Forensic Medicine and Toxicology
What you must understand
Forensic medicine questions test legal definitions and their clinical application. Know the distinction between a summons and a warrant, the meaning of a cognisable offence, and the doctor's duties in a medicolegal case - consent, documentation, preservation of evidence, and reporting. Understand the classification of injuries: abrasion, contusion, laceration, incised wound, stab wound, and firearm injury, with the features that distinguish them. Learn the signs of death and the estimation of time since death, and the medicolegal aspects of sexual assault, poisoning, and suspected torture.
In toxicology, master the toxidromes - opioid, anticholinergic, cholinergic, sympathomimetic - and the classic poisons with their antidotes: organophosphate with atropine and pralidoxime, paracetamol with N-acetylcysteine, opioid with naloxone, benzodiazepine with flumazenil, methanol with ethanol or fomepizole, and heavy metals with chelators. Understand the principles of decontamination, enhanced elimination and supportive care.
Traps that appear
Questions often test the legal status of an act rather than its clinical description. Distinguish suicidal from homicidal and accidental wounds by their characteristics and location. In poisoning, a common trap is offering an antidote where none exists and supportive care is correct, or giving flumazenil in a mixed overdose with a proconvulsant.
Worked rule of thumb
For any poisoning vignette, identify the toxidrome first: pinpoint pupils with respiratory depression means opioid; salivation, lacrimation, urination, diarrhoea, bronchospasm and bradycardia mean cholinergic excess. The toxidrome narrows the antidote before any laboratory result is available.
Study strategy
Build a two-column table of poison and antidote, and a second table of injury type and its distinguishing features.