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BD Exam II Material (Richie) > Abuse/Violence > Flashcards

Abuse/Violence Flashcards

1
Q

Who are the victims of child abuse?

A

Infants. 2/3 or all abuse victims are under 1 year of age. 80% are under 3 years of age.

This makes sense; it’s harder to abuse an older more mature kid.

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2
Q

T/F: kids who are abused in the past are likely to be abused again.

A

T

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3
Q

T/F: Step kids are more likely to be abused

A

T

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4
Q

Types of child abuse

A

Physical
Emotional
Sexual
Neglect

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5
Q

Physical abuse comprises what % of all abuse cases?

A

66%

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6
Q

The most common type of physical abuse, that we’re gonna see as physicians, are ______

A

Bruises.

This is tricky because kids normally have bruises. So we have to be suspicious and discerning about the cause of our pt’s bruises.

Normal bruises are normally on bony prominences. But if they’re on soft tissue (butt, back, trunk, genitalia, cheeks, ears/neck)…

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7
Q

Should babies have bruises?

A

No. It’s abuse until proven otherwise.

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8
Q

Not only should you pay attention to whether or not bruises exist, their location, but also….

A

The PATTERN of bruises. Eg. Handprints, belt marks, loop marks, multiple bruises in various stages of healing.

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9
Q

The 2nd kind of physical abuse, aside from bruises, is _____.

A

CNS injuries…

eg. Shaken Baby Syndrome. Brain literally bounces back and forth in the skull. Catastrophic!

It only takes one violent shake…

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10
Q

3rd most common physical abuse injury….?

A

Burns. 6-20% of physical abuse.

Eg. Cigarette burns, brands, immersion burns (scalding water on stove…sparing around diaper area if immersed).

This is SCARY because it takes premeditation of parent.

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11
Q

The responsible physician should take a thorough medical history, and pay special attention to what 3 things?

A
  1. If story and injury don’t match up…“My baby fell off the couch”
  2. Parent blames the injury on a sibling.
  3. Story doesn’t match the child’s developmental stage.

“Baby rolled off and hit the floor…except 1 month old’s don’t roll!”

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12
Q

DCFS

A

Department of Child and Family Services

report cases of abuse here

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13
Q

Sexual abuse definition

A

Any sexual behavior that the child is forced to partake in…genital, oral, anal contact, sexting, child porn, exhibitionism…

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14
Q

Every year, what percent of kids are sexually abused?

A

1%

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15
Q

The responsible physician should

A

Clearly document, gather forensics, report to DCSF, be sensitive.

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16
Q

Emotional abuse…definition?

A

Repeated pattern of damaging interactions between caregivers and the child that conveys to that child that s/he’s not loved or wanted.

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17
Q

Which form of abuse do you not report?

A

Emotional abuse. Instead we are supporting and educating, not reporting. Engage in an open conversation with a parent…

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18
Q

For emotional abuse, in severe cases, you should file a report to DCFS. T/F.

A

False most of the time. You can refer to anger management classes or parenting classes.

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19
Q

Neglect…definition?

A

Failure to provide: food, shelter, clothing, love, education, medical care…

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20
Q

T/F: neglect of kids is usually a deliberate act

A

False. Typically parents are themselves struggling with their own illnesses or abuse.

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21
Q

True/False: neglect includes actual, but not potential harm.

A

False. Britney Spears driving photo.

It includes both actual, and potential. Not having smoke detectors. Having a loaded gun out in the open.

22
Q

T/F: We are all mandated reporters.

A

T: We are medical personnel now. All docs and med personnel should do it.

23
Q

“Will I get in trouble if I make a report, if there’s no true abuse occurring?”

A

No. As long as you act in good faith, you’re immune from punitive action.

24
Q

“What if I don’t report suspected abuse?”

A

Class A misdemeanor

Loss of Medical License

25
Q

“Can’t I just tell my resident or attending about abuse?”

A

No. Not only should you tell your resident/attending…but you have to report to APPROPRIATE AUTHORITIES (DCFS).

If you are working on a team, chances are, you as a student will spend the most time with the patient. Who, better than you, should file the report?

26
Q

T/F: You need to report abuse that happened in the past.

A

F: It’s ACTIVE abuse that is reportable for sure.

27
Q

DCFS abuse number?

A

1-800-25-ABUSE (2287)

28
Q

What’s the role of a physician after a report?

A

Follow-up. Cooperate.

29
Q

What if it’s an older sibling who’s abusing the victim?

A

Still file, if the victim is under 18.

30
Q

Elder abuse def.?

A

Intentional or neglectful acts given by a trusted caregiver

31
Q

Subtypes of elderly abuse

A 
Financial exploitation
Confinement
Emotional
Sexual
Physical
Neglect
32
Q

Who is most likely to abuse elders?

A

Kids of the elderly person.

33
Q

What is one of the most thankless jobs?

A

Caring for elderly. Make sure they’re okay and not abusing the patient.

34
Q

The child is more likely to abuse the parent if…

A

The parent abused the child growing up.

35
Q

Things to pay attention to for elder abuse.

A 
Suspicious injuries
Personality changes
Poor hygiene
Pressure ulcers
Tension between patient and caregiver
36
Q

Why doesn’t IL have mandated reporting for elder abuse?

A

Don’t compromise autonomy of cogent elderly patients. You are only mandated to report if they are incapable.

37
Q

Elderly abuse hotline…

A

1-866-8800-1409 (if abuse is at home)

IL Longterm Care Ombudsman (if abuse is in nursing home)

38
Q

IPV

A

Domestic violence (intimate partner violence)…adults or adolescents.

Illegal and Legal but damaging.

39
Q

1 in 9 women in ER are seen for

A

IPV issues.

Note: 1/12 pregnant women are abused by partners.

40
Q

If you find child abuse…

A

You should also ask how the mom is doing. Chances are she’s getting abused too.

41
Q

T/F: Minority population have unique concerns that make seeking help, and finding resources/advocates difficult

A

TRUE

Heterosexual
LGBT
Immigrants
Disabled
Elderly
42
Q

What is the recipe for an IPV batterer?

A

3 Major:

  1. Objectification of women/victim (“that bitch”)
  2. Entitlement
  3. Power craving

3 Spices:

  1. Abuse was learned (perhaps at home)
  2. Opportunity to abuse (in private)
  3. Choice to do it (freedom)
43
Q

Why don’t IPV victims just leave? This is very hard to understand…

A 
Women are terrified to leave. 
Lack of safe options.
Batterer controls money.
*Concern for partner's welfare
Batterer promises change, love
44
Q

Are there laws mandating reports of IPV for adult victims?

A

No. Autonomy again.

45
Q

RADAR

A 
Routinely screen (ask about it)
Ask direct questions (be specific: Y/N questions)
Document findings
Assess patient safety
Respond, Review Options, Refer

Resource tool for healthcare members: Cook County Dept. of Public Health Resource Tool (See site…all shelters, legal counsel, it’s all there)

FOLLOW UP.

46
Q

Bullying…what really is it?

A

NOT just fighting/teasing
NOT a developmental norm
NOT a rite or passage

There are direct an indirect bullying.

47
Q

Bullying victims are not chosen.

A

False.

Smaller, weaker boys
Socially isolated girls
Homosexual youth

48
Q

Consequences for bullying

A 
Ashamed
Fear
Poor concentration 
Somatic complaints (my stomach hurts…can i stay home?)
Suicide
49
Q

Can bullies feel or show empathy?

A

No. They don’t feel empathy…they want to increase their popularity. The bullies themselves have the poorest longterm outcomes. We need to help the bullies!

50
Q

For bullying, the responsible physician should…

A
  1. Encourage parents to teach empathy
  2. Limit internet use….MONITORING
  3. Families should be involved in school lives
  4. Refer to counseling…
51
Q

ACE study (reading…landmark study by Kaiser)

A

1,700 participants. Surveyed about childhood history, and current health.

Early death and health problems correlated with abuse, neglect, or household dysfunction!

EDUCATION. We need to go back to childhood and decrease the incidence of childhood experiences.

52
Q

Is violence a public health issue?

A

Yes.

BD Exam II Material (Richie) (7 decks)

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