Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

RC Review > Child Maltreatment > Flashcards

Child Maltreatment Flashcards

1
Q

Risk Factors for Maltreatment

A

Child:
- prematurity
- chronic illness
- developmental disability
- behaviour issues/difficult temperament
- multiple (twins)

Parental:
- history of criminality or violence
- substance abuse
- mental health condition
- personal history of childhood abuse
- young parental age

Environment
- low educational attainment
- unemployment
- non-related adult male in the home
- social isolation/lack of supports
- intimate partner violence/conflict in home (considered child abuse)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Consent for sexual activity

A
  • Age of consent is 16
  • Age for exploitative sexual activity is 18
  • 12-13 can consent </= 2 years older
  • 14-15 can consent </= 5 years older
  • DOES NOT apply to person of authority
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Red flags for bruising

A

TEN 4 FACES P
- torso including genitals
- ears
- neck
- frenulum
- angle of mandible
- cheek
- eyelid
- subconjunctival hemorrhage
- patterned bruising
- ANY bruising in a child less than 4 months of age

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

When do you call police?

A
  • gunshot wound
  • protection for public at large
  • reporting risk of homicide
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Who needs a skeletal survey?

A

ALL children < 2 years of age with concern for physical abuse

**Repeat in 10-14 days if normal with ongoing concerns

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Laboratory tests for bruising in suspected abuse

A
  • CBC + smear
  • PTT
  • INR
  • fibrinogen
  • VW studies (level and activity)
  • blood group
  • Factor VIII and IX
  • liver function tests
  • renal function tests
  • (+ Factor XIII for isolated head injury)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Who needs an ophthalmology assessment in concern for abuse?

A

Any child with positive head imaging

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Fracture types concerning for inflicted injury?

A
  • classic metaphyseal - corner or bucket handle, shearing at end of long bone - yanking force)
  • ribs - especially posterior
  • sternum
  • scapula
  • vertebral spinous processes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Red flags for fractures

A
  • no history of trauma/unwitnessed
  • changes with repetition
  • delayed presentation
  • age < 1 year
  • presence of other injuries
  • age or development does not fit with injury
  • fracture type - location, multiple fractures, different ages of fractures
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Investigations for fractures with concern for abuse?

A
  • CBC
  • Calcium
  • phosphate
  • ALP
  • renal and liver function
  • 25-OH Vitamin D
  • PTH
  • copper, ceruloplasmin
  • OI testing (if concerning features)
  • Skeletal survey
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Screening for other injuries in concern for abuse

A
  • Head imaging
  • Skeletal survey
  • Abdominal trauma screening (liver enzymes, lipase)
  • CT Abdomen (of abdominal bruising or screen positive)
  • Ophthalmology (if head imaging positive)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Medical Causes of Bruising

A
  • ITP
  • HSP
  • Hemophilia
  • Vitamin K deficiency
  • VWD/platelet disorders
  • Leukemia
  • Meningitis/DIC/meningococcemia
  • Ingestion of anticoagulants
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the most common finding in inflicted head injury?

A

Subdural hemorrhages

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

DDx of Fractures

A
  • trauma - accidental or NAT

Nutritional/Metabolic
- Vitamin D deficiency
- Osteopenia
- copper deficiency

Genetic
- OI
- Menkes

Infection
- osteomyelitis
- congenital syphilis

Neoplastic
- Leukemia
- bone tumour
- LCH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is diagnostic of sexual contact?

A
  • pregnancy
  • semen in forensic specimen taken from child
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Exam findings caused by trauma or sexual contact?

A
  • bruising/petechiae/abrasions on hymen
  • acute laceration of the hymen
  • vaginal laceration
  • perianal laceration
  • healed hymenal transection/complete clef between 4 o’clock to 8 o’clock to base of hymen
  • perianal scar or scar in posterior fourchette
  • STIs unless evidence of perinatal transmission or another reasonable explanation (gonorrhea, syphilis, chlamydia, trichomonas, HIV)
17
Q

Normal findings not caused by sexual assault

A
  • notch or clef of hymen above 3 o’clock and 9 o’clock positions
  • smooth posterior hymenal rim thin along entire rim
  • dilation of urethral opening
  • imperforate hymen
18
Q

Investigations for abusive head trauma?

A
  • Skeletal survey (any child < 2)
  • CT/MRI (any child < 1)
  • bleeding disorder work-up
  • Factor XIII, metabolic screen for glutaric aciduria
  • screen for abdominal trauma: ALT, AST. lipase
  • Ophthalmology
  • medical photography
19
Q

Normal sexual behaviours in children 2-6 years

A
  • touching/masturbating
  • viewing/touching peer or new sibling genitalia
  • showing genitalia to peers
  • standing/sitting too close
  • trying to view peer/adult nudity
  • transient, few, distractible behaviours
20
Q

Abnormal sexual behaviours in children

A
  • any behaviour in children > 4 years apart
  • variety of sexual behaviours on a daily basis
  • leads to emotional distress or physical pain
  • associated with physically aggressive behaviour
  • involving coercion
  • persistent behaviours and child becomes angry if distracted
21
Q

STI screening in pre-pubertal sexual assault

A
  • urine NAAT for GC and Chlamydia
  • offer hepatitis B &C, HIV, VDRL
22
Q

Management of acute sexual assault

A
  • SAEK (72 hours prepubertal, 7 days post-pubertal)
  • consult child protection if authority or parents not supportive
  • genital exam
  • emergency contraception (5 days)
  • STI testing and prophylaxis
  • pregnancy test
  • call child maltreatment physician
  • Hep B and HIV prophylaxis
  • psychosocial supports
23
Q

Manifestations of neglect?

A
  • non-adherence of medical management
  • delay in seeking medical care
  • hunger/poor growth
  • injuries/ingestions from inadequate supervision
  • emotional/behaviour difficulties
  • developmental/cognitive delay
24
Q

Manifestations of caregiver fabricated illness

A
  • diagnosis does not match objective findings
  • signs/symptoms bizarre
  • caregiver not relieved if symptoms improved
  • caregiver insists on invasive or painful procedures and hospitalizations
  • signs/symptoms only begin with caregiver
  • failure to respond to normal treatments
  • publicly solicits sympathy or donation

RC Review (26 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions