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139.Explanation Correct Answer - B Ans. is 'b' i.e., Cocaine Magnan's symptoms is tactile hallucination (formication) i.e. feeling of bugs crawling under the skin is seen with cocaine abuse/ poisoning. Cocaine Cocaine is an alkaloid derived from the Coca bush, Erythrexylum CoCa. It was the first local anaesthetic which was used clinically. Toxicity of cocaine may be : ? A) Acute toxicity : - Acute cocaine intoxication is characterized by : ? 1) Sympathetic hyperactivity : - Tachycardia, hypertension, mydriasis, sweating, nausea & vomiting. 2) Hypomanic state : - Increased psychomotor activity, grandiosity, elation, hypervigilance, Increased speech output. B) Chronic overuse : - Chronic overuse can cause : ? 1) Psychotic episodes (Cocaine psychosis) : - Persecutory delusions with tactile hallucinations (formination). Tactile hallucinations are manifested as bugs crawling under the skin → Cocaine bugs or magnan's symptoms. 2) Other : - Anxiety reaction, compulsive behavior, delirium and delusional disorders. 3) Black pigmentation of tongue and teeth A combination of cocaine and heroin taken by injection is called speed ball. Join @FMThubs

138.Explanation Correct Answer - B Ans. is 'b' i.e., Oxalic acid Trousseou's sign and chovstek's sign are seen in hypocalcemia. Oxalic acid poisoning can cause hypoclacemia. Oxalic acid It is also known as salt of sorrel or acid of sugar. It is used to erase writing, as bleaching agent and in calico printing. It occurs in leaves of rhubarb. Local effects : Oxalic acid rarely damages the skin but readily corrode the mucus membrane of digestive tract. Systemic : (i) Shock : Large doses can cause death from shock; (ii) Hypocalcemia : Oxalic acid readily combines with calcium to cause hypocalcemia, which may present as tingling, numbness, twitching, tetany, and convulsions, (iii) Renal damage : It is due to oxaluria which may cause tubular necrosis. Antidote : Any calcium preparation (e.g. calcium gluconate/chloride, lime water, suspension of chalk) which converts poison into insoluble calcium oxalate is an antidote for oxalate poisoning. Join @FMThubs

137.Explanation Correct Answer - D Ans. is 'd' i.e., 210 days Viability means the physical ability of a foetus to lead a separate existence after birth apart from its mother, by virtue of a certain degree of development. A child is viable after 210 days (7 months) of intrauterine life, and in some cases after 180 days (6 months) but in most of these cases fetus is immature. Full term mature infant show :- Length (crown-heel length) 48-52 cm, head circumference 30-35 cm. Ossification center at lower end of femur (appears at the end of 9 months or just before birth) and Ossification center of cuboid and upper tibia may also present (Note : some ossification centers are also present, but they appear before the attainment of viability so their presence does not have importance. These are (i) Clavicle, mandible, ribs vertebra → at the end of 2nd month, (ii) Calcaneum(os calcis) and manubrium sterni → at the end of 5th month and (iii) Sternum → at the end of 6 month). Other center which appears at attainment of viability is primary ossificaion center of talus which appears at the end of 7th month Join @FMThubs

136.Explanation Correct Answer - B Ans. is 'b' i.e., It is developed in presence of air Adipocere formation (saponification). Adipocere is a modification of putrefaction, which occurs in the absence of air. That is when there is excessive moisture (humidity) and warnth (warm temperature), but absence of air i.e. warm humid climate, normal putrefaction does not occur, rather saponification occurs. Thus adipocese formation occurs in dead bodies which are lying in water (immered in water) or burned in damp lay soil. Saponification (adipocer formation) is the conversion of dead body into soft, fatty waxy substance due to conversion of unsaturated liquid fats to saturated solid fats under the influence of intrinsic lipase and lecithinase produced by Cl. perfringens. The process involves gradual hydrolysis and hydrogenation of body fats into higher fatty acids which combine with calcium and ammonium ions to form insoluble soaps. Ultimately, palmitic, oleic, stearic and hydroxystearic acids are formed, mixture of these is known as adipocere. Adipocere formation starts in subcutaneous fat and is marked in areas having excessive fat, eg. cheeks, female breast, buttocks and abdomen. Slowly the whole body including muscles and internalviscera change into adipocere. Adipocere has offensive or sweetish smell, however in early stages, smell is ammonical. Body is converted into soft, waxy and brittle substance, it floats on water, it can be cut easily, it dissolves in alcohol and ethers, and it melts on heating. Facial features and injuries on body are well preserved, thus identfication of body and determination cause of death (in case of injury) are possible. Normally adipocere formation requires 3 weeks to upto 3 to 6 months. However shortest recorded period in india is 3 days 22 hours. In india, it has been observed to begin within 4-5 days. Adipocere may persist for years or decades. Adipocere does not occur in foetus less than 7 month's. Medicolegal importance : (i) Identification of body (facial features are preserved), (ii) cause of death (injury marks are preserved), (iii) time since death can be estimated. Join @FMThubs

135.Explanation Correct Answer - B Ans. is 'c' i.e., < 18 years Juvenile Justice Act 2000 Juvenile justice (care and protection of children Act, 2000 (now Amendment Act 2006) covers :- i. Juveniles in conflict → child who is alleged to have committed an offence. ii. Children in need of care and protection → children who are neglected, abused, or abandoned. This act defines a juvenile / child as a person who has not completed the age of 18 years. Join @FMThubs

134.Explanation Correct Answer - C Ans. is 'c' i.e., Maceration Dead born : A deadborn child is one which has died in utero and shows one of the following signs after it is completely born :? 1) Rigor mortis : Rigor mortis may occur in dead fetus before birth or at birth. 2) Maceration : Maceration is a process of aseptic autolysis. It occurs when a dead fetus remains in the uterus for 3-4 days surrounded by liquor amnii but with exclusion of air. Skin slippage is the earliest sign (occurs within 12 hours). There is gas in the great vessels and chambers of heart (Robert's sign). Except for lung and uterus, which remain unchanged for a long time, all other organs become soft, oedematous and loose there morphology. The one important radiological sign suggestive of maceration is 'Spaulding's sign' i.e. skull bones override each other. The smell is somewhat rancid. 3) Putrefaction (decomposition) : If the membranes are ruptured after death of fetus and air gains entry into liquor amnii, fetus undergoes putrefaction instead of maceration. Body is greenish, foul smelling and bloated. 4) Mummification : It results when there is deficient blood supply, scanty liquor and no air enters uterus. Body is thin, shrivelled dark brown and emitting smell like rotten cheese. Join @FMThubs