Death and Post-Mortem Changes MCQs

BNS Section 2(6) denotes - "death" means the death of a human being unless the contrary appears from the context. Option B: BNS 2(14) defines "Injury". It states that, "injury" means any harm whatever illegally caused to any person, in body, mind, reputation or property. Option C: BNS 2(17) states that, "life" means the life of a human being, unless the contrary appears from the context. Option D: BNS 2(23) deals with oath and solemn affirmation. It states that, The word "oath" includes a solemn affirmation substituted by law for an oath, and any declaration required or authorized by law to be made before a public servant or to be used for the purpose of proof, whether in a Court or not. Reference: The Bharatiya Nyaya Sanhitha, 2023

Article 21 of Constitution of India: This ensures Right to life but does not include right to die. So forcible feeding of persons going on hunger strike is lawful in India Declaration of Malta This deals with the Respect the autonomy of the patient and suggests that the doctor should not feed forcibly in such cases. Feeding is allowed when the patient has lapsed into coma Article 14 of the Constitution of India: "The State shall not deny to any person equality before the law or the equal protection of the laws within the territory of India". Declaration of Sydney: Deals with the determination of death and the recovery of organs Reference: The Essentials of Forensic Medicine & Toxicology, KS Narayan Reddy, 35th edition, Page No. 260

Brain-stem death should be certified by a Board of medical experts consisting of the following namely: The registered medical practitioner (RMP) in charge of the hospital in which brain-stem death has occurred; An independent RMP, being a specialist, to be nominated by RMP specified in cause (i) A neurologist or a neurosurgeon to be nominated by the RMP specified in clause (i) The RMP treating the person whose brain-stem death has occurred. The burden of proof to diagnose brainstem death rests on the specialist with Neurosciences. Reference: THE TRANSPLANTATION OF HUMAN ORGANS AND TISSUES ACT, 1994 - Amendment 2011 and 2014

Explanation: Autolysis is the self-digestion of tissues following death, and it marks the beginning of decomposition. It is caused by lysosomal enzymes , primarily hydrolases , which are released into the cytoplasm after cell death. It is a sterile process , meaning no microbial involvement , and usually begins in soft parenchymatous tissues like the brain, pancreas, and liver . Decomposition involves two major processes: Autolysis - due to lysosomal enzymes (sterile) Putrefaction - due to bacterial action (non-sterile) (Option D) The earliest visible external change is clouding of the cornea (The first external sign of decomposition) Autolysis starts within hours of death , while putrefaction becomes prominent after 24-48 hours . Key Takeaway: Autolysis is a sterile self-digestive process caused by lysosomal enzyme release and marks the beginning of decomposition.

Explanation: Cogwheel rigidity is a classic feature of Parkinsonism and not seen in Wernicke's encephalopathy. Wernicke's encephalopathy is an acute neurological condition caused by thiamine (Vitamin B1) deficiency , most commonly in chronic alcoholics. It is classically associated with the triad of: Ocular abnormalities : e.g., nystagmus, ophthalmoplegia, especially VI th nerve palsy Mental status changes : Confusion, disorientation, apathy, impaired memory Ataxia : Unsteady gait and poor coordination and Peripheral neuropathy Pathology involves neuronal degeneration and petechial hemorrhages in mammillary bodies, thalamus, hypothalamus, and midbrain. Key Takeaway: Cogwheel rigidity is not a feature of Wernicke's encephalopathy; it suggests Parkinsonism.

Explanation: Total deprivation of water and food results death in about 10 to 12 days. Newborns may survive for 7 to 10 days without food and water. If food alone is withdrawn, death may occur in 6 to 8 weeks or even more.

Explanation: The Zasko phenomenon refers to the transient preservation of deep tendon reflexes shortly after death due to residual neuromuscular excitability. When the lower third of the quadriceps femoris muscle, about 10 cm above the patella, is tapped with a reflex hammer, the patella moves upward due to contraction of the entire muscle. This response is known as the Zasko phenomenon. (Options B and D ruled out) This response may persist for 1-2 hours after death and represents a propagated excitation of muscle fibres. Explanation of other options: It refers to postmortem clotting of blood(Option A): A postmortem clot appears dark red, soft, and jelly-like with a shiny surface. It typically separates into a pale " chicken-fat " plasma clot and a darker red-cell clot due to sedimentation after death.