Chapter 13

■■■

C HAPTER 13

M ECHANICAL A SPHYXIA

1. Apoplexy is the term used for
(a) Cerebral congestion
(b) Cerebral ischaemia
(c) Cerebral anoxia
(d) Cerebral concussion
2. Hanging is defined as
(a) Suspension of body by a ligature around
the neck, body weight acting as constricting
force
(b) Suspension of body by ligature after death
(c) Obliteration of air passages by external
factors
(d) Mechanical interference to respiration
3. The commonest cause of death in hanging is
(a) Asphyxia
(b) Cerebral venous congestion
(c) Asphyxia and cerebral venous congestion
combined
(d) Cerebral anaemia
4. Delayed death in hanging can be due to the
following conditions, EXCEPT
(a) Hypoxic encephalopathy
(b) Infraction of brain
(c) Oedema of lungs
(d) Fracture of the cervical vertebrae

5. Weight for occluding internal jugular vein in
hanging is
(a) 2 kg
(b) 4 kg
(c) 8 kg
(d) 12 kg
6. In hanging last to be occluded is
1. (a)

Chapter-13.indd 104

2. (a)

3. (c)

4. (d)

5. (a)

6. (b)

7. (d)

8. (a)

7.

8.

9.

10.

11.

9. (c)

(a) Jugular vein
(b) Vertebral artery
(c) Trachea
(d) Carotid
In typical hanging death occurs due to
(a) Blocking of jugular veins
(b) Blocking of carotid arteries
(c) Blocking of vertebral arteries
(d) Both and (a) and (b)
In typical hanging knot is present at
(a) Occipital area
(b) Mastoid area
(c) In front of ear
(d) Any of the above
Cyanosis occurs when the concentration of reduced haemoglobin exceeds
(a) 2 g%
(b) 4 g%
(c) 5 g%
(d) 6 g%
Cyanosis is caused by
(a) An increased concentration of reduced
haemoglobin
(b) A decreased concentration of haemoglobin

(c) A decreased concentration of oxyhaemoglobin
(d) Hypoxia
A ligature mark on the neck directed obliquely upwards on both sides is seen in hanging
with a
(a) Fixed loop with a single knot in midline at
the back of the head
(b) Running noose
(c) Fixed loop with a knot in the region of one
ear
(d) Low point of suspension
10. (a)

11. (a)

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MECHANICAL ASPHYXIA

12. Which one of the following statements regarding ligature mark in hanging is NOT true?
(a) In the case of a fixed loop with a single knot
at the back of the head, the mark is seen
directed obliquely upwards on both sides
(b) In the case of fixed loop with the knot in the
region of one ear, the mark differs on each
side of the neck
(c) In case of running noose the mark is oblique
on both sides
(d) If the ligature is in the form of loop, the
mark is prominent on the part of the neck

to which the head has inclined
13. All of the following are characteristic of ligature mark of hanging EXCEPT
(a) It is usually oblique
(b) It does not completely encircles the neck
(c) It is usually seen high up on the neck
(d) The base is soft and reddish
14. In hanging, the groove produced by ligature
may be less well marked with
(a) Loop arranged with a fixed knot
(b) Low point of suspension
(c) Running noose
(d) Loop
15. A horizontal ligature mark is seen in the neck
in case of hanging
(a) When a fixed loop with a fixed knot in the
region of one ear is used
(b) When a fixed loop with a single knot at the
back of the head is used
(c) When a fixed loop with a single knot at the
chin is used
(d) In partial hanging
16. A ligature mark may not be seen in the neck in
case of hanging
(a) In partial hanging
(b) If a loop is made of soft material
(c) If narrow ligature is used
(d) When a fixed loop with a single knot at the
chin is used
12. (c)

Chapter-13.indd 105

13. (d)

14. (b)

15. (d)

16. (b)

17. (b)

18. (a)

19. (d)

105

17. In a case of hanging ligature marks in neck are
example of
(a) Contusion
(b) Pressure abrasion
(c) Laceration
(d) Bruise
18. A reliable sign of antemortem hanging is
(a) A thin line of congestion of haemorrhage
along the edges of ligature mark
(b) Congested, livid face marked with
petechiae
(c) Swollen, dark coloured protruded tongue

(d) Protrusion of tongue
19. The most important feature of antemortem
hanging is
(a) Fracture of hyoid bone
(b) Ligature mark on neck
(c) Fracture of thyroid cartilage
(d) Dribbling of saliva
20. The width of ligature mark on skin may not
correspond with ligature when the ligature
used is a
(a) Rope
(b) Woven belt
(c) Nylon or silk fabric
(d) Electric wire
21. Hyoid fracture is common in
(a) Hanging
(b) Strangulation
(c) Throttling
(d) Choking
22. Slow asphyxia is likely to occur in hanging
when
(a) Ligature exerts pressure below the chin and
does not encircle the neck
(b) Ligature exerts pressure below the chin and
encircles the neck
(c) Ligature exerts pressure at the level of thyroid
cartilage
(d) Ligature exerts pressure below the level of
thyroid cartilage
23. In hanging coma occurs rapidly if ligature

completely obstructs
(a) Jugular veins
(b) Vertebral arteries
(c) Carotid arteries
(d) Pharynx
20. (c)

21. (c)

22. (a)

23. (c)

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24. In hanging, asphyxial signs are slight when
(a) Suspension is complete
(b) Suspension is incomplete
(c) The deceased is in a kneeling position
(d) The deceased line prone with only the face
and chest off the ground
25. All of the following are characteristic of death
due to hanging EXCEPT
(a) Ligature mark around
(b) Ecchymosis of subcutaneous tissues under

the ligature mark
(c) Trickling of saliva from the mouth
(d) Ecchymosis of the larynx or epiglottis
26. Reflex vagal inhibition may occur in
(a) Impaction of food in larynx
(b) Drowning
(c) Hanging
(d) All of the above
27. In case of hanging, a typical ligature mark
shows following characteristics EXCEPT
(a) Oblique
(b) High up in neck
(c) Continuous
(d) Above the level of thyroid cartilage
28. Which one of the following statements regarding width of ligature mark compared to width
of ligature in hanging is NOT true?
(a) Equal
(b) More
(c) Less
(d) Variable
29. A ligature mark may not be seen in the neck
in case of hanging in the following condition
EXCEPT
(a) If a portion of clothing intervenes between
the ligature and the skin
(b) If a loop is made of soft material
(c) If a narrow ligature is used
(d) If the ligature is cut soon after death
30. Scratches or nail marks on the neck in hanging
may be found in case of

(a) Suicide
(b) Accident
24. (a)

Chapter-13.indd 106

25. (b)

26. (d)

27. (c)

28. (b)

29. (c)

30. (d)

31. (b)

31.

32.

33.

34.

35.

36.

37.

(c) Homicide
(d) Suicide and homicide
Unequal pupils in hanging is due to pressure
on the
(a) Parasympathetic chain
(b) Sympathetic chain
(c) Optic pathway
(d) All of the above
“Le facie sympathique” is seen in
(a) Hanging
(b) Strangulation
(c) Smothering
(d) Aconite poisoning
In a case of typical hanging, postmortem
hypostasis is seen in
(a) Legs and feet
(b) Hands and forearms
(c) Both (a) and (b)
(d) Genitalia
When a person has suspended himself by
applying ligature around the neck so that the
point of suspension (knot) is situated in the
region of the occiput. Such hanging is called
(a) Typical
(b) Atypical
(c) Partial

(d) Incomplete
Postmortem staining of lower parts of hands
and feet indicates
(a) Prolonged suspension after death
(b) Antemortem hanging
(c) Death due to asphyxia
(d) Drowning
In hanging transverse splits of carotid arteries
may be seen in
(a) Outer coats
(b) Middle coats
(c) Inner coats
(d) None of the above
Intima of carotid arteries is usually ruptured
in
(a) Hanging
(b) Ligature strangulation
(c) Traumatic asphyxia
(d) Burking

32. (a)

33. (c)

34. (a)

35. (a)

36. (c)

37. (a)

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MECHANICAL ASPHYXIA

38. Hanging with feet touching the ground is seen
in
(a) Suicidal hanging
(b) Homicidal hanging
(c) Accidental hanging
(d) Postmortem hanging
39. Dribbling of saliva is characteristic of
(a) Antemortem hanging
(b) Postmortem hanging
(c) Homicidal strangulation
(d) Suicidal strangulation
40. Lynching is a form of
(a) Sexual asphyxia
(b) Homicidal hanging
(c) Judicial hanging (d) Strangulation
41. Lynching is
(a) Practiced in North America
(b) Practiced by white people on Negroes
(c) Hanging publicly on a tree
(d) All of the above
42. Which one of the statement is NOT correct
concerning accidental hanging?
(a) It may be associated with abnormal sexual

behaviour
(b) It may occur in workmen in falling from
scaffolding and getting entangled in ropes
(c) It may occur from suspension of the chin by
the steering wheel of a motor car
(d) It may occur in infant with a string attached
to a toy tied to the crib
43. Postmortem hanging is characterised by the
following EXCEPT
(a) Marks of violence on the body
(b) No dribbling of saliva
(c) Signs of dragging on the body
(d) Continuous ligature mark round the neck
44. Death in judicial hanging is due to
(a) Shock
(b) Fracture-dislocation of upper cervical
(c) Rapid asphyxia
(d) Inhibition of the heart

38. (a)

Chapter-13.indd 107

39. (a)

40. (b)

41. (d)

42. (d)

43. (d)

44. (b)

45. (d)

107

45. In judicial hanging fracture, vertebrae are seen
at
(a) C1–C2
(b) C2–C3
(c) C4–C5
(d) C6–C7
46. In judicial hanging which position of knot is
more effective?
(a) Back of neck
(b) Side of neck
(c) Below chin
(d) All are equally effective
47. The ligature mark of strangulation is
(a) Transverse and completely encircles the
neck
(b) Usually seen high up in the neck
(c) Usually two or three marks are seen due to
multiple tying of the ligature
(d) Oblique, incomplete
48. A ligature mark may NOT be seen in the neck
in case of strangulation by ligature

(a) If the ligature is a thin rope
(b) If the ligature is removed soon after death
(c) If the body is mummified
(d) If the body is embalmed
49. Extensive bruising of muscles and subcutaneous tissues in neck is characteristic of
(a) Hanging
(b) Strangulation
(c) Throttling
(d) Burking
50. Horizontal ligature mark in the neck is seen in
(a) Throttling
(b) Hanging
(c) Strangulation by ligature
(d) Choking
51. All of the following are characteristic of ligature mark of strangulation EXCEPT
(a) The mark completely encircles the neck
(b) It is usually seen high up in the neck
(c) It is transverse
(d) Reddening and congestion is present
immediately above and below the groove

46. (c)

47. (a)

48. (b)

49. (c)

50. (c)

51. (b)

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52. A horizontal complete ligature mark below
the level of thyroid cartilage with extensive
bruising of subcutaneous tissues and muscles
adjacent to it indicate
(a) Accidental strangulation
(b) Homicidal hanging
(c) Homicidal strangulation
(d) Suicidal hanging
53. Seminal emission is more common in
(a) Strangulation by ligature
(b) Hanging
(c) Smothering
(d) Traumatic asphyxia
54. Maximum congestion is seen in
(a) Choking
(b) Hanging
(c) Strangulation
(d) Drowning
55. Bleeding from the nostrils, mouth and ears is
common in

(a) Hanging
(b) Strangulation by ligature
(c) Smothering
(d) Choking
56. Most important sign of strangulation is
(a) Ligature mark around the neck
(b) Haemorrhage under ligature mark
(c) Fracture of hyoid bone
(d) Dislocation of cervical vertebrae
57. Evidence of strangulation includes all EXCEPT
(a) Ligature mark on the neck
(b) Subconjunctival ecchymoses
(c) Dribbling of saliva from mouth
(d) Congestion of face
58. Which one of the following statements regarding internal findings in the neck in case of ligature strangulation is NOT true?
(a) There is severe engorgement and
haemorrhage into the tissues in and above
the area compressed
(b) The muscles of the neck are usually
lacerated
(c) Bruising of the deeper tissues in the
52. (c)

Chapter-13.indd 108

53. (b)

54. (c)

55. (b)

56. (b)

57. (c)

58. (d)

59. (d)

59.

60.

61.

62.

63.

64.

compressed part may be absent if ligature
is tightly applied on the neck until death
occurs
(d) Dislocation of cervical vertebrae may be
fractured
In ligature strangulation, the lungs show all of
the following changes EXCEPT
(a) Congestion is marked
(b) Silvery-looking spots are seen under the

pleural surface
(c) Microscopic areas of collapse are present
(d) Ecchymoses and subpleural haemorrhages
do not occur
Emphysematous bullae on the surface of the
lungs are commonly seen in
(a) Hanging
(b) Ligature strangulation
(c) Drowning
(d) Traumatic asphyxia
Hanging differs from strangulation by the following features EXCEPT
(a) Always suicidal
(b) Ligature mark is oblique
(c) Neck is elongated and stretched
(d) Subcutaneous tissue under the mark is
white, hard and glistening
All of the following findings indicate death
due to ligature strangulation in putrefied body
EXCEPT
(a) Fracture of the larynx or hyoid bone
(b) Bruising of the muscles of the neck
(c) Ligature mark
(d) Signs of asphyxia
Holding the neck of victim in bend of elbow is
known as
(a) Throttling
(b) Mugging
(c) Bansdola
(d) Garrotting
The following are the type of homicidal strangulation EXCEPT

(a) Bansdola
(b) Mugging
(c) Lynching
(d) Garrotting

60. (b)

61. (a)

62. (d)

63. (b)

64. (c)

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MECHANICAL ASPHYXIA

65. Bansdola is a form of
(a) Homicidal suffocation
(b) Homicidal strangulation
(c) Homicidal hanging
(d) Homicidal choking
66. Garrotting is a method of homicidal strangulation which is accomplished by
(a) Placing one bamboo stick across the front
of neck and one at the back, and tying both
ends with a rope
(b) Holding the neck of victim in the bend of

the elbow
(c) Compression of the neck by the hand
(d) Throwing a ligature over the neck from
behind and quickly tightening it
67. Which of the following is used as a method of
execution in some countries?
(a) Bansdola
(b) Garrotting
(c) Mugging
(d) Smothering
68. Last part to be dissected during autopsy in asphyxia death
(a) Neck
(b) Head
(c) Abdomen
(d) Thorax
69. In a suspected case of throttling, the procedure
advised at autopsy is
(a) Block removal of neck structures for
subsequent detailed examination
(b) Skull and chest are opened and examined
before in situ examination of neck structures
(c) In situ examination of neck structures before
opening the skull and chest
(d) It is immaterial if you follow any of the
above methods
70. In case of throttling the situation and extent
of the bruised areas on the neck depend on the
following EXCEPT
(a) Relative positions of the assailant and
victim

(b) The manner of grasping the neck
(c) The degree of pressure exerted upon the
throat
(d) The manner of application of the ligature
65. (b)

Chapter-13.indd 109

66. (d)

67. (b)

68. (c)

69. (b)

70. (d)

71. (a)

72. (a)

109

71. In case of throttling bruises on the neck may
be seen in a completely haphazard manner
(a) In frank struggle of victim
(b) In children
(c) When the neck is small
(d) When the assailant’s hand is large

72. The size of the contused areas on the neck in
case of throttling may be more than the size of
the digits due to
(a) Shifting of the grip
(b) Maintaining the pressure on the neck
(c) Interposing a soft material between the hand
and throat
(d) Pressure exerted by the right hand
73. Hyoid bone fracture is seen in all of the
following EXCEPT
(a) Throttling
(b) Hanging
(c) Choking
(d) Strangulation by ligature
74. Fracture of hyoid bone is more common in
(a) Hanging
(b) Ligature strangulation
(c) Manual strangulation
(d) Traumatic asphyxia
75. In throttling fracture of the hyoid bone is commonly seen in
(a) greater horn
(b) Lesser horn
(c) Body
(d) Both in the body and greater horn
76. Maximum congestion is seen in
(a) Choking
(b) Hanging
(c) Strangulation
(d) Drowning
77. In “commando punch” the injury usually

occurs to
(a) Eye
(b) Neck
(c) Face
(d) Chest
73. (c)

74. (c)

75. (a)

76. (c)

77. (b)

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78. The following are the differences of strangulation from hanging EXCEPT
(a) Carotid arteries damage is rare
(b) Fracture dislocation of cervical vertebrae is
common
(c) Neck is not elongated
(d) External signs of asphyxia are well marked
79. Fracture of hyoid bone, thyroid cartilage and
cricoid cartilage along with neck muscle bruising suggests

(a) Manual strangulation
(b) Ligature strangulation
(c) Hanging
(d) Choking
80. Fracture of hyoid bone with thyroid cartilage
along with neck muscle bruising suggests death
due to
(a) Strangulation
(b) Hanging
(c) Choking
(d) Gagging
81. Bilateral comminuted fractures of the larynx
are usually caused by
(a) Pressing the neck with the hands
(b) A blow to the neck
(c) Ligature strangulation
(d) Garrotting
82. Anteroposterior compression fracture of the
larynx is usually caused by
(a) Ligature strangulation
(b) Throttling
(c) Garrotting
(d) Hanging
83. Adduction type of fracture of hyoid bone is
seen in death due to
(a) Ligature strangulation
(b) Hanging
(c) Throttling
(d) Motor vehicle accidents
84. A blow on the larynx may cause death from

(a) Laryngospasm
(b) Fracture of hyoid bone
(c) Air embolism
(d) Nerve paralysis
78. (b)

Chapter-13.indd 110

79. (a)

80. (a)

81. (b)

82. (d)

83. (c)

84. (a)

85. (c)

85. Fracture of the body of thyroid cartilage may
be seen in the following conditions EXCEPT
(a) Throttling
(b) In a cyclist in traffic accident
(c) Hanging
(d) Karate blow to the front of the neck
86. Bruising of the muscles of neck and larynx with
fracture of thyroid cartilage and hyoid bone is

seen in death due to
(a) Hanging
(b) Throttling
(c) Ligature strangulation
(d) Traumatic asphyxia
87. Palmar strangulation is caused by
(a) Forcibly closing throat by right palm
(b) Forcibly closing throat by both palms
(c) Forcibly closing throat by fingers of both
hands
(d) Karate blow to the front of the neck
88. Swelling and protrusion of the tongue is more
common in
(a) Hanging
(b) Ligature strangulation
(c) Traumatic asphyxia
(d) Gagging
89. Cricoid cartilage is usually fractured in(a) Throttling
(b) Ligature strangulation
(c) Traumatic asphyxia
(d) A blow to the front of the neck
90. Which one of the following regarding death
due to throttling is NOT true?
(a) Fracture of the hyoid bone
(b) Fracture of thyroid cartilage
(c) Collection of blood behind the pharynx,
larynx and on the front of the cervical spine
(d) Fracture of cricoid cartilage
91. Fracture of hyoid bone and larynx indicate
(a) Accidental throttling

(b) Suicidal throttling
(c) Homicidal throttling
(d) All of the above
86. (b)

87. (b)

88. (b)

89. (a)

90. (c)

91. (c)

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MECHANICAL ASPHYXIA

92. The most common cause of suffocation is
(a) Inhalation of irrespirable gases
(b) Closure of glottis
(c) Pressure on chest
(d) Deprivation of oxygen
93. Which one of the following statements regarding suicidal smothering is NOT true?
(a) It can occur by closing the nose and mouth
by the hand
(b) It is possible by burying the face in a mattress
(c) It is possible by lying against the bed clothing

to obstruct the nose and mouth
(d) It can be effected by tying a polythene bag
over the head
94. In suffocation, petechial haemorrhages may be
seen in
(a) Pericardium
(b) Meninges
(c) Peritoneum
(d) All of the above
95. Which one of the following is NOT correct,
concerning accidental smothering?
(a) It is less common than suicidal smothering
(b) It can occur in a vitiated atmosphere
(c) It is not necessary that the mouth and nostrils
should be completely closed at the start
(d) An intoxicated person may smother himself
by burying his face in a pillow or covering
with bed clothes
96. It is true regarding subcutaneous rupture of
larynx and trachea that
(a) It may produce widespread subcutaneous
emphysema
(b) It can be produced by the impaction of large
food bolus
(c) It is only a presumption not a reality
(d) None of the above
97. Paleness of the face with few petechial haemorrhages in the eyelids are seen when smothering
is caused by
(a) Closing the mouth and nose by the hand
(b) In air-tight place

(c) Inhalation of irrespirable gases
(d) Head and face enclosed in a plastic bag
92. (a)

Chapter-13.indd 111

93. (a)

94. (a)

95. (a)

96. (a)

97. (d)

98. (a)

99. (d)

111

98. The postmortem finding seen in smothering
(a) Abrasion on the inner side of the upper lip
(b) Fracture body of hyoid
(c) Thyroid fracture
(d) Curved marks on the neck
99. The positive findings of burial of a living person is
(a) Presence of moulds on the body
(b) Congestion of liver and spleen

(c) Marked pulmonary oedema
(d) Earth or sand in trachea and bronchi
100. From autopsy, it is extremely difficult to detect
(a) Homicidal smothering
(b) Homicidal gagging
(c) Homicidal choking
(d) Homicidal ligature strangulation
101. Burking is a name derived from a
(a) Place
(b) Person
(c) Firearm
(d) Weapon used for murder
102. A method of homicidal smothering and traumatic asphyxia is known as
(a) Choking
(b) Gagging
(c) Burking
(d) Overlaying
103. A method of sitting over chest and closing
nostrils and mouth to cause asphyxial death is
known as
(a) Overlaying
(b) Choking
(c) Burking
(d) Gagging
104. Burking is combination of smothering and
(a) Strangulation by ligature
(b) Throttling
(c) Gagging
(d) Traumatic asphyxia
105. In burking the cause of death is

(a) Smothering
(b) Traumatic asphyxia
(c) Smothering and traumatic asphyxia
(d) Cerebral congestion
100. (a) 101. (b) 102. (c) 103. (c) 104. (d) 105. (c)

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106. The cause of death from choking include all of
the following EXCEPT
(a) Asphyxia
(b) Cerebral anaemia
(c) Cardiac inhibition (d) Laryngeal spasm
107. Choking
(a) It is a form of asphyxia caused by mechanical
occlusion within air passages by a solid
object
(b) A twig of madar 20 cm long
(c) It is practised in India by dais
(d) Occurs due to closure of external respiratory
orifices
108. Mode of death from obstruction of the air passages from within is
(a) Anaemic anoxia
(b) Stagnant anoxia
(c) Anoxic anoxia

(d) Histotoxic anoxia
109. Choking due to regurgitation of food may occur in
(a) Under the influence of drink
(b) Head injury
(c) Traumatic asphyxia
(d) Smothering
110. Death caused due to regurgitation of food and
inhalation into the respiratory tract is called
(a) Smothering
(b) Choking
(c) Traumatic asphyxia
(d) Mugging
111. Homicidal choking can be produced when a
victim is
(a) An infant
(b) Disabled
(c) Under the influence of alcohol
(d) All of the above
112. Cafe coronary commonly occurs in persons
who
(a) Had a previous heart attack
(b) Intoxicated
(c) Suffering from anginal attacks
(d) All of the above

113. “Cafe coronary” is
(a) A type of death due to choking
(b) Sudden death due to coronary thrombosis
(c) Death due to alcoholic cardiomyopathy
(d) Food poisoning

114. The cause of death in cafe coronary is
(a) Asphyxia
(b) Coronary thrombosis
(c) Sudden heart attack
(d) Laryngeal spasm
115. In overlaying death occurs due to
(a) Smothering
(b) Compression of the chest
(c) Inhalation of gastric contents
(d) None of the above
116. The term overlaying implies
(a) Asphyxia caused by an obstruction within
air passages
(b) Homicidal smothering
(c) Asphyxia resulting from forcing a cloth into
mouth
(d) Compression suffocation
117. Presence of mucus, saliva and oedema fluid on
the clothing tied over mouth and is suggestive
of
(a) Antemortem gagging
(b) Choking
(c) Struggle before death
(d) Traumatic asphyxia
118. Detection of buccal epithelium on the gagging
material may help
(a) To establish the sex of the victim
(b) To establish the sex of the accused
(c) To ascertain the age of the victim
(d) To ascertain the age of the accused

119. Traumatic asphyxia results from
(a) Injury to the head
(b) Crushing of the chest and abdomen
(c) Crushing of the lower limbs
(d) Fall from a height on the buttocks

106. (b) 107. (a) 108. (c) 109. (a) 110. (b) 111. (d) 112. (b) 113. (a) 114. (a) 115. (b) 116. (d) 117. (a) 118. (a) 119. (b)

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120. All of the following are causes of traumatic asphyxia EXCEPT
(a) Gross compression of the chest and
abdomen
(b) Stampede in a crowd
(c) Falls of earth or stone during tunnelling
(d) Gross compression of the head
121. All the following can cause traumatic asphyxia
EXCEPT
(a) Railway accident
(b) Road traffic accident
(c) Stampede in crowd
(d) Accidental strangulation
122. The characteristic feature of traumatic asphyxia
is
(a) Multiple fractures of bones

(b) Deep purple colour of the head, neck and
upper chest
(c) Collapse of the lungs
(d) Abrasions and contusions around the mouth
and nose
123. Which of the following is not a cause of death
due to suffocation?
(a) Choking
(b) Gagging
(c) Smothering
(d) Throtting
124. Death is usually accidental in the following
conditions EXCEPT
(a) Traumatic asphyxia (b) Choking
(c) Gagging
(d) Overlaying
125. The term “dry drowning” is used when death
occurs
(a) Within half hour to several days after
resuscitation
(b) From immediate sustained laryngeal spasm
(c) From vagal inhibition
(d) From hyperkalaemia
126. In immersion syndrome death results from vagal inhibition due to
(a) Cold water striking the epigastrium
(b) Cold water stimulating the sensory nerves
in the skin

127.

128.

129.

130.

131.

132.

133.

113

(c) Cold water entering ear drums or mucosa of
the pharynx and larynx
(d) All of the above
Atypical arrest due to drowning is
(a) Cardiac arrest due to drowning
(b) Laryngospasm due to drowning
(c) Drowning in unconscious state
(d) All of the above
Dry drowning is
(a) When a person falls in a dry well and dies
(b) Death occurs due to fall in water from spasm
of larynx
(c) Falls in water and die due to vagal
inhibition
(d) All of the above
Which is NOT a contributory cause of death

in immersion syndrome?
(a) Cold water entering the pharynx and
larynx
(b) Cold water stimulating the nerve endings of
the surface of the body
(c) High emotion
(d) Hyperkalaemia
The salt concentration of seawater is about
(a) 0.5%
(b) 0.1%
(c) 2.0%
(d) 3.0%
In freshwater drowning there is
(a) Hypernatraemia
(b) Hyperkalaemia
(c) Hypermagnesaemia
(d) Hypercalcaemia
Hypervolaemia and hyperkalaemia are seen in
(a) Freshwater drowning
(b) Saltwater drowning
(c) Dry drowning
(d) Immersion syndrome
Haemodilution occurs in
(a) Seawater drowning
(b) Freshwater drowning
(c) Both seawater and freshwater drowning
(d) None of the above

120. (d) 121. (d) 122. (b) 123. (d) 124. (c) 125. (b) 126. (d) 127. (d) 128. (b) 129. (d) 130. (d) 131. (b) 132. (a) 133. (b)

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S ECTION I: FORENSIC MEDICINE

134. Exchange of water in drowning at alveolar level
depends upon
(a) Quantity of the water inhaled
(b) Osmotic gradient between blood and water
(c) Thickness of the alveolar septa
(d) All of the above
135. The common cause of death in freshwater
drowning is
(a) Asphyxia
(b) Ventricular fibrillation
(c) Laryngeal spasm
(d) Vagal inhibition
136. The common cause of death in seawater
drowning is
(a) Laryngeal spasm (b) Vagal inhibition
(c) Exhaustion
(d) Asphyxia
137. In dry drowning death is due to
(a) Laryngeal spasm
(b) Exhaustion
(c) Ventricular fibrillation

(d) Vagal inhibition
138. The cause of death in immersion syndrome is
(a) Laryngeal spasm
(b) Ventricular fibrillation
(c) Vagal inhibition
(d) Asphyxia
139. The complication of drowning in freshwater is
(a) Haemodilution
(b) Severe pulmonary oedema
(c) Hypokalaemia
(d) Hypernatraemia
140. Reflex cardiac arrest is due to
(a) Sudden flow of water into the nasopharynx
(b) Sudden thrust of water over the abdominal
region
(c) In both (a) and (b)
(d) Does not occur in drowning
141. In case of freshwater drowning death occurs
within 4 to 5 min of submersion due to ventricular fibrillation. Which of the following
reasons is responsible for this?

142.

143.

144.

145.

146.

147.

148.

(a) Total asphyxia is produced due to freshwater drowning
(b) Laryngospasm causes vagal inhibition
(c) Haemoconcentration of blood caused by
osmotic pressure effect
(d) Haemodilution, overloading of heart and
haemolysis resulting in release of potassium
Fatal period in freshwater drowning is about
(a) 2 to 3 minutes
(b) 4 to 5 minutes
(c) 4 to 8 minutes
(d) 8 to 10 minutes
Hypernatraemia is seen in
(a) Freshwater drowning
(b) Saltwater drowning
(c) Immersion syndrome
(d) All of the above
Signs of asphyxia are absent in
(a) Wet drowning
(b) Dry drowning
(c) Secondary drowning
(d) Seawater drowning
Slow death occurs from asphyxia in
(a) Freshwater drowning
(b) Saltwater drowning
(c) Secondary drowning

(d) Immersion syndrome
In drowning in unconscious state the lungs
are
(a) Ballooned
(b) Not ballooned
(c) Collapsed
(d) Show congestion and petechial haemorrhages
Which of the following is not seen in sea water
drowning?
(a) Hypernatraemia
(b) Hyperkalaemia
(c) Fluid retention
(d) Intravascular dehydration
Victim of drowning in a state of suspended
animation can be revived within
(a) 10 to 20 minutes (b) 30 to 60 minutes
(c) 1 to 2 hours
(d) 2 to 3 hours

134. (b) 135. (b) 136. (d) 137. (a) 138. (c) 139. (a) 140. (c) 141. (d) 142. (c) 143. (b) 144. (c) 145. (b) 146. (b) 147. (b) 148. (a)

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149. At autopsy, a body was found to have fine froth
from the nose and mouth which increased on

compression of the chest. Which of the following is the most likely cause of death?
(a) Opioid poisoning (b) Hanging
(c) Drowning
(d) Cyanide poisoning
150. Reaction phenomenon is seen in
(a) Burns
(b) Drowning
(c) Poisoning
(d) Gunshot injury
151. It is true regarding seawater and freshwater
drowning that
(a) The mechanism of death is the same
(b) The mechanism of death is different
(c) The mechanism of death is the same but the
time taken is different
(d) All of the above
152. Rigor mortis in case of drowning
(a) Appears late
(b) Appears early
(c) Has no effect on appearance
(d) Appears early in postmortem drowning
153. Which of the following is NOT true about
freshwater drowning?
(a) Hypovolaemia
(b) Ventricular fibrillation
(c) Hyperkalaemia
(d) Haemolysis
154. Cutis anserina is seen in
(a) Drowning
(b) Hanging

(c) Electrocution
(d) Mummification
155. Washerwoman’s hands and feet are usually seen
in a case of drowning in
(a) 6 to 12 hours
(b) 18 to 24 hours
(c) 24 to 36 hours
(d) 36 to 48 hours
156. All of the following are features of washerwoman’s hands, EXCEPT
(a) Soddening of the skin
(b) Thinning of the skin
(c) Wrinkling of the skin
(d) Bleaching of the skin

115

157. Most important sign of death due to drowning
is
(a) Washerwoman’s hands and feet
(b) Weeds and grass grasped in the hands
(c) Cutis anserina
(d) Cyanosis
158. Important sign of antemortem drowning is indicated by
(a) Cutis anserina
(b) Frothy fluid in mouth and nostril
(c) Grass and weeds in hands
(d) Washerwomen’s hands
159. Postmortem staining is usually found on the
face, upper part of the chest and hands and feet
in death due to

(a) Choking
(b) Strangulation
(c) Drowning
(d) Traumatic asphyxia
160. The most characteristic external sign of drowning is
(a) Cutis anserina
(b) Washerwoman’s hands and feet
(c) Fine, white, lathery froth at the mouth and
nostrils
(d) Distended abdomen
161. Specific gravity of human body is
(a) 1.08
(b) 2.01
(c) 1.05
(d) 2.35
162. Large quantity of froth is found at the mouth
and nose in the following, EXCEPT
(a) Strangulation
(b) Electrical shock
(c) Traumatic asphyxia
(d) Opium poisoning
163. A child got drowned in a pond. The most characteristic finding at autopsy is
(a) Petechial haemorrhages
(b) Washerwoman’s feet
(c) Cutis anserina
(d) Froth at mouth and in respiratory passage

149. (c) 150. (b) 151. (b) 152. (b) 153. (a) 154. (a) 155. (b) 156. (b) 157. (b) 158. (c) 159. (c) 160. (c) 161. (a) 162. (c) 163. (d)

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S ECTION I: FORENSIC MEDICINE

164. Froth of drowning can be differentiated from
that due to other causes by
(a) Microscopic detection of mucus
(b) Detecting excess of sodium chloride
(c) Detecting excess of potassium
(d) Detecting excess of magnesium
165. Absence of foam in drowning can be found in
(a) Dry drowning
(b) Immersion syndrome
(c) Both (a) and (b)
(d) Wet drowning
166. The colour of the postmortem staining may be
pink or cyanotic in death due to
(a) Hanging
(b) Drowning
(c) Traumatic asphyxia
(d) Throttling
167. The important finding of antemortem drowning is
(a) Froth in mouth and nostrils
(b) Washerwoman’s hands and feet
(c) Fluid and air in the bronchi
(d) Haemoconcentration

168. All of the following are the findings in sea-water drowning EXCEPT
(a) Pulmonary oedema
(b) Hypernatraemia
(c) Hyperkalaemia
(d) Haemoconcentration
169. Regurgitation of gastric contents into the larynx and trachea in cases of drowning is due to
(a) Ingestion of large quantities of water
(b) Medullary hypoxia
(c) Stimulation of gastric mucosa by substances
in ingested water
(d) All of the above
170. The most characteristic internal finding in
drowning is
(a) Emphysema aquosum

(b) Froth in the trachea
(c) Mud and sand particles in the terminal
bronchioles
(d) Diatoms in the lungs
171. In freshwater drowning the lungs are
(a) Ballooned but light in weight
(b) Ballooned and heavy
(c) The shape of sectioned portion is not
retained
(d) Copious amounts of fluid pours out of the
cut section
172. In saltwater drowning the lungs are
(a) Ballooned and heavy
(b) Ballooned but light in weight
(c) Pale pink in colour

(d) On section water does not pour out
173. In death due to drowning in sea difference of
at least --------% in chloride content in left and
right side of heart is significant
(a) 5
(b) 10
(c) 25
(d) 60
174. A person brought to casualty showing froth at
the mouth and nose, which increases on compression of chest, is seen in
(a) Secondary drowning
(b) Strangulation
(c) Dry drowning
(d) Hanging
175. Petechial haemorrhages in drowning may be
seen in
(a) Subpleural tissues of lung
(b) Submucosa of trachea
(c) Bronchioles
(d) Alveoli
176. Drowning can be diagnosed if there is
(a) Cyanosis
(b) Fracture of hyoid bone
(c) Water and diatoms in lungs and stomach
(d) All of the above

164. (a) 165. (c) 166. (b) 167. (c) 168. (c) 169. (b) 170. (c) 171. (a) 172. (a) 173. (c) 174. (a) 175. (a) 176. (c)

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177. Drowning is characterised by the following
signs EXCEPT
(a) Lungs are ballooned
(b) Trachea and bronchi contain froth and sand
(c) Diatoms are present
(d) Stomach is empty while lungs are full of
water
178. Bulky oedematous lungs with fine froth and
diatoms are suggestive of
(a) Antemortem drowning
(b) Postmortem drowning
(c) Antemortem hanging
(d) Suicidal hanging
179. In drowning, emphysema aquosum is seen in
(a) 30%
(b) 50%
(c) 80%
(d) 95%
180. Emphysema aquosum is seen in
(a) Wet drowning
(b) Dry drowning
(c) Secondary drowning
(d) Immersion syndrome
181. Paltauf ’s haemorrhages are seen in
(a) Electrocution

(b) Hanging
(c) Throttling
(d) Drowning
182. Presence of aquatic vegetation in lower respiratory tract in a case of drowning
(a) Is positive proof of drowning
(b) Not a definite sign
(c) Not significant at all
(d) Can be seen in both antemortem and
postmortem drowning
183. Water is found in the stomach in cases of
drowning in
(a) 20 to 30% cases (b) 30 to 40% cases
(c) 50 to 60% cases (d) 60 to 70% cases
184. Water can be absent in the stomach in cases of
drowning due to
(a) Immersion syndrome
(b) Putrefaction
(c) Both (a) and (b)
(d) Absorption of water after death

117

185. In cases of death due to drowning, water in
small intestine is
(a) An important finding
(b) Not an important finding
(c) Helps in estimating time since death
(d) None of the above
186. Temporal bone haemorrhages are found in
(a) Throttling

(b) Drowning
(c) Cyanide poisoning (d) Arsenic poisoning
187. In a putrefied body, the most important finding indicating death due to drowning is
(a) Specific gravity of plasma from right side of
heart is more than left
(b) Difference in chloride in right and left side
of heart
(c) Presence of water in the pleural cavities
(d) Presence of diatoms in internal organs
188. If the postmortem is delayed in a case of drowning
(a) The typical findings in the lungs may
disappear
(b) The typical findings in the lungs are not
affected
(c) The diatom test becomes negative
(d) None of the above
189. Acid digestion technique is used for
(a) Detection of algae in stomach contents in
drowning
(b) Detection of diatoms in tissues in
drowning
(c) Detection of metallic pieces in the muscles
(d) All of the above
190. One of the following is a sure sign of death due
to drowning
(a) Cutis anserina
(b) Water in the stomach
(c) Pulmonary oedema
(d) Diatoms detected in bone marrow
191. The confirmatory laboratory test for death due

to drowning in seawater is
(a) Diatom test
(b) Chloride test
(c) Specific gravity test (d) None of the above

177. (d) 178. (a) 179. (c) 180. (a) 181. (d) 182. (a) 183. (d) 184. (c) 185. (a) 186. (b) 187. (d) 188. (a) 189. (b) 190. (d) 191. (d)

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S ECTION I: FORENSIC MEDICINE

192. Commonest type of drowning is
(a) Suicidal
(b) Accidental
(c) Homicidal
(d) Undetermined
193. Accidental drowning can be ruled out if
(a) Hands and feet are tied by a ligature
(b) The body is tied up inside a gunny bag
(c) Heavy weights are attached to the body
(d) All of the above
194. Which of the following sign will indicate that
the death due to drowning was antemortem?
(a) Cutis anserina
(b) Washerwoman’s hands

(c) Weeds and grass in the hands
(d) Cyanosis
195. Hydrostatic lung can be seen
(a) If the body is removed from water within 6
hours of drowning
(b) If the body remains in water at a depth of 2
metres for 20 hours
(c) In secondary drowning
(d) Drowning in shallow water
196. False negative hydrostatic test in a live born
foetus is seen in
(a) Atelectasis
(b) Artificial respiration
(c) Emphysema
(d) Putrefaction
197. In a suspected case of drowning diatoms can be
looked for in
(a) Brain
(b) Bone marrow
(c) Liver
(d) All of the above
198. Differenciate between freshwater drowning
and seawater drowning
(a) Frothing is seen in freshwater drowning
only
(b) Diatoms are found in the sternum in
freshwater drowning
(c) Increase in the chloride levels in the left side
of heart
(d) Pulmonary oedema

199. The following is the absolute and confirmatory
laboratory test for deaths due to drowning in
seawater

200.

201.

202.

203.

204.

205.

206.

(a) Diatom test
(b) Chloride test
(c) Magnesium estimation
(d) None of the above
In faked drowning, the following signs may be
present EXCEPT
(a) Lungs will be normal
(b) Heart shows normal chloride contents in
both chambers
(c) Trachea will not be congested
(d) Cutis anserina will be prominent
In a person who died of drowning in seawater

(a) Lungs are pale pink
(b) Signs of asphyxia are not seen
(c) Stomach does not contain water
(d) The chloride content of left side of heart is
higher
Diatoms are
(a) Parasites
(b) Algae
(c) Bacteria
(d) Fungi
The conclusive postmortem finding of death
by drowning is
(a) Cutis anserina
(b) Presence of water in the middle ear
(c) Oedematous lung
(d) Demonstration of diatoms in the organs of
the body
Gettler’s test is used in
(a) Hanging
(b) Strangulation
(c) Drowning
(d) Poisoning
Bleaching of cuticle begins after
(a) 4 to 8 hours of immersion
(b) 12 hours of immersion
(c) 24 hours of immersion
(d) 48 hours of immersion
Floatation of a body in water is due to
(a) Flesh being eaten by fishes
(b) Presence of gases

(c) Water logging of body
(d) All of the above

192. (b) 193. (d) 194. (c) 195. (b) 196. (a) 197. (d) 198. (c) 199. (d) 200. (d) 201. (d) 202. (b) 203. (d) 204. (c) 205. (a) 206. (b)

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207. A dead body will float in summer after drowning in
(a) 6 to 12 hours
(b) 12 to 24 hours
(c) 24 to 36 hours
(d) 36 to 48 hours
208. Air pockets in clothing may cause
(a) Early floatation of the body
(b) Late floatation of the body
(c) No effect on floatation
(d) No floatation at all
209. Deep inspiration above the water level may
cause
(a) No effect on floatation of body
(b) Early floatation of body
(c) Late floatation of body
(d) Late floatation of body only in seawater
210. Hyperventilation before drowning
(a) Can cause immediate death

(b) Does not alter the process of drowning

119

(c) Can cause delayed death
(d) Can cause secondary drowning
211. The most fatal complication that can occur to
divers (under high atmospheric pressure) is
(a) Pulmonary oedema
(b) Air embolism
(c) Vagal inhibition
(d) Suffocation
212. Sexual asphyxias are commonly associated
with
(a) Sadism
(b) Fetichism
(c) Masochism
(d) Voyeurism
213. The most frequent method of sexual asphyxias
is
(a) Hanging
(b) Electrical stimulation of genitals
(c) Enveloping the head in a plastic bag
(d) Inhalation of stupefying substances

207. (b) 208. (a) 209. (b) 210. (c) 211. (b) 212. (c) 213. (a)

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