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FMT QUESTION PAPER - MODEL ANSWERS

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10 MARKS

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1. MEDICAL NEGLIGENCE (MALPRACTICE)

1. Duty - The doctor owes a duty of care to the patient (doctor-patient relationship established)
2. Dereliction (Breach) - Breach of that duty by omission or commission
3. Direct causation - Direct/proximate causal link between breach and damage
4. Damage - The patient suffered actual damage/injury

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• Most common form
• Patient sues for monetary compensation
• Standard: Balance of probabilities
• Governed by Consumer Protection Act (CPA) 1986 in India - doctors' services are covered under "services" definition

• Gross, reckless, and wanton disregard for human life
• Punishable under Sec. 304-A IPC (culpable homicide not amounting to murder)
• Standard: Beyond reasonable doubt
• Examples: administering wrong drug, leaving instruments in abdomen, operating on wrong limb

• Bolam test (1957): A doctor is not negligent if he acts in accordance with a practice accepted as proper by a responsible body of medical men. ("Standard of the ordinary skilled man exercising and professing to have that special skill")
• Jacob Mathew vs. State of Punjab (2005): Supreme Court of India laid down guidelines - a doctor cannot be prosecuted criminally unless there is gross negligence. Prior consultation with an independent expert required before arresting a doctor.
• Hatcher vs. Black & Others (1954): Lord Denning compared negligence to a dagger that wounds the doctor's reputation.

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• Duty to choose patient: A doctor has the right to refuse any patient before accepting. Once accepted, duty of care begins.
• Emergency duty: Morally and ethically bound to provide best possible help to save life, even without formal doctor-patient relationship. If patient dies in such circumstances, doctor cannot be sued.
• Res Ipsa Loquitur ("the thing speaks for itself"): Doctrine applied when negligence is self-evident - e.g., swab left inside abdomen, operation on wrong limb. No expert opinion needed; burden of proof shifts to the doctor.

1. Volenti non fit injuria - patient consented to the risk
2. Error of judgment - one among acceptable alternatives was chosen
3. Contributory negligence - patient's own negligence contributed
4. Following standard textbook/protocol
5. No doctor-patient relationship established

• Maintain proper records and consent forms
• Informed consent before procedures
• Do not exceed competence
• Refer when in doubt
• Keep updated with current medical knowledge

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2. AUTOEROTIC SEXUAL ASPHYXIA

• The individual uses transitory anoxia produced by a noose to intensify sexual gratification produced by masturbation
• Impaired circulation leads to impaired consciousness
• This impaired consciousness causes hallucinations and feelings of erotic rapture
• The degree of asphyxia is controlled by mechanical means (by extending/flexing arms/legs)
• A failure of the mechanism accidentally causes death

• Virtually always male (>99% male victims)
• Homosexual tendency may be present
• Abnormal sexual behaviour such as masochism, transvestism may be associated
• Usually occurs in the victim's own house (bedroom or attic)
• Repetitive pattern of behaviour

1. Incomplete hanging - feet on ground (can relieve pressure by standing straighter)
2. A stool or chair found near the hanging victim
3. Evidence of previous episodes - old scars on the neck
4. Victim is usually naked or partly naked
5. Padding between ligature and neck (pad/cloth between rope and skin to prevent visible marks)
6. Erotic or pornographic photographs/literature at scene
7. Articles of female clothing (transvestism)
8. A mirror placed opposite the individual
9. Evidence of recent ejaculation (seminal stains)
10. No suicidal note
11. Electrical stimulation devices (low voltage stimulation of genitalia) may be present

• Plastic bags over the head to induce partial anoxia
• Inhalation of anaesthetics or narcotic vapours
• Inhalation of carbon tetrachloride, bichloroethane, petroleum products (glue sniffing)

• Asphyxial signs: petechiae, cyanosis, conjunctival hemorrhages
• Ligature mark (usually padded, hence incomplete mark)
• No features of suicidal intent
• No features of homicide (no self-defence injuries, no signs of struggle)

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5 MARKS

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3. PUTREFACTION

• Usually follows the disappearance of rigor mortis
• During hot season, may commence before rigor mortis has completely disappeared from lower extremities
• Begins immediately after death at the cellular level (not grossly evident initially)

1. Gram-negative organisms from the alimentary canal enter tissues shortly after death and through the respiratory tract or skin wounds
2. Bacteria multiply using tissue carbohydrates and proteins; peak reached in all body parts within 24-30 hours
3. Fall in O2 and rise in H+ after death favours bacterial growth
4. Absence of protective agencies allows spread through blood vessels
5. Chief destructive agent: Clostridium welchii (causes haemolysis, liquefaction of clots, tissue disintegration, gas formation)
6. Lecithinase produced by Cl. welchii hydrolyses lecithin in all cell membranes - causes postmortem hemolysis
7. Other organisms: Streptococci, Staphylococci, Bacteroids, B. proteus, B. coli

• Hydrogen sulphide (H2S) - characteristic foul odour
• Carbon dioxide, methane, ammonia, nitrogen

• Heat (optimal: 21-38°C)
• Moisture
• Air (surface bodies decompose faster)
• Obesity
• Traumatised tissue, infections, septicaemia
• Shallow burial

• Cold (below 0°C halts putrefaction)
• Dryness (leads to mummification)
• Deep burial
• Submersion in water (initially retards, then accelerates)
• Antiseptics/embalming
• Antimicrobials given before death

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4. COCAINE

• Intranasal snorting (most common)
• Intravenous injection ("shooting up")
• Smoking as "crack" cocaine (free base form)
• Oral (rare)

1. Blocks reuptake of dopamine, serotonin, and norepinephrine (monoamine reuptake inhibitor)
2. Local anaesthetic - blocks Na+ channels
3. Powerful CNS stimulant and euphorigenic

• Anorexia, loss of weight, weakness, tremors
• Impotence, moral deterioration, insanity
• Magnan's symptom (Cocaine bugs/Formication): Sensation of grains of sand under skin or small insects creeping on skin - most characteristic tactile hallucination
• Tongue and teeth black (in cocaine eaters)
• Nasal septal ulceration/perforation (snorters)
• Women: Increased erotic tension, nymphomania
• Men: Sexual perversions, mainly homosexuality
• Delusions of persecution, visual and tactile hallucinations

• Nasal septum perforation
• Cardiac hypertrophy
• Pulmonary oedema
• Chemical analysis of blood/urine for benzoylecgonine (metabolite)

• Benzodiazepines for agitation/seizures
• Cooling for hyperthermia
• Drugs to AVOID:
  • Beta-blockers (propranolol) - cause paradoxical hypertension/coronary spasm
  • Haloperidol/phenothiazines - hyperpyrexia, convulsions
  • Lignocaine/quinidine - arrhythmias
  • Dantrolene - cardiac insufficiency
• Bromocriptine 0.625 mg 6-hourly reduces craving and counters withdrawal

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5. GUSTAFSON'S METHOD OF AGE ESTIMATION

• Young adults: Attrition most useful
• Older adults: Root dentin translucency most reliable

• Can be used even with fragmentary remains
• Teeth resistant to putrefaction, fire, trauma
• Applicable from adolescence to old age
• Most accurate among dental methods

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6. SIDS (Sudden Infant Death Syndrome)

• Leading cause of death between ages 1 month and 1 year in developed countries
• 90% of cases: infant younger than 6 months
• Peak age: 2-4 months
• More common in males
• Winter months more common
• Usually dies while asleep
• SIDS in a previous sibling: 5-fold relative risk

• Young maternal age (<20 years)
• Maternal smoking during pregnancy
• Drug use (maternal opiate/cocaine use, paternal marijuana)
• Short inter-gestational intervals
• Late or no prenatal care
• Low socioeconomic group

• Brainstem abnormalities (delayed development of arousal and cardiorespiratory control)
• Prematurity and/or low birth weight
• Male sex
• Product of multiple birth

• Prone sleeping position (most important modifiable risk factor)
• Soft sleeping surface
• Hyperthermia (overheating)
• Bed-sharing (co-sleeping)
• Second-hand smoke exposure

1. Vulnerable infant (intrinsic susceptibility - brainstem serotonin receptor abnormality)
2. Critical developmental period (2-4 months - transitional arousal period)
3. Exogenous stressor (prone position, soft bedding, overheating)

• Petechial haemorrhages on pleural and pericardial surfaces (most constant finding)
• Pulmonary oedema
• Thymic petechiae
• Mild bronchopneumonia/laryngeal inflammation
• No definitive cause of death identified

• Supine sleeping position
• Firm flat sleeping surface
• Avoid soft bedding, pillows
• Room temperature comfortable
• Avoid smoking during pregnancy
• Breastfeeding encouraged

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7. CIVIL RESPONSIBILITIES OF A MENTALLY ILL PERSON

• Contracts made by a person of unsound mind are void ab initio
• A person who is occasionally of sound mind may contract during lucid intervals
• Burden of proof: The party seeking to avoid contract must prove unsoundness at the time of contract

• Under the Hindu Marriage Act, 1955: Marriage is voidable if one party was of unsound mind at the time of marriage (Sec. 5 & 12)
• Under Special Marriage Act: Any mental illness/unsoundness that prevents valid consent makes marriage void

• A Will made by a person of unsound mind is invalid (Sec. 59, Indian Succession Act)
• "Lucid interval" doctrine: A Will made during a lucid interval is valid
• Test of testamentary capacity: Person must know the nature of the act, extent of property, persons naturally expected to benefit, and be free from delusion

• Courts may appoint a guardian for a person with mental illness
• National Trust Act 1999 covers guardianship for autism, cerebral palsy, mental retardation, multiple disabilities

• Manager may be appointed by court to manage estate (Committee of the Person/Estate under old MHA 1987)
• Under MHCA 2017: Nominated Representative concept replaces committee system

• Mental illness is a disqualification for obtaining a driving license

• Persons of unsound mind are disqualified from voting (Representation of People's Act)

• A mentally ill person may give evidence if the court is satisfied they understand the questions and can give rational answers (Sec. 118, Indian Evidence Act)

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8. MTP (MEDICAL TERMINATION OF PREGNANCY) AND RECENT AMENDMENTS

• Termination allowed up to 20 weeks
• By a Registered Medical Practitioner (RMP)
• In a Government hospital or approved private facility
• Grounds for termination:
  1. Risk to life or grave injury to physical/mental health of the woman
  2. Substantial risk of serious physical/mental handicap in the child
  3. Pregnancy due to rape (presumed to cause grave mental injury)
  4. Failure of contraceptive device (for married couple)

1. Survivors of sexual assault or rape or incest
2. Minors
3. Change of marital status during ongoing pregnancy (widowhood, divorce)
4. Women with physical disabilities (50% disability as per RCI Act)
5. Mentally ill women (including intellectual disability)
6. Fetal malformation incompatible with life/substantial fetal abnormality
7. Women in humanitarian settings/disasters/emergencies

• Each state/UT must constitute a Medical Board
• Comprises: Gynaecologist, Paediatrician, Radiologist/Sonologist, and other members as prescribed
• Decision must be given within 3 days of reference

• Unmarried women included: Previously only married women could use contraceptive failure as ground; 2021 amendment extends to "any woman or her partner" (unmarried women included)
• Confidentiality: Details of the woman cannot be disclosed except to authorized persons
• Name and privacy protected

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9. DACTYLOGRAPHY

• Francis Galton (1892): First to classify and study fingerprints scientifically; first to prove permanence and uniqueness
• Sir William Herschel (1858): First to use fingerprints for identification in India (Bengal, British India)
• Henry Faulds (1880): First to suggest fingerprints could identify criminals
• Edward Henry (1901): Developed the Henry Classification System (still used); established Scotland Yard fingerprint bureau
• Juan Vucetich (1892): Developed fingerprint classification (South America)

1. Permanence - Fingerprint ridges are formed at 12th week of fetal life and remain unchanged until decomposition after death
2. Uniqueness (Individuality) - No two individuals have identical fingerprints (even identical twins); probability of two identical prints: 1 in 64 billion
3. Practicability - Can be easily taken and classified

• Formed by dermal papillae in dermis and ridges of epidermis (friction ridges)
• Papillary ridges are permanent - burn/injury damages but ridges regenerate (Eguchi's case - skin grafted after deliberate destruction still shows original pattern)

• Plastic/Three-dimensional prints: Left in soft substances (wax, clay, putty, butter)
• Visible/Patent prints: Left by fingers contaminated with coloured substance (blood, grease, ink)
• Latent prints: Invisible impressions left by sweat; require development by:
  • Dusting with aluminium powder (light surfaces), carbon black (dark surfaces)
  • Chemical development: Ninhydrin (reacts with amino acids), silver nitrate
  • Iodine fuming

1. Identification of criminals (AFIS - Automated Fingerprint Identification System)
2. Identification of unknown dead bodies
3. Identification of victims of mass disasters (MCI)
4. Identification of unknown persons (amnesia, unconscious)
5. Thumb impression on legal documents
6. Detection of forgery of thumb impressions

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10. ARSENIC POISONING

1. Reversible combination with sulphydryl (-SH) groups in tissue proteins
2. Interference with enzyme systems essential for cellular metabolism
3. Capillary dilation and damage (capillary poison)
4. Fatty degeneration of liver
5. Hyperaemia and haemorrhages in intestine
6. Renal tubular necrosis
7. Peripheral axonal neuropathy (axis cylinder disintegration)

1. Metallic taste, slight garlicky odour in breath, xerostomia, dysphagia
2. Severe nausea, vomiting, colicky abdominal pain
3. Profuse diarrhoea with rice-water stools (due to vasodilation with transudation into bowel lumen)
4. Intense thirst; cold, clammy skin
5. Hyperpyrexia, acute haemolysis
6. Periorbital oedema, skeletal muscle cramping
7. Oliguria, proteinuria, haematuria
8. Cardiac manifestations: Cardiomyopathy, prolonged QT interval, ST-T changes
9. Hepatic and renal failure (if dose not immediately fatal)
10. Convulsions, encephalopathy, death from irreversible circulatory insufficiency

• Skin changes: Raindrop pigmentation (hyperpigmented spots on white background), keratosis of palms and soles, Bowen's disease
• Mee's lines: White transverse lines on nail plate (1-2 mm wide, 1-2 mm from lunula; seen 2-4 weeks after ingestion)
• Aldrich-Mee's lines are pathognomonic
• Hair loss (alopecia)
• Sensorimotor peripheral neuropathy ("glove and stocking" distribution)
• Peripheral vascular disease (Blackfoot disease in Taiwan)
• Skin, lung, and bladder cancer (carcinogen)
• Arsenic has predilection for keratin (high concentration in hair, nails, skin)

• Gastroenteritis pattern
• Fatty degeneration of liver
• Renal tubular necrosis
• Well-preserved body (arsenic retards putrefaction)
• Hair analysis (Reinsch test, Marsh's test positive)

• Marsh's test (most reliable) - arsenic deposits as shiny black mirror
• Reinsch test - arsenic deposits on copper strip
• Gutzeit test
• Atomic absorption spectrophotometry (gold standard)

• Gastric lavage with water
• BAL (Dimercaprol/British Anti-Lewisite) - chelating agent; forms non-toxic complex with arsenic
• DMSA (Succimer) - oral chelator, preferred
• Supportive care

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3 MARKS

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11. RUN AMOK (AMOK)

• A condition of sudden homicidal frenzy seen originally among Malay people (Malaysia, Indonesia)
• The individual suddenly starts running about indiscriminately attacking anyone he meets with weapons
• The person has no recollection of events afterwards (amnesia for the episode)
• Classification: Medically classified as a dissociative disorder or culture-bound syndrome (ICD-10: F44)
• In Malay language "amok" = engaging furiously in battle
• Medicolegal importance: Persons committing acts during amok state may be held partially or fully non-responsible (diminished responsibility)
• After the frenzy, the individual may commit suicide or is overpowered

1. Prodrome: brooding, social withdrawal
2. Acute phase: Sudden outburst of violent homicidal behaviour
3. Post-episode: Exhaustion, amnesia for the episode
4. Usually triggered by frustration, humiliation, or perceived insult

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12. PHOSSY JAW (Phosphorus Necrosis of Jaw)

• An occupational disease caused by chronic phosphorus poisoning - specifically white/yellow phosphorus
• Historically seen in match factory workers (banned after 1906 Berne Convention when red phosphorus replaced white)
• Still seen with exposure to rodenticides, munitions, and fireworks containing white phosphorus

• White phosphorus vapours inhaled → periodontal disease
• Periostitis of the jaw (mandible more than maxilla), progressing to osteomyelitis and necrosis
• The jaw becomes soft, swollen, painful
• Affected bone gives off faint greenish-white phosphorescence in dark (characteristic sign)
• Disfiguring - jaw may become grossly distorted
• Fatal if spreads to vital organs; may cause brain abscess if extends intracranially

1. Toothache, gum inflammation
2. Alveolar bone absorption
3. Periostitis, osteomyelitis
4. Necrotic bone - sequestrum formation
5. Pathological fracture and disfigurement

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13. COUP AND CONTRECOUP INJURY

• Coup injury: Brain injury occurring at the site of impact (directly beneath the blow)
• Contrecoup injury: Brain injury occurring at the site opposite to the point of impact

• When a moving head hits a fixed object (fall): Contrecoup > Coup (brain lags behind moving skull, hits opposite pole)
• When a stationary head is hit by a moving object: Coup > Contrecoup
• Due to: (1) Pressure waves generated at impact, (2) Movement of brain within skull (translational/rotational acceleration), (3) Negative pressure (cavitation) at contrecoup site

• Fall backward (occiput hits ground): Bifrontal contrecoup injuries (most common)
• Fall forward: Occipital contrecoup

• Contusions, haemorrhage, laceration at coup and/or contrecoup site
• Extradural haematoma (EDH): usually coup side (middle meningeal artery tear)
• Subdural haematoma (SDH): often contrecoup or rotational injury (bridging veins)

• Presence of contrecoup injury indicates the head was moving at impact (fall) rather than stationary head being struck (assault)
• Helps determine mechanism of injury

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14. HESITATION CUTS (Tentative Cuts)

• Linear incised wounds made before the fatal wound in suicidal cases
• Found at the same site as the main wound; usually parallel to each other and the main wound
• Characteristics:
  1. Multiple, parallel, superficial incisions
  2. Shorter than the fatal wound
  3. Usually located on wrists (ventral surface), throat, or forearms
  4. Do not penetrate deeply - involve only skin and superficial fascia
  5. Often overlying the main fatal wound or adjacent to it
  6. Dried scabs/healed marks indicate they were made earlier
  7. Old healed scars from previous attempts may also be present

• Strong indicator of suicidal intent - reflects the victim's hesitation before the decisive act
• They are virtually never found in homicidal wounds
• The absence of hesitation cuts does NOT exclude suicide

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15. SUMMONS

1. Summons to witness (Sec. 61, CrPC): Directs a person to appear as witness
2. Summons to accused (Sec. 204, CrPC): Issued in summons cases (minor offences)
3. Summons to produce a document (Sec. 91, CrPC)

• Summons case: Offence punishable with up to 2 years imprisonment
• Warrant case: Offence punishable with >2 years imprisonment

• Served personally by a police officer or court officer
• If person not found, may be given to adult male member of family
• If service not possible, affixed to house
• Must be in duplicate; recipient must sign one copy

• Can be treated as contempt of court
• A bailable or non-bailable warrant may then be issued

• On receiving summons, doctor must attend court
• Cannot refuse unless valid reason given
• Should bring original records/documents as specified

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16. DYING DECLARATION

• Section 32(1) of Indian Evidence Act, 1872
• Principle: "Nemo moriturus praesumitur mentire" - "A man will not meet his Maker with a lie in his mouth"
• Not subjected to cross-examination (declarant is dead)

1. Written - written by the patient themselves or by another at their dictation
2. Oral - spoken declaration recorded by physician, magistrate, or any reliable person
3. Gestural - signs, nods, or other gestures in response to questions (if unable to speak)
4. Thumb impression - signed by thumb impression

• Best: Executive Magistrate (preferred)
• Judicial Magistrate
• Doctor (when magistrate not available)
• Any person present (when imminent death is likely before a magistrate arrives)

1. Declarant must be in fit mental state to make declaration
2. Doctor must certify mental fitness before recording
3. Must be voluntarily made (no coercion)
4. Declarant should believe death is imminent (proximity to death)
5. Need NOT be corroborated - can be sole basis for conviction

• Does NOT require oath
• No need for presence of accused
• Multiple dying declarations: All are admissible; court decides consistency
• If declarant recovers - the declaration becomes irrelevant (hearsay rule)
• Must relate to cause of death or circumstances of the transaction resulting in death

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17. FRACTURES OF HYOID BONE WITH DIAGRAMS

        [Body]
       /       \
[Lesser horn]  [Lesser horn]
[Greater horn] [Greater horn]

        ___________
       |    Body   |
      /|           |\
     / |           | \
Lesser             Lesser
cornu              cornu
|                           |
Greater                   Greater
cornu                     cornu

• Fracture is rare in young (bone is cartilaginous and elastic up to 30-40 years)
• Fracture occurs most commonly after 40 years (bone becomes ossified/brittle)

1. Greater cornu fracture - Most common in strangulation; bilateral compression causes lateral to medial fracture of greater horns
2. Body fracture - Less common
3. Lesser cornu fracture - Rare

         Body
        _______
       |       |
LH----+       +----LH    LH = Lesser Horn/Cornu
       |_______|
      /         \
    GH*           *GH    GH = Greater Horn/Cornu
                         * = Common fracture sites (bilateral)

• Hands grip the neck
• Greater cornua are compressed medially against the spine
• Fracture occurs at the junction of body and greater cornu
• Fracture usually associated with haemorrhage at fracture site

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18. TYPES OF HYMEN

1. ANNULAR (Circular)     2. CRESCENTIC (Semilunar)
   ___________                 _________
  |     O     |               |    _    |
  |   (hole)  |               |   ( )   |
  |___________|               |_________|
  Most common type            Opening at anterior

3. CRIBRIFORM              4. SEPTATE
   ___________                 _________
  | o  o  o  |               |  | o |  |
  | o  o  o  |               |  |   |  |
  |___________|               |_________|
  Multiple small holes        Band crosses opening

5. IMPERFORATE             6. FIMBRIATED (Denticulate)
   ___________                 _________
  |           |               |~~~~~~~~~|
  | No opening|               |  scalloped edges
  |___________|               |_________|

7. SLEEVE/TUBULAR          8. BIFENESTRATE/BIFORAMINATE
   (Tubiform)                  Two openings

• Fresh tear: Bleeds, red, swollen edges
• Old tear: Complete, healed, smooth edges, reaching base
• Old scars/incomplete tears are not reliable indicators of virginity
• Carunculae myrtiformes: Remnants of hymen after defloration/delivery

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19. JOULE'S BURN (Crocodile Burn / Contact Burn)

1. Shape: Round or oval, punched-out appearance
2. Central area: Depressed, pale/grey-white or yellowish charred centre
3. Margins: Raised, hyperaemic, reddened border ("heaped up" edges like a crater rim)
4. Surface: Dried, hard, parchment-like
5. Crocodile skin appearance - alternating ridges and furrows on the burnt surface (hence "crocodile burn")
6. Surrounding area: Redness, vesicles
7. Size usually small (0.5-2 cm)

• "Comet cells" or "streaming" of nuclei due to electrical force
• Palisading of nuclei
• No inflammatory reaction (death is instantaneous)
• Vacuolation of epidermal cells

1. Confirms death by electrocution
2. Helps determine entry and exit points
3. Helps reconstruct the incident
4. May be absent in high voltage cases (flash burns predominate)

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20. BANSDOLA

• A bamboo stick (or heavy pole) is placed across the victim's neck while the victim is lying on the ground
• The executioner/assailant stands or sits on both ends of the bamboo pole, pressing it down forcibly onto the neck
• This causes compression of the neck structures leading to:
  • Compression of trachea and major vessels
  • Asphyxia due to obstruction of airway
  • Venous obstruction leading to cerebral congestion
  • Possible fracture of cervical vertebrae
  • Occasionally cervical cord injury

• Used as a method of execution in certain parts of India
• Occasionally used in homicidal cases (disguised as accident or suicide)
• Also encountered in accidental cases (vehicle accidents with rods)

• Signs of asphyxia (petechiae, cyanosis, congestion)
• Broad, horizontal ligature mark or compression mark across the neck (differs from narrow ligature mark)
• Fracture of thyroid cartilage and/or cervical vertebrae
• Bruising and haemorrhage in neck muscles
• No signs of struggle if victim was pinned down

• Bansdola produces a broad compression mark
• No finger marks or nail abrasions (unlike throttling)
• Evidence of the bamboo/stick may be found at scene

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QUICK REFERENCE INDEX

• For Medical Negligence (10 marks): Always mention the 4 Ds, Bolam test, Res Ipsa Loquitur, Jacob Mathew case, and civil vs. criminal distinction
• For Autoerotic Asphyxia (10 marks): The scene examination checklist is the most important component - examiners expect all 10 points
• For MTP amendments: The 2021 amendment is very likely to be tested; stress the expansion to 24 weeks, inclusion of unmarried women, and the Medical Board provision
• Hyoid bone fracture diagram should always be included when asked