A 26-year-old woman delivers a stillborn baby at 34 weeks in a district hospital after not feeling movements for five days. The baby's skin is reddish and soft, with large fluid-filled blisters that peel easily; the body is flaccid, the skull bones overlap loosely, and the smell is sweetish rather than foul. What do these changes indicate?

Death in utero some days before birth

Putrefaction after a live birth

Death during labour from cord compression

Death after birth from asphyxia

A 22-year-old athlete collapses and dies after running a half-marathon in hot weather, and a 70-year-old bedridden man dies of chronic illness in a cool room. At autopsy, rigor mortis set in and passed off much sooner in the athlete. What is the biochemical basis of rigor mortis?

Loss of ATP locking actin-myosin cross-bridges

Lactate build-up coagulating muscle protein

Heat denaturation of myosin after death

Loss of calcium preventing actin-myosin binding

Death, post-mortem changes and time since death

22 NEET-PG practice questions on Death, post-mortem changes and time since death, part of Forensic Medicine. The first 22 are below; the first 5 with answers and explanations (tap Show answer after you have chosen), the rest in Learn with a free account.

Question 1 · Medium
Police find a man's body lying prone on a bed. At autopsy, the post-mortem staining lies over the back and buttocks, spares the skin over the shoulder blades, and does not blanch on firm thumb pressure. The autopsy surgeon weighs four inferences: 1. The body lay on its back for some hours after death and was later turned over. 2. Death occurred within the last 2 hours. 3. The pale areas over the shoulder blades are contact pallor. 4. Staining that does not blanch shows that decomposition has begun. Which inferences are correct?
1. A3 and 4 only
2. B1 and 3 only
3. C1, 3 and 4 only
4. D1, 2 and 3 only
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Answer: B · 1 and 3 only
Inferences 1 and 3 are correct. Hypostasis forms in dependent parts as blood settles under gravity, sparing areas pressed against a surface (contact pallor), and becomes fixed after several hours, when it no longer shifts or blanches on pressure. Fixed staining on the back of a body found face down therefore means the body lay supine for hours after death and was then turned, which should raise suspicion of interference with the scene. Inference 2 is wrong because in the first hours staining is not fixed and still blanches; inference 4 is wrong because fixation reflects time since death, while decomposition shows as greenish discolouration and marbling.
- A: Includes decomposition and omits that the body was moved, the key inference.
- C: Includes decomposition, which fixed staining does not indicate.
- D: Includes death within 2 hours, when staining would still blanch.
Question 2 · Easy
A body lying in open air reaches a certain stage of decomposition in about one week. According to Casper's dictum, about how long would a similar body buried in earth take to reach the same stage?
1. AAbout 2 weeks
2. BAbout 1 week
3. CAbout 8 weeks
4. DAbout 4 weeks
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Answer: C · About 8 weeks
Casper's dictum states that, other conditions being similar, a body decomposes in air twice as fast as in water and eight times as fast as in earth: one week in air equals two weeks in water and eight weeks in soil. Water and soil are cooler and have less oxygen and fewer insects. The rule is only approximate, as temperature, depth of burial, clothing and soil type all change the rate. It explains why a buried body may still be examined usefully long after death.
- A: Two weeks is the equivalent time in water.
- B: One week is the time in air, the fastest of the three.
- D: Four weeks is not a ratio in Casper's dictum.
Question 3 · Medium
A 26-year-old woman delivers a stillborn baby at 34 weeks in a district hospital after not feeling movements for five days. The baby's skin is reddish and soft, with large fluid-filled blisters that peel easily; the body is flaccid, the skull bones overlap loosely, and the smell is sweetish rather than foul. What do these changes indicate?
1. APutrefaction after a live birth
2. BDeath during labour from cord compression
3. CDeath in utero some days before birth
4. DDeath after birth from asphyxia
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Answer: C · Death in utero some days before birth
These are signs of maceration, the aseptic autolysis of a fetus that dies in the uterus and remains in the amniotic fluid, sealed from air and bacteria. It shows skin slippage and blisters, reddish discolouration, softening and loose, overlapping skull bones, with a sweetish rather than putrefactive smell. It proves that the fetus died before birth, which excludes infanticide. Overlapping skull bones (Spalding sign) may also be seen on imaging before delivery.
- A: Putrefaction gives a foul smell and greenish discolouration, not sterile softening.
- B: Death during labour leaves too little time for these changes.
- D: A baby that breathed and died after birth would putrefy, not macerate.
Question 4 · Hard
In one winter week the autopsy room of a medical college in Shimla receives four bodies. The postgraduate notes the colour of hypostasis in each and writes four statements: 1. Bluish-purple staining in a man who died of a heart attack suggests that he was poisoned. 2. Bright cherry-red staining in a man found in a closed garage with a running car engine suggests carbon monoxide. 3. Chocolate-brown staining in a worker who drank a nitrite solution reflects methaemoglobin. 4. Bright pink staining in an elderly woman found dead outdoors after a freezing night fits cold exposure. Which statements are correct?
1. A2, 3 and 4 only
2. B1, 2 and 3 only
3. C3 and 4 only
4. D2 and 4 only
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Answer: A · 2, 3 and 4 only
Statements 2, 3 and 4 are correct. Carbon monoxide gives cherry-red staining from carboxyhaemoglobin; nitrites, chlorates and aniline oxidise haemoglobin to methaemoglobin, giving chocolate-brown staining; and in cold exposure or refrigeration oxyhaemoglobin is retained in the cold skin, giving bright pink staining. Statement 1 is wrong: bluish-purple hypostasis from deoxygenated blood is the usual colour in most deaths and has no toxic significance. An unusual colour is a pointer, never proof: blood and viscera must be analysed.
- B: Includes statement 1, which treats normal hypostasis as a sign of poisoning.
- C: Omits statement 2; carbon monoxide gives cherry-red hypostasis.
- D: Omits statement 3; nitrites form methaemoglobin and chocolate-brown staining.
Question 5 · Medium
A 22-year-old athlete collapses and dies after running a half-marathon in hot weather, and a 70-year-old bedridden man dies of chronic illness in a cool room. At autopsy, rigor mortis set in and passed off much sooner in the athlete. What is the biochemical basis of rigor mortis?
1. ALactate build-up coagulating muscle protein
2. BHeat denaturation of myosin after death
3. CLoss of ATP locking actin-myosin cross-bridges
4. DLoss of calcium preventing actin-myosin binding
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Answer: C · Loss of ATP locking actin-myosin cross-bridges
After death ATP is no longer regenerated. ATP is needed to release myosin heads from actin, so as it runs out the cross-bridges stay fixed and the muscles become rigid. Rigor sets in earlier and lasts a shorter time when ATP and glycogen stores are low at death and the surroundings are warm, as after violent exertion, convulsions or in hot weather. It passes off when muscle proteins break down by autolysis and putrefaction.
- A: Lactic acid accumulates but is not what fixes the cross-bridges.
- B: Protein denaturation by heat causes heat stiffening, not rigor mortis.
- D: Calcium favours binding; it is the absence of ATP that locks the bridges.
Question 6 · Hard
A 24-year-old man is on a ventilator in a Chennai ICU after a severe head injury, with fixed dilated pupils, absent brain-stem reflexes and no spontaneous breathing. His parents are willing to donate his organs. The ICU team lists four statements about certifying brain-stem death under the Transplantation of Human Organs and Tissues Act: 1. It is certified by a board of four doctors, including a neurologist or neurosurgeon where available. 2. An EEG showing electrical silence is mandatory before certification. 3. The tests are repeated after an interval of at least six hours. 4. The apnoea test is part of the certification. Which statements are correct?
1. A1, 3 and 4 only
2. B1, 2 and 3 only
3. C1 and 3 only
4. D2, 3 and 4 only
Answer and explanation in LearnFree account
Question 7 · Hard
A 45-year-old man is found dead, clothed, on the floor of a room kept at about 24°C. At 6 am his rectal temperature is 86.4°F. Using the formula taught in the department, time since death (hours) = (98.4 - rectal temperature in °F)/1.5, and assuming his temperature was normal at death, at about what time did he die?
1. AAbout 6 pm the previous evening
2. BAbout 10 pm the previous night
3. CAbout noon the previous day
4. DAbout 2 am the same night
Answer and explanation in LearnFree account
Question 8 · Medium
A 9-year-old boy is pulled out of a cold river after several minutes under water. He is not breathing, no pulse is felt and his pupils are dilated. A bystander says he is dead and should be left alone. In which state may he be, which justifies continuing resuscitation?
1. ABrain-stem death
2. BMolecular death
3. CSuspended animation
4. DSomatic death
Answer and explanation in LearnFree account
Question 9 · Medium
The body of a 30-year-old woman missing for two months is recovered from a shallow, waterlogged grave beside a canal in Punjab. The fat of the cheeks, breasts and buttocks has turned into a greyish-white, greasy, waxy material with a rancid smell, and her facial features are preserved. Which conditions favoured this change?
1. AWarm, moist surroundings with little oxygen
2. BDry sand in a sealed, airtight coffin
3. CFreezing temperatures and high humidity
4. DHot, dry air with free ventilation
Answer and explanation in LearnFree account
Question 10 · Medium
At autopsy of a 60-year-old woman found dead on her bed, there are purple patches over the back. The doctor must decide whether one patch over the left loin is a bruise or hypostasis, so he incises it. Which finding indicates hypostasis?
1. AYellowish-green colour changes at the margin
2. BClotted blood infiltrating the subcutaneous fat
3. CA raised swelling with a sharply defined edge
4. DBlood confined to vessels, easily washed away
Answer and explanation in LearnFree account
Question 11 · Hard
A 42-year-old businessman is found dead in his locked office with a contact firearm wound of the right temple and a revolver in his right hand. His relatives allege that he was shot and that the weapon was placed in his hand afterwards. Which finding at the scene and autopsy most strongly suggests that he was holding the revolver at the moment of death?
1. ABlackening and tattooing around the wound
2. BFully developed rigor mortis in all four limbs
3. CA firm grip on the revolver, needing force to free it
4. DFixed hypostasis over the back and buttocks
Answer and explanation in LearnFree account
Question 12 · Medium
The charred body of a 35-year-old man is recovered from a burnt house. The elbows, hips and knees are flexed and the fists clenched, in a 'boxer' posture. The police ask whether this posture shows that he was fighting before death. What does the posture indicate?
1. ARigor mortis that set in before the fire
2. BProof that he was alive during the fire
3. CHeat stiffening of muscle by coagulation
4. DCadaveric spasm from a struggle at death
Answer and explanation in LearnFree account
Question 13 · Medium
A 45-year-old man is found dead at home two days after he was last seen. In the hot weather, rigor and hypostasis are no longer helpful. The forensic expert wants a chemical value that rises fairly steadily after death to help estimate the interval. Which sample and analyte are best suited?
1. ACerebrospinal fluid glucose
2. BUrine creatinine
3. CVitreous humour potassium
4. DFemoral blood sodium
Answer and explanation in LearnFree account
Question 14 · Hard
A 35-year-old man's body is found in a closed room in Lucknow in June. At autopsy: hypostasis over the back is fixed; rigor has passed off from the jaw, neck and upper limbs but persists in the lower limbs; there is greenish discolouration over the right iliac fossa only; there is no marbling, bloating or skin slippage. For this setting the department uses these working timings: hypostasis fixed by 6-8 h; rigor complete by about 12 h and passing off by 24-36 h; green discolouration of the right iliac fossa from about 18-24 h; marbling and bloating from about 36-48 h. What is the best estimate of the time since death?
1. AAbout 48-72 hours
2. BAbout 6-8 hours
3. CAbout 24-36 hours
4. DAbout 12-18 hours
Answer and explanation in LearnFree account
Question 15 · Medium
A 25-year-old man dies in a district hospital after severe generalised spasms with risus sardonicus and opisthotonus, ten days after a rusty nail pierced his foot. Four hours after death the body feels warmer than expected, and the rectal temperature is higher than when he died. What is this phenomenon?
1. APost-mortem caloricity
2. BPost-mortem hypostasis
3. CEarly putrefaction
4. DHeat stiffening
Answer and explanation in LearnFree account
Question 16 · Easy
At autopsy of a 40-year-old man who died a few hours earlier, rigor mortis is present in the eyelids, jaw and neck but not yet in the limbs. According to Nysten's rule and the known sequence of rigor, which muscle stiffens first of all, even before these?
1. AThe diaphragm
2. BThe muscles of the lower limbs
3. CThe small muscles of the fingers
4. DThe myocardium
Answer and explanation in LearnFree account
Question 17 · Easy
The body of a 50-year-old man lying on his back is recovered from a sugarcane field in Uttar Pradesh in May. The autopsy surgeon looks for the first external sign of decomposition. Where does it typically appear?
1. ASkin of the soles of the feet
2. BSkin over the right iliac fossa
3. CSkin over the left iliac fossa
4. DSkin of the face and neck
Answer and explanation in LearnFree account
Question 18 · Medium
A 40-year-old man is found dead with his eyelids partly open. At autopsy there are brownish-black triangular patches on the sclera on either side of the cornea. The investigating officer thinks they are bruises from an assault. What do they represent?
1. ALeakage of blood into the conjunctiva
2. BAntemortem subconjunctival haemorrhage
3. CPetechial haemorrhages from asphyxia
4. DDrying of the exposed sclera after death
Answer and explanation in LearnFree account
Question 19 · Medium
A 70-year-old man living alone in Jaisalmer is found dead in a closed room months after he was last seen. The skin is dry, brown and leathery, stretched over the bones; the body is shrunken and light, with little smell. What is the main forensic value of this change?
1. AIt proves the body was embalmed after death
2. BIt allows dating of death to within a day
3. CIt shows that death was due to starvation
4. DIt preserves features and injuries for identification
Answer and explanation in LearnFree account
Question 20 · Medium
A badly decomposed body, with the external genitalia no longer recognisable, is recovered from a forest in Assam. The skeleton is not yet exposed. Which internal organ is the autopsy surgeon most likely to find preserved to help determine sex?
1. AThe stomach and intestines
2. BThe liver
3. CThe brain
4. DThe uterus or prostate
Answer and explanation in LearnFree account
Question 21 · Easy
In January in Delhi, a couple and their child are found dead in a closed room where a coal brazier (angithi) had been burning all night. At autopsy the post-mortem staining is cherry red. Which compound explains this colour?
1. ASulphmethaemoglobin
2. BMethaemoglobin
3. CDeoxyhaemoglobin
4. DCarboxyhaemoglobin
Answer and explanation in LearnFree account
Question 22 · Easy
A 32-year-old man's body is pulled out of a village pond. His right hand is tightly clenched around weeds and mud from the bottom, and the grip cannot be loosened without force. What is this finding called?
1. AHeat stiffening
2. BRigor mortis
3. CCold stiffening
4. DCadaveric spasm
Answer and explanation in LearnFree account

Death, post-mortem changes and time since death

A body lying in open air reaches a certain stage of decomposition in about one week. According to Casper's dictum, about how long would a similar body buried in earth take to reach the same stage?

A 22-year-old athlete collapses and dies after running a half-marathon in hot weather, and a 70-year-old bedridden man dies of chronic illness in a cool room. At autopsy, rigor mortis set in and passed off much sooner in the athlete. What is the biochemical basis of rigor mortis?

A 9-year-old boy is pulled out of a cold river after several minutes under water. He is not breathing, no pulse is felt and his pupils are dilated. A bystander says he is dead and should be left alone. In which state may he be, which justifies continuing resuscitation?

At autopsy of a 60-year-old woman found dead on her bed, there are purple patches over the back. The doctor must decide whether one patch over the left loin is a bruise or hypostasis, so he incises it. Which finding indicates hypostasis?

The charred body of a 35-year-old man is recovered from a burnt house. The elbows, hips and knees are flexed and the fists clenched, in a 'boxer' posture. The police ask whether this posture shows that he was fighting before death. What does the posture indicate?

A 45-year-old man is found dead at home two days after he was last seen. In the hot weather, rigor and hypostasis are no longer helpful. The forensic expert wants a chemical value that rises fairly steadily after death to help estimate the interval. Which sample and analyte are best suited?

At autopsy of a 40-year-old man who died a few hours earlier, rigor mortis is present in the eyelids, jaw and neck but not yet in the limbs. According to Nysten's rule and the known sequence of rigor, which muscle stiffens first of all, even before these?

The body of a 50-year-old man lying on his back is recovered from a sugarcane field in Uttar Pradesh in May. The autopsy surgeon looks for the first external sign of decomposition. Where does it typically appear?

A 40-year-old man is found dead with his eyelids partly open. At autopsy there are brownish-black triangular patches on the sclera on either side of the cornea. The investigating officer thinks they are bruises from an assault. What do they represent?

A 70-year-old man living alone in Jaisalmer is found dead in a closed room months after he was last seen. The skin is dry, brown and leathery, stretched over the bones; the body is shrunken and light, with little smell. What is the main forensic value of this change?

A badly decomposed body, with the external genitalia no longer recognisable, is recovered from a forest in Assam. The skeleton is not yet exposed. Which internal organ is the autopsy surgeon most likely to find preserved to help determine sex?

In January in Delhi, a couple and their child are found dead in a closed room where a coal brazier (angithi) had been burning all night. At autopsy the post-mortem staining is cherry red. Which compound explains this colour?

A 32-year-old man's body is pulled out of a village pond. His right hand is tightly clenched around weeds and mud from the bottom, and the grip cannot be loosened without force. What is this finding called?