17. Child/Elder Abuse Flashcards
What is the physician’s primary role in child abuse?
TO report, not investigate
Risk factors for child maltreatment include the child being fussy, colicky infanct, hyperactive, medically ill, nonbiological relationship with caregiver **Stepdad, prematurity, caregiver risk factors include mainly?
Substance abuse
There are four types of child abuse: neglect, emotional, physical and sexual. Neglect is the most common type of child abuse and is due to a failure to provide for a childs basic needs- it is also the most common cause of?
death in abused children
The physicians role when suspecting neglect includes full medical history, psychosocial history and *complete physical exam, and to ensure safety of the child one should contact?
child protective services even when in doubt
Emotional abuse is hard to recognized and results in demonstrable harm to child- such as social withdrawal, eating disorders, failure to thrive (note these problems are not the result of abuse), in clinic if appears recurrent or possibility of imminent harm to the child you should?
Report to child protective services
Suspicious signs on PE include bruises/bites/cig burns/ post rib fractures, scapular fracture, spinous process, sternal fracture, metaphyseal lesions, if you see any evidence of harm you can meet separaetly to gather info, document carefully, and should do what with the injuries?
Photograph and download them in a secure location
There are three types of sexual abuse including nontouching (showing kids porn/allowing kid to hear sex), touching and exploitation (prostitution). 50% sex abuse are within the family, 60% female, aged 9-12, most likely perpetrator is?
Step father/boyfriend of mother/ uncles/older sibs
50-70% of victims have never told anyone of their sexual abuse, on PE there are usually no physical signs, history is the most important, do PE ASAP if young pt presents with anal/vaginal bleeding, vaginal discharge or pain, increase concern when the child does what?
Acts that are not normal such as puts things inside vagina, touches mom/childs parts, tries to have sex with another kid, etc
BEST PRACTICE FOR SEXUAL ABUSE (or most abuse) CASES is refer for forensic interview with CPS ***, if immediate interview is necessary what interview would you do?
Minimal Facts Interview (just who what where how- DONT ask WHEN)
There are high risk populations associatd with sexual abuse, including intellectually disables (4x more likely), among them 83% are females, 32% are males, LGBTQ 3x more likely, and what two groups are common?
Deaf children and transgender - 50% experience sexual abuse
Reporting sexual abuse in missouri- Class A misdemeanor for failure to report and a Class B misdemeanor for failure to report in Kansas, even when another mandated reporter has made a report
MEOW
Elder abuse is common, victim risk factors include dementia and or psychiatric diagnosis, physical dependence, incontinence, substance abuse, and older than 75y/o and?
female
perpetrator is usually financially dependent on the victim and a substance abuser
there are 5 types of elder abuse including physical, sexual, psychological, financial and neglect (50%-most common). Abuse signs include: lack nutrition, poor personal care, lack meds, bilateral bruises on inner arms, bruising of ST not over bony prominences, cigarette burns/other burns, fractures at different stages of healing, spiral fractures (from twisting), wrist rope burns (tying), injures to mouht and or evidence of depleted personsal?
Finances (money was spent by abuser)
On PE of elder abuse, one may see bruising/burns, unexplained injuries and findings of sexual abuse, the physician’s role when expecting elder abuse includes careful documentation and reporting it to senior?
senior protective services
