LEcture 17: Child Abuse & Neglect Flashcards
T/F: Failure to act falls under child abuse.
True
T/F: Neglect due to lack of financial means still falls under child abuse
False
Thats what im guessing?
T/F: Sexual contact under sexual abuse applies even if victim is married to the actor.
False
If i am misinterpreting pls lmk
80% of child abuse deaths occur to children younger than () years
4 years old
T/F: Referral and CPS contact means a child is extremely unlikely to die from child abuse.
False
Who is required to report child abuse?
ANYONE who suspects it!
She wrote anyone, but then had this slide after.
Failure to report suspected child abuse is a (misdemeanor/felony) in 40 states
Misdemeanor
Can upgrade to felony if child is harmed and you shouldve suspected.
Although abuse is very tragic, we do need to keep in mind that ()
Not all abusers do it intentionally
One of the biggest common historical features seen in child abuse is that there was a () in seeking care
delay
The two biggest red flags of child abuse seen are () of care and () injury
- Delay of medical care
- Unwitnessed injury
The MC form of child abuse is ()
Neglect
75%+ of reported CPS cases
The #1 way children are neglected is via…
Inadequate supervision
Used to be FTT
Child neglect should always be reported to () and any child experiencing FTT should be ()
- Report to CPS
- Hospitalize FTT kids
Also educate parents, maybe they are first-time and really clueless
Children who return to their families after an event of maltreatment can have up to a 50% chance of recurrent events. The recurrent abuse type is ()
Neglect again :(
The most common perpetrators of physical child abuse are…
Biological parents, esp fathers (abusive head trauma)
Mother’s BFs, female sitters, then mothers
Physical abuse is slightly different than discipline because discipline is (), it is not due to (), and it is not to keep their child in line.
- Discipline is usually predictable
- It usually is not due to anger
The MC physical finding seen in child abuse is…
Bruises (esp weird ones)
Sentinel injuries can be memorized by the mnemonic TEN-4, which means:
- Trunk
- Ear
- Neck
- In any child less than 4 months = suggestive of abuse
A child cannot roll over prior.
The most common isolated fx in child abuse is…
Femur
Fx of what bone is pretty indicative of abuse?
Rib fx
71%
The most normal bruising areas in a child that are NOT suspicious would be
- Elbows
- Shins
As long as they are a toddler or older
The most common fx seen on XR in physical abuse is…
Spiral or transverse fx of the diaphysis of long bones.
In a patient 2 years or younger with a suspicious fx, the imaging of choice is…
Skeletal survey
A child suspected of being a victim of physical abuse might need labs ordered, such as: (2)
- CBC/Coags
- ALT/AST/Lipase (internal injuries)
One of the biggest red flags when it comes to interviewing a child is ()
A parent who won’t let the child interview alone
T/F: Sexual abuse also includes exposing a child to sexual situations/abusive materials
True
Flashing, undressing, showing porn, or saying dirty jokes
Gonorrhea/Syphilis is diagnostic of sexual abuse after the () period
Perinatal period
Chlamydia, Trich, and HIV is only diagnostic of sexual abuse if the mother had ()
A prenatal care workup.
The presence of these (4) STDs is not automatically diagnostic of sexual abuse.
- HSV
- HPV
- BV
- Molluscum
The main factor in deciding whether you go to the ED vs sexual abuse clinic for sexual abuse management is…
120 hours or less = ED
And always refer to CPS!
Im guessing high suspicion but 120+ hrs is still sexual abuse clinic
T/F: You should always perform a speculum exam in all cases of sexual abuse.
False. Only if active bleeding.
The anogenital area for a child is best viewed in the () position
Knee-chest
A rape kit is needed if sexual abuse occurred within the past () hours
120 hours
Otherwise culture G/C and evaluate for trichomonas
Sexual assault cases require serum testing for (3) STDs at baseline, 3 months, 6 months, and 12 months
- RPR (syphilis)
- Hep B
- HIV
Sexual abuse requires () prophylaxis, but () and () are only for high risk.
- Always do STI prophylaxis with Rocephin + Metro + Azithromycin
- Hep B with Ig for high risk
- HIV for high risk
Also pregnancy prevention if its been less than 120 hours.
Generally, the first-line treatment for emotional child abuse is…
Parental education
Can also refer to psychologist and psychiatrist.
CPS only for extreme cases
The most common perpetrator of Munchausen by Proxy is…
Mother
85% of the time!!!!!!!!!!!!!
Munchausen by Proxy can be characterized by a child’s symptoms () in the hospital, but () at home
Improving in the hospital, but worsening/recurring at home
Generally, the primary way to prevent child abuse is…
Parent education!
If you suspect child abuse, you should call (3)
- Police
- CPS
- Hospital personnel
Any sort of injury on the () is suspect
Ear
