CHILD ABUSE

1. A four-year-old male presents to the clinic because of a sore throat for two days. During the physical examination, patterned bruises (including looped shaped marks) on his back and arms are seen. How would you evaluate and manage this patient. What would you tell the parents?
2. A two-year-old presents to the emergency department after breaking her arm during a fall. The child was seen six months ago with a broken leg. What are your concerns? How would you evaluate this child?
3. A seven-year-old female patient presents with vaginal discharge. How would you approach the history and physical exam? In addition to poor hygiene, what else is in the differential diagnosis?
4. An eight-year-old male with urethral discharge grows N. gonorrhea from a urethral culture. What medical, legal, and social issues should you address?
5. A two-month-old boy presents with lethargy and is poorly responsive. He has retinal hemorrhages. What are your ethical and legal obligations? To whom would you report your findings? What would you say to the boy’s parents?
6. A nine-month-old boy has a history of poor weight gain for several months. His weight has fallen from the 50% to the 10% over the past four months. During a hospitalization for poor weight gain, he had a normal physical examination; normal laboratory values, and demonstrated excellent weight gain on an age-appropriate diet. Now one month following discharge from the hospital he has lost weight. What would you do for this child? Discuss the medical, legal, and social implications of your actions.
7. An eighteen-month-old infant presents with scald burns to the buttocks and legs. The parents report the child “turned on the hot water tap while playing in the bathtub.” How would you differentiate an accidental burn from an inflicted burn?