Spring 2011 Child Abuse Mch Final

Front 1

How many cases of
sexual abuse are reported by CPS each year?
What percent are girls?

Back 1

150,000

80%

Front 2

More often male than females and include parents
relatives
teachers
family members of the clergy
and other individuals who have access to children.

Back 2

Perpetrators

Front 3

Withdrawn
aggressive
angry
or depressed
or they may show no behavioral manifestation
Hyper sexualized behaviors
Unexplained vaginal
penile
or anal injury
or by the discovery of a STD

Back 3

Presentations of a child who has been sexually abused

Front 4

If no professional has spoken to the child about the abuse
or the child makes a spontaneous disclosure to the physician
the child should be interviewed with

Back 4

Questions that are open-ended and non leading.

Front 5

Diagnosis of sexual abuse can be made by the history obtained from

Back 5

The child

Front 6

In all cases
the child who is a suspected victim of sexual abuse should be questioned about what?
(2)

Back 6

Timing and symptoms such as bleeding
discharge
or genital pain.

Front 7

Physical exam should be complete with careful inspection of the

Back 7

Genitals and anus

Front 8

T or F:
Most sexually abused children have normal genital examination at the time of
medical evaluation

Back 8

T

Front 9

Most injuries are noted in children who report genital bleeding and present within how many hours of
their most recent assault?

Back 9

72

Front 10

Highest yields of
blood or semen come from

Back 10

The child's clothing or bed linens

Front 11

What do acute
unexplained lacerations or ecchymoses of
the hymen
posterior fourchette or anus
complete transaction of
the hymen
unexplained anogenital scarring
or pregnancy in an adolescent with no history of
sexual activity tell us?

Back 11

They are the most specific signs of
sexual abuse

Front 12

Sexual abuse should be considered in children who have behavioral problems
Is there a pathognomic behavior?

Back 12

No

Front 13

Neisseria gonorrhea
Trichomonas vaginalis
Chlamydia
and Herpes simplex
Blood testing for syphilis
HIV
HBV
HCV.

Back 13

Labs for suspected sexual abuse

Front 14

What finding should always raise suspicion in infants?

Back 14

Bruises

Front 15

Delayed medical care

multiple organ injury

Hx of
self-inflicted trauma does not correlate
w
child's developmental abilities

Hx of
Injury changes

Back 15

Clues that arouse suspicion for

Physical Abuse

Front 16

Clues from observing the child’s behavior that may provide supportive evidence for the diagnosis of
child abuse.

Back 16

Compliant
submissive
overly affectionate to the medical staff

Front 17

Universal findings in
Non abused children
but
among the most common identifiable injury
in
abused children.

Back 17

Bruises

Front 18

Common pediatric injuries
though 10% are a result of
abuse
Commonly they are scald injuries that have what characteristics?
(2 or 3)

Back 18

Clear lines demarcation

uniformity of burn depth

characteristic pattern.

Front 19

Certain fractures have a high specificity
for
Abuse

Such as?
(4ct)

Back 19

Metaphyseal
Rib
Scapular
Vertebral
Fractures.

Front 20

Occurs almost exclusively with abuse. Even in severe cases
there may be little or no bruising

Back 20

Injury to solid and hollow organs

Front 21

Omission that prevent a child's basic needs from being met.

Back 21

Child neglect

Front 22

May appear in the ED dirty
improperly clothed
and unimmunized
Their medical problems may not have been attended to in a timely manner
They may have suffered from burns or fractures because of
inadequate supervision.

Back 22

Child neglect

Front 23

Child neglect from early infancy also can result in the syndrome of
what?
Usually affects children younger than 3 years
although older children who remain in a non-nurturing environment show similar manifestations.

Back 23

Failure to thrive (FTT).

Front 24

Often brought to the emergency department because of
other medical problems
such as intercurrent infections; skin rashes
in particular severe monilial diaper dermatitis; or acute gastroenteritis.

Back 24

FTT patient

Front 25

When left alone
they assume a "straphanger's position
" with their arms flexed at the elbows and extended over their shoulders
Very little subcutaneous tissue
The skin of
buttocks hangs in loose folds
Muscle tone is usually increased

Back 25

FTT

Front 26

The first and second leading causes of
mortality from physical abuse

Back 26

Head injury and abdominal trauma

Front 27

Shaking
blunt trauma to the head
Usually precipitated by the perpetrator's intolerance to crying
Present with sx ranging from lethargy to coma
This is missed 25% of
the time by physicians.

Back 27

CNS trauma