Case 58: Child Abuse
Terms in this set (16)
If a 4 month old boy presents with two days or irritability and a right transverse femur fracture, what is the most likely diagnosis?
What is the next step in this scenario?
Performing a skeletal survey
What government agencies should be reported to in suspected cases of child abuse?
Child protective services or local law enforcement
What is Munchhausen syndrome by proxy?
Abuse in which the caretaker falsifies symptoms or inflicts injury upon a child to necessitate medical intervention
What is shaken baby syndrome?
Brain injury resulting from violent shaking of an infant. They may present with seizures, respiratory arrest, bulging fontanelles, and irritability
What is the classic sign of fundoscopic exam for shaken baby syndrome?
What is the most common form of child abuse?
Neglect. This is a failure to provide adequate nutrition, shelter, supervision, and medical care.
What sort of background does a person with Munchausen's typically have?
A history in the medical field
What are health care providers legally required to do if they suspect child abuse?
Report it to either CPS or a local law enforcement agency
What sort of history is important to take when child abuse is suspected?
A thorough family history, developmental history, and history from the child if old enough
What is done for children under 3 years of age with suspected child abuse?
A skeletal survey
Where are accidental bruises typically found?
Over bony areas such as the forehead, elbows, knees, and shins
What are some places where bruising should be considered suspicous?
Abdomen, buttocks, thighs, and inner arm
What is the classic burn pattern for an intentional burn?
A burn with a sharply demarcated border with a stocking glove distribution
What should be included in the differential diagnosis for multiple eccymosys?
hemophilia, ITP, HUS, and DIC
What types of skeletal injuries are suspicous?
Long bone metaphyses, injuries or complex rib fractures, and multipel fractures