NAI_Flashcards

Question 1

What are some common presentations of non-accidental injury?

Answer 1

Bruising, broken bones, drowsiness (subdural haematoma), neglect (e.g., unkempt), failure to thrive

Question 2

What should be assessed to determine if the child is in danger?

Answer 2

Assess if the child, siblings, or parents are in danger. Make sure the child is in a safe place

Question 3

Who should be involved in cases of suspected non-accidental injury?

Answer 3

Senior colleagues, named doctor for child protection, social services (formal referral), police (Child Abuse Investigation Team - CAIT), Multi-Agency Safeguarding Hub (MASH)

Question 4

What investigations should be conducted in suspected non-accidental injury?

Answer 4

Skeletal survey, CT +/- MRI head scan, bloods and bone profile to rule out leukaemia, ITP, etc., ophthalmology referral (fundoscopy for retinal haemorrhages)

Question 5

What is the general rule if non-accidental injury is suspected?

Answer 5

It is always safe to admit the child

Question 6

Which conditions do not require school exclusion?

Answer 6

Conjunctivitis, slapped cheek syndrome (fifth disease), roseola infantum, infectious mononucleosis, head lice, threadworms

Question 7

What conditions require exclusion for 24 hours after starting antibiotics?

Answer 7

Scarlet fever

Question 8

What conditions require exclusion for 48 hours after starting antibiotics?

Answer 8

Whooping cough (if no antibiotics are given, exclude for 21 days from onset of symptoms)

Question 9

What conditions require exclusion for 4 days from onset of rash?

Answer 9

Measles, rubella

Question 10

What conditions require exclusion until all lesions are crusted over?

Answer 10

Chickenpox, impetigo

Question 11

What condition requires exclusion for 5 days from onset of swollen glands?

Answer 11

Mumps

Question 12

When can children with diarrhoea and vomiting return to school?

Answer 12

When symptoms have settled for 48 hours

Question 13

When can children with scabies return to school?

Answer 13

Until treated

Question 14

When can children with influenza return to school?

Answer 14

Until recovered

Question 15

What is the initial treatment for somatisation, chronic pain, or unexplained symptoms?

Answer 15

Primary care management with regularly scheduled visits. Schedule regular outpatient visits, acknowledge somatic symptoms, communicate with specialists, evaluate and treat diagnosable general medical diseases, limit diagnostic testing and referrals, reassure patients, explain the body’s ability to generate symptoms without disease, assess for comorbid psychiatric disorders, stop unnecessary medications

Question 16

What should be done for treatment-resistant patients with somatisation, chronic pain, or unexplained symptoms?

Answer 16

Continue to meet regularly with the patient, discuss the case with a psychiatrist

Question 17

What should be done next in cases where the cause of an injury is unknown?

Answer 17

Involve social services, child safeguarding team, and possibly the police. This is routine to ensure the child’s safety. Explain that similar injuries can sometimes be caused by someone else