ML case - Skills

1. M. L. Cases

2. Components of a MLR
 Identification
 Injury or illness
 Signature and date

3. Identification
Requesting party
Physician’s name and specialty or degree
Patient’s information: N.A.A.S.I: name,
age (or date of birth), address, sex, ID
Date, time, and place of examination

4. Traumatic Non-traumatic
 Identification  Identification
 Injury:  Illness
 Injury description: number,
site, size, shape, edges, type  Chief signs(s)
 Instrument and force used  Cause
 Investigations  Investigations
 Intervention  Intervention
 Prognosis: healing period
 Severity: mild, moderate,
(<,> 20 d) and permanent
infirmity severe
 Legal type of injuries:  Prognosis: current and
simple, dangerous, fatal expected
 Signature and date  Signature and date

5. Opinion - Trauma
 Upon the request of the Forensic Medicine Department of
ASU, I (physician name) , fourth year student, examined and
reviewed records of (person’s name), (person's age) years old
male/female patient who lives in (address) with ID (number);
on (date) in (place) at (time). I found that he had injury(ies) in
the form of (complete description) caused by (instrument
description). The following investigation(s) was/were done
and showed (findings). Intervention in the form of (…). This
injury requires more/less than 20 days for healing
with/without leaving a permanent infirmity. The patient has
recovered/in recovery/died. He was discharged/is still
hospitalized. This injury is simple/dangerous/fatal.
Signature and date

6. –


7. Opinion – non trauma
 Upon the request of the Forensic Medicine Department
of ASU, I (physician name) , fourth year student,
examined and reviewed records of (person’s name),
(person's age) years old male/female patient who lives in
(address) with ID (number); on (date) in (place) at
(time). I found that he had (chief signs) caused by
(disease or agent). The following investigation(s)
was/were done and showed (findings). Intervention in
the form of (…). The patient has recovered/in
recovery/died. He was discharged/is still hospitalized.
The case is mild/moderate/severe.
Signature and date

8. –


9. Cases
 You are the attending resident at El Demerdash surgical
hospital. At 2 pm, Ahmed Ali 55 year-old male, engineer
was brought to the reception room by his son . The son
stated that his father received a blow on the head by a stick
during a quarrel , he felt down and lost consciousness.
 On examination you found that the patient was in coma.
Vital data were: Pulse 55 beat/min, blood pressure
200/100 with slow respiration. Local examination of the
scalp revealed the following lesion. Urgent CT was done
showing this finding. Patient was urgently operated upon.
 Write a full medico legal report for this case.

11. Ahmed youssef kamel, 22 years old male, alleged
that he was beaten by one of his friends today. The
police referred him to you in order to write a 1ry
medico- legal report & to give your opinion about
his allegation.
Write the 1ry medico legal report & your opinion
about the truthfulness of his allegations.
The following slide demonstrate the injury:

13.  Akram Fouad 25-years-old male rush to the ER of
El Demerdash Hopital. He was complaining of this
lesion, after falling from his motorcycle. He
reported that he lost consciousness for 5 min after
the fall. Plain X ray skull was done ,it revealed no
abnormality.
1) Write a full medico legal report for this lesion.
2) Mention the next investigation which must be done for this special
case.
3) What is the medico-legal responsibility of the doctor in this case.

15.  You are the attending resident at El Demerdash hospital. At
4 pm, Ahmed Fouad 25-years-old male, worker in a motor
workshop rushed to the reception room accompanied by
two of his friends. They stated that Ahmed was injured
during a quarrel at the workshop.
 General examination revealed pallor, tachycardia,
hypotension and the following lesion. Urgent X ray was
done showing this finding. Urgent treatment started.
 What are your duties in this case?(main items in short)

17.  Engineer Sami Gaber El-Ashry arrived to El-Demerdash
causality, on 16th of May 2011 telling that 2 hours ago,
while he was working at the building construction site, a
piece of block accidentally fell on his head. Examination
revealed the lesion shown in the next slide. He was
admitted for observation (suspected brain concussion). He
had CT scan on the brain with no remarkable abnormality.
He received wound care in the form of stitching, analgesics
and antibiotic. He was discharged 48 hours after.
 Write down a full medico-legal report .

19.  This case was presented to you in Eldemerdash
University hospital emergency room. The patient is
Mrs. Hala Maged Gouda, 45 years old, housewife
from Kalyoubeya who fell off the stairs and
complaining of pain and swelling in her left leg. An
x-ray was done and her leg was bandaged. An
analgesic was prescribed and she was advised to rest
in bed.
 Write down a full medico-legal report .

21.  Fahmy El-Kazzaz is a 50 years old man who was
presented to the ER two days ago after a hit-and-run
accident by about 30 minutes.
 According to the patient, he was first hit in the thighs
then thrown up on the front bonnet then fell to the
ground.
 O/E a single irregular bruise (20x15 cm) was found on
lateral aspect of the right thigh with edema and
tenderness. An x-ray for that thigh was obtained and
revealed two irregular fractures of the right femur.
 He was operated upon and a nail was inserted. He is still
in the hospital.

22.  Eman Farouk Naguib is 34 years old housewife
referred to you from the police station to issue a
medical report.
 She claimed that during an argument with her
neighbor, she was hit by a stick on her left forearm 3
hours ago.
 O/E two wounds were observed on the lateral aspect
of the left forearm about 7 and 10 cm long. Edges
were regular with gaping and no bridging, bruises or
abrasions.
 The wound was sterilized and sutured.

23.  Atef Abdel Naeem is 59 years old diabetic hypertensive
man with chronic renal failure who is doing regular
sessions of hemodialysis.
 He was presented to the ER an hour after his colleague
pushed him on the stairs in the workplace.
 O/E multiple abrasions and contusions (smallest 2x2 cm,
largest 15x10 cm) were observed on forearms, ankles and
forehead. Skin of abdomen was normal, but abdominal
US revealed abdominal fluid collection and ruptured left
kidney for what it was surgically removed.
 Patient was discharged a week later.

24.  Saly Ibrahim Salama is a 21 years old medical student.
 She was presented to Poison Control Center 6 hours after
ingesting 40 Aspirin 325 mg tablets. She was presented by
repeated vomiting, abdominal pain and air hunger.
 O/E she was obtunded, pale, hypotensive, tachypnic,
tachycardic with moist skin. Chest auscultation showed
bilateral fine basal crepitations. Epigastric tenderness was
also found. Hyper-reflexia and muscle twitches were observed
that rapidly progressed into seizures.
 ABG revealed metabolic acidosis with salicylate level of 85
mg/dL.
 She was admitted to the ICU where she is sedated,
mechanically ventilated and kept on vasopressors and
inotropics.

25.  Esraa Ali Nasef is a 29 years old, 36 weeks pregnant
housewife who was presented to ER with heroic
vaginal bleeding.
 O/E she was obtunded, pale, hypotensive, tachypnic,
tachycardic with moist skin.
 Pelvic-Abdominal U/S revealed placenta previa.
 She was immediately blood transfused and
underwent caesarian section. Then, she was
admitted to ICU where she stayed for 3 days.
Afterwards she moved to inpatient and discharged
from hospital after another 3 days.

26. This injury was
found on the
anterior chest wall
of a 40 y old
patient called
Sayed El Arabi
who died in the
hospital on the day
the photograph
was taken. It
measured 10x5 cm.

27. Ali Ahmed El-Fouly
is 6 years old boy
who was presented
to you at the ER with
left arm edema, pain
and loss of
movement. You
decided an x-ray on
that arm.
You treated him and
then he was
discharged
immediately.