PSYCHOSOCIAL ISSUES AND CHILD ABUSE

Question 1

Factors that determine the understanding of death and expression of grief

Answer 1

Chronologic age and levels of cognitive development

Question 2

What does exposure to high levels of parental conflict lead to?

Answer 2

Predictive of poor emotional adjustment by the child regardless of the parents’ marital status

Question 3

What are the most helpful measures for children in cases of divorce?

Answer 3

Regular schedule with flexibility Consistency with structure and routine Cooperative co-parenting

Question 4

Consequences of divorce on a child’s emotional adjustment

Answer 4

May affect his/her subsequent intimate relationships

Question 5

Consequences of adoption on children from institutional or orphanage care

Answer 5

A higher risk of medical and developmental problems than their counterparts who have resided in foster care

Question 6

Child is being placed in foster care; how soon should this child be evaluated by a provider?

Answer 6

Initial visit should take place within 72h after placement in the foster care system

Question 7

TV watching is not recommended at what age?

Answer 7

Children younger than 2years of age

Question 8

How long should children 2years and older be allowed to watch TV?

Answer 8

2h/day or less for all children, including other forms of screen (solitary TV watching is highly discouraged)

Question 9

Increased aggressive behavior and acceptance of violence, obscuring of the distinction between fantasy and reality, trivialization of sexuality are effects of

Answer 9

Excessive media time

Question 10

One of the most common causes of school refusal in children

Answer 10

Separation anxiety disorder

Question 11

A set of clinical features in which unfounded parental anxiety about the health of a child results in disturbances of the parent–child interaction

Answer 11

Vulnerable child syndrome

Question 12

At what age should discussions start regarding transition of care for adolescents and young adults with chronic medical conditions?

Answer 12

Around 12years of age

Question 13

A child tends to have asynchronous developmental patterns, very advanced in one domain area compared to the rest

Answer 13

Gifted child

Question 14

Maternal depression, substance use/abuse, and physical injuries

Answer 14

May indicate intimate partner violence

Question 15

A frequent risk factor for child abuse

Answer 15

Intimate partner violence

Question 16

Consequences of children who are exposed to corporal punishment and intimate partner violence

Answer 16

More likely to exhibit aggressive/violent behaviors than other children

Question 17

What is the most common form of child abuse?

Answer 17

Neglect

Question 18

What is the most common presentation in an abused child?

Answer 18

Asymptomatic—just because there are no physical signs does not mean that the child has not been abused

Question 19

What is the most common cause of head injury in a child less than 1year of age?

Answer 19

Child abuse

Question 20

A 3-week-old girl presents to ER with lethargy, poor sucking, and retinal hemorrhages; mother stated the child rolled over and fell from the bed. What is the most likely cause?

Answer 20

Abusive head trauma (shaken baby syndrome)

Question 21

What are the consequences of child abuse during early development?

Answer 21

Physiologic and anatomic changes in the brain, increased risk of physical and behavioral problems

Question 22

Parents or guardians who failed to provide adequate medical care for a child, e.g., refused to administer medications for a serious medical condition

Answer 22

Medical neglect

Question 23

Parents or guardian fail to provide basic needs (nutrition, shelter, clothes) or who abandon the child

Answer 23

Physical neglect

Question 24

Parents or guardian fail to enroll the child in school or provide homeschooling, allow frequent absenteeism, or ignore special education needs

Answer 24

Educational neglect

Question 25

Parents or guardian isolate the child, withhold emotional support, expose the child to interpersonal violence or substance abuse, e.g., fight or engage in sex in front of the child

Answer 25

Emotional neglect

Question 26

Parents or guardian leave the child alone or improperly supervised, fail to keep the child from safety hazards, e.g., leaving strong chemicals open and not safely secured in the house

Answer 26

Supervision neglect

Question 27

Posterior rib fracture, bucket handle fracture, femur fracture in child less than 1 year old, distal humeral physeal fracture, and humeral shaft fracture in child less than 3 years old are high suspicion of

Answer 27

Child abuse

Question 28

Bucket handle fracture (also known as a classic metaphyseal fracture or metaphyseal corner fracture) in infants

Answer 28

High specificity for child abuse. It may occur with shaking, vigorous pulling or twisting of an infant’s extremity

Question 29

What is the next best step with any suspicion of child abuse in a child less than 2 years of age?

Answer 29

Skeletal survey

Question 30

Difference between bucket handle fractures and buckle fractures

Answer 30

Fracture of the distal radius (buckle fracture) is common and is not associated with child abuse

Question 31

A 7-month-old healthy infant with a few bruises on arms and legs

Answer 31

Must be evaluated for child abuse and reported to child protective services

Question 32

A 7-year-old healthy child with multiple bruises on both tibial shins and elbows

Answer 32

Reassurance

Question 33

Entire foot is burned, with a well- demarcated line of injury around the leg and absence of splash marks (stocking distribution)

Answer 33

Child abuse (possible forced immersion into hot water)

Question 34

Entire hand is burned, with a well- demarcated line of injury around the forearm and absence of splash marks (glove distribution)

Answer 34

Child abuse (possible forced immersion into hot water)

Question 35

What is the most common physical examination finding in a child with sexual abuse?

Answer 35

Normal examination

Question 36

Physical contact between the victim and the perpetrator, with or without oral, anal, or vaginal penetration

Answer 36

Child sexual abuse

Question 37

Which gender is less likely to disclose sexual abuse and might be victimized more often than the reported ratio

Answer 37

Boys

Question 38

A 16-year-old adolescent presents to the ER due to a sexual assault that occurred 1 day ago, what should be done?

Answer 38

SANE exam—should be done by a specialized nurse. The cutoff for exam 72–120 h (within 5 days)

Question 39

What is the SANE exam?

Answer 39

Exam performed by a Sexual Assault Nurse Examiner who examines the victim of sexual assault and collects all forensic evidence

Question 40

A healthy child with multiple recurrent ER visits; the mother is a healthcare professional who demands tests and imaging with each visit; before discharge patient’s blood glucose is 40 mg/ dL. Further evaluation shows high serum insulin level and absence of serum C-peptide level

Answer 40

Caregiver-fabricated illness