S-upor®

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Forensic Medicine
i.. em
. Delirium: It i> . [Link] „r
critic^ faculty |,iwlevmt w in orient.,

- Stupor: A *''»^[Link]^
disturbance consciousness. Movement 4 U|fh %()

7. Datums W ft ft
•^•-««[Link] .
poison. Roadside poison. Iravdkr .
8 Traveller's po^

10. Datura 3 CW
^?

11. Datura poisoning 4 Unique feature W W .

- Ludicrous Movement (Pill Rolling Movement)
12. Pill Rolling movement C^T
cwuo i
13. Morton Sign 'QC'IT <1«?1C\d| I
-Hot like “Hare"
-Red like “Beet"
-Blind like “Bat”
-Mad like “Wet Hen"
-Dry like “Bone”
14. Datura 3 Medicolegal importance <«11^1 1
-Traveller’s poison (Robbery)
-Abortificant (Pregnant women)
-Kidnapping (Children)
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 -Fake Signature (Old people)
-Aphrodisiac
-Country Liqor

15.
«11®^ W'D ^)

1 6. C«O W *ns fa fa’H' I

-What arc the complications of Rape?

• -Rape followed by murder.

• -Death
• -Local injury of the genitalia
• -STDs
• -Social stigma
• -Rape trauma syndrome
• -Pregnancy.

17. Rape trauma syndrome I

-Rape trauma syndrome consists of those behavioral, somatic and psychological

reactions that occurs as a result of forcible rape or attempted to forcible rape.
1 8. Next card IjT 05M I
-Define impotence, sterility, frigidity
-Impotence is the inability of a person to perform sexual
intercourse.
-Sterility is inability of male to beget child and in female the inability
to conceive
children.
-Frigidity is the inability to initiate and maintain the sexual
arousal pattern in
female.
19. Next box.
-What arc the positive signs of pregnancy?
• Fetal parts and movements
• Fetal heart sound
• USG
• X ray

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 placental souffle
Umbilical souffle
CWT I
20. Next card
Define dead birth. What arc the PM changes of dead birth.
is one which has died in utco and showa rigor mortis,
A dead born child
maceration or mummification after it is completely born.
-Pm findings are:-

• Rigor mortis
• Maceration
• Mummification
21.-^^ ^31
uterine finding in a recent delivery case.
-Define delivery. Most important
of a chils at birth.
. Delivery means expulsion or extraction
becomes contacted and feels like
-Most important uteine sign is uterus
muscular tumor.

22. Define lucid interval.

g which all the
during
symptoms of tnsa y
tv dun
insanity
in
-It is a periodoccuring
disapper completely

23. WW
injury.
-yes sir. In case of head
question
(urarH w ul5tn top c

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 AXIS
Medical School

m Workshop
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ideo Library &
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