Knowledge Check: Abusive Head Trauma
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Question 1 of 10
1. Question
Abusive Head Trauma is the leading cause of death from child physical abuse.
Hint
Due to the potential for extensive brain trauma, there is significant mortality associated with abusive head injury.
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Question 2 of 10
2. Question
The diagnosis of Abusive Head Trauma is often challenging to make because:
Hint
Medical providers are encouraged to develop a broad differential and consider Abusive Head Trauma, as the diagnosis is often challenging to make since caretakers may not be fully forthcoming about the events contributing to the child’s presentation, clinical symptoms can be nonspecific, there may be no outward signs of physical injury, and radiographic findings can be missed or inaccurately diagnosed.
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Question 3 of 10
3. Question
Abusive Head Trauma occurs most commonly in children residing in poor families with a single parent caregiver.
Hint
Abusive Head Trauma and child abuse, in general, crosses all socioeconomic, racial/ethnic, and geographic divides. No child is immune to being abused.
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Question 4 of 10
4. Question
Which of the following is the most common intracranial finding associated with Abusive Head Trauma?
Hint
Described in 77-89% of patients with Abusive Head Trauma, the subdural hemorrhage is the most common intracranial finding.
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Question 5 of 10
5. Question
Retinal hemorrhages are present in 100% of cases of Abusive Head Trauma.
Hint
An associated finding in Abusive Head Trauma, retinal hemorrhages have an incidence ranging from 50-95%. Thus, they are not present in all cases of Abusive Head Trauma.
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Question 6 of 10
6. Question
The mere presence of a subdural hemorrhage(s), retinal hemorrhage(s), and encephalopathy is sufficient to make the diagnosis of Abusive Head Trauma.
Hint
The diagnosis of Abusive Head Trauma requires a comprehensive and complete evaluation with consideration of underlying medical conditions, which may exacerbate the presenting symptoms. Moreover, a differential diagnosis should be considered for associated findings such as subdural hemorrhage and retinal hemorrhage, as their mere presence is not diagnostic of Abusive Head Trauma.
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Question 7 of 10
7. Question
The characteristics of retinal hemorrhages described in Abusive Head Trauma include all of the following except:
Hint
The characteristics of retinal hemorrhages described in Abusive Head Trauma are extensive and involve multiple layers of the retina. Subject to excessive acceleration/deceleration forces, traction can be exerted at various points of the retinal vessels and layers causing tearing or splitting of delicate retinal vessels and tissues.
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Question 8 of 10
8. Question
If there are siblings or other children living in the home of the index patient, they should be examined and receive appropriate medical screening labs and/or radiographs to identify potential injuries.
Hint
As other children/siblings may be exposed to the perpetrator in question, it is most prudent that they be examined, as well.
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Question 9 of 10
9. Question
The extent of deficits associated with Abusive Head Trauma may not be fully appreciated until the child is out of the acute period.
Hint
With increasing chronologic age, academic demands, and tracking of developmental milestones, the extent of the neurologic and cognitive sequelae gradually becomes apparent in the survivor of Abusive Head Trauma.
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Question 10 of 10
10. Question
The most common precipitant to Abusive Head Trauma is:
Hint
Although infant crying is a normal, developmentally appropriate behavior in the first few months of life, research has shown that crying is a common precipitant to Abusive Head Trauma.