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Pediatrics > Child Abuse > Flashcards

Child Abuse Flashcards

1
Q

What is the most common form of child abuse?

A

Neglect

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2
Q

What age are most children abused?

A

<1yr

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3
Q

Who are the main preparators?

A

parents (mother)

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4
Q

Who is a mandated reporter?

A

You!

any personnel engaged in the examination, care or treatment of persons

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5
Q

Who is required to report abuse in Texas?

A

Everyone

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6
Q

When should child abuse be reported?

A

Whenever you SUSPECT a child is being physically abused, sexually abused, or neglected

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7
Q

T/F You have to know that abuse is occurring to report it?

A

FALSE

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8
Q

What is the number for abuse?

A

1-800-252-5400

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9
Q

How long does it take for abuse to be processed on the website?

A

> 24hrs

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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
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11
Q

Where is child abuse reported?

A

Department of Family and Protective Services (DPS)

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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

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13
Q

If a person is required to report and doesn’t what offense can they get?

A

Class A misdemeanor

State jail felony

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14
Q

T/F can CPS tell the family who called?

A

False

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15
Q

T/F should you tell the family that you reported?

A

Yes you can

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16
Q

What should never be used when telling a family?

A

using reporting as a threat to families

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17
Q

What are the two outcomes for missed abuse cases?

A

returned to same abusive environment

Concern that the perpetrator will escalate

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18
Q

What is neglect?

A

No clear definition

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19
Q

“We know it when we see it “ refers to?

A

Neglect

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20
Q

Act of Omission?

A

Neglect

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21
Q

Act of commission

A

Abuse

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22
Q

Not Tangible (Developmental delay)

A

Neglect

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23
Q

Tangible (Bruises, Fractures)

A

Abuse

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24
Q

Attracts less attention?

A

Neglect

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25
Q

Evokes intense response from professionals, public and media

A

Abuse

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26
Q

What does neglect fall in between?

A

Adequate Care and Inadequate Care

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27
Q

What is physical neglect?

A

inadequate food, clothing, shelter and hygiene

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28
Q

What is medical neglect?

A

failure to provide prescribed medical care or treatment, and seek care

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29
Q

What is supervisory neglect?

A

failure to provide age appropriate supervision

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30
Q

What is psychological or emotional neglect?

A

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

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31
Q

In homes of Domestic violence how likely are children abused and neglected?

A

15 x higher

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32
Q

What is the most common presentation in physical abuse?

A

cutaneous injuries (bruises, lacerations, abrasions, bites, burns)

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33
Q

What is the most fatal form of child abuse?

A

abusive head trauma

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34
Q

What is the 2nd most fatal form of child abuse?

A

abdominal trauma

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35
Q

What sentinel injury is most common seen?

A

bruising

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36
Q

What age is most sentinel injuries seen?

A

<7mo

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37
Q

T/F bruising anywhere on an immobile infant is concerning for physical abuse

A

TRUE

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38
Q

What is associated with more bruises?

A

increasing developmental stage

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39
Q

What is the older of age for increase bruises?

A

walkers> cruisers> crawlers> non-crawlers

40
Q

What is the saying for bruising and age?

A

“Those who don’t cruise don’t bruise”

41
Q

What are the 6 most common areas for accidental bruising?

A

legs, knees, forearm, thighs, elbows, forehead

42
Q

What is TEN FACES-P used for?

A

evaluation of bruises

43
Q

What does TEN FACES-P stand for?

A

Torso
Ears
Neck

Frenulum
Angle of jaw
Cheek 
Eyelids
Subjunctival hemorrhage
44
Q

A patterned injury is suggestive of?

A

an object

45
Q

What are 3 generalizations that can be made about an object?

A

flat
textured
flexible

46
Q

Accidentally injuries are…

A

rarely patterned

47
Q

What periorbital ecchymosis?

A

mimics an injury resulting from direct periorbital trauma from physical abuse

48
Q

What is key?

A

History

49
Q

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

A

scalding by hot liquid

50
Q

Most commonly due to immersion in hot tap water?

A

abusive burns

51
Q

How does abusive burns present?

A

symmetric w/ sharp demarcations

Usually w/o splash marks

52
Q

How does accidental burns present?

A

smaller, less severe, w/o a pattern, with an irregular depth

53
Q

Where is the burns most common?

A

bilateral lower leg/foot
bilateral lower arm/hand
bilateral upper leg
buttocks/perineum

54
Q

What are the 6 common types of fractures?

A 
impacted
Oblique
Spiral
Avulsed
Transverse
Torus
55
Q

What is the most common location of a fracture?

A

Ribs posteromedial

56
Q

“Corner Fractures, Buckle Handle Fractures”

A

Classic Metaphyseal Lesions

57
Q

What causes a CML ?

A

twisting, pulling yanking, shaking

58
Q

What is true about CML

A

RARELY accidental
Normal parenting does not cause this
NOT from a fall

59
Q

What 5 fractures are high specificity for abuse?

A 
rib
classic metaphyseal lesions
scapular fractures
spinous process fractures
sternal fractures
60
Q

What are 4 common but low specificity fractures?

A

Subperiosteal new bone formation
Clavicular fracture
Long bone shaft
Linear skull fracture

61
Q

What is inertial brain injury?

A

whole head acceleration or deceleration

62
Q

What is the presentation for a abusive head trauma?

A

fussiness, vomiting, BRUE, macrocephaly, bulging fontanelle

63
Q

When does a child need further medical evaluation?

A

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
Q

Who has the highest priority in abuse?

A

infants under 2yr

65
Q

Who has the next highest priority in abuse?

A

preschool children >5 yr

66
Q

What 3 things makes up the medical evaluation?

A

complete hx
head to toe examination
photodocumentation

67
Q

What screening should be done for fractures?

A

complete skeletal survey (22 xrays series)

<24 mo

68
Q

What is screening for occult injuries?

A

LFT, amylas, lipase, urinalysis

Abdomen/ pelvis CT with contrast (if AST/ALF>80, or polytrauma)

69
Q

Screening for intracranial injuries?

A

Head CT without contrast

< 6 mo all children

70
Q

Screening for abnormal head CT?

A

MRI brain w/o contrast

71
Q

Screening for intracranial blood?

A

Ophthalmology exam

72
Q

Who has a 90% reported incidence of sexual abuse?

A

girls

73
Q

How many times are girls to be sexually abused than boys?

A

3x

74
Q

When are girls more likely to be sexually abused?

A

in their teen years

75
Q

What are the myths of sexual abuse?

A

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
Q

What does Child Sexual Behavior Inventory demonstrate?

A

that normal young children exhibit sexual behavior

77
Q

When does child sexual behavior peak?

A

> 5 yr

78
Q

What are 3 normal sexual behaviors?

A

self-stimulation
exhibitionism
behaviors related to personal boundaries

79
Q

What does abnormal sexual behavior look like?

A

no single behavior that indicates sexual abuse

80
Q

What is the most common way that sexual abuse is detected?

A

child tells someone

81
Q

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

A

child’s disclosure

82
Q

What should not be done if there is a disclosure?

A

DO NOT conduct an interview

83
Q

What are 4 reasons Kids don’t disclose?

A 
not developmentally ready
Psychological manipulation
Trapped and helpless
Fears on one will believe
Feels responsible
Protect their parents
Dissociate and repression
84
Q

What does the Hymen mean?

A

Greek God of the Wedding Feast

85
Q

Girls can be born without a hymen?

A

False

86
Q

Straddle injuries tear the hymen?

A

False

87
Q

The hymen is always injured with sexual contact?

A

False

88
Q

The hymen presence is proof there has been no penetration

A

False

89
Q

The absence of a hymen does not rule out the possibility of sexual abuse and/or penetration?

A

True

90
Q

What percent of cases with known sexual abuse have normal findings?

A

95%

91
Q

T/F the hymen is absent at birth?

A

FALSE

92
Q

When is the hymen estrogenized?

A

0-3 yrs of life

9-10yrs of life

93
Q

When is the hymen unestrogenized?

A

3-9yrs of life

thin, sharp, vascular, very sensitive and painful to touch

94
Q

Where does straddle injuries occur?

A

anterior, external to hymen, unilateral, painful

95
Q

What are 4 non-specific findings of sexual abuse?

A

erythema
Labial adhesions
Vulvovaginitis
Anal fissures

Pediatrics (7 decks)

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