Injuries: practice question

A Forensic Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

Try it

Forensic Medicine · Injuries

Sample item

A six-month-old infant with irritability and drowsiness has no external signs of injury but has bilateral retinal haemorrhages and subdural haemorrhage. Which diagnosis must be considered?

ANormal birth-related change in a six-month-oldBIdiopathic thrombocytopenic purpura onlyCVitamin K deficiency bleeding due to maternal anticoagulation onlyDAbusive head trauma (shaken baby syndrome)

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Abusive head trauma (shaken baby syndrome)

Violent shaking of an infant causes rotational acceleration, tearing of bridging veins and retinal haemorrhages with few external signs. The triad of subdural haemorrhage, retinal haemorrhage and encephalopathy should prompt evaluation for child abuse, with skeletal survey and exclusion of bleeding disorders.

Option by option

A. Normal birth-related change in a six-month-old
Birth-related haemorrhages resolve within weeks and would not explain this at six months.
B. Idiopathic thrombocytopenic purpura only
Immune thrombocytopenia is a diagnosis of exclusion and would show skin bleeding and a low platelet count.
C. Vitamin K deficiency bleeding due to maternal anticoagulation only
Vitamin K deficiency can cause intracranial haemorrhage, but the pattern with retinal findings requires abuse to be excluded first.
D. Abusive head trauma (shaken baby syndrome) (correct)
Correct. The triad of subdural, retinal haemorrhage and encephalopathy points to abusive head trauma.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Forensic Medicine question

What is the answer to this Forensic Medicine question?

The best answer is D, Abusive head trauma (shaken baby syndrome). Violent shaking of an infant causes rotational acceleration, tearing of bridging veins and retinal haemorrhages with few external signs.

Why is "Normal birth-related change in a six-month-old" not the answer?

Birth-related haemorrhages resolve within weeks and would not explain this at six months.

Why is "Idiopathic thrombocytopenic purpura only" not the answer?

Immune thrombocytopenia is a diagnosis of exclusion and would show skin bleeding and a low platelet count.

Why is "Vitamin K deficiency bleeding due to maternal anticoagulation only" not the answer?

Vitamin K deficiency can cause intracranial haemorrhage, but the pattern with retinal findings requires abuse to be excluded first.

What concept does this question test?

It tests Injuries in Forensic Medicine. The triad of subdural haemorrhage, retinal haemorrhage and encephalopathy should prompt evaluation for child abuse, with skeletal survey and exclusion of bleeding disorders.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Injuries?

Learn postmortem changes with their timelines, and toxicology as poison, sign, test and antidote. Then use the flashcards and the other Forensic Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.