Child Abuse

Question 1

Types of physical child abuse

Answer 1

Drowing
Hair pulling
Blows or Strikes
Twists or pulls (causing fractures)
Forced restraint
Forced ingestion
Burns or scalds
Strangulation

Question 2

Other terms for child abuse

Answer 2

• Shaken baby syndrome (now it’s called shaken impact syndrome)
• Non Accidental Trauma (NAT)
• Child battering

Question 3

Parental factors correlated with being abuser:

Answer 3

Teenage parent
Single or divorced parent
Drug or alcohol abuser
Crowded house
Low socioeconomic status
Emotionally immature
Himself abused as a child

Question 4

Children prone to being abused

Answer 4

Less than 6 years
Unwanted pregnancy
Twins
Chronically or reccurently ill
Physically or mentally handicapped

Question 5

Features of medical history, which may indicate child abuse:

Answer 5

• History not consistent with type or severity of injury
• child is afair of caretaker
• caretaker doesn’t know the etiology of the injury
• different history bt the caretaker and the child

Question 6

Physical exam findings indicative of possible child abuse:

Answer 6

• Multiple injuries of various ages
•sharply demarcated burns (scalds)
• retinal hemorrhage (SBS)
• bizarre injuries (cigarettes burns, bite, or belt marks)
• perioral, perineal, anal, or genital injuries

Question 7

X-ray findings indicative of possible child abuse:

Answer 7

Spiral fracture of long bone (twists)
Multiple rib fracture
Femur fracture
Multiple fractures in different stages of healing

Question 8

Skin conditions that may mimic signs of child abuse:

Answer 8

• Mangolian spots
• Other “birthmark” like hemangioma
• Folk treatments (cupping or coning)
Thrombocytopenia or congenital coagulation disorders
Alopecia areata or tinea infection

Question 9

Medical conditions that can mimic skeletal findings of child abuse:

Answer 9

Osteogenesis imperfecta
Rickets
Scurvy
Metastatic bone tumours
Meningomyelocele
Congenital syphilis
Homocystinuria
Prostaglandin therapy
Hypophosphatasia

Question 10

Leading cause of fatal child abuse

Answer 10

Head trauma

Question 11

Most common skeletal injury with child abuse:

Answer 11

ribs and long bone fractures (in lecturer words)

Question 12

Type of intracranial hemorrhage in child abuse:

Answer 12

Subdural hemorrhage

Question 13

Second most common skeletal injury with chid abuse:

Answer 13

Skull fractures

Question 14

how much percent of abused children show signs of head trauma?

Answer 14

10%

Question 15

Suspect child abuse if skull fracutre:

Answer 15

Complex (multiple or “eggshell”, displaced, diastatic, comminuted, or cross suture line)

Question 16

Percent of retinal hemorrhage in shaken impact syndrome:

Answer 16

80%
Can lead to blindness

Question 17

Percent of retinal hemorrhage in accidental head trauma cases:

Answer 17

3%

Question 18

Shaken baby syndrome may presetn with:

Answer 18

Coma or seizures without evidence of scalp trauma

Question 19

We suggest renaming “shaken baby syndrome” to “shaken impact syndrome”

Answer 19

Recent studies indicate that most cases are not caused by shaking alone but by thrown the impact of head against wall or object

Question 20

First cause of death in child abuse

Answer 20

Head injury

Question 21

Second cause of death in child abuse:

Answer 21

Abdominal trauma:
May have organ perforation, obstruction, laceration and rupture

Question 22

Perineal or genital injuries may not always represent sexual abuse:

Answer 22

May be punishment for toilet training accidents

“All of them are child abuse”