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Flashcards in Abuse/Neglect/Shaken Baby Deck (23)
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1
Q

What is the legal term for a report of child abuse or neglect? WHO, by law, is considered to be a MANDATED reporter?

-WHEN must a report be made?

A

51A report

  • anyone with a PROFESSIONAL responsibility for children (includes any/all docs)
  • where there is SUSPICION/reason to believe that a child has been abused/neglected
2
Q

potential consequence if you…

  • don’t report suspected abuse/neglect, child is INJURED:
  • don’t report suspected abuse/neglect, child DIES:
A

injured: license loss/fine
dies: license loss/fine, JAIL

3
Q

approximately how many kids DIE each year from suspected child abuse/neglect?

A

~1,500, give or take 100ish

4
Q

Most common fatalities:

  • boys/girls?
  • AA/white/hispanic?
  • more than 75% of deaths are under WHAT age?
A

white boys, usually LESS THAN 3 Y/O

5
Q

~80% of fatalities involved at least one ____

-another 15% of fatalities are performed by a perpetrator (with/without) a PARENTAL RELATIONSHIP to the child

A

PARENT

  • 15% WITHOUT parental relationship (but still known)
  • only 5% by UNKNOWN perpetrator
6
Q

About what percent of reported cases of abuse/neglect actually get “screened in”

A

~60%

7
Q

MOST COMMON type of maltreatment?

A

NEGLECT (75%)

17% physical abuse, 8% sexual abuse, 7% “other”

8
Q

for YOUNGER victims: boys/girls more commonly victimized?

for OLDER: boys/girls?

-who dies more? boys/girls?

A

younger: boys
older: girls (sexual)

boys die more

9
Q

Bruises (physical abuse) are concerning when they’re in multiple locations, unusual locations, and/or when they have WHAT characteristics?

A
  • different healing stages
  • oddly shaped
  • small, round, oval
  • @ corners of mouth, wrists/ankles
  • loop or linear shapes

-DON’T mistake for congenital mongolian spots, hemangiomas, accidentals, CT disorders, coining, or cupping (cultural)

10
Q

Sexual abuse:

1 in __-__ girls by 18Y/O
1 in __-__ boys by 18 Y/O
__% KNOW offender
__% are committed BY __, AGAINST ___

A

3-4
6-10
85%
96% men against women/children

11
Q

If you suspect ANY type of abuse, you have ___hrs to VERBALLY report, and ___hrs to submit a ____ report

-DCF (Massachusetts type of CPS) has __ days to investigate a 51A report that was screened in

A

24h verbal
48h written

10 days

12
Q

T/F: YOUR role is not to determine guilt, innocence, or outcome, but rather, to gather basic info and interview parent/child separately

A

true

-may sure to ask both parent/child (separately) - how it happened, where/what/when/who

13
Q

In most cases, you should tell the parent that you will be filing a 51a…EXCEPT in which circumstances?

A

DON’T tell parent you’re filing if:

  • domestic violence
  • kidnapping threat
  • guns/drugs in home
  • suicidal parent
  • parents w/ hx of threatening to harm child if tell, or if they abuse the child after report was made
14
Q

T/F: about 40% of cases are d/t false allegations by children trying to get their parents in trouble, or by docs that don’t like the parents

A

false. only ~1%.

15
Q

Most common intracranial hemorrhage in SBS?

Most common eye finding in SBS

Other classic signs of shaken baby syndrome?

A

SUBDURAL

RETINAL hemorrhaging (multi-layer)

-skeletal injuries, esp fractured RIBS, LONG bones in parents w/ an inconsistent hx and/or delay in seeking medical care

16
Q

One of the biggest triggers to SBS?

A

Prolonged crying

Mech: weak neck muscles can’t support head weight, angular acceleration/deceleration lead to shearing/traction on vitreoretinal adhesion sites

-NO surface impact necessary

17
Q

Symptoms of child w/ SBS are usually (delayed/immediate), and include what?

**most common misdiagnosis of SBS

A

IMMEDIATE - irritability, lethargy (or poor feeding), vomiting, bruising, seizures

-Viral gastroenteritis!! (general flu-like sx)

18
Q

T/F: mild/moderate abuse will likely lead to SBS sx/signs/retinal hemes?

A

FALSE. must be severe/serious car accident or significant fall onto hard surface/concrete

19
Q

Retinal hemorrhage ddx:

  • accidental trauma (severe only)
  • birth trauma: most hemes present d/t birth are gone by __ wks
  • CPR - key differential?
A

birth trauma: hemes gone by 6 wks

-CPR: hemes will only be 1 or 2

20
Q

Up to ___% of victims die from SBS injuries

-two common manifestations of abnormal visual fxn?

A

25% (1 in 4 die)

  • CVI, optic atrophy
  • note: amblyopia also possible if (+)vit heme lead to dense amblyo over long course
21
Q

How many cases of SBS are reported annually in the U.S.?

Typically, victims are how old?

A

1,000/year

22
Q

Other ddx for retinal hemorrhages:

A

accidental trauma, birth trauma (resolved in 6wks), CPR/Purtcher, terson, ruptured cerebral aneurysm, CNS infx, seizures, blood anomaly (anemia/leukemia)

23
Q

5 types of disclosure for a child to tell you they’ve been abused/neglected? (DTARR)

A

DTARR
Denial, tentative disclosure, active disclosure, recanting, reaffirmation

-AVOID these!