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Women's Health > Lecture 10: Violence > Flashcards

Lecture 10: Violence Flashcards

1
Q

Define human trafficking

A

Use of force, coercion, or fraud to obtain some form of labor or commercial sex act

3rd most profitable transnational crime

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2
Q

What is the MC demographic of a trafficked human?

A

Female minor

55-70% female, 50% are minors

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3
Q

What are the 3 methods traffickers primarily use to ensnare victims?

A
  1. Threats
  2. Manipulation
  3. Control
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4
Q

What are the warning signs of human trafficking? (4)

A
  • Personal behaviors (disconnected, missing school/work)
  • Abuse/Neglect
  • Living situation (unstable, lack of personal items)
  • Suspicious presentation (controlling partner, “coached”)
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5
Q

What should we do if we suspect human trafficking?

A
  • Call the feds: 1-866-347-3423
  • Build rapport
  • Only call local law if immediately life-threatening
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6
Q

What % of domestic violence victims are female?

A

85%

Overall, 21% of violent crime experienced by Females is DV/IPV

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7
Q

How common is IPV occurring per minute?

A

24 people PER MIN

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8
Q

What is the MC form of IPV for males? Females?

A
  • Males: Physical violence
  • Females: Multiple forms
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9
Q

How common is sequelae after IPV/DV for both men and women?

A
  • Women: 27%
  • Men: 12%

Sequelae: PTSD, injury, IBS, mental health

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10
Q

When does victimization often occur by? (age)

A

25

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11
Q

What is the average length of victimization before presentation to healthcare providers or police?

A

4 years

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12
Q

How high is the estimate that an american woman will be physically assaulted by a partner or ex-partner?

A

1/5

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13
Q

What races are considered RFs for DV/IPV?

A
  • AA
  • Indigenous
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14
Q

What is the leading cause of death among pregnant women?

A

Homicide

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15
Q

When is IPV more frequent, severe, and at a high risk for homicide?

A

Pregnancy

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16
Q

What age is the highest risk for DV/IPV?

A

16-24

Prior to age 25

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17
Q

What are the S/S that may increase suspicion for DV/IPV? (6)

A
  • Chronic, vague pelvic pain
  • Sexual dysfunction (decreased libido, dyspareunia, anorgasmia)
  • Chronic/recurrent vaginitis
  • Anxiety/tearfulness prior to pelvic/breast exam
  • Persistent multiple bodily complaints
  • Psychiatric complaints

Essentially, vague complaints

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18
Q

How common is DV during pregnancy?

A

4-9%

More common than preeclampsia, gestational DM<, or placenta previa

19
Q

How accurately do practitioners identify women experiencing DV?

20
Q

What are the 4 steps in the cycle of abuse?

A
  1. Tensions building
  2. Incident
  3. Reconciliation
  4. Calm
21
Q

What is the single most important thing a provider can do for a battered woman?

A

Ask about violence

Screen everyone

22
Q

When should non-pregnant women be screened for DV?

A
  • Routine OB/GYN visits
  • Family planning visits
  • Preconception visits
23
Q

When should pregnant women be screened for DV?

A
  • First prenatal visit
  • EVERY TRIMESTER
  • Postpartum checkup
24
Q

How should we approach screening for DV/IPV?

A
  • Establish that screening is universal.
  • Direct questioning
  • Face to face
  • Specific descriptions

Actually ask do you get hit, pushed, etc

25
What are some of the screening tools we can use to assess for DV?
* **HITS** (Hurt, insult, threaten, screen) * **WAST** (woman abuse screening tool) (scoring) * **PVS** (Partner violence screen)
26
When is mandatory reporting indicated generally?
Generally, **any injury that seems like it was caused illegally** (firearm, stabbing, arson) | State dependent
27
What are some ways we can help prevent DV?
* **Offer shelter** * **Pocket cards** with suggested safety/exit plans * **Educational materials and resources**
28
When do acquaintance rapes typically occur during?
Adolescence
29
What is statutory rape?
**Sexual intercourse with a female under an age** specified by state law | WV is 16 for age of consent.
30
Where is child sexual abuse mandated to be reported?
All 50 states.
31
What clinical findings could suggest sexual assault?
* **Complaints of being "mugged"** * **Concerns over STDs or AIDS** * Psych complaints * **Must obtain a sexual history!!**
32
How common are obvious physical findings in sexual assault?
only 30-40% have obvious injuries. | Most will be minor.
33
What physical exam sign is MC among sexual assault victims?
Vaginal irritation | More likely than any other sign. > 50% of victims.
34
What are the MC **nongenital injuries** seen in sexual assault?
Bruises, cuts, scratches, swelling
35
What is the **acute phase** of the rape-trauma syndrome + associated symptoms?
* Distortion/paralysis of coping mechanism * Complete loss of control to unnatural calm * Somatic symptoms: **disturbed eating/sleep, GI irritability, MSK soreness, fatigue, etc** | Wide range; like they're in shock/petrified
36
How long does the **acute phase** of rape-trauma syndrome typically last?
Up to 2 weeks.
37
What are some of the common sequelae of **delayed phase** rape-trauma syndrome?
* PTSD (**common long-term**) * Psychologic distress (mistrust of others, phobias, depression) * SI (33-50%) * Substance abuse * Depression
38
How common is a suicidal attempt for patients that were raped that did not seek tx?
1 in 5
39
If a victim presents to you with evidence of sexual assault, what are your responsibilities?
You are both medically and legally responsible. | Can request assistance from a sexual assault nurse examiner (SANE) ## Footnote Need hx, kits, full PE
40
Why are bite marks useful in evidence collection for sexual assault?
They can leave DNA evidence.
41
What kind of **lubricant** is preferred for a **speculum** during a pelvic exam for **sexual assault**?
Sterile saline | Don't want to interfere with any DNA collection.
42
How soon do you f/u regarding sexual assault?
2 weeks | Recheck PE and collect specimens
43
What tx can we offer for an SA victim?
* **Tx any physical injuries** as appropriate * **Emergency contraception** * **STI tx**: Rocephin + Metro + Doxy + HPV vaccinations * Psych (**even if they seem calm at the moment**)
44
When is sexual assault awareness month?
April

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