Child Abuse

Question 1

Locations of inflicted bruising

Answer 1

buttocks, lower back, inner thighs, cheeks, ears, mouth, neck

Question 2

How to date bruise based on color?

Answer 2

red: 0-1 d
blue/purple: 1-4 d
green/yellow: 5-7 d
yellow/brown: 8-10
cleared: 1-3 wks

• not highly accurate

Question 3

osteogenesis imperfecta inheritance

Answer 3

autosomal dominant, some are spontaneous mutation

Question 4

signs of osteogenesis imperfecta

Answer 4

blue sclerae
multiple fractures
joint laxity

Question 5

How is osteogenesis imperfecta dx’d?

Answer 5

XR: multiple fx, wormian bones

skin biopsy: collagen abnormalities

Question 6

osteogenesis imperfecta tx

Answer 6

prevention of injury
bisphophonates
orthotics

Question 7

Karley’s Law

Answer 7

Mandates that children in Oregon who exhibit suspicious physical injuries in the course of a child abuse investigation must receive medical attention within 48 hours

Question 8

Bone fractures with high specificity of physical abuse

Answer 8

Metaphyseal chip, bucket handle fx (femur, humerus)
Posterior rib
Scapular
Spinous process
Sternum

Question 9

bezoar

Answer 9

mass of indigestible material found in intestinal tract, commonly in stomach

Question 10

Define neglect

Answer 10

failure of parent or caregiver to provide for child’s basic needs

Question 11

Types of neglect

Answer 11

physical
healthcare
emotional
supervision
education

Question 12

Most serious form of physical abuse with highest mortality rate in children less than 2 yrs old

Answer 12

head trauma

Question 13

What symptoms differentiate abusive head trauma from severe infections?

Answer 13

retinal hemorrhages (80% of cases)

Question 14

Behavioral changes in children that have been sexually abused

Answer 14

sexual acting out
knowledge of sex beyond level of development
anxiety/depression
enuresis
school failures