INI-CET 2026 FMT Recall with Dr Gautam Biswas

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[00:00:01][music] >> Hey guys, welcome to this INICET May 2026 recall exam.

[00:00:13]Today we'll discuss forensic part and I am Dr. Gautam Biswas, professor and head DMCH Ludhiana. Let's begin.

[00:00:23]The questions this time, they are not very tough. Again, most of them they are repeat of previous years and you must have done pretty well.

[00:00:32]So let's begin with question number one.

[00:00:35]It is based on the the examination of rape survivor and it covers the MTP Amendment Act as well as the POCSO Act and part of consent also. So let's begin. A 16-year-old rape survivor presents at 16 week of pregnancy. All of the following are responsibilities of the examining doctor except you have to find the odd one out of all the four options.

[00:01:01]The options are A, fetal tissues for DNA to be preserved.

[00:01:06]B, inform the police. C, MTP if needed can be conducted by one doctor's opinion. So whether the MTP can be conducted by one doctor's opinion and D, parents consent for medico-legal examination. So whether it is required or not.

[00:01:23]So let's discuss the options.

[00:01:26]Fetal tissues for DNA to be preserved.

[00:01:29]Yes, it is important that you preserve the fetal tissues for DNA for DNA evidence.

[00:01:42]Inform the police as the patient is below 18 years, so you need to inform the police. Police information is mandatory as per the POCSO Act patient is minor.

[00:02:05]But for conducting the MTP, you need the consent of the guardian for conducting MTP.

[00:02:15]The guardian consent is required.

[00:02:20]MTP if needed can be conducted by opinion of one doctor. Yes. Up till 20 weeks, single doctor can opine for this MTP.

[00:02:33]Beyond 20 weeks, 20 to 24 weeks, two doctors.

[00:02:40]And beyond 24 weeks, a medical board.

[00:02:49]So, this is also correct.

[00:02:53]Parent consent for medical legal examination is not required for this is you have to make a distinguish between it's a medical legal examination. It is not the consent for MTP. For medical legal examination, a person who is more than 12 years can give consent.

[00:03:11]So, this is the wrong option.

[00:03:14]So, answer here will be D.

[00:03:16]Now, to recap what Just to recap what we have discussed up to 20 weeks, one doctor. 20 to 24 weeks, two doctors opinion is required.

[00:03:26]And more than 24 weeks, it's a medical board.

[00:03:30]In case of substantial fetal abnormality. In case of pregnant women special categories like minors, rape survivor, 20 to 24 weeks, they can go undertake MTP.

[00:03:46]And if they In case of any emergency, any doctor one doctor can do that in case of any emergency cases.

[00:03:54]The next question is image based question. The question number two is the injury shown in the image is best described as just observe the injury as which has been provided to me.

[00:04:07]The option given here are A laceration, B contusion, C stab injury, D bomb blast.

[00:04:15]So observe the injury carefully. You can see here it is a irregular margins are there like this with the tissue nerve bridges can be seen in between and there are some contusion around it.

[00:04:31]You can see the contusion here.

[00:04:34]So what do you say?

[00:04:36]Contusion here you can see the skin is intact. Here the skin is not intact.

[00:04:43]Along with abrasion may be there in contusion.

[00:04:47]In stab injury it is the margins are regular and depth is more than length.

[00:05:03]Which is also not seen here in the image. Bomb blast there multiple things which are there it may be laceration, it may be abrasions, contusions.

[00:05:16]Multiple injuries may be there. So it is also not bomb blast. So it's not a stab injury, not bomb blast, not contusion.

[00:05:22]It is a laceration injury. The option correct option will be A here.

[00:05:28]Right?

[00:05:30]Irregular margins, tissue bridges are there, contusion is there.

[00:05:36]And foreign material may also be there.

[00:05:39]Now coming to the next question, that is question number three. Following an explosion a person sustained burns to the face and chest.

[00:05:47]What type of blast injury is this?

[00:05:50]Uh I've seen that most of the in recent INICET, the blast injury is invariably asked. So, you should be knowing what are these: primary, secondary, tertiary, and quaternary blast injury. These are the options given, A, B, C, D. So, let's examine the first, what are these.

[00:06:07]Primary blast injury is because of the blast wave or over-pressuration wave.

[00:06:16]Causes injury to the hollow organs like GIT, lungs, tympanic membrane rupture is there.

[00:06:32]Secondary blast injury is because of the shrapnel from the bomb, the glass particles, the particles that are comes with the explosion of the bomb.

[00:06:43]So, they are the maybe penetrating or blunt injuries.

[00:06:48]Can be lacerated wound, abrasions, contusions, and there may be punctate tattooing.

[00:07:04]It's known as the Marshall triad.

[00:07:13]So, they can be penetrating or blunt.

[00:07:16]Tertiary blast injury is because of the person is with because of the bomb blast, the person may fall onto the physical object, any physical object, and he may sustain injuries like fracture or head injury.

[00:07:34]Fracture or head injury.

[00:07:37]It can be intracranial Quaternary blast injury is that category of injury which doesn't come in any of this three categories. We When we are not able to categorize any of this injury in either of these three, primary, secondary, or tertiary, we categorize or mark it under the quaternary injuries.

[00:08:06]It can be burns.

[00:08:10]It can be exacerbation of previous injuries, complications.

[00:08:15]So, they come under this quaternary blast injury.

[00:08:19]So, the question asked is that burns to the face and chest. So, it will come under D. Answer will be D, quaternary blast injury.

[00:08:31]So, just a recap of what we discussed.

[00:08:35]This is the primary because of the blast wave, secondary because of the sharpnel injuries.

[00:08:48]The particles from the bomb itself, glass particles, will cause secondary.

[00:08:53]Tertiary injury because the person is thrown onto some object which will cause this tertiary.

[00:09:00]And the fourth one was the quaternary.

[00:09:07]Now, the next question is which type of injury is characterized by the sparrow foot pattern? Sparrow foot pattern. The question is asked is where you find the sparrow foot pattern.

[00:09:19]The option given here A, bomb blast. B, motor vehicle accident. C, contusion. D, collision.

[00:09:28]So, sparrow foot injury is also sometimes known as dicing.

[00:09:35]Dicing injuries, they're always related to road traffic accidents.

[00:09:39]They are caused by tempered glasses, windshield when it shatters, it breaks into small pieces which causes this type of injury. Dicing injuries, parrot foot injury like this.

[00:09:53]They're lacerated small lacerations.

[00:09:57]They're sparrow foot pattern which is seen over the face and the chest. Mostly it will be on the right side of the driver and left side of the passenger, front seat passenger.

[00:10:09]So answer here will be B, that is motor vehicle accident.

[00:10:15]Clear?

[00:10:16]So this type of injuries that you see in motor vehicle accident, sparrow foot injuries or dicing injury.

[00:10:28]The next question is match each of the poison with its characteristic feature. It is a easy question. Again it's a again I can say it's a repeat question.

[00:10:37]You have to match the poison which is shown given here in column one with the feature which is there in column two.

[00:10:44]So carbon monoxide poisoning, organophosphate poisoning, phosphorus poisoning, cyanide poisoning.

[00:10:50]The other side it is mentioned smell of bitter almond, pinpoint pupils with secretions, cherry discoloration and garlicky odor.

[00:10:59]Again, it's a easy question. Carbon monoxide poisoning will give cherry red discoloration.

[00:11:08]Because of the formation of COHP.

[00:11:12]Which gives a cherry red coloration to the skin as well as the blood.

[00:11:20]Organophosphate poisoning we have pinpoint pupils with secretions.

[00:11:26]There's meiosis is seen as well as there's excessive secretions in OPC poisoning.

[00:11:32]Phosphorus poisoning, the white phosphorus will give the classic garlicy smell.

[00:11:39]Garlicy odor.

[00:11:41]The garlicy odor is seen in phosphorus poisoning, white phosphorus, particularly with white phosphorus.

[00:11:49]And cyanide poisoning will give a bitter almond smell.

[00:11:55]So, correct option will be A three, B two, C four, and D one.

[00:12:13]So, D is correct.

[00:12:17]Right?

[00:12:18]So, this kind of picture is seen in OPC poisoning, as well as opium poisoning will have this pinpoint pupil.

[00:12:34]And this is the in case of CO poisoning.

[00:12:40]Cherry red discoloration.

[00:12:46]This is a brain which shows the color is cherry red in color.

[00:12:50]All the the blood, as well as the lungs and all, they will have this similar picture, cherry red coloration.

[00:12:57]Now, coming to the next question.

[00:13:00]Question number six, a male traveler from Afghanistan is found dead in a hotel room. Autopsy shows the stomach packed with foreign substances. What is this phenomena called?

[00:13:13]The option given here are A body packing, B body stuffing, C body storage, D body smuggle.

[00:13:21]So, you can see the image here. It is virtual autopsy image.

[00:13:30]What do you see here? The small packets which are there can be seen all over the GIT.

[00:13:40]Now, uh in this option body smuggle, body storage that we can remove this kind of words are not there.

[00:13:48]So, we can cancel these two words.

[00:13:51]But, this can see a little bit of confusion maybe there about body packing and body stuffing.

[00:13:59]Both can be correct.

[00:14:01]But, uh if you go through the detail of his body packing is a the if you uh like differentiate the two, if you differentiate on the basis of intent or the packaging material and the quantity.

[00:14:21]So, in intent in body packing is there it's a deliberate intent is there pre-planning is there in body packing to smuggle the drugs.

[00:14:33]So, that the intent is seen in body packing. The quantity is also more and the intent is to smuggle. So, they act as drug mule.

[00:14:45]in body packing.

[00:14:47]In body stuffing is that all of a sudden if a person is caught, then he will try to hide those things in whatever material he can. Like maybe an aluminum foil, plastic bags, maybe whatever. So, that intent is the quantity is also small in body stuffing. So, we can you can see here the packet there neatly arranged packets they are made.

[00:15:08]So, it is we'll go with body packing.

[00:15:12]Answer A will be correct in this situation.

[00:15:16]The next question, question number seven.

[00:15:19]After ingesting a liquid, a patient presents to the emergency department with pinpoint pupils, respiratory depression, excessive salivation, bradycardia, sweating, and lacrimation.

[00:15:31]What is the treatment of choice? Again, it is a repeat question.

[00:15:35]If you have gone through the previous years INICET recall exams, the videos, you would have it's a you know that's a recall or it's a easy question or it's a repeat question.

[00:15:48]So, option given here are A pralidoxime, B atropine, C flumazenil, and D naloxone. You should be able to answer the signs and symptoms mentioned here are pinpoint pupils, respiratory depression, excessive salivation, lacrimation, and sweating, as well as this bradycardia.

[00:16:31]So, they are all features of OPC poisoning.

[00:16:39]And what is the treatment of choice in OPC? It's you know, it's a should be atropine.

[00:16:46]Atropine blocks the muscarinic receptors, the action of acetylcholine, and all these features, they will come down.

[00:16:56]It will be the patient will feel better with atropine. So, it is a primary choice for treatment. Pralidoxime is an adjunct.

[00:17:07]Add to it to reactivate the acetylcholinesterase.

[00:17:12]Flumazenil is for benzodiazepine poisoning.

[00:17:20]And naloxone is for opium or morphine.

[00:17:27]So, correct option will be here is B.

[00:17:31]Remember, these are the symptoms which is known as sludge in OPC.

[00:17:39]Salivation, lacrimation, urination, defecation, GIT distress, and emesis.

[00:17:48]Right?

[00:17:50]Now, coming to the next question. Again, an image-based question. Nowadays, image-based questions are asked quite a lot.

[00:17:57]So, you should be like well-versed in the going to the emergency and to the clinics. So, based on the image, what is the range of firearm wound?

[00:18:07]The option given here are A, close close shot, B, contact shot, C, exit wound, D, distant.

[00:18:18]So, you can see from the image here, it is a circular wound with slight abrasion is there and a grease color will be there around. So, abrasion color is there and a circular wound. But, there is no tattooing.

[00:18:42]The tattooing or blackening, it is not there.

[00:18:49]So, in close shot, what will happen?

[00:18:52]You will have a The close means it's near about within few centimeter.

[00:18:59]You will have tattooing, blackening, and abrasion and grease color will be there definitely.

[00:19:14]In contact wound there may be a muzzle impression.

[00:19:22]The margins may be everted. The blackening and tattooing the blackening and tattooing will not be seen.

[00:19:30]It will be there in the depth of the wound.

[00:19:34]As well as uh it may be uh little cherry red color because of carbon monoxide.

[00:19:45]In contact injury margins will be everted. Exit wound will be there where abrasion collar uh grease collar will everything the tattooing and all will not be there. And distant wound where will have only abrasion and grease collar which is seen here in the image.

[00:20:02]So, here we'll go with the distant.

[00:20:06]Only when you see the abrasion collar and the grease collar. But, you have to keep in mind that the this tattooing and blackening they may be filtered out by the clothing of the person also.

[00:20:17]So, you have to examine the clothing in such cases.

[00:20:24]The next question is question number nine. An infant ingests a pesticide.

[00:20:28]Which drug reverses the acetylcholinesterase block?

[00:20:32]As you are aware in OPC, the OPC blocks the enzyme acetylcholinesterase.

[00:20:39]So, which is which out of this compound will help in reactivating the acetylcholinesterase? This is the question. The option given here are A pralidoxime, B atropine, C flumazenil, and D naloxone.

[00:20:54]We have discussed earlier also that in OPC poisoning what do we give?

[00:21:02]Pralidoxime.

[00:21:06]And atropine.

[00:21:10]Atropine is useful.

[00:21:12]It's for immediate treatment.

[00:21:19]And it reverses the muscarinic block. It muscarinic receptors. It acts on the muscarinic receptors.

[00:21:27]The action of acetylcholine is reversed.

[00:21:30]So, the salivation, the sludge part is taken care of by atropine.

[00:21:36]When the muscarinic receptors are blocked, the salivation, lacrimations, and all the the urination, the symptoms they are relieved. The excess acetylcholine will not act.

[00:21:49]But to reactivate the enzyme acetylcholinesterase, we require pralidoxime.

[00:21:59]So, it reactivates acetylcholinesterase and specifically reverses the acetylcholinesterase block.

[00:22:07]And is effective, most effective when it has not aged the when the the enzyme has not aged.

[00:22:15]That when there is it has not become an irreversible bonding.

[00:22:19]So, this is used in treatment of OPC poisoning.

[00:22:25]Flumazenil, as already we have discussed, is for benzodiazepine.

[00:22:32]And naloxone is for opium, morphine, heroin. They are the antidote.

[00:22:41]So, correct option here will be A.

[00:22:46]Pralidoxime reverses the acetylcholinesterase block.

[00:22:51]Now, coming to question number 10.

[00:22:53]Respiratory depression is not a feature in which of the following poisonings?

[00:22:57]The options given here are A, gelsemium, B, strychnine, C, opium, D datura.

[00:23:04]So, let's examine the option.

[00:23:06]Gelsemium is a plant poison.

[00:23:15]And it causes CNS depression, paralysis, as well as it will cause paralysis of respiratory muscles also.

[00:23:28]So, respiratory depression is seen in gelsemium.

[00:23:33]Causes muscle weakness and paralysis.

[00:23:39]Opium it shows a classic triad where there is pinpoint pupils, impaired sensorium, usually coma is seen, impaired and respiratory depression.

[00:24:18]So, it is also seen in opium poisoning.

[00:24:22]Datura in severe Usually, it is not seen, but in severe poisoning, respiratory depression can be seen. CNS depression is there, followed by respiratory depression. But in strychnine, it acts on the spinal cord.

[00:24:40]It acts on spinal cord and it blocks the inhibitory compound glycine.

[00:24:49]So, inhibition is not there and there is release excitation.

[00:24:54]So, there may be >> The person will have seizures, convulsions are there.

[00:25:09]But respiratory depression is not seen.

[00:25:12]So the correct option here will be B.

[00:25:19]Respiratory depression is not a feature in strychnine poisoning.

[00:25:24]So it inhibits the neurotransmitter glycine.

[00:25:31]So that may be because of uh sustained contraction.

[00:25:35]Uh asphyxia is there, but there is no respiratory depression, right?

[00:25:40]The next question, question number 11, a child presents with hypertension, respiratory depression, and pinpoint pupils. What is the most appropriate antidote?

[00:25:50]The options given here are A naloxone, B flumazenil, C naltrexone, and D atropine.

[00:26:00]Again, I think we have whatever we discussed, it's say it will be easy for you to answer also. We already discussed this part. So hypertension, respiratory depression, pinpoint pupils.

[00:26:12]So what What do you think? It indicates diagnosis is opium.

[00:26:21]Diagnosis is opium poisoning.

[00:26:26]Heroin.

[00:26:29]Morphine.

[00:26:32]Classic triad is respiratory depression, pinpoint pupils from myosis, and altered sensorium.

[00:26:58]And hypotension is also part of it.

[00:27:06]So, the treatment is the pure antagonist is naloxone.

[00:27:12]So, we give naloxone to treat OPC the Sorry. To treat the opium poisoning.

[00:27:25]Morphine poisoning. Flumazenil again, benzodiazepine.

[00:27:33]Naltrexone is for long-term use.

[00:27:36]Abusers can be given alcohol dependence.

[00:27:40]So, it's not for immediate treatment.

[00:27:44]Atropine, as we have discussed, is for OPC poisoning.

[00:27:48]So, correct option here will be A.

[00:27:52]Naloxone to treat this child.

[00:27:55]And the last question is question number 12. The structure shown in the image is located in which layer?

[00:28:04]The options given here are A, dermis, B, epidermis, C, superficial layer, D, muscle.

[00:28:10]As you can see, it is a The image is that of a tattoo.

[00:28:15]And tattoo is permanent, best made if it is there in the level of dermis.

[00:28:21]If it is in the level of epidermis, it will get removed. The The temporary tattoos are in the level of epidermis only, superficial ones. But for permanency, it should be at the level of dermis. So, option here will be A.

[00:28:37]Dermis, not in the epidermis, superficial layer, or the muscle.

[00:28:43]So, at the level of dermis, it will be permanent.

[00:28:47]So, that's about it.

[00:28:49]Uh there are So, that's about it.

[00:28:52]Uh there were 12 question. I think you all must have done pretty well.

[00:28:57]The questions were not very tough.

[00:28:59]And all the best wishes. [music] Thank you.