Sexual offences and forensic psychiatry: signs of recent delivery: 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 and forensic psychiatry: signs of recent delivery

Sample item

A woman is examined three days after an alleged concealed delivery. Which combination supports recent childbirth?

AA firm pelvic uterus, no discharge and flat breastsBIntact hymen and a small, firm uterusCA soft, bulky uterus palpable above the pubis, lochia and engorged breastsDA closed nulliparous os with no lochia

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

The answer and the reasoning

C. A soft, bulky uterus palpable above the pubis, lochia and engorged breasts

After delivery the uterus is large and soft and falls slowly, lochia drains for days and breasts become full with colostrum or milk. Together with a lax vaginal and perineal state these indicate recent delivery. Their absence argues against it.

Option by option

A. A firm pelvic uterus, no discharge and flat breasts
A firm pelvic uterus without discharge or breast change indicates no recent delivery.
B. Intact hymen and a small, firm uterus
An intact hymen with a small uterus is consistent with no pregnancy.
C. A soft, bulky uterus palpable above the pubis, lochia and engorged breasts (correct)
Correct. Large soft uterus, lochia and engorged breasts indicate recent delivery.
D. A closed nulliparous os with no lochia
A closed nulliparous os with no lochia indicates no previous delivery.

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, A soft, bulky uterus palpable above the pubis, lochia and engorged breasts. After delivery the uterus is large and soft and falls slowly, lochia drains for days and breasts become full with colostrum or milk.

Why is "A firm pelvic uterus, no discharge and flat breasts" not the answer?

A firm pelvic uterus without discharge or breast change indicates no recent delivery.

Why is "Intact hymen and a small, firm uterus" not the answer?

An intact hymen with a small uterus is consistent with no pregnancy.

Why is "A closed nulliparous os with no lochia" not the answer?

A closed nulliparous os with no lochia indicates no previous delivery.

What concept does this question test?

It tests Sexual offences and forensic psychiatry: signs of recent delivery in Forensic Medicine. Together with a lax vaginal and perineal state these indicate recent delivery. Their absence argues against it.

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 and forensic psychiatry: signs of recent delivery?

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.