Schmidt: Child/Elder Abuse

Question 1

Risk factors for child maltreatment

Answer 1

Fussy infant

Behavior problems

Illness

Non-biological relation

Prematurity

Substance abuse (of caregiver)

Question 2

What is the most common cause of death in abused children?

Answer 2

Neglect: failure to provide for the child’s basic needs (delay of medical care)

Question 3

Doc’s role when suspecting child neglect?

Answer 3

Full medical hx

Psychosocial hx

Complete physical exam

Contact CPS

Question 4

Signs of physical child abuse on PE?

Answer 4

Posterior rib fractures

Scapular fracture

Spinous process fracture

Sternal fracture

Cigarette burns

Metaphyseal lesions: numerous bone lesions

Question 5

What is the avg age of children who are sexually abused?

Answer 5

9-12yrs old

50-70% of victims never tell anyone

Question 6

What is the best practice to work up a sexually abused child?

Answer 6

Refer to forensics for interview (CPS)

If immediate info is needed, do Minimal Facts interview

Question 7

What are some high risk populations for sexual abuse?

Answer 7

Deaf kids - 50%

Disabled adults - 83% are female

Transgender - 50% are victims as kids & adults

Question 8

What are the repercussions for not reporting child abuse in MO and KS?

Answer 8

MO = Class A misdemeanor

KS = Class B misdemeanor

Question 9

What are some risk factors of elder abuse?

Answer 9

Dementia

Physical dependence

Incontinence

Perpetrator characteristics = substance abuse

Question 10

What are some signs of elder abuse?

Answer 10

Neglect = under-nourished, poor personal care, lack of medical care

Bruises = bilat and inner surface of arms

Burns = cigarette

Fractures = in different healing stages, spiral fx

Other = rope burns, mouth injuries, dec personal finances