Maltreatment

Question 1

Name 3 risks to children from physical punishment per CPS.

Answer 1

• Physical injury
• Poor mental health
• Impaired relationship with parents
• Weaker internalization of moral values, antisocial behavior
• Tolerance of violence in adulthood

Question 2

What is the leading cause of death for ages 1-19 years of age per CPS?

Answer 2

Unintentional injuries

Question 3

Name 3 red flags for inflicted injury in kids with bruising.

Answer 3

• Bruises in babies who are not yet cruising
• On the ears, neck, torso (chest, back, abdomen, genitalia), buttocks, feet
• When bruises are NOT in the front of the body and/or overlying bone
• Unusually large or numerous
• Clustered or patterned; positive imprint (shoe sole, iron, belt), negative imprint (parallel lines representing spaces between fingers)

Question 4

In what age group is it indicated to complete a skeletal survey if there is suspected physical abuse?

Answer 4

<2 years, consider in 2-5yo

Question 5

A 1yo has arm pain and you are suspicious of physical abuse. Aside from tenderness to the upper arm the physical exam in normal and they are well. A skeletal survey is done and found to be benign but your suspicion is HIGH for maltreatment. The concern has been reported and there is a safe plan in place for discharge. Which of the following is the next best step?
A. Follow up in 1 week for repeat physical exam/assessment
B. Consult endocrinology
C. 25-Vitamin D
D. Repeat skeletal survey in 2 weeks

Answer 5

If a skeletal survey is initially negative but suspicion is high for maltreatment, a repeat skeletal survey in 2 weeks is recommended for children <2 years

Question 6

A 12-13 year old can give consent for sexual activity with someone < __ years older.

Answer 6

2

Question 7

A 14-15 year old can give consent for sexual activity with someone < ___ years older.

Answer 7

5

Question 8

What fracture location has the strongest association with inflicted trauma?

Answer 8

Ribs