Paediatric forensic medicine Flashcards

1
Q

Act concerning birth etc

A

Births and Deaths registration act No 51. of 1992

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2
Q

Define a major

A
  • any person who has attained the age of 21 years or who has been declared to be a major (under 21 who is legally married)
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3
Q

Define birth

A

the birth of a child born alive

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4
Q

Define corpse

A

Any dead human body, including the body of any still-born child

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5
Q

Define still-born

A

Has had at least 26 weeks of intra-uteirne existence but showed no sign of life after complete birth

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6
Q

How does the criminal procedure act relate to children and birth?

A

Can be charged with murder or culpable homicide if a child that has breathed, was exposed, the birth concealed or if the body was disposed in order to conceal the fact of its birth

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7
Q

Define infanticide

A

The intentional killing of a newly-born child

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8
Q

Things that are important at autopsy in cases of infanticide

A
  • whether the infant reached 26 weeks
  • whether it breathed
  • how long it lived
  • cause of death
  • if stillborn, why?
  • how long had it been dead when found
  • identity of child and mother
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9
Q

How to estimate gestational age according to body length

A

Use the square root (up to 25cm)

if more than 25, divide by 5

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10
Q

When do ossification centres close?

A
  • calcaneum 5 months
  • talus 7 months
  • distal epiphysis of femur 9 months
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11
Q

How to identify lungs that have breathed

A
  • mottled with round edges
  • fill pleural cavity and overlap heart
  • crepitate on palpation
  • hydrostatic test
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12
Q

Typical parents involved in child abuse

A
  • early twenties
  • removed from family ties
  • father often not biologic with criminal tendencies
  • one parent battered as a child
  • lack of remorse
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13
Q

Statory obligations for reporting of abused or neglected children

A
  • any person who suspects must report and substantiate their report
  • professionals are obliged to report
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14
Q

In terms of Children’s Act, a child in need of care and protection is identified as the following:

A
  • abandoned or orphaned child without support
  • displays behaviour that cannot be controlled by parent
  • lives and works on the streets or begs for a living
  • addicted to a dependence producing substance
  • has been or currently exploited
  • lives in or exposed to circumstances that may harm physical, mental or social well-being
  • state of physical or mental neglect
  • being abused, maltreated, neglected or degraded
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15
Q

Tell-tale signs of battered child at autopsy

A
  • small tears at ear lobe, alae of the nose, frenulum of the upper lip
  • cigarette burns
  • bruises, lacerations and abrasions of varying ages
  • evidence of fractures of bones and long bones
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16
Q

Possible causes of SUDI

A
  • natural (obvious/obscure)
  • non-natural (non-accidental/accidental)
  • totally unexplained
17
Q

Definition of SIDS

A
  • the sudden death of an infant under 1 year that is unexplained after a thorough case investigation including performance of a complete autopsy, death scene exam and review of clinical history
18
Q

Pathogenesis of SIDS

A
  • vulnerable infant
  • critical developmental period
  • exogenous stressor
19
Q

How can the umbilical cord be used to determine when a newborn died?

A
  • dessication 24hrs
  • inflammation 40hrs
  • ulceration 60hrs
  • separation 6-9 days
20
Q

Possible causes of death in stillborn children

A
  • placental
  • maternal
  • fetal
21
Q

Peak incidence of SIDS

A

2-4 months

22
Q

Babies more at risk of SIDS

A
  • male
  • twin
  • low birth weight
  • premature
  • disadvantaged
  • maternal and paternal smoking
23
Q

Autopsy findings in SIDS

A
  • froth at lips and nostrils
  • normal external exam
  • petechial haemorrhages in visceral pleura and epicardium
  • moderate pulmonary oedema
24
Q

Highly suspicious fractures for child abuse

A
  • metaphyseal fractures
  • posterior rib
  • scapular
  • spinous process
  • sternal
25
Q

Suspicious fractures of child abuse

A
  • multiple
  • different ages
  • epiphyseal separation
  • vertebral body
  • complex skull fractures
26
Q

Evidence of abuse in long limb fracture types

A
  • corner fractures
  • epiphyseal injury
  • bucket handle
  • spiral/ oblique fractures
  • periosteal lifting
27
Q

Suspicious skull fractures in children

A
  • non-parietal
  • bilateral
  • cross suture lines
  • diastatic fractures
28
Q

Types of burns seen in child abuse

A
  • scalds
  • contact
  • flame
  • cigarette
  • electrical
  • chemical
  • friction
29
Q

Characteristics of shaken baby syndrome

A
  • acute encephalopathy
  • SDH
  • retinal haemorrhages
  • cerebral oedema