Clinical Approach to Child/Elder Abuse (Schmidt) Flashcards

(29 cards)

1
Q

What are some signs of child maltreatment?

A

1) Fussy, colicky infant
2) Hyperactive behavior
3) Illness
4) Non-biologic relationship with caregiver
5) Prematurity

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2
Q

What is an important caregiver risk factor for child maltreatment?

A

Substance abuse

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3
Q

What are the four main types of child abuse?

A

1) Neglect
2) Emotional
3) Physical
4) Sexual

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4
Q

What is the most common type of child abuse?

A

Neglect

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5
Q

Neglect is the most common cause of?

A

Death in abused children

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6
Q

What is the physician’s role when suspecting neglect?

A

1) Full medical history
2) Psychosocial history
3) Complete physical exam

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7
Q

What should you do when suspecting neglect, even when in doubt?

A

Ensure safety of child and contact Child Protective Services

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8
Q

When should the physician report to child protective services due to emotional abuse?

A

If it appears recurrent or possibility of imminent harm to child

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9
Q

What are suspicious signs of abuse on the physical exam?

A

1) Posterior rib, scapular, and sternal factures
2) Cigarette burns
3) Metaphyseal lesions

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10
Q

What are the three types of sexual abuse?

A

1) Non-touching
2) Touching
3) Exploitation

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11
Q

What are examples of non-touching sexual abuse?

A

1) Expose child to porn

2) Neglectfully allow child to see/hear active sexual activity

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12
Q

What are examples of sexual exploitation?

A

1) Engaging a child for purposes of prostitution
2) Using a child to film, photograph or model pornography
3) Human trafficking

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13
Q

Most victims of sexual abuse are in what age range?

A

9-12 years old

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14
Q

While 25% of US females report were a victim of child sexual abuse, what percentage of victims have never told anyone?

A

50% - 70%

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15
Q

In the evaluation of sexual abuse what is the general rule in diagnosis?

A

No single behavior, sign, or symptom is diagnostic

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16
Q

What is usually found on PE when examining a child for sexual abuse?

17
Q

If immediate interview is necessary, what should be done?

A

Minimal Facts Interview

18
Q

What is asked in a Minimal Facts Interview?

What should be avoided?

Why is this question avoided and what should be asked instead of this question?

A

1) Who, what, where, how
2) When
3) Young children are poor at spatial timing, instead ask “Did this happen one time or more than one time?”

19
Q

What are very high risk populations for sexual abuse?

A

1) Deaf children
2) Developmentally disabled adults
3) Transgender

20
Q

What is a Class A misdemeanor in Missouri and a Class B in Kansas for physician’s when presented with a sexual abuse case?

A

Failure to report

21
Q

What are victim risk factors for elder abuse?

A

1) Dementia, psychiatric diagnosis
2) Physical dependence
3) Incontinence

22
Q

What is a perpetrator characteristic for elder abuse?

A

Substance abuse

23
Q

What are the types of elder abuse?

Which type makes up 50% of cases?

A

1) Physical
2) Sexual
3) Psychological
4) Financial
5) Neglect (50% of cases)

24
Q

What are abuse signs of elderly neglect?

A

1) Lack of nutrition
2) Poor personal care
3) Lack of medications

25
What are signs of elderly abuse in terms of bruises?
Often bilateral and on the inner surface of the arms from being grabbed
26
What are signs of elderly abuse in terms of burns?
Often cigarette burns
27
What are signs of elderly abuse in terms of fractures?
1) Fractures at different stages of healing | 2) Spiral fractures caused by twisting of limbs
28
What are other common signs of elderly abuse?
1) Wrist rope burns 2) Injury to mouth caused by forced feeding 3) Depleted personal finance
29
What is a class A misdemeanor in Missouri (1 year jail + $2,000 fine) and a class B misdemeanor in Kansas (6 months jail + $1,000 fine) in terms of elderly abuse?
Failure to report