Child Abuse Flashcards
What are parental risk factors of child abuse?
- Young/teenage parent
- Parent abused as a child
- Nonbiological caregiver
- Emotionally vulnerable
- Mental health
- History of domestic violence/intimate partner violence
What are child risk factors associated with child abuse?
- Premature child
- Younger child, less mature
- Chronic illness/Colic
- Developmental delays
- Unwanted child
- Child misbehavior
What are the catagories of child abuse?
What is the most commonly reported catagory of abuse?
- Neglect
- Emotional
- Physical
- Sexual
Neglect
What are the four subtypes of neglect?
- Physical
- Emotional
- Educational
- Medical
What is the more challenging form of abuse to recognize?
What is the treatment?
Emotional
Mental health counseling for child and family
If abuse is recurrent or possibility of harm then DYFS should be contacted
When should physical abuse be suspected in kids?
- Injuries to multiple organ systems
- Multiple injuries in different stages of healing
- Patterned injuries
- Injuries to non-bony or other unusual locations
- ANY injury in a pre-ambulatory infant
What is the most cammon abuse presenting injuries in kids?
- Contusions
- Fractures: extremities, thorax, spine, skull
- Head injury
- Abdominal injury
- Burns
Also includes shaken baby syndrome, Muchausen by Proxy
What locations are worrisome for contusions and may indicate abuse?
- Face
- Trunk including buttocks
- Any bruising in young infants who are not ambulatory
What are some conditions that can be missed or characterized as abuse?
- Osteogenesis imperfecta
- Primary bone dysplasia
- Metaphyseal and spondylometaphyseal dysplasias
- Myelodysplasia
How is child abuse observed on imaging?
Skeletal Survey
When should a CT be considered in abuse?
Can confrim fractures that were questionable on XR and can evaluate for other injuries (i.e. intracranial and solid organ injury)
What fracture type is highly specific for child abuse in infancy?
What can be an exception and should be collected as part of the history?
Bucket-handle fracture
Obstetric trauma during delivery (shoulder distocia)
A fracture in what bone has a 95% predictive value of being an indicator for abuse?
Ribs
What is a “Ping pong” skull fracture?
Refers to a depressed skull fracture of the infant skull caused by inner buckling of the calvarium
May not be child abuse if fall from < 4ft
What are the neurological clinical features of shaken baby syndrome?
- Mental status changes
- Signs of elevated intracranial pressure
- Respiratory changes
- Suggestive bruising
- Retinal hemorrhages
