18-FMT

FORENSIC MEDICINE term-meaning atria mortis/gateway of death/mode of death-coma, syncope, asphyxia borrow servant doctrine-new employer responsible for borrowed employee boxer/pugilistic attitude/defence/fencing posture-burn cardiac polyp-PM fibrinous clot commoriant-dying together corpus delicti/essence of crime-body of offence curator bonis-person to manage affairs of mentally ill Diminished responsibility-borDerline mental disorder dipsomania-impulse to drink alcohol Ewing postulate-accident are cause of death filicide-parent killing own child gossypiboma(textiloma or cottonoid)-foreign object(cotton matrix, sponge) injury-illegal harm to property, body, reputation lafacies sympathique-antemortem compression of cx sympath chain-i/l pupil dilatation, eye open Locard principle-person come in contact with other loco parentis-emergence-consent taken fr person in charge of child lucid intErval-state of consciousn b/n 2episode unconsciousn in Epidural hematoma, insanity Manchausen synd by proxy-child abuse by mother, bringing child rptedly to hosp molotov cocktail-petrol bomb mutilomania-impulse of maiming animal novus actus interveniens-person responsible for logical conseq of his action-assault, accident inj paternalism-abuse of medical knowledge that pt is deprive of autonomy pharmacoDynamic-Drug Does to body pharmacokinetic-body does to drug posthumous child-child born after death of father privileged communication-Dr& concerned authority pseudocyesis/spurious/phantom preg-false preg Rachiotomy Saw-Remove Spinal cord res ipsa loquitor-things speak for itself resAim4aiims.in judicata/doctrine of jeopardy-let the decision rest superfecundation-fertilization of 2ova same MC bt 2diff act of coitus superfetation-fertilization of 2ova of diff MC supravital period-time b/n somatic& molecule death tort-civil negligence vagitis uterinus-cry of unborn in uterus vagitis vaginalis-cry of unborn in vag vicarious liability/respondent superior/captain of ship doctrine-employer responsible for negligence of his employees death certificate line1a-immediate cause of death-ren fail/CCF line1b-underlying condition-DM nephropathy/MI line1C(essenCe of Certif)-main antecedent/underlying cause-DM/HTN part II(associated condition) COPD

MCI-medical record of indoor pt maintain≥3y

compoundable-out of court settlement-theft noncompoundable-murder bailable-police nonbailable-Magistrate/court cognisable-arrest without warrant noncognisable-cant arrest without warrant

dactylography, Henry Galton system identification-fingerprint study Sir William Herschel(1858) discovered-fingerprinting 1st fingerprinting Bureau-writer building Calcutta(1897) Quetlet rule of biologic variation-fingerprint different in identical twins palatoprint(Harrison Allen, 1889)-wrinkle(plica palatine) ant⅓ hard palate prim rugae=5-10mm sec rugae=3-5mm fragment rugae<3mm podogram-footprint cheiloscopy, queiloscopy-lipprint poroscopy-pore(opening of subepidermal sweat gld over given lth of ridge on finger pulp) brain fingerprinting Dr Lawrence Farwell, test memory Memory&Encoding Related Multifaceted EEG Response(MERMER) scar(cicatrix) fibrousAim4aiims.in ts no elastic ts, sweat gld, hair follicle hypo/hyperpigmented flat/raise latent tattoo mark visualisation UV light, infrared photography, rubbing part& examine under magnifying glass, 3%H2O2, 0.5%caustic potash, HPE local LN blacken&tattoo skin, cloth-infrared photography race cephalic index=(max breadth/max lth)×100(DMB) Dolicocephalic=70-74.9(Caucasian, Negro, Arborigene) Mesaticephalic=75-79.9(Indian, Chinese, European) Brachycephalic≥80(Mongol) scapecephaly-AP diam>transv diam orbit, nasal opening, palate square-Indian(Aryan), Negro, Arborigene triangul-Chinese, European round-Mongol hair fragment medullary-negro sex corporobasal index chilotic line-hip bone ischiopubic index-mal

Bertillon system identification/anthropometry stature crural index=(lth tibia/lth femur)×100 brachial index=lth(rad/humer)×100 humerofem index=lth(humer/fem)×100 intermembral index=lth(rad+humer/tib+fem)×100 ht=2×arm lth+30cm(2clavicle)+4cm(sternum) ht=5×humerus lth ht=2×lth fr vertex→ pubic symphysis ht=3.3×lth fr sternal notch→ pubic symphysis ht=8×lth fr vertex→ top chin ht=0.33×lthAim4aiims.in vert column+3cm lth of soft part added to skeletal ht=2.5cm bone-% of ht humerus=20 tibia=22 femur=27 spine=35 Hepburn osteometric board-lth long bone dentition Stack method-infant-wt/ht of tooth Boyde incremental line method-child Mile meth-transparency root eruption of teeth Gustafson method(>21y)(TRAPCD) Transparency of root(best) Resorption root(least) Attrition Paradentosis Cementum apposition sec Dentine(2nd best) dental numbering FDI 2digit syst anat&diagrammatic charting palmar notation postmortem luminescence Armillaria, Photobacterium fischerii

suspended animation/apparent death-drowning, shock, electrocution, cholera, anesth, cerebral concussion, insanity, sun stroke, narcotic poisoni, neonat, yogi(voluntary) event after death-time after death rigor mortis set=1-2h IOP nill=2h hypostasis mottled=3h taches noir=3-4h maggot in rainy day=6h full developm rigor mortis=12h washerwoman hand, rt ilac discolorat=12-18h drown body float=24h(summer), 2-3d(winter) intern organ cool=24h wholeAim4aiims.in body discolourat, marbling, bloating body, app stom content&froth on nose&mouth, degloving&destocking, app of putrefact blister, emptying of heart=24-48h maggot appear=48h gas rigidity, hair become loose=72h nail&teeth become loose=3-5d colliquative liquefaction, Spalding sign=1w adipocere formation=3w skeletonisation dead body=1-3mth saponification drowning=5w nuclear feature persist=2-3y bone begin to decompose=3-10y precipitin test +ve opium poisoni=10y benzidine test +ve=150y starvation hunger contraction stom(hunger pang)-12-24h feeling of intense hunger last=36-48h emaciat&loss of fat begin>4-5d survive without food&H2O neonat=7-10d adult=10-12d survive without food=6-8w(50-60d) adipocere/saponification-hot,humid,absence air, gradual hydrolysis&hydrogenation of body fat(Cl perfringens) mummification-hot,dry, c/c As poisoni, antimony poisoni

Casper dictum-rate of decomposition air:H2O:remove fr H2O:soil=1:½:2:⅛ post mortem lividity/livor mortis/PM staining/cadaveric lividity/cadaveric staining/hypostasis/vibices/suggilation/darkening of death condition-colour aniline-deep blue BuRn, cold-BRight Red CO-bright Cherry red CN-pink(brick red) hge, anem-pale purple H2S-greeniSH blue opium-black P-dark brown Aim4aiims.inKCl, K2CO3, bromate, nitrobenzene, NO3-chocolate/coffee brown rigor mortis/cadaveric rigidity/death sti ffening-Sommer movem+

algor mortis/chill of death rate of fall of temp(°C/h)=0.5(summer)- 1.5(winter)

instantaneous rigor/Cataleptic rigidity Cadaveric spasm

marbling-Hb dissociates fr RBC→ bld vess, seen as prominent purple,green,brown colour on shoulder,axilla,inguinal area, v become visible d/t bld decomposition

maggot fly lay egg=6-12h maggot=2-3d adult fly=8-12d

putrefaction order of putrefaction→ larynx,trach→ infant brain→ stom,intest,spleen→→ prostate,nongravid uterus→ skin,m,tendon→ bone delay-As green discolour-sulphmethHb

Duret hge small hge in ventral¶med part up brainstem cause-a/c trauma, edema, abscess, tm

puncture wound-enter ts, not cavity penetrating wound-enter cavity, not come out perforating wound-enter cavity, come out

stab single edge-fish tailing margin harakiri-suicidal stab inj abd

chop/slash deep gaping wound by blow with sharp cutting edge of heavy weapon dimension-cross section of penetrating blade

abrasion type scratch/linear/point-single linear mark Aim4aiims.ingraze/brush burn/gravel rash/scuff burn/friction burn/sliding/scraping/grinding-multipl linear mark, furrow/groove press/crushin-sustained press, teethbite impact/imprint/pattern/contact-RTA Antemortem-Antbite mark colour change-start at periphery pedestrian inj prim impact adult-leg(85%)>head(50-80%)>arm child-head sec impact scooping up-impact bel centre of gravity sec inj-d/t fall rolling/runover/degloving-child>adult contusion/bruise ectopic-black eye(#floor of ant cranial fossa, forehead trauma), bruise behind ear(basal#), bruise neck(#jaw), bruise thigh(#pelvis), bruise ankle(calf inj) colour-age of contusion(RBBGY) Red–immediately after the injury Blue–few h to 3d Bluish black or brown–4th d Greenish–5-6d Yellow–7-12d artif Bruise-Bhilawanol laceration tearing skin, subcut ts, ts bridging, irregular margin split-blunt perpendicular impact flaying/degloving inj-avulsion laceration lacerated looking incised wound-scrotum, axilla incised looking lacerated wound-scalp, elbow, tibia shin punchdrunk/traumatic encephalopathy/demetia pugilistica rpted punch→ tear of subdural emissary v→ subdural hge in middle cranial fossa boxer hge-pontine hge retin detachm, choroid tear, vitr hge c/f-slurr speech, def memory, slow thought proc, stiff limb, ataxia, broad base gait, outburst of violence, dementia plaque jaune/yellow plaque/remote cerebral contusion resorptionAim4aiims.in of inj ts→ cavitat → golden yellow discoloration(hemosiderin) violent shaking by parent-subdural hematoma

whiplash inj-hyperflexion→ hyperextension(dangerous)→ inj railway spine-concussion inj asphyxia cafe coronary(Dr Robert Haughen)-reflex cardiac arrest> asphyxia d/t choking drowning hydrocution/immersiin synd/duck diving-reflex CNX inh atypic/dry drown-sustained laryngeal spasm typical/prim/wet drown-fresh water(3-4min-hemolysis, hyperkalemia, arrhythm), salt water(8-10min-crenation of RBC) sec/near drown/post immersion synd-metab acidosis, dyselectrolemia hanging typical hanging-knot on post neck judicial hanging-knot-lt angle of mandible(#C2-C3) lynching-homicidal hanging by mob strangulat ligature manual(throttling)-d/d-inj d/t ETT bansdola-b/n 2stick judicial(garrotting, Spanish windlash) mugging(choke hold)-elbow masque ecchymotique diatom oligohalophilic-freshwater(<0.05%salinity) mesophilic-brackish water polyhalophilic-sea water electrocution/Joule/crocodile burn contact-contact with live wire spark-sparking of current flash-being near main power line, with no actual contact entry wound-nonblding, thick, leathery, greyish white, depressed, hard, cauliflower like, crater formation, skin coloured d/t metallic pigm(green-brass, black-Fe, blue-Cu, grey-Al) exit wound-like laceration, blding current pearl-melt metal carried into ts boneAim4aiims.in pearl(wax dripping)-melt bone(CaP) Filigree burn/arborescent marking/arborescent burn/arborising mark/Litchenberg flower/lightening burn discharge direct effect high V current b/n –ve cloud&+ve article on earth superheat air expand&displace air sledge hammer effect&blow death invert tree pattern not correspond to bld vess

Balistic bore depRession-gRoove eLevation-Land dist b/n 2Groove-Gauge dist b/n 2Land-caLibre(internal measure of rifled weapon) projectile shotgun-cartridge-detonator cap→ primer → gunpowder→ wad → pellet → cardboard disc rifle[↑ stability,2-20(6)]-bullet-detonator cap→ primer → gunpowder→ bullet Entry wound(SBTC) Singeing(flame)-SG(15cm), rifle(8cm) Blackening(smoke)(30cm) Tattooing(unburnt particle of gunpowder)-(60-90cm) Cherry red colour-CO rifled-bullet, grease collar, abrasion collar shotgun contact-cruciate, cruciform, stellate(backspatter) close(point blank<30cm)-oval near(<1m)-rathole >2m-satellite >4m-individual pellet gunpowder black-KNO3(75%)+C(15%)+S(10%), 3000-4000ml/g, fg/ffg/fffg(better)-f-fine,g-granule, cavitation=K(v²) smokeless-singlebase-nitrocellulose (NC), doublebase-NC+nitroglycerine(NG), triplebase-NC+NG+nitroguanidine, 12000-13000ml/g semismokeless-80%black powder+ 20%smokeless powder(nitrocellulose) bullet-Pb±antimony, KE=½mv² Dumdum-max Damage, fragments on striking souveiner/retain-Pb poisoni richochet-deflected tandem-piggyback tracer-bullet leave visible mark Aim4aiims.infrangible-nontoxic metal smooth bore-shotgun, musket, muzzle loader rifled weapon-pistol, rifle, revolver paradox gun-shotgun(muzzle end rifled) Pb/metal ring-deposit of Pb in skin peppering-grain of gunpowder driven into skin scorching-flame emerging fr muzzle smudging-superf deposit of smoke on skin Kennedy phenom-Sx artefact prevent distinguish b/n entry&exit wound explosion inj prim-shock wave-ear(TM)>lung(least-liver) sec-projectile, flying debris-skin tert-impact against object, blast wind quart-fire, building collapse, dams underwater blast-intest torture bell/campana-head placed in metal container, then struck rptdly black slave-insert hot Fe rod into anus buzzer/chicharra-rpted electric shock carry on-group of guard beat prisoner cattle prod-electric shock given using high V current chepuwa-thighs tightly bound with bamboo falanga/falolka/baatinada-sole rptdly beaten helicopter trip-person hung upright or upside down fr large blade of ceiling fan& struck rptdly as blade revolves labandera-suspens by wrist mercelago-suspens by ankle necklacing-tire, filled with gasoline or similar flammable liquid placed around neck and set afire picana-electric torture plantom-prolonged standing torment of stick/supplice de baguette-2stick placed through wire encircling head and slowly turned, tightening wire telephone/telefono-both ears clapped dry submarino-tying plastic bag over head upto suffocation wet submarino/latino/labaneva/pileta-forced immersion of head in water sexual definition aptavira-fem capable of taking part in coitus defloration-loss of virginity fecunda ab externa-preg fr semen on vulva/thigh(without penis penetration) frigidity-inabilityAim4aiims.in to initiate& maintain sexual arousal pattern fem impotence-inability to perform coitus pseudovirgin-intact hymen+coitus quode/impotence quadhoc-mal impotent with particul fem, not with other virgin-intact hymen+no coitus sexual offence bestiality-coitus with lower animal bondage-1partner-sadist, other-masochist buccal coitus/coitus per os/sin of GomORrah-ORal sex coprolagnia-sight,smell,taste faeces coproLAlia/SCatologia-obSCene LAnguage cunningulus-oral stimulat fem genital exhibitionism-exhibit genital in public fellatio-oral stimulat mal genital fetichism-object of desire frotteurism-rubbing clothed genit with other in public gerontophilia-sodomy with passive agent adult kLIsmaphilia-put LIquid anu→ colon lesbianism/tribadism/fem homosexual love/sin of Lesbos-coitus b/n fem(active-butch/dyke/bull dyke)& fem(passive-femme) masochism/passive algolagnia-self pain, autoerotic/sexual asphyxia masturbation/onanism/ipsation-stimulat own genital, perversion narcism-watching own body nymphomania-uncontrolled sex desire fem paraphilia-sex with certain part of body pederasty-sodomy with passive agent Child(Catamite) pedophile-adult who coitus with child rptdly platonic/statue love-loving of statue pygmalionism-loving object made by him pyromania-sight of fire SADism/algolagnia(to make SAD)-beat the partner satyriasis/gynaecomania/satyrism/satyromani-uncontrollable sexual desire mal sodomy/buggery-anal intercourse b/n 2mal or 1mal&fem transvestism/eOnism(disord of sex preference)-crOss dressing troilism-submit wife to other undinism-watch other person urinate uranism-sexual perversion urolagnia-sight,smell,taste urine voyeurism/peeping tom/scoptophilia-watching other people sex/undressed rape custodial-by person in authority date-sedativeAim4aiims.in drug(ketamine, robypnol, GHB) statutory-girl<16y hymen rupture at 1st coitus-5,7,6'O clock position rupture at masturbat-11-1'O clock position rpted coitus-tag of ts(carunculae hymenales) lost after childbiRTh-knoblike projection at periphery(carunculae myRTiformis) Glaister Keene rod used sudden infant death synd/cot death/crib death-sudden natural death<2y child d/t unexplainable cause

TOXICOLOGY PM technique VirchOw-organ removed One by One RokitanSky-in Situ dissection(infant) GhOn-en blOck dissection Letuelle-en masse dissection head→ neck → thorax → abd spinal cord-dissect fr back condition-1st-last dissected neonAt-Abd-head head inj-thorax-head asphyxia-head-neck poisoni-head infanticide-head-abd air embolus-head-thorax viscera preservation routine-stom, intest, ½kg liver, ½of each kidn, spleen, 100g brain(cerebrum/cerebellum), 10g fat fr abd, 100ml bld digoxin-heart Strychnine-Spinal cord, heart alcohol-CSF, vitreous, bld, urine inhalat anaesth agent-lung(nylon bag), mesenteric fat morphine, Barbiturate-Bile As-stom, bld, liver pesticide, insecticide-fat chloroform-vitreous preservative best, acid except phenol-rectif spirit MC,Aim4aiims.in phenol-sat soln NaCl alcohol-supersat saline, NaF, K oxalate brain-NS, rectif spirit CO-liq paraffin DNA fingErprinT-EDTA F-K oxalate, NaNO3 gout-alcohol P(yellow)-H2O urine-thymol, toluene virological examn-50%glycerol vitreous-fluoride

DNA analysis-recent death-spleen, 2-3w-brain typical embalming solution Formalin Methanol Phenol(germicide) Glycerine(wetting agent) Na borate Na citrate NaCl eosin soluble wintergreen water ethanol embalming-Discontinuous inj&Drainage

PM on body contaminat with RA comp <5mCi-rubber glove >5mCi-consult rad officer <30mCi-Gieger counter used >30mCi-mandat body embalmed psychologic autopsy-assesm of mental status of deceased person bef death artefact therapeutic agonal(introduced during death) PM gastric lavage child-Ryle tube aDult-EwalD/BoasAim4aiims.in tube gold period<3h hemodialysis abs indication(BLAST) Barbiturate Li Alcohol(methanol) Salicylate Theophylline abs contraindication(BODY) BDZ OP comp Digitalis kerosene poison-antidote universal-activate charcoal(destructive distillation wood+passing steam, act by adsorpt): tannic acid(ppt alkaloid): MgO(neutralise acid)=2:1:1 coma cocktail-dextrose(hypoglycemia)+ naloxone(opioid)+ vitB1(alcoh) a/c As-dimercaprol/BAL atropine-physostigmine BDZ-flumazenil benzoic acid-Gly cocaine-amyl nitrite inhalation heparin-protamine SO4(seafish sperm- 1mgPS≈100U heparin) I2-starch a/c Fe-deferoxamine MgSO4-Ca gluconate mineral acid-CaO,MgO OPC-atropine oxalic acid-lime(Ca gluconate) paracetamol-Nacetyl cysteine P-CuSO4 strychnine-short act barbiturate warfarin-vitK1 smell—poisoni acetone, apple-lacquer acrid pear, pungent-chloral hydrate bitter almond-CN BurNt rope-caNNaBis choking-nitric oxide fishy-ZnAim4aiims.in phosphide fruity-ethanol garlic-As, P, thallium kerosene-kerosene,OPC offensive rancid, unpleasant sweetish-adipocere rotten egg-H2S shoe polish-nitrobenzene SuffOcating-SO2 gas-name Methane-Marsh H2S+CO2+CH4-sewer H2S+other poisonous gas=Japanese detergent suicide war muSTaRd gas,BAL-BLiSTeR N2O-laughing diphenyl amine chlor arSIne-SIckening BromoBenzylCN(BBC), ChloroAcetoPhenone(CAP)-tear

MC-drug psychoactive-caffeine addictive-nicotine substance Abuse-Alcohol iliCit-Cannabis

ideal homicid poison-thallium ideal suicidal poison-CN

OPC poisoni aLkylP-HETP, OMPA, TEPP, sulfoTEPP, maLathion, dimefox, demeton, tichlorfon aRylP-paRathion(folidol), methylparathion, chlorthion, fenthion, paraoxon, diazinon(Tik20) late onset polyneuropathy-after 2-4w

ARsenic poisoni As2O3(white As), AsCl3(butter As) fatal dose=100-200mg arsenophagist-who survive upto-300mg c/f-suba/c-cholera like, fading meAsles C/c(blaCkfoot ds)-alopecia, raindRop pigm on face&neck, milk rose complexion, nail-AldRich Mees transv line, bone-pancytop, hypertherm, subendoc hge, red velvetty stom, asymmet periph sens neuropathy Rx-BAL,Aim4aiims.in dimercaprol Hg poisoni,diwali poison c/f-c/c-hypergyrism, erethism-neural manif, Hg tremor-Hatter/glassblower shake/Danbury tremor, affect PCT, diphtheria like colitis, aerodynia-pink ds, ptyalism-excess salivat, mercuria lentis-brownish discolorat eyelens capsule Rx-BAL

Pb poisoni Pb arsenate, PbO, PbCO3 leaSt tox-Pb Sulphide inhalation>ingestion c/f-c/c(plumbism, saturnism)-facial pallor, basophillic stippling, Burtonian line, wrist drop, foot drop, encephalopathy lab parameter—level—remark coproporphyrin urine->0.15mg/l-exposure to Pb Pb in bld->0.7mg/l-c/f Pb in urine->0.8mg/l-exposur&absorpt aminolevulinic acid in urin->5mg/l-Pb absorption norm ingest=0.2-0.3mg/d Rx-succimer, CaEDTA, child-DMSA

Cu poisoni green line gum-Clepten line greenish blue froth at mouth&nostril CuSO4 c/c poisoni-vineyard Sprayer lung

Physostigmine-ordeal poison

PHOSphoruS poisoni(diwali,rat) yellow/white(toxi)-spontaneous combustion>30°C protoplasm poison→ ↓ cellular oxidat→ anoxic necrobiosis→ affect liver a/c-a/c yellow atrophy liver c/c-PHOSSy/glass jaw(osteomyelitis), Smoky Stool, Priapism fumes-caries tooth FD=60-120mg Rx-vitK

Jamaican vomiting sickn unripe fruit of ackee tree toxin-hypoglycinA→ MethyleneCycloPropylAcetic acid(MCPA)→ ↓ βoxidat FA c/f-vomit, coma, free fatty acidem, dicarboxylicaciduria, ↓ liver glycogen, FA degeneration

AbrusAim4aiims.in precatorius/ratti/gunchi/gunja/jequirity/Indian liquoric/rosary bead poisoni seed wt=108mg abrin(~viper venom)-vasculotox suis

Spanish fly/blister beetle/cantharide cantharidin-aphrodisiac c/f-priapism, blister

scombroid poisoni fish→ Proteus → histamine

dinitrocompound resemble thyrotoxicosis

thallium resemble natural death

snake COlubridae-pupil rOund Elapidae-cobra, krait Hydrophidae-sea snake Viperiaedae-pupil Vertical-Viper

snake bite kiNg cobra-Neurotox comm krait(most poisoni)-FD=6mg(dried venom)-neurotox(bungarotoxin)-Nm antag-sk m paralysis russel Viper, sawscaled Viper-Vasculotox-max pain d/t max organism in oral cavity sea snake-myotoxic Rx-reassure→ wash with soap&water→ Sutherland wrap→ inj TT→ ASV(1vial=1mg)→ neostigmine(cobrabite) nonpoisonous-rat snake

poisonous snake body scale large, cover whole width viper-head scale small cobra-3rd labial large, touch eye fang-vIper-canalIse, cObra-grOOve tail-compress nocturnal bite mark-2fang mark

dinoflagellate(infAim4aiims.in shellfish) saxitoxin, tetradoxin-Na ch antag CO poisonip parkinsonism like c/f

alcohol alcoholDH, Microsomal Ethanol Oxidising System(MEOS-cyt450), catalase peroxisom alcohol→ ↑ NADH → ↑ (pyruvate → lactate, OAA→ malate) → hypoglycem→ lactic acidosis, hyperuricem, lipogenesis, TAG synth, cholesterol synth, lipid deposit in myocard, liver rectif spirit=95% abs alcoh=99.5% denature alcohol=95%alcohol+5%wood naphtha 100proof ethanol=50%ethanol drunkometer/intoximeter/alcometer/breathalyser Widmark formula, amount of alcoh(a)=body wt(p)×const(r)×conc bld alcoh(c) r=0.085(mal), 0.055(fem) rate of metab=15mg/100ml/h legal limit=30mg%(60ml) alcohol gaze nystagmus=80mg% under influence=80-100mg% intoxicat>140mg% critical level=0.15% dead drunk=0.5% bld:urine=1:1.3 K dichromate-qualit&quant assessm alcohol in expire air alcoholic palimpset/blackout-inability to recall what happen during drink spell stage excitement=50-100mg/100ml bld incoordinat=100-300mg/100ml bld narcosis/coma=300-500mg/100ml bl medullary paralys>500mg/100ml bld methanol/wood alcoh/illicit liquor-irrevers optic neuritis, FD=60-200ml Hooch tragedy-500people blind toxicity-methyl alcohol: formaldehyde: formic acid=1:33:60 visual hallucination seen alcohol sz peak after withdraw-12-24h drug use in alcoh dependence to prevent relapse-naltrexone, nalmefene, disulfiram, acamprosate, ondansetron, topiramate alcoh-↑ pol III(RNA polymerase dep)gene

StupefyingAim4aiims.in poison dhatura/D stramonium/thorn apple/road poison c/f-dilated pupil, diplopia, dryhot skin, delirium FP=24h Rx-physostigmine

Nux vomica/kuchila strychnine/brucine FD=1crush seed act on ant horn cell, inh inhibit NT(Gly) c/f-GTCS, opisthotonous(backward arching), emprosthotonous(forward), pleurosthotonous(sideward) Rx-diazepam

mushroom poisoni amantoxine-bind mRNA inocybe-muscarine isoxazole-antiACh, hallucinat Amania muscarine-ACh A phalloides-phalloidin-peptide tox, phalloides, galerin, amatoxin Rx-thiotic acid, penicillium

acid vitriolage H2SO4-FP=18-24h Rx-MgO, Mg(OH)2, steroid

acid poisoni magenstrasse-pathw acid through stom empty stom-low⅔ body stom–fundus food fill stom-less curvat+pylorus

phenol/carbolic acid/phenic acid miosis, lock jaw, carboluria(colourless→ greenish/blackish on standing-hydroquinone/pyrocatechol), ochronosis-blackish cartil(hydroquinone), phenol marasmus-ashwhite colour skin, leather bottle stom Rx-hemodialysis

oxalic acid/salt of Sorrel/acid of Sugar spinach, cabbage, raddish, carrot, beet, tomato forging writing

cardiac poison aconite/monk hood/blue rocket/bish-hippocampus-pulsatile pupil, hypersalivation, tingling,Aim4aiims.in numbness, chest pain NerIum odorum(whIte oleander)-nerin Cerebra theVetia(Yellow oleander)-cerebrin, thevetin CN-cytochrome a3, carbonic anhydrase FD(mg)-HCN=50-60, KCN=200-300 FP=2-3min Rx-ELISKIT(amylNO3, Na thioSO4, hydroxocobalamin), 4dimethylaminophenol, dicobalt edetate, glu, O2 caffeine withdrawal sympt-headache, depression, wt gain nicotine withdrawal sympt-depression, headache, anxiety cocaine/crack/crystal/freebase(Erythroxylon coca) snorting-perforation nasal septum(ischemia) crack(smoked)=cocain+baking soda+H2O crackhouse-place where cocaine is sold/smoked c/f-cocaine bug/Magnan sympt/formication reverse tolerance→ psychic sympt

Cannabis tetrahydrocannabinol, anandamine bhang-dried leaves(1-15%), FD=10g/kg majoon-sweet prepare fr bhang ganga-small leaves& bracket of inflorescence fem plant(15-25%) charas-resin flower top(25-40%), FD=2g hash oil-resin mix lipid soluble plant extract(70-90%) c/f-run amok(impulse to kill) rave drug ectasy, GHB(γhydrobutyrate), LSD, ephedrine, ketamine, methamphetamine

angel dust/Peace Pill/hog/rocket fuel-Phencyclidine body packer/bag-person tpt drug body puSher-person diStribute drug body stuffer-consume drug for fear of being caught kick, rush-flushing face+pleasure liquid gold-urine of amphetamine abuser(40%) main line-prominent v d/t IV inj drug skin popping-multiple old&new SC puncture mark on forearm speedAim4aiims.in ball/hotshot-IV cocaine+heroine opioid withdrawal sympt-rhinorrhoea, yawning Rx- treat withdrawal sympt βadr antag clonidine prevent withdrawal sympt methadone(10mg) buprenorphine pREvent RElapse naltRExone(block μ,δ,κ) oral treat OverdOse nalOxOne(IV) opium-FD=2000mg opioid alkaloid(PMCT) Phenanthrene-Morphine, Codeine, Thebaine benzylisoquinoline-papaverine, narcine, noscapine chloral hydrate/hypnotic drug/dry wine/knock out drop/Micky finn cystalline

Abbreviations a-artery, AA-amino acid, abtc-antibiotic, AI-autoimmune bef-before, bel-below, b/l-bilateral, bld-blood, b/n-between, bn-benign, br-branch, Bx-biopsy ca-carcinoma, carb-carbohydrate, c/i-contraindication, c/l-contralateral, conc-concentration, cong-congenital, Cx-cervix d-day, def-deficient, ds-disease, d/t-due to, Dx-diagnosis E-estrogen fem-female, fr-from gld-gland, glu-glucose h-hormone idiop-idiopathic, i/l-ipsilateral, inf-infection, inj-injury lig-ligament, LL-lower limb, l/t-leading to m-muscle, maj-major, mal-male, MC-most common, met-metastasis, min-minor, mtx-methotrexate, Mx-management n-nerve, norm-normal P-progesterone, pl-plasma, prot-protein, pt-patient Rx-treatment SCC-squamous cell carcinoma, sr-serum, Sx-surgery, sz-seizure tm-tumour, ts-tissue UL-upper limb, u/l-unilateral vag-vagina, VC-vocal cord, vel-velocity, vert-vertebra, vit-vitamin, vol-volume w-week, wt-weight Xr-X ray y-year #-fractureAim4aiims.in °-degree THESE NOTES ARE ONLY FOR THE PURPOSE OF GUIDANCE AND HELP TO PG ASPIRANTS, NOT FOR COMMERCIAL OR OTHER PURPOSE. REFERENCE HAS BEEN TAKEN FROM VARIOUS STANDARD TEXTBOOKS.

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