Abuse, Neglect, and Sexual Assault -- SD

Question 1

Every ____ seconds a woman is battered or injured

Answer 1

9

Question 2

1 in ______ women in US report experiencing violence at some point in their life

Answer 2

4

Question 3

Women who experience domestic violence are at risk for experiencing/developing these four things

Answer 3

Stroke, heart disease, asthma, alcoholism

Question 4

What are common areas on the body for abuse?

Answer 4

Back of head, neck and shoulders, face, posterior arms, thighs, buttocks, back

Question 5

What are some injuries that signify “pattern of abuse”?

Answer 5

injuries inconsistent with history, multiple areas, different stages of healing, symmetrical bruising

Question 6

Should we use direct quotes from the victim when documenting?

Answer 6

yup

Question 7

If a patient is 33 and they’ve been assaulted, do we have to report it? What if the patient is 16?

Answer 7

If they are NOT a minor, they do not have to report. If they are a minor, we as providers HAVE to report.

Question 8

What is one of the most lethal forms of domestic violence?

Answer 8

Strangulation

Question 9

What is felt to be the best predictor of future homicide victims?

Answer 9

Strangulation

Question 10

What is the most common form of strangulation?

Answer 10

Manual

Question 11

What structure are typically affected from strangulation?

Answer 11

Cartoids, jugular veins, and tracheal occlusion

Question 12

Voice changes, difficult or painful swallowing, shortness of breath, and mental status changes, are all symptoms of?

Answer 12

Strangulation symptoms

Question 13

What is a complication of strangulation?

Answer 13

Delayed death; carotid dissection or stroke

Question 14

What are our best imaging options in terms of strangulation?

Answer 14

MRI or CDTA

Question 15

What is a SAFE?

Answer 15

Sexual assault forensic examiner

Question 16

Should we remove a patients clothing immediately if they are reporting sexual assault?

Answer 16

No – avoid removal of clothing unless acutely necessary

Question 17

True or false

the word “alleged” should be in the CC?

Answer 17

False – very false

Question 18

What should you do if a SAFE is not available?

Answer 18

Primary nurse and ED provider must work as a team to care for patient

Question 19

What should we offer any patient of child-bearing capacity after a sexual assault?

Answer 19

Pregnancy prophylaxis

Plan B or Ella

Question 20

What STD’s do we prophylactically treat for?

Answer 20

Trichomonas, Bacterial Vaginosis, gonorrhea and chlamydia, hep B, HIV

Question 21

What drug do we prescribe for Trich and BV ppx?

Answer 21

Flagyl

Question 22

What abx do we prescribe for gonorrhea and chlamydia?

Answer 22

Ceftriaxone and azithromycin

Question 23

What type of intercourse presents the highest risk of HIV transmission

Answer 23

anal

Question 24

Whats the biggest problem with HIV ppx?

Answer 24

Most patients stop taking the meds because of the extreme side effects

also hella expensive

Question 25

When do we consider HIV ppx?

Answer 25

When we KNOW there was unprotected intercourse, when we KNOW reception of seminal, vaginal, or blood occurred, and the victim is ready and willing to complete tx

Question 26

What are our two HIV ppx drugs?

Answer 26

Truvada and Kaletra

Question 27

If the assault happened 48 hours ago can we still give HIV ppx?

Answer 27

Yep -- not after 72 hours

Question 28

What are some long-term sequelae from sexual assault?

Answer 28

Depression, EtOH, PTSD, 13x more likely to attempt suicide

Question 29

If you suspect sexual assault you can do a forensic exam within _____ days for adults and _____ days for children.

Answer 29

5 days for adults 3 for kiddos

Question 30

True or False Its ok to use a speculum on a prepubescent child if you suspect assault?

Answer 30

FALSE

Question 31

PG testing and ppx should be offered to ANY female child with sexual development at this tanner stage and above?

Answer 31

Tanner stage 2

Question 32

Babies with low or high birthweight are more at risk for abuse?

Answer 32

Low

Question 33

what 3 exams should always be part of your physical exam if you suspect child abuse?

Answer 33

Fundoscopic exam Intraoral exam Anogenital exam

Question 34

Any bruise in an infant under ___ months without confirmed accident accounting for it is a concern for abuse

Answer 34

6

Question 35

Assymmetric, irregular borders are more likely to accidental or non-accidental?

Answer 35

accidental

Question 36

What two organs (in the abdomen) are most at risk for a child suffering from abuse?

Answer 36

Liver and small bowel

Question 37

What is the most common form of elder abuse?

Answer 37

Neglect