Abuse

Question 1

Key history in abuse

Answer 1

Establish confidentiality; directly question about physical, sexual, or emotional abuse and about fear,
safety, backup plan; history of frequent accidents/injuries, mental illness, drug use; firearms in the home

Question 2

Key physical exam in abuse

Answer 2

Vital signs; complete exam ± pelvic

Question 3

28 yo F with multiple facial and bodily injuries
+ claims she fell on stairs
+ hospitalized for physical injuries seven months ago
+ presents with husband

Answer 3

Domestic violence
Osteogenesis imperfecta
Substance abuse
Consensual violent sexual behavior

XR—skeletal survey
CT—maxillofacial
Urine toxicology
CBC

Question 4

30 yo F with multiple facial and physical injuries

+ attacked and raped by two men

Answer 4

Rape
Domestic violence

Forensic exam (sexual assault forensic evidence [SAFE] collection kit)
Pelvic exam
Urine hCG
Wet mount, KOH prep
Cervical cultures
XR—skeletal survey
CBC
HIV antibody
Viral hepatitis serologies