Child Abuse Flashcards
1
Q
What is the most common form of child abuse?
A
Neglect
2
Q
What age are most children abused?
A
<1yr
3
Q
Who are the main preparators?
A
parents (mother)
4
Q
Who is a mandated reporter?
A
You!
any personnel engaged in the examination, care or treatment of persons
5
Q
Who is required to report abuse in Texas?
A
Everyone
6
Q
When should child abuse be reported?
A
Whenever you SUSPECT a child is being physically abused, sexually abused, or neglected
7
Q
T/F You have to know that abuse is occurring to report it?
A
FALSE
8
Q
What is the number for abuse?
A
1-800-252-5400
9
Q
How long does it take for abuse to be processed on the website?
A
> 24hrs
10
Q
When are 4 circumstances that warrants for calling instead of using the website?
A
- You believe your situation requires action less than <24hrs
- To remain anonymous
- Insufficient data to complete information on the report
- You do not want a email confirmation
11
Q
Where is child abuse reported?
A
Department of Family and Protective Services (DPS)
12
Q
Who is immune from civil or criminal liability that might be incurred or imposed when reporting?
A
a person acting in good faith
13
Q
If a person is required to report and doesn’t what offense can they get?
A
Class A misdemeanor
State jail felony
14
Q
T/F can CPS tell the family who called?
A
False
15
Q
T/F should you tell the family that you reported?
A
Yes you can
16
Q
What should never be used when telling a family?
A
using reporting as a threat to families
17
Q
What are the two outcomes for missed abuse cases?
A
returned to same abusive environment
Concern that the perpetrator will escalate
18
Q
What is neglect?
A
No clear definition
19
Q
“We know it when we see it “ refers to?
A
Neglect
20
Q
Act of Omission?
A
Neglect
21
Q
Act of commission
A
Abuse
22
Q
Not Tangible (Developmental delay)
A
Neglect
23
Q
Tangible (Bruises, Fractures)
A
Abuse
24
Q
Attracts less attention?
A
Neglect
25
Evokes intense response from professionals, public and media
Abuse
26
What does neglect fall in between?
Adequate Care and Inadequate Care
27
What is physical neglect?
inadequate food, clothing, shelter and hygiene
28
What is medical neglect?
failure to provide prescribed medical care or treatment, and seek care
29
What is supervisory neglect?
failure to provide age appropriate supervision
30
What is psychological or emotional neglect?
failure to provide adequate nurturance or affection, support, and allowing child to use drugs/alcohol
31
In homes of Domestic violence how likely are children abused and neglected?
15 x higher
32
What is the most common presentation in physical abuse?
cutaneous injuries (bruises, lacerations, abrasions, bites, burns)
33
What is the most fatal form of child abuse?
abusive head trauma
34
What is the 2nd most fatal form of child abuse?
abdominal trauma
35
What sentinel injury is most common seen?
bruising
36
What age is most sentinel injuries seen?
<7mo
37
T/F bruising anywhere on an immobile infant is concerning for physical abuse
TRUE
38
What is associated with more bruises?
increasing developmental stage
39
What is the older of age for increase bruises?
walkers> cruisers> crawlers> non-crawlers
40
What is the saying for bruising and age?
"Those who don't cruise don't bruise"
41
What are the 6 most common areas for accidental bruising?
legs, knees, forearm, thighs, elbows, forehead
42
What is TEN FACES-P used for?
evaluation of bruises
43
What does TEN FACES-P stand for?
Torso
Ears
Neck
```
Frenulum
Angle of jaw
Cheek
Eyelids
Subjunctival hemorrhage
```
44
A patterned injury is suggestive of?
an object
45
What are 3 generalizations that can be made about an object?
flat
textured
flexible
46
Accidentally injuries are...
rarely patterned
47
What periorbital ecchymosis?
mimics an injury resulting from direct periorbital trauma from physical abuse
48
What is key?
History
49
What is the most common agent for both accidental and inflicted burns?
scalding by hot liquid
50
Most commonly due to immersion in hot tap water?
abusive burns
51
How does abusive burns present?
symmetric w/ sharp demarcations
| Usually w/o splash marks
52
How does accidental burns present?
smaller, less severe, w/o a pattern, with an irregular depth
53
Where is the burns most common?
bilateral lower leg/foot
bilateral lower arm/hand
bilateral upper leg
buttocks/perineum
54
What are the 6 common types of fractures?
```
impacted
Oblique
Spiral
Avulsed
Transverse
Torus
```
55
What is the most common location of a fracture?
Ribs posteromedial
56
"Corner Fractures, Buckle Handle Fractures"
Classic Metaphyseal Lesions
57
What causes a CML ?
twisting, pulling yanking, shaking
58
What is true about CML
RARELY accidental
Normal parenting does not cause this
NOT from a fall
59
What 5 fractures are high specificity for abuse?
```
rib
classic metaphyseal lesions
scapular fractures
spinous process fractures
sternal fractures
```
60
What are 4 common but low specificity fractures?
Subperiosteal new bone formation
Clavicular fracture
Long bone shaft
Linear skull fracture
61
What is inertial brain injury?
whole head acceleration or deceleration
62
What is the presentation for a abusive head trauma?
fussiness, vomiting, BRUE, macrocephaly, bulging fontanelle
63
When does a child need further medical evaluation?
any injury in a child 0-6 mo of age
any patterned of bruises, lacerations or burns <5yr, speech delay, child discloses they have been hit
-eats out of trash cans
- sibling are injured
64
Who has the highest priority in abuse?
infants under 2yr
65
Who has the next highest priority in abuse?
preschool children >5 yr
66
What 3 things makes up the medical evaluation?
complete hx
head to toe examination
photodocumentation
67
What screening should be done for fractures?
complete skeletal survey (22 xrays series)
| <24 mo
68
What is screening for occult injuries?
LFT, amylas, lipase, urinalysis
| Abdomen/ pelvis CT with contrast (if AST/ALF>80, or polytrauma)
69
Screening for intracranial injuries?
Head CT without contrast
| < 6 mo all children
70
Screening for abnormal head CT?
MRI brain w/o contrast
71
Screening for intracranial blood?
Ophthalmology exam
72
Who has a 90% reported incidence of sexual abuse?
girls
73
How many times are girls to be sexually abused than boys?
3x
74
When are girls more likely to be sexually abused?
in their teen years
75
What are the myths of sexual abuse?
Perpetrators are strangers
Perpetrators who sexually abuse boys don't sexually abuse girls
Children tell about the abuse immediately
Children tell fantasies
Any child with penetration will have an abnormal exam
76
What does Child Sexual Behavior Inventory demonstrate?
that normal young children exhibit sexual behavior
77
When does child sexual behavior peak?
>5 yr
78
What are 3 normal sexual behaviors?
self-stimulation
exhibitionism
behaviors related to personal boundaries
79
What does abnormal sexual behavior look like?
no single behavior that indicates sexual abuse
80
What is the most common way that sexual abuse is detected?
child tells someone
81
What is the most important evidence that sexual abuse or assault has occurred?
child's disclosure
82
What should not be done if there is a disclosure?
DO NOT conduct an interview
83
What are 4 reasons Kids don't disclose?
```
not developmentally ready
Psychological manipulation
Trapped and helpless
Fears on one will believe
Feels responsible
Protect their parents
Dissociate and repression
```
84
What does the Hymen mean?
Greek God of the Wedding Feast
85
Girls can be born without a hymen?
False
86
Straddle injuries tear the hymen?
False
87
The hymen is always injured with sexual contact?
False
88
The hymen presence is proof there has been no penetration
False
89
The absence of a hymen does not rule out the possibility of sexual abuse and/or penetration?
True
90
What percent of cases with known sexual abuse have normal findings?
95%
91
T/F the hymen is absent at birth?
FALSE
92
When is the hymen estrogenized?
0-3 yrs of life
| 9-10yrs of life
93
When is the hymen unestrogenized?
3-9yrs of life
| thin, sharp, vascular, very sensitive and painful to touch
94
Where does straddle injuries occur?
anterior, external to hymen, unilateral, painful
95
What are 4 non-specific findings of sexual abuse?
erythema
Labial adhesions
Vulvovaginitis
Anal fissures
