30 August 2007 Paper I (3 hours)

You are asked to clinically examine a 6-month-old baby. The baby was allegedly injured when falling from his cot, while under the supervision of his stepfather. Answer the following questions relating to the case Which injuries would you specifically look for to exclude possible child abuse? (6) b) What is your legal obligation in this case when suspecting child abuse? (4) c) Describe the relevance of radiological examination in cases of possible child abuse. (5) [15] Write short notes on the following a) b) The definition of torture. (5) The responsibilities of the doctor treating a prisoner who claims to have been tortured. (10) [15] In terms of the Criminal Procedure Act (Section 335B), discuss consent where parents or guardians are not available (4) In terms of the Road Traffic Act discuss i) ii) Illegal blood alcohol limits for all categories of drivers (5) The reason(s) for the 2 hour time limit for blood alcohol sampling in drunk drivers. (6) [15] a)

a) b)

Describe the following examination techniques in cases of rape, including their advantages, as well as their limitations a) b) c) Foleys catheter technique. The use of ultra-violet light. The use of Toluidine Blue dye. (5) (5) (5) [15]

Discuss the definition of mild, moderate and severe intoxication and the different clinical pictures expected in each category. [15]

PTO/Page 2 Question 6...

-26 Discuss briefly, in terms of The National Health Act (Act 61 of 2003): a) The rights of the patient. b) When a doctor may legally disclose information about his/her patient. [15] List the circumstances and conditions under which a pregnancy may be legally terminated in South Africa, as contemplated in the Choice on Termination of Pregnancy Act of 1996. [10]

Paper II

30 August 2007

(3 hours)

You are called to a scene of a murder to determine the time of death. Answer the following related questions a) b) How can rigor mortis be helpful in determining death interval? Refer to relevant time intervals that can be used as a spot check. (8) You determine the body temperature to be 31oC with the ambient temperature being 10 oC. Use the following table to determine the death interval: Please show all calculations. (4) Ambient temperature in oC 0 5 10 15 Factor 1 1,25 1,5 1,75 Describe the effect of rigor mortis on the Erector Pili muscles. 20 2 (3) [15]

c)

Regarding complications of injuries, briefly discuss the following a) b) c) Causes of venous air embolism. Pathophysiological mechanism(s) of death in venous air embolism. Causes and pathogenesis of fat embolism syndrome. (5) (4) (6) [15]

A foetus, slightly decomposed, was retrieved from a dumping site and presented to you as Forensic Medical Examiner. Briefly describe how you will determine the following a) b) The gestation period of the foetus. Whether this was a live- or still birth. (7) (8) [15]

Discuss the autopsy findings in drowning and the different mechanisms of death. [15] Tabulate and compare the findings of gunshot entry wound of the forehead by a handgun at the following ranges: contact, near contact, intermediate and distant. [15] Tabulate the essential differences between the following (5) (5) [10] Discuss your autopsy approach to a victim of alleged fatal poisoning, with particular reference to the collection of specimens. [15] a) b) Acute-mortem and postmortem blood clots. Subdural and epidural haematomas.