Child Abuse

Question 1

any recent act or failure to act on the part of a parent or caretaker which results in death, serious physical or emotional harm, sexual abuse or exploitation; or an act or failure to act, which presents an imminent risk of serious hard.

Answer 1

child maltreatment

Question 2

what are the 5 types of child maltreatment?

Answer 2

physical abuse
sexual abuse
medical child abuse
emotional abuse
neglect

Question 3

what is the most common combination of child maltreatment?

Answer 3

neglect + physical abuse

Question 4

who is most likely to commit child maltreatment?

Answer 4

parents

Question 5

who is a mandated reported in texas?

Answer 5

everyone

Question 6

when can someone report physical abuse, sexual abuse, or neglect?

Answer 6

when it is suspected

Question 7

when can a mandatory reporter be committing an offense? what is it lawfully considered?

Answer 7

if knowingly fails to make a report
class A misdemeanor

Question 8

why is making anonymous reports no longer allowed?

Answer 8

CPS cannot tell family
giving name and position adds credibility

Question 9

what is the most common form of child maltreatment?

Answer 9

neglect

Question 10

is an act of omission and not tangible

Answer 10

neglect

Question 11

is an act of commission and tangible

Answer 11

abuse

Question 12

neglect of inadequate food, clothing, shelter, and hygiene

Answer 12

physical neglect

Question 13

failure to provide prescribed medical care/treatment and failure to seek appropriate medical care in a timely manner

Answer 13

medical neglect

Question 14

failure to provide age-appropriate supervision

Answer 14

supervisory neglec

Question 15

failure to provide adequate nurturance or affection, psychological support, and allowing children to use drugs / alcohol

Answer 15

psychological / emotional neglect

Question 16

in homes with domestic violence, children are physical abused and neglected at a rate _____ times higher than the national average

Answer 16

15

Question 17

any non-accidental or inflicted physical injury

Answer 17

physical abuse

Question 18

what is the most fatal form of abuse?

Answer 18

abusive head trauma

Question 19

what is the 2nd most fatal form of abuse?

Answer 19

abdominal trauma

Question 20

what is the most common presentation of physical abuse?

Answer 20

cutaneous injuries

Question 21

a minor, detectable and poorly explained injury that is often missed

Answer 21

sentinel injury

Question 22

bruising anywhere on an _____ infant is concerning for physical abuse

Answer 22

immobile

Question 23

a gray-blue macule with indefinite borders what is most frequently on the sacral-gluteal region

Answer 23

congenital dermal melanosis

Question 24

what is the evaluation of bruises that would indicate abuse?

Answer 24

TEN FACES-P

Torso
Ears
Neck

Frenulum
Angle of jaw
Cheek
Eyelids
Subconjunctival hemorrhage

Patterned injury

Question 25

cell mediated delayed hypersensitivity reaction that shows up as a erythematous macule +/- bulla; caused by lemons, dill, parsley, and carrots.

Answer 25

phytophotodermatitis

Question 26

accidental injuries are RARELY _____

Answer 26

patterned

Question 27

caused by a basal skull fracture or forehead contusion that mimics an injury resulting from direct periorbital trauma from physical abuse

Answer 27

periorbital ecchymosis

Question 28

what is the most common agent for both accidental and inflicted burns?

Answer 28

scalding by hot liquid

Question 29

what are abusive burns most commonly due to?

Answer 29

immersion in hot tap water

Question 30

how are abusive and accidental burns different?

Answer 30

abusive burns are symmetric w/ sharp demarcations, usually without splash marks accidental burns are smaller, less severe, without a pattern, and with an irregular depth

Question 31

what is the most common skin infection worldwide?

Answer 31

impetigo

Question 32

usually on the face, preceding break in skin, and occurs with regional adenopathy

Answer 32

non-bollous impetigo

Question 33

caused by staph aureus, anywhere on the body, no preceding break in skin

Answer 33

bullous impetigo

Question 34

ulcerative, goes through epidermis to deep into into dermis, and appears a punched out lesions, yellow crust, and raised red borders

Answer 34

ecthyma impetigo

Question 35

what is ecthyma impetigo mistaken as?

Answer 35

cigarette burn

Question 36

appears as a diamond shaped lesion, with linear borders lined up with diaper edge, and spars the skin folds

Answer 36

laxative induced burns

Question 37

what causes laxative induced burns?

Answer 37

exposure of skin to diarrhea induced by ex-lax (senna)

Question 38

what 5 types of fractures have a high specificity for abuse?

Answer 38

rib fractures (esp. posteromedial) classic metaphyseal lesions scapular fractures spinous process fractures sternal fractures

Question 39

fracture that occurs in the immature end of the bone via twisting, pulling, yanking, or shaking.

Answer 39

classic metaphyseal lesions (bucket handle)

Question 40

what 3 types of fractures are common but low specificity for abuse?

Answer 40

clavicular fracture long bone shaft linear skull fracture

Question 41

whole head acceleration or deceleration +/- impact

Answer 41

inertial brain injury

Question 42

when does a child need further medical evaluation?

Answer 42

any injury in a child 0-6 months

Question 43

which children are the highest priority?

Answer 43

infants under 2 years

Question 44

which children are the 2nd highest priority?

Answer 44

preschool children (5 years and under)

Question 45

what is the medical evaluation for fractures in all children 24 months and under?

Answer 45

complete skeletal survey (series of 22 xrays)

Question 46

what is the medical evaluation for intra-abdominal injuries?

Answer 46

abdominal/pelvis CT with contrast

Question 47

what is the medical evaluation for intracranial injuries in all children 6 months and under?

Answer 47

head CT w/out contrast

Question 48

what is the medical evaluation for intracranial injuries if abnormal head CT?

Answer 48

MRI brain w/out contrast

Question 49

what is the medical evaluation for intracranial injuries if intracranial blood present?

Answer 49

ophthalmology exam

Question 50

what is the most important evidence that sexual abuse or assault has occurred?

Answer 50

child's disclosure

Question 51

what should documentation be done for sexual abuse?

Answer 51

in patient's own words

Question 52

what is the most common finding in sexual abuse?

Answer 52

normal physical exam