This is syllabus for my FMT exam I have zero knowledge give me questions asked and answers for them which are most probably come or asked in exam

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I now have enough material from the FMT textbooks to give a thorough exam prep answer. Let me compile everything.

FMT Exam - Most Important Questions & Answers

Based on P C Dikshit, Parikh's, and Essentials of Forensic Medicine & Toxicology textbooks

1. MECHANICAL ASPHYXIA

Q1. Define mechanical asphyxia. What are its types?

Ans: Mechanical asphyxia is a term applied to circumstances in which mechanical interference to respiration occurs that either:

(a) Impedes access of air to the lungs, OR
(b) Reduces blood supply to the head and neck, OR
(c) Causes sudden cardiac arrest due to stimulation of the carotid sinus (vagal reflex mechanism)

Types:

Hanging
Strangulation (manual / ligature)
Smothering
Choking
Traumatic (positional/postural) asphyxia
Drowning
Burking (simultaneous smothering + traumatic asphyxia)

Q2. What are the classical signs of asphyxia? (MOST ASKED)

Ans: The classical 5 signs of asphyxia (nonspecific - can occur in other deaths too):

Sign	Details
1. Cyanosis	Bluish discoloration of skin/lips/nails. At least 5 gm% reduced hemoglobin needed before it becomes visible. Most significant if found within a few hours of death.
2. Congestion	Visceral congestion due to capillo-venous congestion from hypoxia. Dilatation of right side of heart + pulmonary congestion.
3. Petechiae (Tardieu spots)	Pinpoint hemorrhages on pleura, pericardium, conjunctiva, and brain. Due to rupture of capillaries. Very significant forensically.
4. Oedema of lungs	Waterlogging of lungs due to increased permeability of capillaries.
5. Fluidity of blood	Blood is dark and fluid due to lack of oxygen; fibrinolysis is increased.

Q3. Differentiate Hanging from Strangulation.

Feature	Hanging	Ligature Strangulation
Weight	Body weight constricts	External force
Ligature mark	Oblique, non-continuous, above thyroid cartilage	Horizontal, continuous, below thyroid cartilage
Petechiae	Rare in typical hanging	Common and marked
Dribbling of saliva	Present	Absent
Face	Pale in typical	Congested, cyanosed
Manner of death	Usually suicide	Usually homicide

Q4. What is Burking? What are Tardieu spots?

Ans:

Burking = Simultaneous application of smothering AND traumatic/compressional asphyxia. Named after the murderer William Burke (1828, Edinburgh). It leaves no external marks of violence, making it a method used in homicide.
Tardieu spots = Subpleural, subpericardial, and subconjunctival petechial hemorrhages (pinpoint dark red spots) seen in asphyxial deaths. They are caused by rupture of capillaries due to raised intravascular pressure during struggling. Most significant when found in numbers on the pleural and pericardial surfaces.

Q5. What is positional/postural asphyxia?

Ans: Asphyxia resulting from a body position that interferes with breathing. Seen in:

Intoxicated persons falling in a bent/prone position
Infants placed face-down (prone sleeping - contributor to SIDS)
The diaphragm and chest wall cannot move properly, restricting ventilation.

2. SEXUAL JURISPRUDENCE

Q6. Define Rape. What are its legal requirements under IPC? (MOST ASKED)

Ans: Under Section 375 IPC, rape is defined as sexual intercourse by a man with a woman under any of the following conditions:

Against her will
Without her consent
With consent obtained by fear of death or hurt
With consent when she believes the man to be her husband
With consent when she is of unsound mind or intoxicated
With or without consent when she is under 18 years of age (statutory rape)
When she is unable to communicate consent

Even slight vulval penetration is sufficient to constitute rape - full penetration is NOT necessary. Emission of semen is NOT necessary.

Q7. What are the medical signs of rape? (VERY FREQUENTLY ASKED)

Ans:

General signs:

Torn, dirty, or bloodstained clothing
Bruising, scratches, bite marks on body
Signs of struggle (torn nails, bruises on arms/thighs/breast)

Local genital signs:

Laceration / tears of hymen (especially at 3, 6, 9 o'clock positions)
Bruising of labia majora/minora
Injuries to fourchette and perineum
Vaginal discharge (may contain semen)
Presence of spermatozoa on vaginal smear

Smears taken:

From vagina - for spermatozoa
From urethra - for gonorrhea
From sore - for syphilis/chancroid

Note: A normal examination does NOT exclude rape. Signs depend on how quickly the examination is done, whether she bathed, the nature of force used, and her age.

Q8. What is the medicolegal significance of the hymen?

Ans:

The hymen is a fold of mucous membrane at the vaginal opening. Its presence does NOT prove virginity and its absence does NOT prove rape.
A hymen may remain intact even after sexual intercourse (especially in elastic or fimbriated hymen).
Fresh tears (with raw edges, bleeding, no healing) at 6 o'clock position are significant.
Old healed tears show rounded smooth edges and may indicate prior intercourse.
In legal medicine, hymenal condition is noted but NOT conclusive alone.

Q9. What is examined on the accused (male) in a rape case?

Ans:

General build and age
Genitals: condition of penis, prepuce, any injury, presence of blood/secretions
Presence of pubic hair (comparative)
Smear from urethra for spermatozoa, gonorrhea
Blood group examination
Signs of struggle (scratches, bite marks)
Signs of recent sexual activity

3. REGIONAL INJURIES

Q10. What are the medicolegal aspects of head injuries?

Ans:

Scalp injuries: Lacerations vs incised wounds; can reveal nature of weapon
Skull fractures: Linear, depressed, comminuted, diastatic, growing fracture
Intracranial hemorrhages:

Type	Source	Clinical Feature
Extradural (Epidural)	Middle meningeal artery tear	"Lucid interval" then deterioration
Subdural	Bridging veins	More insidious onset
Subarachnoid	Berry aneurysm rupture / trauma	Sudden severe headache
Intracerebral	Brain parenchyma	Focal neurological deficit

Lucid interval (most important exam point) = A period of normal consciousness following a head injury, after which the patient deteriorates. Classic of extradural (epidural) hematoma.

Q11. What is "contre-coup" injury?

Ans: Contre-coup (French = "counter-blow") injury is brain injury that occurs on the opposite side of the skull from the impact site. It happens because the brain, being a semisolid, moves within the skull and hits the far wall. It is typically more severe than the coup (direct) injury and is most commonly seen in falls (occipital impact causing frontal lobe injury).

Q12. Medicolegal aspects of neck injuries?

Ans:

Fracture of hyoid bone - strongly suggests manual strangulation
Cricoarytenoid dislocation - sign of throttling
Ligature marks - location and direction help distinguish hanging vs. strangulation vs. throttling
Dissection of neck structures is mandatory in all suspicious neck deaths

4. ABORTIONS

Q13. Define abortion. Differentiate medical and legal definition. (MOST ASKED)

Ans:

	Medical Definition	Legal Definition
Meaning	Spontaneous or induced expulsion of products of conception before viability (28 weeks)	Expulsion of products of conception at any period prior to full term
Trimester terminology	Abortion (1st trimester), Miscarriage (2nd), Premature labor (3rd)	All three are synonymous
Products	Ovum (7-10 days), Embryo (10 days to 9 weeks), Fetus (>9 weeks)	No distinction made

Q14. Classify abortion. (FREQUENTLY ASKED)

Ans:

A. Natural (Spontaneous):

Spontaneous - natural causes
Accidental

B. Artificial (Induced):

Justifiable (Legal/Therapeutic) - under MTP Act
Criminal - illegal termination

C. Clinical Types:

Threatened - vaginal bleeding, cervix closed, fetus viable
Inevitable - bleeding + cervical dilation, cannot be saved
Incomplete - partial expulsion of products
Complete - all products expelled
Missed - fetus dies but retained >8 weeks (carneous/blood mole)
Septic - infection complicates incomplete abortion
Habitual/Recurrent - 3 or more consecutive abortions

Q15. What is the MTP Act? What are the grounds for legal abortion in India? (IMPORTANT)

Ans: The Medical Termination of Pregnancy (MTP) Act, 1971 (amended 2021):

Grounds for legal abortion:

Up to 20 weeks - by one registered medical practitioner if:
- Continuation endangers the woman's life or physical/mental health
- Risk of physical/mental abnormality in child
- Pregnancy due to rape
- Contraceptive failure
Up to 24 weeks (2021 amendment) - for special categories (rape survivors, minors, disabled women) - requires opinion of two RMPs
After 24 weeks - only by Medical Board for fetal abnormalities

Q16. What are the signs of criminal abortion at autopsy?

Ans:

Uterus enlarged, soft, and congested
Products of conception partially or fully expelled
Evidence of instrumentation: perforations, lacerations of cervix/uterus
Signs of sepsis (peritonitis, purulent discharge)
Signs of air embolism (frothy blood in right heart - if air was introduced)
Chemical burns to vagina if chemicals were used
Blood clots, placental tissue in uterine cavity

5. CORROSIVES

Q17. Define a corrosive poison. Classify corrosives. (MOST ASKED)

Ans:

Definition: A corrosive poison fixes, destroys, and erodes the surface with which it comes in contact. They act by:

Extracting water from tissues
Coagulating cellular proteins
Converting hemoglobin into hematin

Classification:

Group	Examples
Inorganic acids	Sulfuric acid (H2SO4), Nitric acid (HNO3), Hydrochloric acid (HCl)
Organic acids	Carbolic acid (phenol), Oxalic acid, Formic acid, Acetylsalicylic acid
Alkalis	Sodium hydroxide (caustic soda), Potassium hydroxide, Ammonia

Q18. Describe the features of Sulfuric acid poisoning. (VERY FREQUENTLY ASKED)

Ans:

Synonyms: Oil of vitriol; H2SO4

Characteristics: Heavy, odorless, colorless, nonfuming, hygroscopic, oily liquid with tendency to carbonize organic substances.

Mechanism of action:

Exothermic reaction on contact with moist skin
Causes coagulation necrosis (forms a hard crust = eschar)
Crust may limit penetration but acid is absorbed systemically causing acidosis, hemolysis, decreased cardiac output

Signs and symptoms:

Mouth/lips: Black/brown burns, charring
Stain: Grayish-black eschar (darkens with time)
Nitric acid stain: Yellow (xanthoproteic reaction)
Hydrochloric acid stain: Grayish-white eschar
Severe burning pain from mouth to stomach
Vomiting of dark blood-stained matter
Abdominal rigidity
Hematemesis

Treatment:

Do NOT give emetics or gastric lavage
Dilute with water/milk immediately
Neutralize with alkali (sodium bicarbonate, lime water, chalk)
Treat shock, pain (morphine), maintain airway

Q19. What are the differences between acids and alkalis as corrosives?

Feature	Acids	Alkalis
Action	Coagulation necrosis (harder eschar, limits spread)	Liquefaction necrosis (saponification - continues to spread deeper)
Stain color	Variable (H2SO4 = black, HNO3 = yellow, HCl = gray-white)	Soapy, grayish
Perforation risk	Stomach (acid damages pylorus)	Esophagus (alkali damages esophagus more)
Examples	Sulfuric, nitric, HCl, carbolic acid	NaOH, KOH, ammonia

Key: Alkalis cause liquefaction necrosis - they are MORE dangerous because the eschar does not limit penetration.

6. HEAT INJURIES

Q20. Classify heat injuries. (MOST ASKED)

Ans:

Type	Mechanism	Features
Heat cramps	Salt (NaCl) depletion due to excessive sweating	Painful muscle cramps, mainly in calves and abdomen; temperature normal; no cyanosis
Heat exhaustion (Heat syncope)	Peripheral vascular collapse from heat + humidity; NO elevation of temperature	Prostration, pallor, hypotension, poor venous return, cold clammy skin; recovers with treatment
Heat stroke (Sunstroke/Hyperpyrexia)	Failure of heat regulating mechanism	Temperature rises to 43°C+, hot and DRY skin (sweating fails), flushed face, rapid pulse, delirium, convulsions; HIGH mortality
Heat hyperpyrexia	Synonymous with heat stroke	See above

Q21. Describe heat stroke in detail. (FREQUENTLY ASKED)

Ans:

Synonyms: Sunstroke, hyperpyrexia, thermic fever, systemic hyperthermia

Cause: Impaired functioning of the heat regulating center in hypothalamus, caused by:

Failure of cutaneous circulation and sweating
Prolonged exposure to sun's infrared rays
A temperature of 32°C with 100% humidity can cause heat stroke

Prodromal symptoms:

Headache, nausea, vomiting
Dizziness, weakness in legs
Excessive desire to urinate

Signs:

Sudden loss of consciousness
Face: flushed and congested
Skin: hot and DRY (sweating fails - KEY sign)
Temperature rises to 43°C or above
Pulse: full and rapid
Respirations: stertorous
Pupils: contracted
Delirium and convulsions may precede death

Fatal period: A few minutes to 3 days

Cause of death: Paralysis of the medullary heat regulating centre

Treatment:

Move to cool place immediately
Active cooling (ice packs, cold water sponging)
IV fluids (saline, glucose, sodium bicarbonate)
Prevent/treat complications

Q22. Differentiate heat exhaustion from heat stroke. (EXAM FAVOURITE)

Feature	Heat Exhaustion	Heat Stroke
Body temperature	Normal or slightly raised	Markedly raised (>40-43°C)
Skin	Cold, clammy, pale	Hot, DRY, flushed
Sweating	Present (profuse)	ABSENT (key feature)
Consciousness	Intact	Loss of consciousness
Mortality	Rare - recovers	High mortality
Mechanism	Peripheral vascular collapse	Failure of heat regulation

Q23. What are the postmortem findings in heat stroke?

Ans:

Brain: congested, edematous; petechial hemorrhages
Lungs: congested and edematous
Heart: subendocardial hemorrhages; right ventricle dilated
Liver: centrilobular necrosis (due to hyperthermia)
Kidneys: acute tubular necrosis
Petechiae in serosal surfaces
Blood: dark and fluid

Quick Revision - HIGH YIELD FACTS

Topic	Key Fact
Asphyxia	Tardieu spots = subpleural/subpericardial petechiae
Cyanosis	At least 5 gm% of reduced Hb needed
Rape	Even slight vulval penetration = rape; emission NOT needed
MTP	Up to 20 weeks (normal); up to 24 weeks (special cases - 2021 amendment)
Abortion (medical)	Before 28 weeks
Corrosive action	Extracts water + coagulates proteins + converts Hb to hematin
Sulfuric acid stain	Black/grayish-black
Nitric acid stain	Yellow (xanthoproteic reaction)
Alkalis vs acids	Alkalis cause liquefaction necrosis (more dangerous)
Heat stroke skin	Hot and DRY (no sweating)
Heat stroke temp	43°C or above
Lucid interval	Extradural (epidural) hematoma
Contre-coup	Injury opposite to impact
Burking	Smothering + traumatic asphyxia; no external marks

Sources: P C Dikshit Textbook of FMT, Parikh's Textbook of Medical Jurisprudence FMT, Essentials of Forensic Medicine & Toxicology (36th ed, 2026)

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