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19 Cards in this Set

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  • Back
What is domestic violence
Intentional control or violent behavior by a perpetrator with an intimate relationship with the victim
Types of abuse?
-Verbal
○ Intimidation
○ Physical
○ Social isolation
○ Sexual
○ Economic control
What is the main issue with (central of focus domestic violence)
power and control
What are some clinical signs of domestic abuse?
- inadequate explanation of injury
○ Central bruising
○ Defensive wounds
○ Oversolicitous partner
○ Difficulty with GYN exams
% of women presenting to ER threatened ro injured at some point in life by partner?
50% only 9% present for fthese problems
a. % of women sexually assaulted
b. % of women less than 21 sexually assaulted
c. % sexually assaulted woman sustaining injury?
d. % mortality rate
 40% of woman have been sexually assaulted
 20% of woman less than 21 have been sexually assaulted
 40% of sexually assaulted women sustain injury
 1% mortality rate
What are the three cycles of violence?
1. calm phase
2. explosive phase
3. tension building phase
What are the SAFE questions?
 Safety – Do you feel safe in your relationship?
 Afraid/Abused – Have you ever been in a relationship where you were threatened ,hurt or afraid?
 Friends/Family – Are your friends or family aware that your have been hurt? Could you tell them and would they be able to give you support?
 Emergency plan – Do you have a safe place to go and
the resources you need in an emergency?
How do you bring up the abuse questions? Important questions?
introduce the subject of abuse in general way alone
At any time has a partner hit kicked or otherwise hurt or threatened you?
What should u do to comfort and instruct pt with abuse?
1. make sure they know they are not alone, help is available, make sure they know their partner's behavior is unacceptable
2. Notify SSW and Safe HOME
3. supply safety plan and restraining order
Differ assaut vs rape?
rape= penetration
First thing you have to do to when suspected violence?
- request to call police... don't leave person alone take samples (usually take 2 hrs)
What can DNA be obtained from in rape?
 Saliva
 Blood
 Fingernail scrapings
 Bed sheets
 Underclothes
 Hard surfaces
 Condoms
Medical treatment for sexual assault/ rape is for?
 Gonorrhea
 Chlamydia
 Wet smear for trich or sperm
 Bacterial vaginosis
 HIV
 Syphyllis
 Hepatitis B
 Tetanus
 Pregnancy
If raped what is protocol for HIV prophylaxis?
 Side effects can be significant
 Zidovudine (AZT) 200mg po every 8hrs for 4 weeks
- Lamivudine (Epivir) 150mg  BID for 4 weeks
Treatment for human bits?
Augmentin- 875 BID for 3 days (amoxicillin and clavulanate)
- tentanus
MCC drug facilitated sexual assault?

What is a roofy?
alcohol

- what your sister likes to drink... jk but seriously Flunitrazepam (Rohypnol)- a Benzodiazepines
Post traumatic stress disorder phases?
1. acute and disorganization phase- lasts days to weeks
2. integration and resolution phase- changes in life, nighmares, phobic reactions, flashbacks that occur at GYN exams, decreased libido, secondary anorgasmia and vaginismus
What the ACOG and AMA guidlines for pregnant women and domestic violence?
Physicians should routinely assess all pregnant women for domestic violence. The clinician should be aware of characteristics of abuse such as bruising, improbable injury, depression ,late prenatal care, and missed prenatal appointments