Drowning

Drowning

Q. 1 All of the following are seen in the lungs in fresh water drowning, EXCEPT:

 A Lungs are ballooned and light

 B

Colour is pink

 C

Emphysematous

 D

No crepitus heard

Q. 1

All of the following are seen in the lungs in fresh water drowning, EXCEPT:

 A

Lungs are ballooned and light

 B

Colour is pink

 C

Emphysematous

 D

No crepitus heard

Ans. D

Explanation:

Ans.D
A crepitus is heard on sectioning and each portion retains its normal shape. On compression, little froth is squeezed out, and there is no fluid in the tissue unless there is oedema, it is absent in sea water drowning.
 
Difference in lungs between freshwater and seawater drowning:

 

Trait

Freshwater drowning

Seawater drowning

Size and weight

Ballooned but light

Ballooned and heavy; weight upto 2 kg

Colour

Pale pink

Purplish or bluish

Consistency

Emphysematous

Soft and jelly like

Shape after removal from the body

Retained; do not collapse

Not retained; tend to flatten out

Sectioning

Crepitus is heard

Little froth and no fluid

No crepitus. Copious fluid and froth


Q. 2 In each freshwater drowning the death occurs within 4-5 minutes of submersion due to ventricular fibrillation. Which of the following reasons is responsible for this?

 A Total asphyxia is produced due to fresh water

 B

Laryngospasm causing vagal inhibition

 C

Haemoconcentration of blood caused by the osmotic pressure effect

 D

Haemodilution, overloading of heart and haemolysis resulting in release of Potassium

Ans. D

Explanation:

D i.e. Hemodilution, overloading of heart and hemolysis resulting in release of potassium


Q. 3

Hyperventilation before drowning :

 A

Can cause death

 B

Does not alter the process of drowning

 C

Can cause delayed death

 D

Can cause secondary drowning

Ans. D

Explanation:

D i.e. Can cause secondary drowning


Q. 4

A typical 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

Ans. D

Explanation:

D i.e. All


Q. 5

Froth of drowning can be differentiated from that due to other causes by :

 A

Microscopic detection of mucous

 B

Detecting excess of salt in the froth

 C

Detecting excess of pottassium

 D

Detecting excess of magnesium

Ans. A

Explanation:

Microscopic detection of mucous

  • The entry of fluid into the respiratory passage provokes the production of mucus, which when mixed with water and air is churned into the tenacious foam by the violent respiratory movements made by
  • The victim during the course of drowning. Foam of almost similar nature may also occur in cases of opium poisoning, organophosphorous poisoning, strangulation, epileptic attacks, acute pulmonary oedema and occasionally after an electric shock.
  • Normally, the chloride content of the left and right sides of the heart is the same, i.e. about 600 mg per 100 ml. The difference between two chambers may not be more than 5 mg/100 ml under usual circumstances. 
  • A difference of 25 mg% between the chloride concentrations of the two sides of the heart was an indication of death due to drowning. In fresh water drowning, the chloride content of left heart was lower than that of the
    right heart and in case of salt water drowning, reverse situation is observed.

Q. 6 Suicidal drowning differs from homicidal drowning by the following except :

 A

Absence of signs of struggle

 B

Marks of violence on body absent

 C

Untorn cloths

 D

None of the above

Ans. D

Explanation:

D i.e. None


Q. 7

Accidental drowning is ruled out if :

 A

The body is tied up inside a gunny bag

 B

Hand and feet are tied by a ligature in way that is inconsistent with suicidal drowning

 C

Heavy weight are attached in such a way that suicide drowning is excluded

 D

All of the above

Ans. D

Explanation:

D i.e. All

Accidental (>suicidal) is the most common type of drowningQ

In suicidal drowning body should be free from marks of any injury indicating an assault or struggle (violence)e. In cases of women the body is usually fully dressed and clothes are tied in such a manner that their private parts are not exposed. Sometimes a determined suicide may tie his legs & hands together or attach weights to his body, take poison, or cut throat before immersion. However, it should be examined whether tie could have been made by person himself.

– If the body is found with heavy weights attached to it or hand & legs tied with rope, it must be either homicide or suicide and with children homicide alone.

Homicidal drowning is very rare except in infants & children. Mark of severe violence applied to head, strangulation, throttling, or bruises are strongly presumptive of homicide.

Post mortel injuries by fishes, crabs, frogs etc. lack signs of vital reaction.


Q. 8 Causes of death in drowning are all except :

March 2009

 A Vagal hyperactivity

 B

Asphyxia

 C Ventricular fibrillation

 D

Laryngospasm

Ans. A

Explanation:

Ans. A: Vagal hyperactivity

Causes of death in drowning:

  • Asphyxia
  • Ventricular fibrillation/ if an examination of the larynx reveals that a spasm occurred, the victim may have died from sudden exposure to the cold, which caused an immediate heart attack.
  • Laryngeal spasm
  • Vagal inhibition
  • Exhaustion
  • Injuries
  • In some cases, hypothermia may have been the cause of death rather than drowning.

Bodies discovered in the water are examined to see whether water is actually present in the airway and stomach of the victim and if the lungs have swollen up. If such signs are apparent, then the victim did actually die due to drowning. Further examination of the corpse will reveal if bleeding occurred in the lungs, suggesting that there was a struggle for breath during the drowning.


Q. 9 NOT true about fresh water drowning:

Kerala 09; KCET 13

 A

Hyperkalemia

 B

Hypovolemia

 C

Ventricular fibrillation

 D

Hemolysis

Ans. B

Explanation:

Ans. Hypovolemia


Q. 10

In case of drowning in sea water:  

TN 06

 A

Hemoglobin increases

 B

Hemoglobin decreases

 C

No change

 D

Either may occur

Ans. A

Explanation:

Ans. Hemoglobin increases


Q. 11

NOT seen in salt water drowning:        

Maharashtra 11

 A Hyperkalemia

 B

Progressive hypovolemia

 C

Circulatory collapse

 D

Acute pulmonary edema

Ans. A

Explanation:

Ans. Hyperkalemia


Q. 12

In dry drowning:

FMGE 09; AP 11

 A

Death occurs in few days of submersion episode

 B

Death occurs due to sudden immersion in cold water

 C

Water does not enter lungs because of laryngeal spasm

 D

Seen in alcoholics due to drowning in shallow pool

Ans. C

Explanation:

Ans. Water does not enter lungs because of laryngeal spasm


Q. 13

Cause of death for drowning in cold water:

 A

Vagal inhibition

 B

Asphyxia

 C

Loss of consciousness

 D

Ventricular fibrillation

Ans. A

Explanation:

Ans. Vagal inhibition

  • Death in drowning can happen either due to asphyxia, ventricular fibrillation, laryngeal spasm, vagal inhibition, exhaustion, and other injuries. 
  • Sudden death in cold water immersion can cause death from inhibition of heart due to vagal stimulation. 
  • Such death is usually known as instantaneous physiological death, vasovagal shock, vagal inhibition of neurogenic shock.
  • As a result of this, cardiac and respiratory centers are suddenly paralyzed with consequent stoppage of heart and respiration resulting in immediate loss of life. 
  • The cause of such vagal inhibition includes sudden fright or emotion and injury to trigger receptor areas, such as carotid sinus, various plexus, testicles, serous membranes, etc. even a trifling injury to these areas may result in sudden death.

Q. 14 What of the following is seen in fresh water drowning ‑

 A

Hypovolemia

 B

Hemoconcentration

 C

Hyperkalemia

 D

Hypernatremia

Ans. C

Explanation:

Ans. is ‘c’ i.e. Hyperkalemia


Q. 15

Most common drowning in India-

 A

Suicidal

 B

Homicidal

 C

Accidental

 D

Infanticide

Ans. C

Explanation:

Ans. is ‘c’ i.e., Accidental

  • Most of the cases of drowning (2/3) in India are accidental. Rest 1/3 being suicidal. Homicidal drowning is less common in India.
  • Drowning is a mode of asphyxial death due to aspiration of water or other fluid into the respiratory tract. For death it is not necessary that the whole body is submerged in the liquid, it is sufficient if the face and nostrils are submerged in the liquid. Drowning in India is mostly suicidal attempted by non-swimmer.
  • Suicidal drowning is indicated by the absence of signs of struggle or assault (e.g. torn clothes, injury marks). 
  • In homicidal drowning, there are signs of struggle and violence (assault) (e.g. head injury, signs of strangulation, or throttling). Head and feet may be tied, heavyweight may be attached to body or body may be tied up inside a gunny bag. Homicidal drowning is very rare except in infants and children.
  • Accidental drowning is quite common and usually seen in children, non-swimmers, during floods or due to fall in well etc.


Leave a Reply

%d bloggers like this:
Malcare WordPress Security