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Paediatrics > Safeguarding > Flashcards

Safeguarding Flashcards

1
Q

Symptoms of meningitis in babies

A 
Temperature
Refusing feeds and vomiting
Irritable, dislike being handled
Bulging soft spot
Rapid breathing
Pale mottled skin/rash
Unusual cry
stiff neck
dislike for bright lights
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2
Q

What is shaken baby syndrome?

A

Serious form of abuse

Usually occurs when someone shakes the baby out of anger or frustration

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3
Q

What agencies need to be informed if shaken baby syndrome is suspected?

A

Social services

They may involve the police if appropriate

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4
Q

Possible diagnoses for widespread bruising

A

Leukaemia
Aplastic Anaemia

(Wait for platelets and coagualtion screen before speaking to the family)

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5
Q

Normal Hb for a child

A

11-13 gm/dL

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6
Q

Normal WCC for a child (1-6)

A

5 - 17

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7
Q

Normal platelets count in children

A

150-400

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8
Q

What are the different types of Child Maltreatment?

A 
Physical
Emotional
Neglect
Sexual
Factitious and Induced Injury
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9
Q

Factors which increase the likelihood of child abuse

Child:

A

Younger child
Increased needs - disability
Low birth weight
multiple births

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10
Q

Factors which increase the likelihood of child abuse

Adult

A 
Young parental age
Mental Illness
Drug/alcohol abuse
Domestic Violence
Lower Socio-economic group
Parents were themselves abused
Parental criminal history
Family chaotic, disorganised, socially isolated
Vulnerable and unsupported parent
Previous child maltreatment in members of the family
Known maltreatment of animal
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11
Q

Recognising a NAI

History:

A

No mechanism offered/mechanism not consistent with the injury
Delay in reporting/seeking medical attention
Inconsistent histories from parents
Inappropriate reaction of parents e.g vague, elusive, unconcerned, excessively distressed, aggressive
Recurrent injuries
Injuries inconsistent with the child’s age, development, mobility (bruising in non-mobile babies)

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12
Q

Recognising a NAI

Fractures:

A 
Metaphyseal fractures
Posterior rib fractures
Fractures of different ages
Complex skull fractures
Long bone shaft fractures in non-mobile child
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13
Q

Recognising a NAI

Bruises:

A

Normal bruises in toddlers - shins, forehead

NAI - face, back, buttocks
Outline of particular objects - hand, belt
Patter of bruising - fingertips

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14
Q

Recognising a NAI

Burns:

A 
Uniform shape (cigarette)
Glove-stocking distribution
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15
Q

Clinical features of a baby with NA head injury

A 
Irritability
Poor feeding
Increasing head circumference
Seizures
Reduced GCS
Full fontanelle
Anaemia
Retinal haemorrhages
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16
Q

What is a Child Protection Medical Assessment and what is its function?

A

Requested by social services
Carried out by at least a reg (must be a Named Consultant)
Full history, examination, growth chart, observations, body map, photography, investigations as appropriate
Meticulously noted

Child must be questioned away from carers
Voice of child crucial

Peadiatrician makes a report about the likelihood of an injury being accidental

17
Q

What is a body map and what is it used for?

A

Used to accurately document visible findings on examination

Different types of body map that vary by age and gender

18
Q

Other investigations used in a Child Protection case:

A 
Clinical photography
Bloods
Detailed clotting studies
Opthalmology review
Skeletal Survey - Expert opinion may be used to exclude osteogenesis imperfecta
CT Head
19
Q

Differential Diagnosis for child with bruising

A 
Accidental injury
NAI
Immune thrombocytopenic purpura (ITP)
Meningococcal Septicaemia 
Henoch Schonlein Pupura
Mongolian Blue Spot
Leukaemia
Haemophilia A
Christmas Disease
Von Willebrands disease
Children with hypermobility syndromes - Ehlers Danlos syndrome
Vasculitis
20
Q

What is mongolian blue spot?

A

Type of birthmark caused by pigment in the skin

Most commonly seen in the lumbosacral area

21
Q

What is Henoch-Schonlein Purpura?

A

Tyope of vasculitis
Causes the small blood vessels in skin, joints, intestines, and kidneys to become inflamed and bleed
Purplish rash typically on lower legs and buttocks
Can cause aching joints and abdo pain
Rarely, serious kidney damage can occur

22
Q

What is ITP?

A

Immune Thrombocytopenic Purpura
Bleeding disorder - immune system destroys platelets
In children, can develop after viral infection
Easy/excessive bruising
Superficial bleeding into skin (petechiae)

23
Q

What is clotting factors are affected in Haemophilia A and Christmas Disease (Haemophilia B)

A

A - VIII

B - IX

24
Q

What is Ehlers Danlos Syndrome?

A

Connective tissue disorder

Characterised by:
- Joint hypermobility, skin hypermobility, skin hyperextensibility, tissue fragility

25
Q

Differential diagnosis for child with fractures

A 
NAI
AI
Osteogenesis Imperfecta
Copper Deficiency
Vit D deficiency
Vit C deficiency
Ehlers Danlos and other hypermobilty syndromes
JOBs syndrome
26
Q

What is JOBs disease?

A

Autosomal dominant hyper IgE syndrome
Caused by genetic mutation of chromosome 4
Recurrent infections common
Can cause fracture and scoliosis

27
Q

Differential diagnosis for child with burns

A

AI
NAI
Bullous impetigo
Scalded Skin Syndrome

28
Q

What is Scalded skin syndrome?

A

Caused by certain types of Staphylococcus

Produces toxin that damages outer layer of the skin and causes it to blister

29
Q

What is Pierre Robin syndrome?

A

Underdeveloped lower jaw
A tongue that falls back in the throat
Difficulty breathing

30
Q

What is the toxic trio?

A

Domestic Violence and Abuse
Parental Mental Health
Parental Substance Misuse

31
Q

How can neglect manifest clinically?

A

Failure to thrive
Inadequate hygiene (nappy rash)
Poor development of emotional attachment to child’s caregiver
Delay in development and speech and language
Poor attendance for school and health appointments
Unsupervised young children at home (law unclear)

32
Q

Emotional Impact of physical/psychological abuse on a child

Sexual abuse:

A 
Disclosure
STDs
Sexualised behaviour
Pregnancy
Soiling
33
Q

Fabricated or Induced Illness (FII)

A

Often on background of existing disease
Bizarre illness events
Strange new symptoms
Parental reportage out of keeping with physical findings
Symptoms only witnessed by one
Unneeded operations (tonsils removed at parents requests)

34
Q

What is neglect?

A

Persistent failure to meet a child’s basic physical or psychological needs

35
Q

Three concerning areas to find bruises on children?

A

Torso
Ears
Neck

Paediatrics (19 decks)

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