Child Maltreatment MCQ Flashcards
(30 cards)
Most concerning bruises in an 11-month-old?
A. Forehead
B. Chin
C. Sternum
D. Knee
Sternum
18 month old with spiral femur fracture. Parent say he tripped over a toy. Next step?
A. Call CAS
B. Do nothing
C. OI work up
Do nothing
10 month old male present to ED with bilateral burn in symmetric glove distribution. Mother said he touched radiator in living room. Patient is irritable but otherwise normal exam besides the burn. What is your next investigation after wound care?
A. Skeletal survey
B. Ophthalmology assessment
C. MRI brain
D. No further investigations
Skeletal survey
What is the biggest risk factor for abusive head trauma?
A. Prematurity
B. Jealous sibling
C. Single parent
D. Colic
Colic - think “purple cry”. Head injuries can happen from that impulsive decision to “shake the baby”
12 year old female discloses she was sexually assaulted by her coach 9 months ago. Which finding is most consistent with external genital penetration
A. A complete cleft in the posterior hymenal ring
B. A complete cleft in the anterior hymenal ring
C. A hymenal tag at 3 o clock
D. A complete cleft at 12 o clock.
A complete cleft in the posterior hymenal ring
4 year old boy with cerebral palsy presents with multiple bruises. The kid lives with his mom and grandparents. Mom is unemployed and takes care of the kid during the weekdays. His parents watch him on nights and weekends. Which of the following is the MOST protective factor against NAI?
A. Child has CP
B. Lives in a small town
C. Mom has a high school education
D. Lives with multiple caregivers
Lives with multiple caregivers
3mo old infant, brought in by aunt after she woke from a nap due to lethargy/listlessness. There is no evidence bruising/evidence of trauma to body. Bedside fundoscopy shows probable retinal hemorrhages. Which intracranial lesion would you expect to see?
A. Subdural hemorrhage
B. Intraventricular hemorrhage
C. Epidural hemorrhage
D. Subarachnoid hemorrhage
Subdural hemorrhage
12mo old child is found to have fractures in multiple stages of healing on skeletal survey. Which fracture is MOST in keeping with non-accidental injury?
A. Linear parietal skull fracture
B. Metaphyseal fracture
C. Vertebral fracture
Metaphyseal fracture
School-aged boy with lots of bruising everywhere (buttocks, over his back) all in different stages of healing, some are yellow and some are purple. What is the cause?
A. Hemophilia
B. Non-accidental trauma
Non-accidental trauma
Humerus fracture in baby (?non ambulatory) what next test
A. Refer to ophthalmology
B. Skeletal survey
C. Abdominal imaging
Skeletal survey
5-year-old girl discloses that she has been sexually abused by her stepfather. On examination you notice absence of the hymenal tissue at the 12 o’clock position. Which of these statements is true?
A. This is diagnostic of sexual abuse
B. This is diagnostic of previous hymenal injury
C. This is a normal anatomic variant
D. This is caused by chronic masturbation
This is a normal anatomic variant
Child with failure to thrive, poor feeding. On exam has lingual frenulum laceration and induration of the floor of the mouth . What do you do next:
A. Admit and call CAS
B. DC home and follow up in a week
C. Admit and call ID
D. Admit and call ENT
Admit and call CAS
12yo F has recently consented to sexual activity. What is the oldest her partner could be for her consent to be valid.
A. 12 yo
B. 14 yo
C. 16yo
D. Her consent is not valid
14 year old
2y female touching perineum frequently after coming back from father’s house 5 days ago. Normal intact hymen, labia are erythematous. What do you do?
A. Call CPS as exam is diagnostic of sexual abuse
B. Do nothing as no evidence of abuse
C. Interview child and call CPS if concerns
D. Call CPS as there is concern for sexual abuse
Do nothing as no evidence of abuse
18 month old with warts on anus and hands. Mother doesn’t have HPV. What’s the cause?
A - Autoinoculation
B - Hetero-inoculation
C- Sexual abuse
Autoinoculation
3mo with femur fracture. Skeletal survey normal (except for femur fracture). What else should you do?
A. Abdo u/s
B. Head CT
C. Bone scan
Head CT
7 year old discloses that her 15 year old step-brother has been sexually assaulting her for the last 2 years. On physical examination in the supine position you see a complete tear of the inferior hymen. What do you say to the police.
a. Diagnostic of sexual abuse
b. Diagnostic of past hymenal trauma
c. Normal variant
Diagnostic of past hymenal trauma
9mo NAT, humerus spiral fracture, normal labs -
a. genetics,
b. skeletal survey in 2 wks
skeletal survey in 2 wks
4 yo F, brought in by CAS worker due to concerns about sexual abuse. Exam shows vulvar irritation and discharge. What to do?
A. STI swabs and culture
B. Avoid bubble baths
C. Reassure
D. Something else
Avoid bubble baths
What is the best way to prevent people with disabilities from suffering sexual abuse.
a) Less autonomy
b) Putting them in day facilities with more supervision
c) Better sexual education
Better sexual education
2 year old infant presents with refusal to weight bear and is found on imaging to have a spiral fracture. What is the most likely explanation?
a. Toddler’s fracture
b. Non accidental injury
c. Metabolic bone disease
d. Osteogenesis imperfecta
Toddler’s fracture
7 year old girl discloses to you that she has been sexually abused by her 15 year old brother for the last 2 years. On genital examination with her lying supine, you see a cleft in the inferior hymen rim. Which is true?
a. Diagnostic of previous trauma to the hymen
b. Congenital malformation
c. Normal variant
d. Diagnostic of sexual abuse
Normal variant
Which fracture is most consistent with abuse?
A. Femur fracture
B. Posterior rib fracture
C. Clavicle fracture
D. Metatarsal fracture
Posterior rib fracture
A 2 month old baby presents for a routine check-up. You notice a bruise behind his ear and on his chest. He previously had a circumcision with no complications. What is the most likely diagnosis?
a. Accidental trauma
b. Hemophilia
c. Child maltreatment
Child maltreatment
