Child Psychiatry: Child Abuse Flashcards
1
Q
- What are the 4 General Principles Concerning the Rights of the Child/Children
A
- All children should not be discriminated
- Children have a right to survival and development in all aspects of their lives
- Best interests of the child must be a primary consideration in all decisions and actions affecting the child
- Children should be allowed to express their Opinions
2
Q
- The law which protects Children against
Child Abuse
A
RA 7610
3
Q
- Known as the Child and Youth Welfare Code
A
PD 603
4
Q
- T or F. PD 603 enumerates children’s rights and it is more comprehensive than RA 7610
A
False. PD 603 enumerates children’s rights but RA 7610 is more comprehensive.
5
Q
- Physicians should report case of child abuse within this time period. Failure to report will held him/her liable.
A
48 – 72 Hours
6
Q
- T or F: Failure to render immediate treatment to a child is not a form of child abuse but rather a neglect of duty
A
False. It is a form of Child Abuse.
7
Q
- Beating your child even just once can already held you liable for abuse
A
True
8
Q
- T or F. Physical discipline such as spanking or paddling is not considered abuse as long as it is reasonable and causes no bodily injury to the child
A
True
9
Q
- Factors in Interviewing a child who is a victim of abuse
A
Language level, Cognitive development, Chronological (storytelling) Capacity, Reluctance to disclose
10
Q
- T or F. Chronological and Detailed information given by the child will increase the veracity of the story and the accuracy of the incident.
A
False. Physician should doubt the veracity of the story if it is too detailed or chronological in order. One should suspect that it is a fabricated story since children are not usually capable of giving such details.
11
Q
- T or F. Children are usually able to make associations between incidents rather than dates.
A
True.
12
Q
- What are the DON’TS or things that physician should AVOID in conducting an interview with a child
A
- Allowing the child to feel in trouble or at fault
- Criticizing the child’s choice of words or language
- Probing or pressing for answers that child seems unwilling to give
- Suggesting an answer to the child
- Displaying shock or disapproval of the parents, the child or the situation
- Forcing the child to remove clothing
- Conducting the interview with a group of interviewers
- Leaving the child alone with a stranger
13
Q
- What are the things that physician should DO in conducting an interview with a child
A
- Making sure that the interviewer is someone the child trusts.
- Conducting the Interview in private
- Sitting next to the child and not across the table or desk
- Asking the child to clarify words/terms that you do not understand
- Being supportive
- Stress that anything that happened was not the child’s fault
- Tell the child if any future action will be required
- Be truthful, do not make promises that you cannot keep
14
Q
- Red Flags in the interview or assessment of child abuse
A
- There is a discrepancy between history given and injuries sustained
- The oral history is incompatible with the child’s development
- The story changes or varies
- There was unreasonable delay before seeking care
- The parent or caretaker denies that there is an injury
- Hostile behavior of parent/caretaker towards the child
15
Q
- Risk Factors of Physical Abuse
A
Prematurity, Intellectual Disability and Physical Handicap
16
Q
- Most common form of injury seen in physical abuse
A
Bruising
17
Q
- Give example of behaviors that can be observed in physically abused children
A
- Wary of Physical Contact
- Show no expectation of being Comforted by Adults
- Alert for danger
- Continually size up the environment
- Afraid to go home
18
Q
- Physically abusive parents may show these following behaviors
A
- Feel significant guilt
- Delay seeking help for the child’s injuries
- Fearful that the child will be taken away
- Implausible or Incompatible history of the child’s injury with the result of physical findings
- Blaming the sibling, or claiming that the child injured themselves
- History of abuse in their own early lives
- Lack of empathy for the child
- Unrealistic expectations of the child
- Impaired parent – child attachment
19
Q
- A red or purple bruising which is swollen and tender to touch is a hematoma present for how long
A
0 – 48 Hours.
20
Q
- A 2 – 3 days old hematoma will appear with this color
A
Purple or Bluish
21
Q
- A 4 – 7 day old hematoma will most likely show this color
A
Green or Yellow.
22
Q
- Brown colored hematoma have been present for how long
A
> 7 Days
23
Q
- Normal Bruising Areas
A
Elbows, Knees and Shin
24
Q
- Suspicious Bruising Areas
A
Back, Buttocks, Back of Thighs, Back of Calves
25
Q
- Red Flags of Abusive Burns
A
- Located in the dorsum of Hands, feet and Anogenital area
- Repeated burns
- Symmetric or Patterned burns
- Uniform thickness and Clear border
- Delay in seeking care
26
Q
- Single burn that diminishes in intensity from point of contact
A
Splash Injury
27
Q
27 . This injury result from immersion into hot liquid or steam. Some areas of skin are spared by flexion
A
Scald Injury
28
Q
- These are specific fractures in a child below 18 months
A
- Metaphyseal – epiphyseal
- Thoracic cage (Posterior Ribs)
- Shoulder (Scapula)
- Clavicle (Medial or Lateral)
- Vertebral Body (from lateral compression)
29
Q
- These are non – specific fractures
A
- Diaphyseal shaft of long bones
- Clavicular, Midshaft
- Skull, Linear
30
Q
- Highly Suggestive Fractures
A
- Multiple, Bilateral, Symmetric
- Repetitive, Different ages
- Complex Skull Fracture
- With Intracranial, visceral Injury
31
Q
- Mechanism of Injury in Spiral Fracture
A
Twisting of the extremities
32
Q
- This refers to different rates of hair growth. Usually result of hair pulling
A
Trichotillomania
33
Q
- This variation of prepubertal hymen can be mistaken as an injury due to abuse
A
Fimbriated and Cribriform
34
Q
- T or F. Vaginal discharge is specific for sexual abuse that’s why it is examined in children who are suspected to be a victim.
A
False. Not all discharges are specific for sexual abuse. It will depend on the kind of discharge
35
Q
- If you examined a child with purulent vaginal discharge, the most probable cause would be
A
Infection (Gonorrhea)
36
Q
- Fishy odor vaginal discharge is indicative of
A
Bacterial Vaginosis
37
Q
- Suspicious Genital Findings
A
- Narrow Inferior hymen (< 1mm)
- Notch in inferior hymen
- Local Erythema or Abrasions within vestibule
- Presence of STI’s
38
Q
- Genital Findings that are Clear Indications of an abuse
A
- Complete absence of hymen down to the vaginal wall
- Recent partial or complete transection or laceration of hymen or anus
- Presence of sperm, gonorrhea or syphilis
39
Q
- Genital Findings that are indicative of Chronic Abuse
A
Scarring or Attenuation of Posterior rim of Hymen, Distortion of Hymen Orifice, Scarring and adhesion of labia, lateral scarring and adhesion, redundant hymen, patulous anus and loss of sphincter tone
40
Q
- The result of local study about abuse showed that the median age of physical abuse victims is
A
15 years
41
Q
- Median age of sexual abuse victims
A
12.33 years
42
Q
- Median age for perpetrators of sexual and physical abuse
A
25 years
43
Q
- Most of the victims belonged to a family size of
A
4 – 6 children
44
Q
- It has also been found out in this study that the frequently abused child is
A
Middle Child
45
Q
- Most common abuser
A
Neighbors. Followed by Father of the victim
46
Q
- A preschool children will show these signs of trauma
A
- Fearing separation from parents or caregivers
- Crying/Screaming a lot
- Eating poorly and losing weight
- Having nightmares
47
Q
- Elementary School Children will show these signs of trauma
A
- Becoming anxious or fearful
- Feeling guilt or shame
- Difficulty concentrating
48
Q
- Middle and High School Children will show these signs of trauma
A
- Feeling depressed or alone
- Learning disorders and self – harming behaviors
- Beginning to abuse alcohol and drugs
- Becoming sexually active
49
Q
- T or F. Emotional abuse is the most difficult to defend in the court and is the most detrimental to the child
A
True
50
Q
- What are the components of Child abuse Accommodation Syndrome
A
Secrecy, Helplessness. Entrapment and Accommodation, Delayed Unconvincing Disclosure, Retraction of Statements
