Sexual offences: hymen: 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.

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Forensic Medicine · Sexual offences: hymen

Sample item

A 17-year-old girl alleges forced intercourse four days ago. Examination shows an intact, elastic, annular hymen and no genital or extragenital injuries. How should this be interpreted?

AThe girl must be lying since there are no injuriesBRape is proved because the hymenal opening is wideCAn intact hymen does not exclude penetration, so sexual assault can be neither proved nor excluded on this findingDRape is excluded because the hymen is intact

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

The answer and the reasoning

C. An intact hymen does not exclude penetration, so sexual assault can be neither proved nor excluded on this finding

Penetration of even a few centimetres can occur without rupture, particularly with an elastic, annular or fimbriated hymen, or when the girl is accustomed to sexual activity. The medical opinion should not comment on rape, which is a legal conclusion, but describe findings. Absence of injury does not exclude assault. The so-called two-finger test is unscientific and must not be performed.

Option by option

A. The girl must be lying since there are no injuries
The absence of injury is common and is not a sign of falsehood.
B. Rape is proved because the hymenal opening is wide
The size of the hymenal opening varies and does not prove intercourse.
C. An intact hymen does not exclude penetration, so sexual assault can be neither proved nor excluded on this finding (correct)
Correct. Intact hymen and absent injuries do not exclude penetration.
D. Rape is excluded because the hymen is intact
An elastic hymen may stay intact after penetration, so rape is not excluded.

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 C, An intact hymen does not exclude penetration, so sexual assault can be neither proved nor excluded on this finding. Penetration of even a few centimetres can occur without rupture, particularly with an elastic, annular or fimbriated hymen, or when the girl is accustomed to sexual activity.

Why is "The girl must be lying since there are no injuries" not the answer?

The absence of injury is common and is not a sign of falsehood.

Why is "Rape is proved because the hymenal opening is wide" not the answer?

The size of the hymenal opening varies and does not prove intercourse.

Why is "Rape is excluded because the hymen is intact" not the answer?

An elastic hymen may stay intact after penetration, so rape is not excluded.

What concept does this question test?

It tests Sexual offences: hymen in Forensic Medicine. The medical opinion should not comment on rape, which is a legal conclusion, but describe findings. Absence of injury does not exclude assault. The so-called two-finger test is unscientific and must not be performed.

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 Sexual offences: hymen?

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.