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Peds Exam 2 > Lecture 2: Psychosocial Issues > Flashcards

Lecture 2: Psychosocial Issues Flashcards

1
Q

What is failure to thrive

MC cause

A

Physical sign of inadequate nutrition

MC causes = psychological (not medical)

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2
Q

What 3 the long term sequelae of FTT?

A
  1. cognitive deficits
  2. Marasmus
  3. Kwashiokwor
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3
Q

What is diff b/t Marasmus and Kwashiokwor? end results of each?

A 
Marasmus = lack of protein + calories--> wasting 
Kwashiokwor = lack of protein --> edema
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4
Q

4 possible causes of FTT

A
  1. Not enough food (intake/offered)
  2. Emesis
  3. Malabsorption
  4. Incr metabolic demand
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5
Q
  1. poor hygiene
  2. inapprop/ill fitting clothes
  3. left alone w/person not able to provide supervision
  4. lack of necessary medical Tx
A

Physical signs of neglect

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6
Q
  1. chronic hunger/sleepy
  2. delayed speech/development
  3. clinging behavior/indiscriminate attachments
  4. freq complaints “feel unwell”
  5. freq school absences or tardiness
A

Behavioral signs of neglect

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7
Q

definition of sentinel injuries

MC type? MC locations for abuse

Note: often Hx of prior MISSED sentinel events

A

EARLY warning sign of potential abuse

MC = bruise
- intraoral injury

MC locations = head/face*, arms and legs

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8
Q
  1. attempt to hide injuries
  2. difficulty sitting/walking
  3. wary of physical contact w/adults
  4. reluctance to o home
  5. depression, self-mutilation
  6. fear of parents/caregivers
A

Signs of behavioral abuse in older child

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9
Q

Age group w/highest rate of abuse/maltreatment

why?

A 
Young kids (esp < 1)
- infants have complete dependence, cant get away
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10
Q

When should there be incr suspicion for sentinel injury (3)?

A
  1. Lack of or changing Hx
  2. Hx inconsistent (w/ dev stage, type/severity of injury)
  3. Inapprop delay in seeking care
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11
Q

4 Components of Occult Injury survelliance?

A
  1. Head CT
    - kids < 6 mo or abn neuro findings
  2. Skeletal survey
    - kids < 2 (repeat 2 wk later)
  3. Dilated ophthalmic exam
    - if suspect abusive trauma
  4. screen for predisposing conditions
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12
Q

Do providers need Dx certainty before reporting child abuse?

Are providers required by law to report child abuse?

A

NO

YES - to child protective services

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13
Q

What are possible consequences of failing to report suspected child abuse

A
  1. child’s safety compromised
  2. fines/criminal persecution
  3. lose medical license
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14
Q

Pnemonic FRAMER stands for what regarding child abuse?

A
  1. Facts
  2. Required to report
  3. Assessment
  4. Menu
  5. Empathy
  6. Report Back
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15
Q

definition of Factitious Disorder by Proxy (FDP)

A

parent/caregiver falsely brings kid to medical attention

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16
Q

3 clues/situations when to consider FDP

A
  1. Sxs repeatedly noted only by 1 parent
  2. Testing fails to confirm dx
  3. approp Tx = ineffective
17
Q

Who is often the person responsible for FDP

A

MC = mother/female caregiver

18
Q
  1. unusually calm or very demanding/angry
  2. highly attentive (dont want to leave child)
  3. form close relationships w/healthcare team
  4. interest in child’s condition but distant emotionally
  5. background/interest in healthcare
  6. Sxs/signs dont occur in absence of caregiver
  7. PMH unexplained medical illness/Sxs
A

Parental features of FDP

19
Q

How to manage FDP

A

child abuse, child protective services, +/- out of home placement

Peds Exam 2 (9 decks)

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