Tag Archives: Forensic toxicology

Forensic Toxicology

Forensic Toxicology is a branch of Forensic Science which deals with the toxicology and related disciplines such as analytical chemistry, pharmacology, and clinical chemistry to help in the legal investigation of medical or death, toxicity, and drug use.

Forensic Medicine & Toxicology (MCQs)

Q-1. Segmented blood in retinal blood vessels, sign is: (AIIMS MAY 2015)

a) Rokitansky

b) Tache noir

c) Kevorkian

d) None

Answer: Kevorkian sign

Q-2. The ideal place to record temperature in dead body is from: (AIIMS MAY 2006)

a) Axilla

b) Groin

c) Rectum

d) Mouth

Answer: Rectum

Q-3. Brachiocephaly is due to fusion of

a) Saggital suture      

b) Coronal suture

c) Parietal suture

d) Lambdoid suture

Answer: Coronal Suture

Q-4. A dead body is having cadaveric lividity of bluish green color. The most likely cause of death is by poisoning due to: (AIIMS MAY 2006)

a) Hydrocyanic Acid

b) Hydrogen Sulfide

c) Oleander

d) Sodium Nitrite

Answer: Hydrogen Sulfide

Q-5. A dead body with suspected poisoning is having hypostasis of red brown or deep blue in color. It is suggestive of poisoning due to: (AIIMS NOV 2002)

a) Nitrates

b) Carbon monoxide

c) Cyanides

d) Barbiturates

Answer: Nitrates

Q-6. Rigor mortis is not seen in (AIIMS NOV 2013)

a) Female with strong built

b) Male with strong built

c) Old person >80yrs old

d) Fetus <20 wks gestation age

Answer: Fetus <20 wks gestation age

Q-7. In a suspected case of death due to poisoning, where cadaveric rigidity is lasting longer than usual, it may be a case of poisoning due to: (AIIMS May 2003)

a) Lead

b) Arsenic

c) Mercury

d) Copper

Answer: Arsenic

Q-8. Heat stiffening in muscles occurs above temperature- (AIIMS MAY 2012)

a) 30°C

b) 40°C

c) 50°C

d) 60°C

Answer: 60°C

Q-9. When a group of muscles of a dead body were in state of strong contraction immediately prior to death and remain so even after death, the condition is termed as: (AIIMS May 2005)

a) Gas stiffening

b) Rigor mortis

c) Cadaveric spasm

d) Cold stiffening

Answer: Cadaveric spasm

Q-10. Postmortem caloricity may be seen in all the following causes of death except: (AIIMS May 2005)

a) Septicemia

b) Barbiturate poisoning

c) Strychnine poisoning

d) Tetanus

Answer: Barbiturate poisoning

Q-11. Which one of the tissues putrefies late? (AIIMS NOV 2003)

a) Brain

b) Prostate

c) Liver

d) Stomach

Answer: Prostate

Q-12. Condition promoting adipocere formation (AIIMS MAY 2011)

a) Dry and hot

b) Hot and humid

c) Dry and optimum

d) Cold and moist

Answer: Hot and humid

Q-13. A dead born fetus does not have: (AIIMS May 2003)

a) Rigor mortis at birth

b) Adipocere formation

c) Maceration

d) Mummification

Answer: Adipocere formation

Q-14. Constituents of a typical embalming solution are all except (AIIMS NOV 2008)

a) Phenol

b) Glycerin

c) Formalin

d) Ethanol

Answer: Phenol

Q-15. The dead body of a murdered person is brought for preservation in mortuary. Which of the following statements is not correct? (AIIMS NOV 2004)

a) The body should be stored averagely at 4°C

b) The body can be embalmed before postmortem

c) The body should be never undressed before the forensic doctor has seen it

d) The body can be stored at –20°C to preserve it for long duration

Answer: The body can be embalmed before postmortem

MCQs On Forensic Toxicology

1. Which of the following is NOT a side effect of Digoxin toxicity?

A. Bradycardia
B. Yellow vision changes
C. Scooping of the T segment on ECG
D. Hypokalemia

2. Which information can be obtained from an acute toxicity study?

A. Median toxic dose (TD50)
B. Median lethal dose (LD50)
C. No Observed Adverse Effect Level (NOEL)
D. Target organ
E. All of the above

3. A particular dose of a substance X is minimal toxic to animal. Substance Y is also minimal toxic to the animals at the same dose, but when both the substances are administered together they show the toxicity several orders of magnitude higher than compared with individual administrations. This is an example of:

A. Potentiation
B. Synergism
C. Additivity
D. Acute Toxicity
E. Agonism

4. Which of the following chelating agents is recommended for acute Lead poisoning with signs of encephalopathy?

A. Succimer
B. Penicillamine
C. Dimercaprol
D. Calcium EDTA
E. Dimercaprol + Calcium EDTA

5. Which of the following dermatologic findings and potential causes is INCORRECT?

A. Cyanosis- Methemoglobinemia
B. Erythroderma – Boric Acid
C. Pallor – Carbon Monoxide
D. Jaundice – Hypercarotinemia (excess carrot intake)

6. All of the following symptoms can occur with Ciguatera poisoning EXCEPT…

A. Myalgias
B. Flushing
C. Metallic taste
D. Reversal of temperature sensation

7. Which of the following is true with regard to Acetaminophen toxicity?

A. The Rumack-Matthew Normogram may be used for both acute and chronic ingestions.
B. The APAP level should ideally be checked within 1-4 hours of ingestion.
C. The Rumack-Matthew Normogram applies for ingestions up to 48 hours post-ingestion.
D. N-Acetylcysteine (NAC) should be started within 8 hours of ingestion if an APAP level cannot be obtained.

8. All of the following are treatment options for toxic alcohol poisoning, EXCEPT…

A. Fomepizole
B. Hydroxocobalamin
C. Thiamine
D. Folic Acid

9. Which one of the following are the main targets of lead toxicity?

A. Liver and kidneys
B. Nervous system and hematopoietic system
C. Heart and lung
D. Bones and muscles

10. ‘Itai-itai’ disease is caused by______

A. Cadmium
B. Mercury
C. Lead
D. Copper


Answers with Explanation:

1. Answer: D.

Despite the number of patients who come in taking Digoxin, it is important to remember that this medication comes with a large range of side effects. Bradycardia (along with any of the other SLUDGE Toxidrome symptoms) is a common effect due to the Parasympathetic activity of Digoxin. (Note: This is also the reason it works as a second-line agent for rate control of Atrial Fibrillation.) Yellow, halo-like vision changes (think Van Gogh’s ‘Starry Night’) are a more rare, but classic finding.

2. Answer: E.

In an acute toxicity study any end point parameter such as death, brain damage, liver damage etc. can be used to obtain information regarding a particular toxicant.


References:

Wright RO et al. Methemoglobinemia: etiology, pharmacology, and clinical management. Ann Emerg Med. 1999 Nov;34(5):646-56.

Prescott LF, Illingworth RN, Critchley JA, et al. Intravenous N-acetylcysteine: the treatment of choice for paracetamol poisoning. BMJ. 1979 Nov 3;2(6198):1097-100.

Yeates PJ, Thomas SH. Effectiveness of delayed activated charcoal administration in simulated paracetamol (acetaminophen) overdose. Br J Clin Pharmacol. 2000 Jan;49(1):11-4.

Sivilotti ML, Burns MJ, McMartin KE, et al. Toxicokinetics of ethylene glycol during fomepizole therapy: implications for management. For the Methylpyrazole for Toxic Alcohols Study Group. Ann Emerg Med. 2000 Aug;36(2):114-25.

Brent J. Fomepizole for ethylene glycol and methanol poisoning. N Engl J Med. 2009 May 21;360(21):2216-23.

Lheureux P, Penaloza A, Gris M. Pyridoxine in clinical toxicology: a review. Eur J Emerg Med. 2005 Apr;12(2):78-85.

Forensic Toxicology

INTRODUCTION

The word “Toxicology” is derived from the Greek word “Toxicon” which was used as a poisonous substance in arrowheads.Forensic Toxicology is the branch of science which is deal with the nature, effects and detection of poisons.Forensic Toxicologist’s primarily concerned is the Medico-legal aspect of the harmful effects of chemicals on human and animals .
Mainly it’s utilized for establishing the cause of death and to interpret its circumstances in Post-mortem Investigation.
Work of Forensic Toxicologist
The work of forensic toxicologist is therefore considered as highly complicated as small quantities of poison and their metabolites are to be isolated, purified and quantified from a highly complex matrices.

CLASSIFICATION OF POISONS

Poisons can be classified in a variety of ways, depending upon the interests and needs of classifier e.g. classification may be done on the basis of mode of action of poison, toxicity rating, in terms of their physical states, their labeling requirements, their chemistry etc.
For the purpose of toxicological analysis, poison are classified on the basis of their chemical properties and method of isolation from tissues and other biological fluids which are given further:
👉 Noxious Gases
👉 Volatile Inorganic
👉 Volatile Organic
👉 Non-Volatile Inorganic
👉 Non-volatile Organic Neutral Compounds
👉 Non-volatile Organic Acidic Compounds
👉 Non-volatile Organic Alkaline Compounds
👉 Plant Poisons
👉 Miscellaneous Poisons

👉 Noxious Gases

✔ Carbon Monoxide (CO)
✔ Carbon Dioxide (CO2)
✔ Hydrogensulphide (H2S)
✔ Sulphurdioxide (SO2)
✔ Chlorine (Cl2)
✔ Nitrous oxide (N2O)
✔ Methane (CH4)
✔ Methylisocyanide
✔ War gases
✔ Ammonia
✔ Chloracetophenon (Tear gas)

👉 Volatile Inorganic

⚡Cyanide
⚡Phosphine
⚡Arsine
⚡Phosgene
⚡Stilbine
⚡Carbonyl
⚡Chloride Flurocarbon
⚡Isocyanide

👉 Volatile Organic

🕯Methanol
🕯Ethanol
🕯Formaldehyde
🕯Acetaldehyde
🕯Chloral Hydrate
🕯Pyridine
🕯Ketones
🕯Hydrocarbons
🕯Chloroform

👉 Non-Volatile Inorganic

ANIONS:

1. Halides
2. Selenide
3. Dichromate
4. Chlorate
5. Azide
6. Nitrite
7. Sulphide
8. Sulphate
9. Nitrate
10. Phosphide
11. Cyanide etc.

CATIONS:

1. Mercury
2. Arsenic
3. Barium
4. Thallium
5. Lead
6. Antimony
7. Bismuth
8. Copper
9. Aluminum
10. Zinc, etc.

👉 Non-volatile Organic Neutral Compounds

🗯 Pesticides (Organophosphorous, Organochioro, Carbamates and Pyrethroids)
🗯 Neutral Compounds.

👉 Non-volatile Organic Acidic Compounds

Acidic Drugs like Barbiturates, Sulpha and Phenolic compounds, Salicylatesc etc.

👉 Non-volatile Organic Alkaline Compounds

All basic Drugs like benzodiazepines, alkaloids etc.

👉 Plant Poisons

🌱Dhatura
☘Aconite
🍀Oleander
🌿Nuxvomica
🌾Abrus Precatorius, etc.

👉 Miscellaneous Poisons

💨 Mechanical: Glass powder, Diamond dust, chopped hair, etc.
🍞 Food poisons/Mycotoxins.
🐉 Animal/Insect poisons
🧪 Water soluble Compound

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