Child Protection/Ethics Flashcards
What age is chlamydia more likely to be related to contact with infected genital secretions compared to perinatally acquired
<3 = may be perinatally acquired
Which 4 STDs are diagnostic for sexual abuse (if outside of perinatal transmission period)
Gonorrhea
Chlamydia
Syphilis
HIV
When can children move to a forward facing car seat
At least 2 years old
> 9 kg
When can children move to a booster seat
4 years old
18-36 kg
< 145 cm tall
When can children use a seatbelt alone
145 cm
When can children sit in the front seat
13 years
4 high risk fractures for child abuse
Rib fractures
Metaphyseal fractures
Humerus fractures < 18 months
Femur fractures in non ambulatory children
Scapula, spinous processes, and sternal fractures are also uncommon, NAI on differential
What is the time frame for urgent sexual abuse exam
< 72 hours
What weeks gestation is
1. palliative care
2. palliative or resus
3. resus
recommended
- 22 weeks or very low weight
- 23-24 weeks
- 25 weeks or late 24th week with good fetal status
Symptoms of vulvovaginitis
Itching, burning, redness, rash
Inflammation of vaginal can cause discharge, odor, or bleeding
What type of humerus fractures are more consistent with falls vs NAI
Falls = more often supracondylar injuries
Inflicted = spiral, oblique, midshaft, or proximal
Canada’s age of consent with exceptions
16 is age of consent
14-15: < 5 years older
12-13: < 2 years older
NO porn < 18
< 18 cannot consent if relationship of trust, authority, dependency, or exploitation
Treatment of urethral prolapse
Estrogen cream 2-3x daily for 3-4 weeks
Sitz baths
Manual lysis if failing medical therapy
Vaginal sarcoma
Grapelike mass of tumor through vaginal orifice (sarcoma botryoides)
Vaginal bleeding, obstruction of bladder or bowel
Will need chemo
Concerning bruises
TEN 4 FACES-P
Trunk, ears, neck
Frenulum, auricular area, cheek, eyes, sclera
Patterned bruising
In a child 4 years or younger
Any bruising on a child < 4 months
Most common intracranial hemorrhage from NAI
Subdural hemorrhage
4 normal findings on female genital exam
Hymenal notches and bumps
Intravaginal ridge
Failure of midline fusion
Partial dilatation of external anal sphincter
Signs suggestive of trauma on genital exam
Acute signs of injury or signs of healed injury
Hymena transection/complete cleft below 3-9 oclock position that extends to or through the base
2 findings with no consensus on significance on genital exam
Complete anal dilatation with relaxation of both sphincters without predisposing condition
Notch or cleft nearly to the base of the hymen at or below 3-9 oclock
Which children need a sketal survey
< 2 years or nonverbal children with concern for physical maltreatment
Consider between 2-5 years when strong history or concern
Concerning burn features
Clear delineation between burn/no burn
Uniform depth, deep
Stocking or glove distribution
No splash marks
Symmetric burns
Burns on buttocks or perineum
