Mastering Forensic Medicine and Toxicology for NEET-PG and INI-CET in Just 3 Days

2‑Day Plan (quick)

  • Day 1: Legal medicine, injuries/mechanical violence, asphyxial deaths.
  • Day 2: Toxicology (general + common poisons), identification & postmortem, documentation.
  • Revision: High‑yield differences, antidotes, algorithms, and last‑day cues.

1) Legal medicine: basics

  • Medicolegal case (MLC): registration, documentation, consent, confidentiality.
  • Types of consent: informed, implied, proxy; emergency care principles.
  • Professional secrecy and privileged communication (concepts); record keeping.
  • Chain of custody: labeling, sealing, dispatch, receipt.

2) Courts, inquests, and testimony

  • Types of courts; medical witness roles (fact vs expert).
  • Summons, oath, examination‑in‑chief, cross‑examination, re‑examination.
  • Inquest basics: police vs magistrate (concepts and indications).
  • Dying declaration and deposition: essentials and precautions.

3) Negligence and ethics

  • Duty, breach, causation, damage: essentials of negligence.
  • Civil vs criminal negligence; standard of care; common defenses.
  • Res ipsa loquitur (concept); documentation pearls to avoid litigation.

4) Identification

  • Age estimation: teeth eruption, common epiphyseal fusions (concept level), Gustafson overview.
  • Sex determination: pelvis and skull differences (key pointers).
  • Stature estimation: long‑bone formulae (concepts).
  • Individualizing features: scars, tattoos, fingerprints, DNA basics, blood groups.

5) Death diagnosis and postmortem changes

  • Somatic vs brain death; signs of death.
  • Early changes: cooling, lividity, rigor (onset, progression, disappearance).
  • Late changes: putrefaction sequence, adipocere, mummification.
  • Time since death: practical markers; cadaveric spasm note.

6) Injuries and mechanical violence

  • Types: abrasion, bruise, laceration (split, stretch, avulsion), incised, stab (penetrating/perforating).
  • Patterned injuries; defense wounds; hesitation cuts.
  • Blunt vs sharp force features.
  • Firearm injuries: entry vs exit, range indicators (blackening, tattooing, burning), shotgun spread basics.
  • Blast injuries; road traffic injuries; falls.
  • Thermal injuries (burns: degrees, antemortem vs postmortem signs), electrical and lightning injuries (Joule burn basics).

7) Asphyxial deaths

  • Hanging: ligature mark features, typical internal findings.
  • Ligature strangulation and throttling: key differences from hanging.
  • Smothering and choking; traumatic asphyxia.
  • Drowning: external signs (froth, washer‑woman changes, cutis anserina), internal pointers; brief note on diatoms (concept).

8) Sexual offences and related examinations

  • Consent, confidentiality, and chain of custody in sexual assault exams.
  • Evidence collection: clothing, swabs, nail scrapings, foreign material.
  • Signs of recent and old intercourse (concepts); semen detection basics.
  • Hymen variations; potency/virginity evaluation approach.
  • Age considerations for consent (know local thresholds at a concept level).

9) Obstetric/infant forensic points

  • Signs of live birth vs stillbirth; hydrostatic test (concept), maceration.
  • Foetal age estimation: quick pointers.
  • Concealed birth and infanticide (overview only).

10) Forensic psychiatry (high‑yield basics)

  • Insanity defenses (concept); true vs feigned insanity indicators.
  • Testamentary capacity; fitness to stand trial (competency).

11) Toxicology — general principles

  • Toxidromes: cholinergic, anticholinergic, opioid, sympathomimetic, sedative‑hypnotic.
  • Stabilization priorities (ABCDE); decontamination overview.
  • Gastric lavage: indications and contraindications (concepts).
  • Activated charcoal: dose basics; multiple‑dose charcoal (when used).
  • Whole‑bowel irrigation: when considered; enhanced elimination (dialysis/alkalinization) overview.

  • Antidotes: concept and when to prioritize.

12) Common poisons and key management cues

  • Alcohols: ethanol, methanol, ethylene glycol — fomepizole/ethanol; adjuncts as appropriate.
  • Asphyxiants: carbon monoxide (100% oxygen), cyanide (antidote kit/hydroxocobalamin), hydrogen sulfide (supportive).
  • Organophosphorus/carbamates: cholinergic toxidrome; atropine; oximes (where indicated); watch for intermediate syndrome.
  • Aluminum phosphide: no proven antidote; early decontamination and aggressive supportive care.
  • Paraquat: decontamination; avoid high FiO₂; supportive management.
  • Corrosives (acids/alkalis): no gastric lavage; airway and perforation risk management.
  • Metals: iron (deferoxamine), lead (chelation options), arsenic/mercury (appropriate chelators) — concept level.
  • Analgesics/antipyretics: paracetamol (N‑acetylcysteine), salicylate (alkalinization; dialysis criteria concept).
  • Cardiovascular/tox CNS: beta‑blocker (glucagon), calcium‑channel blocker (calcium; high‑dose insulin), digoxin (Fab), TCA (sodium bicarbonate), benzodiazepines (flumazenil caution), opioids (naloxone).
  • Respiratory/CNS stimulants: theophylline (charcoal; consider dialysis in severe), caffeine.
  • Snakebite: neurotoxic vs hemotoxic features; antivenom indications; first‑aid (immobilize; no incision/suction/tourniquet); basic 20‑min whole blood clotting test concept.
  • Scorpion/spider: autonomic storm (prazosin concept); supportive.
  • Plants: Datura (anticholinergic), oleander/thevetia (cardiac glycosides), abrus (abrin), castor (ricin) — core features and first steps.
  • Food poisoning: staphylococcal (short incubation), botulism (neurotoxin; antitoxin), salmonella (GI illness) — key patterns.

13) Poison identification and lab approach

  • Clinical clues: odour, pupil size, skin signs, colour of vomitus/urine, ECG patterns.
  • Samples for analysis: stomach contents, intestine contents, liver, kidney, spleen, blood, urine (typical set).
  • Preservation: appropriate containers; common preservatives (e.g., sodium fluoride for blood alcohol); avoid incompatible preservatives for volatile/oxidizable poisons (concept level).

14) Medico‑legal documentation and reports

  • Injury certificate; age certificate; fitness for statement; sexual assault proforma (concepts).
  • Postmortem report essentials; death certificate basics.
  • Sample labeling, sealing, forwarding; chain of custody.

15) Last‑day revision (high‑yield cues)

  • Age/sex ID keys; injury differentials (incised vs laceration; stab vs chop).
  • Hanging vs strangulation vs throttling — spot differences.
  • Drowning hallmark signs.
  • Top toxidromes and first antidote steps.
  • Snakebite first‑aid and ASV indications.
  • Decontamination contraindications (corrosives, hydrocarbons with high aspiration risk).
  • Time since death pointers and order of postmortem changes.
  • Court/inquest differences and dying declaration essentials.

16) Practice pattern

  • MCQs in timed blocks (25–50); review and rewrite the rule you learned from each error.
  • Mix recall + application: 60% recall, 40% case vignettes.
  • Keep a one‑page “antidote first steps” sheet and an “injury differentiators” sheet for last‑minute review.
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