midterms(exam)

Question 1

minimizing the need for the child or adolescent to repeatedly tell their history of sexual assault as it can be retraumatizing.

Answer 1

good practice (who guidelines, 2017)

Question 1

the involvement of developmentally immature children or adolescents in seal activities that they do not fully comprehend to which they are unable to give informed consent, or that violate taboos of family relationships.

evidenced by this activity between a child and an adult or another child by age or development is in a relationship of responsibility, trust, or power, the activity being intended to gratify or satisfy the needs of the other person

Answer 1

child sexual abuse

Question 2

child sexual abuse is often carried out without physical force, but rather with manipulation.

it may occur on a frequent basis over weeks or even years, as repeated episodes become more invasive over time, and it can also occur on a single occasion.

who, 2017

Answer 2

true.

Question 3

the philippines has the highest teen-age pregnancy rate in Asia:

1 in 10 are pregnant or mothers at 15-19 years old.

Answer 3

true

Question 4

the philippines is one of only 7 countries with a rising HIV; majority of new cases arr aged 15-24 years.

1 in 4 new cases of HIV is a young person aged 15-24 years.

Answer 4

true

Question 5

1 in 5 children in the philippines has been sexually violated.

Answer 5

true

Question 6

adolescents may also experience sexual abuse at the hands of their peers including in the context of dating or intimate relationships.

this includes non-contact sexual abuse (sexual solicitation, indecent exposure, exposing the child to pornography) as well as contact sexual abuse.

Answer 6

true

Question 7

acts such as inappropriate touching, fondling, and kissing as well as sexual asssault/rape

Answer 7

contact sexual abuse

Question 8

the medical evaluation is only one part of a comprehensive, multidisciplinary evaluations when sexual abuse is suspected.

Answer 8

true

Question 9

1. identify treatable injuries or infections
2. collect forensic specimens if the abuse was recent
3. screen and treat sexually transmitted conditions
4. reassure the child that they are still OK and have not been damaged or injured in a way that won’t heal quickly.
5. asses the patient and parent’s mental and emotional state and make referrals for counseling and medical follow-up
6. provide accurate documentation of the results of the evaluations including drawings of the appearance of the anal area and genitlia
7. address the child’s safety
8. be available for court testimony if necessary
9. be knowledgeable in the appearance of the genitalia and anal area in children and know when to refer patients
10. be knowledgeable about legal issues and the law on women and children

Answer 9

roles of the medical examiner in the evaluation of suspected child sexual abuse cases

Question 10

health care providers should provide gender-sensitive child or adolescent-centered and first-line support in response to the disclosure of sexual abuse

Answer 10

good practice statement 1
who clinical guidelines, 2017

Question 11

history from the child remains the single most important evidence and diagnostic feature in coming to the conlcusion that a child has been sexually abused

Answer 11

true

Question 11

the credible disclosure of a minor that the accused raped her is the most important proof of sexual abuse

Answer 11

people vs de jesus

Question 12

conducting the interview of the child or adolescent separately from their caregiver as long as it is in accordance with their preferences. however, they should be offered to have another person as support

Answer 12

true

Question 13

a good medical history comprises 90% of the diagnosis of sexual abuse

Answer 13

finkel, 2011

Question 14

in child sexual abuse, physical findings are rare and the only available evidence is what the child says about their experiences

Answer 14

adams, 2009

Question 15

the medical history is not a forensic interview

Answer 15

true

Question 16

fact-finding procedure
includes detailed info concerning the indetity and age of alleged assailant, or number of assailants
where assault took place and the date and time of alleged assault
how the assault was perpetrated
whether there is force, threat, or restraint
description of any weapon used
injuries of victim or assailant

patient’s activity after the assault: will have the impact on the presence of physical injuries and the value of special investigation

Answer 16

forensic interview

Question 17

routine background
medical interview
gynecological
sexual
what happened

Answer 17

(medical) history

Question 18

bruised and contusions (inner aspect of thighs, scalp, face, lips)
lacerations (scalp, forearm)
ligature marks (ankle, wrists, neck)
patter injuries (fingertip marks, scratch marks, bite marks, factitious, self-inflicted injuries

Answer 18

physical injuries

Question 18

(WCCPC)

Answer 18

Women’s Crisis and Child Protection Center

Question 19

magnify and photographically record anogenital findings

Answer 19

colposcope

Question 20

reported evidence of genital injuries in only 19-28% of cases

Answer 20

conventional sexual assault exams without colposcope

Question 21

evidence of genital trauma up to 87% of cases

Answer 21

with colposcopic exam

Question 22

the victim's body is the primary crime scene in sexual assault cases

Answer 22

true

Question 23

sexual activity occurred the sexual act produced injuries consistent with a history of forced sex a given person committed the acts by DNA analysis

Answer 23

forensic exam collects evidence that can establish the following

Question 24

normal or nonspecific genital findings in children does not rule out sexual abuse

Answer 24

true

Question 25

genitalia findings: normal does not mean nothing happened

Answer 25

true

Question 26

in a 2002 study by heger et al. of 2,384 children and adolescents presenting with a sexual assault history, 96% had a normal medical exam findings even with a history of sever abuse such as vaginal or anal penetration, the rate of abnormal medical findings is onnly 5.5%

Answer 26

true

Question 27

a review of 153 sexually abused pregnant adolescents seen at the PGH-CPU showed: age at diagnosis: 15.69 years (mean), 16 years (mode), 15.5 years (media

Question 27

a review of 153 sexually abused pregnant adolescents seen at the PGH-CPU showed: age at diagnosis: 15.69 years (mean), 16 years (mode), 15.5 years (media

Question 28

a review of 153 sexually abused pregnant adolescents seen at the PGH-CPU showed: age at diagnosis: 15.69 years (mean), 16 years (mode), 15.5 years (median) the hymen is normal in half (52.3) of the cases

Answer 28

true

Question 29

`Research in medicine even points out that negative findings are of no significance since the hymen may not be torn despite repeated coitus

Answer 29

people vs felix ortoa

Question 30

normal findings do not rule out sexual abuse because many sexual acts do not leave physical findings

Answer 30

true

Question 31

Abnormal findings are not common in sexually abused girls. Thus more emphasis should be placed on documenting the child's description of the molestation and educating prosecutors that, for children alleging abuse. "It's normal to be normal."

Answer 31

joyce adams evolution of a classification scale: medical evaluation of suspected child abuse

Question 32

no abuse happened abuse happened but did not cause any injury abuse happened and cause superficial injuries but those injuries have since healed completely.

Answer 32

a normal genital examination is always consistent with three things

Question 33

performed if the most recent episode of abuse occurred within the last 72 hours

Answer 33

Acute Evidentiary Exam

Question 34

performed if the most recent episode of abuse occurred more than 72 hours earlier

Answer 34

Non-Acute Exam

Question 35

 Laceration of the hymen  Bruising of the hymen  Perianal lacerations deep to the external anal sphincter  Healed hymenal transaction  Absence of hymenal tissue

Answer 35

Evidence of blunt force or penetrating trauma

Question 36

 Finding sperm or seminal fluid on the child’s body  Pregnancy  Presence of Sexually Transmitted Diseases (STDs)  Cases where photographs or videotape show the child being sexually abused  HIV infection not due to other causes

Answer 36

Further Conclusive Proof of Child Sexual Abuse:

Question 37

a) Forms of Abuse – Child sexual abuse committed can be with or without physical contact or contact, such as fondling the child’s genitals, is not sufficient to produce injury. b) Deliberate Avoidance of Causing Injury to the Child c) Difference in Child and Adult View of “Penetration” d) Elasticity of Hymen and Anal Sphincter e) Delay in Disclosure and Examination – Children’s injuries heal fast and may even heal back to normal f) Limitation of Equipment or Technique g) Limitation of Examiner

Answer 37

Reasons Why Physical Findings are Absent

Question 38

 Probative value of medico-legal report  Absence of hymenal laceration does not rule out rape  Absence of spermatozoa  “Virginity” and the “intact hymen”  Size of the penis  Preliminary Investigation and Inquest  Arrest and Search  Testifying in Court  Handling the Media  Civil and Criminal Liability of Police Officers

Answer 38

Major Issues in the Evaluation of Medico-Legal Findings

Question 39

 Exactly what object caused the injury  When the injury occurred (once injury has healed)  How many times it happened  Who did it

Answer 39

What Physicians Cannot Tell:

Question 40

 a collection of evidence gathered from the victim by a medical professional / medico-legal officer  the type of evidence to be collected depends on what occurred during the assault  The contents of a kit vary but generally include swabs, test tubes, microscopic slides, and evidence collection envelopes for hairs and fibers.

Answer 40

SEXUAL ASSAULT KIT