FSM classes for FMGE 2023
at Kings

    The rate of failure among Indian students in the FMGE (Foreign Medical Graduate Examination) is high, which is often attributed to the lack of necessary skills for practicing medicine in India. This exam has become increasingly competitive over the years, with only the best candidates being selected after a rigorous assessment process. However, with a significant shortage of doctors in the country, the failure of medical degree holders to qualify in the FMGE will only exacerbate the problem for patients. Therefore, passing the FMGE is not only crucial for a student’s medical career but also for the betterment of the country’s healthcare system. While self-study is vital, seeking guidance from experienced professionals can enhance the learning experience. Kings International Medical Academy (KIMA) provides high-quality coaching for FMGE to foreign medical graduates from various countries, aiming to help them achieve success in the exam. Dr. Akhilesh, a leading faculty in our country gave an insight into the subject of FSM.

FSM

    Blood stains – Confirmatory

    Teichman- Hemin crystal- Brown-Rhombic

    Takayama- Hemochromygen- Pink feathery

    Spectroscopy- m.specific test

Semen:

1. Florence- choline- brown Rhombic
2. Barbarios test- Spermine crystal → Yellow needle
3. Most specific test- LDH (Lactate dehydrogenase)

Abrasion types– loss of epidermis

1. Grazed abrasion- sliding m/c RTA aka Brush burn
2. Imprint abrasion/ patterned- Tyre mark on body
3. Battle sign- middle cranial fossa # → Bruise on mastoid tip aka (contusion) @ dermis

        →Migratory bruise

        →Ectopic bruise

4. Tramline bruiseo → ex of patterned bruise- Ex. Baby (pinching), Butterfly bruise

        →Lathi/ROD

Split laceration → Epi+D+Sct

    → Incision lokking laceration → lens → crushed bulb

    ↓

Hard-surface

1. Scalp
2. Fore-head
3. Eye-brow
4. Chin
5. Elbow
6. Iliac crest
7. Shin

EDH   – I-DALY shape → Biconvex           SDH → Sickle-shaped

    ↓              Exclusively by trauma

    MMA     Lucid interval

               Medical negligence

ICH – Intra Cerebral Hem → BP↑ → Putamen

Motorcyclist Injuries or motorcyclist # aka Hinge type

Pedestrian Injuries

1. Primary impact injuries- First contact – leg → Bumper
2. Secondary impact injuries → same vehicle → 2^nd impact → Bonnet, Glass
3. Tertiary impact injuies aka 2° Injuries/ Ground → Tyre mark, multiple grazed abrasion

            ↓

    (Injury by object other than same vehicle)

M/C Organ damaged:

    Blunt- Spleen

    Penetrating- Liver

    Blast- Tympanic membrane – lung- fatal

Marshall Triad:

    Blast Injury

        1° = Blast injury= Air compression→ Tympanic membrane- Lung

        2° = Blast injury= Flying object/missile → Patterned abrasion

        3° = Blast injury= Ground and skeletal → Patterned contusion

        4° = Blast injury= Burn/flame → Patterned laceration

PM finding– Hanging → India → judicial hanging

                        ↓

            Mostly suicidal if Homicidal → Lynching

Neck → External features

    Ligature- oblique

    Abrasion- pressure

    Above- Thyroid

    Dissection- pale- Glistening

    AM Hanging- most common → dripping of saliva- opposite side of knot

Strangulation – Neck compression

            ↓

    Constrictions of neck

Types:

1. Ligature S+ → PM findings
2. Manual S+ → Throttling
3. Bend of elbow/ forearm→ mugging
4. Bamboo sticks → Bonsdola
5. Garroting → Judicial in Spain

PM findings:

    Ligature mark – Complete transverse

    Level- Below or thyroid

    Peri-ligature injuries and on dissection

    Asphyxia signs → more-prominent

    Throttling always – Homicidal, Hyoid (m/c)

    External – neck

1. Abrasion → finger nail – semilunar
2. Bruises→ fingertip → six penny bruises- after dissection→ Hematoma