In Shaken Baby Syndrome you would NOT find?
1.a comatose baby with no signs of trauma
2.acute subdural haematoma
3.retinal hemorrhages
4. fractured long bones of lower limbs
With regards to domestic violence which is false?
1.95% of the time the women is the victim
2. 30 – 50% of reported cases of spousal abuse also report child abuse
3.one of the lowest risk times for domestic violence is during pregnancy D. injuries especially include head and neck
4. it is more common in women of colour and poverty
Examining a girl who is victim of sexual assault, which is false?
1.they are usually examined in the frog leg position
2. the use of a small speculum is usually advocated
3. general anaesthetic should only be used if internal injuries requiring surgical repair are suspected
4.the hymen can be best seen without instrumentation and the girl supine with her knees drawn to her chest
How should the morning after pill be taken?
1. two OCP each containing ethinyl oestradiol 50micrograms within 12 hours of sexual intercourse and two more taken at 72 hours post sexual intercourse
2. two such pills taken as a single dose within 72 hours of sexual intercourse
3.two such pills taken within 72 hours of sexual intercourse and two more taken twelve hours later
4.two pills taken at twelve hours post sexual intercourse and two more taken 72 hours later
If you suspected a child of a NAI what investigation would not usually be appropriate?
1.Bone scan if child less than three years
2.Clotting
3.Platelet count
4.CUE
Most non genital injuries of sexual assault are found on the
1.head
2.arms
3.chest
4.back
Regarding SIDS which is a false statement?
1. the peak incidence is between the ages of 2-3 months
2.the incidence is 0.5:1000 live births
3.80% of cases occur prior to 8 months of age
4.the incidence in the aboriginal population is twice that of Caucasian Australians
Sexual assault does not include
1. rape
2.forced sexual activity that does not result in penetration
3.oral or anal intercourse
4.flashing ones genetalia at the victim
The definition of rape is?
1. A. penile penetration of the labum majus
2.penile penetration of the labum minora
3.penile penetration of the distal most walls of the vagina
4.deep penile penetration of the vagina
The risk of becoming pregnant from a rape is
1.15%
2.10%
3. 7.5%
4.5%
What Xray is not routinely included in a skeletal survey?
1.long bones
2.thoracolumbar vertebrae
3. ribs and clavicles
4. fingers and toes
Which fracture would not make you concerned re NAI in a 2 year old?
1.Metaphyseal chip fracture of humerus
2.Spiral fracture of a femur
3.Fractured ribs
4.Transverse fracture midshaft of radius an ulnar
Which is incorrect with regards to death in the ED?
1.rarely should any information about death be given over the telephone
2. one a pt is dead organ donation is no longer possible
3. generally sedatives should not be given to a grieving relative as it only lengthens the grieving process
4.brain death is the time that brain death is established not when life support is ceased
Which is not an injury you would associate with NAI in a 2 year old?
1.Lacerated frenulum of the tongue
2.Trauma to pinna of ear
3. Hyphema
4.Laceration through eyebrow
Which is not currently considered a likely aetiology for SIDS?
1.airway obstruction
2.central apnoea
3.rebreathing of expired gases
4.arousal deficit
Which is not true with regard to SIDS?
1. up to 10% of multiple SIDS deaths are due to child abuse
2.botulinum toxin may be implicated in a small percentage of SIDS deaths
3.There is no relationship between infantile apnoea and SIDS
4.Death is a respiratory arrest not a cardiac arrest
Which is true with regard to specimen collection of a sexual assault?
1.vaginal and cervical swabs are taken with a wet swab stick and plated onto slides. Both slide and swab are included for evidence
2.semen on the skin is collected by using a wet swab stick then a dry swab stick, both are plated onto slides and all swabs and slides are included for evidence
3.a dry swab stick rubbed in the buccal mucosal is insufficient to gain pt DNA for comparison
4.pt blood collected for drug analysis put into normal hospital collection tubes bit these tubes go with the police for forensic assessment
Which of the below is not very suggestive of domestic violence?
1. forearm fracture
2. substantial delay between injury and seeking medical attention
3. multiple injuries in different stages of healing
4.fractured first metatarsal
Which site of bruising would make you suspicious of child abuse?
1. anterior shins
2.knees
3.upper arms
4.elbows
Which statement is correct with regards to an ALTE?
1.there is no relationship between these babies and those that die of SIDS
2. zanthine derivatives have been proven to be useful in both preterm babies who experience apnoea and term babies who have an ALTE
3. home apnoea monitors are proven to decrease the risk of SIDS in babies who experience a true ALTE
4. the definition of an ALTE includes infection with RSV
Which statistics are incorrect with regard to sexual assault?
1. 90% of victims of sexual assault are women
2.98% of offenders are men
3.1.5% of the adult women are sexually assaulted each year
4. 25% of sexual assault victims report the incidence to police
Which subgroup of infants are NOT at an increased risk of SIDS?
1. term infants who have had an ALTE
2.Premerature, low birth weight babies
3.Siblings of an infant that died of SIDS D.
4. Infants whose mothers smoke (but did not smoke during the pregnancy)
With regards to ecchymoses which is a false statement?
1. A. day 1-5 they are reddish/blue in colour
2.day 6 they are brown C. day 7- 10 they are yellow
3.they usually have resolved by day 14
4. a bruise usually develops within 1 hour of an injury
With regards to the forensic medical examination of a sexual assault which is false?
1.Photography of genitalia is not allowed routinely
2.Each item of clothing that a person is wearing must be placed in a separate bag, they cannot be put in the same bag
3.All clothes and specimens should be handed directly to the attending police officer
4.The results of the forensic tests are available for the victim if they approach the VIFM