Child Abuse

Question 1

abusive actions or acts of commission and lack of action,

or acts of omission that result in morbidity or death

Answer 1

Child maltreatment

Question 2

intentional injuries to a child by a caregiver that result in bruises, burns, fractures, lacerations, punctures, or organ damage; also may be accompanied by short- or long-term emotional consequences

Answer 2

Physical abuse

Question 3

intentional verbal or behavioral acts or omissions
that result in adverse emotional consequences—spurning, exploiting/corrupting, withholding emotional responsiveness, isolating, terrorizing

Answer 3

Psychological maltreatment

Question 4

any act intended for sexual gratification of an adult

Answer 4

Sexual abuse

Question 5

intentionally giving poisons or toxins, or any other deceptive action to simulate a disorder

Answer 5

Factitious disorder

Question 6

MC finding in child abuse

Answer 6

Bruises

Question 7

WHat Fx?

Wrenching or pulling an extremity →

Answer 7

corner chip or bucket handle fracture of metaphysis

Question 8

WHat Fx?

Inflicted fracture of bone shaft →

Answer 8

more likely are spiral fractures from twisting

rather than transverse from impact

Question 9

A ______ of the femur before child can walk independently has usually been inflicted by someone else.

Answer 9

spiral fracture

Question 10

Fx Highly specific for abuse

Answer 10

– Rib fractures in infants
– Fractures of different stages of healing
– Bilateral fractures
– Complex skull fracture

Question 11

MC type of burns in abused children

Answer 11

Immersion burns

Question 12

Clues of immersion burns

Answer 12

° Demarcation is uniform and distinct
° Flexion creases spared
° No splash burns
° Hands and feet spared

Question 13

• Consider when injured infant presents with coma, convulsions, apnea, increased ICP

Answer 13

Intentional head trauma

Question 14

A subdural hemorrhage in which there are no scalp marks or skull fracture is possibly from ______

Answer 14

a hand blow

Question 15

Shaking—acceleration-deceleration; may have no external marks; 85% associated ______

Answer 15

with retinal hemorrhage

Question 16

Recurrent vomiting, abdominal distension, absent bowel sounds, localized tenderness, shock.

What is the dx?

Answer 16

Intra-abdominal injuries

Question 17

_______ when you suspect abuse in child age <2 years; in child >2 years, appropriate film area of injury, complete survey not usually require

Answer 17

Skeletal survey

Question 18

Law enforcement agency performs
1
2
3

Answer 18

forensics, interviews suspects, and if criminal act

has taken place, informs prosecutor (state by state)

Question 19

T or F

Answer 19

The earlier the age of abuse, the greater the risk of mortality

Question 20

Most common reported sexual abuse is that of ____

Answer 20

daughters by fathers and stepfathers

Question 21

Most common sexual abuse overall is _____

Answer 21

brother-sister incest

Question 22

sexual abuse should be considered as a possible cause if presenting with

Answer 22

– Vaginal, penile, or rectal pain, discharge, bruising, erythema, or bleeding
– Chronic dysuria, enuresis, constipation, or encopresis
– Any STDs in prepubertal child

Question 23

Dxtics for possible sexual abuse

Answer 23

– Test for pregnancy
– Test for STDs
– Test for syphilis, HIV, gonorrhea, hepatitis B