Safeguarding

Question 1

What investigations are done for safeguarding?

Answer 1

Skeletal survey
Ophthalmology review (retinal haemorrhages)
Metabolic testing (exclude glutamic acuduria)
Testing of blood coagulation

Question 2

What are the different types of child maltreatment?

Answer 2

Physical
Emotional
Sexual
Neglect
Factitious

Question 3

What features in the history suggest NAI?

Answer 3

No mechanism
Delay
Inconsistency
Recurrent injuries

Question 4

What fractures suggest NAI?

Answer 4

Metaphyseal
Posterior ribs
Complex skull fractures
Long bone shaft fractures in a non-mobile child

Question 5

What bruises suggest NAI?

Answer 5

Face, back, buttock
Outline of an object
Pattern of bruising

Question 6

What burns suggest NAI?

Answer 6

Uniform shape

Glove-stocking distribution

Question 7

What clinical features may a baby with a non-accidental head injury show?

Answer 7

Irritability 
Poor feeding 
Seizures
Reduced GCS
Full fontanelle 
Anaemia

Question 8

What is a child protection medical assessment?

Answer 8

Requested by social services
Registrar or above 
Full history and exam 
Growth chart 
Observations
Body map
Photography

Question 9

What are the differential diagnoses for fractures?

Answer 9

Osteogenesis imperfecta
Copper deficiency
Vit D/C deficiency
Ehlers Danlos

Question 10

What are the differentials for burns?

Answer 10

Bullous impetigo

Scalded skin syndrome