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PEDS II, exam 2 > child abuse > Flashcards

child abuse Flashcards

1
Q

highest percentage of death from child abuse occurs in children under what age

A

12 months

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2
Q

what is the most common cause of lethal child abuse

A

abusive head trauma

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3
Q

who are the primary perpetrators of child abuse

A

parents

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4
Q

risk factors for babies/children to be abused

A
  • medical conditions
  • non-biologic caregiver
  • Age
    • severe physical abuse common children < 3 yo
  • prior abuse
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5
Q

What is the most common form of abuse

A

Neglect

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6
Q

bruising over the pinna of the ear is suggestive of

A

blow to ear or side of head

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7
Q

what is the normal distance between maxillary inter-canines in adults

A

2.5-3 cm

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8
Q

what is the second most common injury in physical abuse

A

fx

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9
Q

what are fx of high suspicion

A
  • rib fx in babies < 1 yr
  • long bone fx in non-walking children
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10
Q

presentation

  • third degree burn
  • heal slowly with scarring
  • typically dorsa of hands, feet or face
A

cigarette burns

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11
Q

rejection

A

lack of affection or attention

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12
Q

locking child in a room or basement

A

isolation

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13
Q

verbal assault, threatening behavior

A

terrorizing

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14
Q

psychological unavailability to the child

A

ignoring

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15
Q

encouraging destructive or sexually exploitative behavior

A

corrupting

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16
Q

name-calling, sarcasm, humiliation

A

verbal assault

17
Q

Neglect is failure to provide a child basic needs. this comes in what 4 categories

A
  1. physical: starvation, dehydration
  2. emotional: injuries caused by lack of supervision
  3. educational: excessive absences
  4. medical: poor dental health, untreated illness
18
Q

which type of intracranial bleeding is not typically accidental

A
  • subdural hemorrhage
    • would require significant force such as MVA or drop from high height
19
Q

which type of intracranial bleeding occurs more frequently following unintentional head trauma

A

epidural hemorrhage

20
Q

which type of intracranial bleeding is present in nearly all fatal inflicted head trauma

A

subarachnoid hemorrhage

21
Q

what is something you are looking for in optic exam after a head injury if you expect abuse

A
  • retinal hemorrhage
    • typically numerous in abusive trauma
22
Q

what are the two most common type of fx associated with abuse

A
  • metaphyseal lesions of the long bones (injuries in infancy)
  • rib fx
    • most often posterior ribs near costovertebral articulation
23
Q

salicylate ingestion can present with

A
  • hyperventilation
  • vomiting
  • metabolic acidosis
  • bruising
24
Q

clinical presentation

  • african american, asian, or hispanic infants
  • lower back and buttocks
  • absense of swelling or tenderness
  • fade over months to years
A

Mongolian spots

25
Q

what is osteogenesis imperfecta

A
  • genetic disorder resulting in brittle bones, due to problem with collagen formation
    • prone to repeated fx
    • prone to bruising, subdural hemorrhage, and retinal hemorrhage
26
Q

what is impetigo and how can it be differentiated from cigarette burns

A
  • infection of skin caused by strep or staph
  • superficial layers only
    • cigarette burns are usually 3rd degree and heal with scarring
27
Q

What is phytophotodermatitis

A
  • burn-like skin lesion when sun interacts with certain fruits/vegetables (lemons, oranges, celery, figs)
28
Q

what is Caida de mollera

A
  • poultices
  • shaving of head
  • suction or immersion of top of head in water
  • seen in mexican american cultures
29
Q

describe spooning

A
  • wet skin is rubbed with a spoon
  • causes ecchymosis
  • seen in china
30
Q

what is coining

A
  • oiled coin is rubbed firmly into skin
  • seen in SE asia
31
Q

what labs should be gotten when you expect child abuse

A
  • Coag studies
  • CBC with diff and platelets
  • CMP
  • amylase, lipase for pancreatic injury
  • UA
  • toxicology (serum and urine)
32
Q

what is first line imaging for abdominal injury if you expect abuse

A

CT with contrast

33
Q

skeletal survey is necessary in children under 9 months old with bruising in the following locations

A

>1 bruise in any location

34
Q

skeletal survery is necessary in children < 24 m.o with bruising if any of the following are present

A
  • h/o confessed abuse
  • domestic violence
  • additional injuries on PE
  • patterned bruising
  • > 4 bruises NOT limited to bony prominences
  • ear, neck, torso, buttocks, genital, hands, feet if no h/o trauma
35
Q

skeletal survery is necessary in children < 12 m.o with bruising in the following locations

A
  • cheeks, eye, ear, neck
  • upper arms or legs (not bony)
  • hands, feet
  • torso, buttocks, genital
  • > 1 bruise NOT limited to bony prominences
36
Q

skeletal survery is necessary in children < 6 m.o with bruising in the following locations

A
  • bony prominences except if single bruise and patient presents with h/o fall

PEDS II, exam 2 (3 decks)

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