Please proceed directly to the the Pre-Test.
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1
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Which
one of the following is a clear indication for an emergent physical
examination to be performed? |
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2
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Which
of the following signs or symptoms may be an indication of sexual
abuse? |
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3
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A
15 year old was raped by an acquaintance whom she was dating.
One week later, she is brought to the office for an examination
by her mother. She has no abnormal genital symptoms and states
that the perpetrator used a condom. The 15 year old is considered
a mature minor and understands why the examination may be necessary
for medical and legal reasons. Which of the following is true? |
a.
If the adolescent agrees to have the examination, the examination
should be performed.
b. If the parent wants the adolescent to be examined, but
the adolescent refuses, the adolescent should be examined.
c. If both the parent and adolescent refuse the examination,
the local Child Protective Services hotline should be called and
the examination should be performed.
d. a and b
e. All of the above
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4
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On
physical examination of a sexually abused 5 year old girl, you
observe vaginal bleeding. Due to the child’s uncooperativeness,
you are unable to locate the source of the bleeding. You should: |
a.
Get assistance from a nurse who can hold the child down while
you perform the examination.
b. Have the parent apply cold compresses and bring the
child back tomorrow.
c. Arrange for an examination under anesthesia by a pediatric
gynecologist.
d. Use a Huffman speculum and perform a pelvic examination.
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5
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Which
of the following are indications for collection of forensic evidence? |
a.
A child within 72 hours of a stranger abduction.
b. A child who is examined within 72 hours of the sexual
assault.
c. A child in whom the history is non-specific, but there
is fluorescence on the Woods lamp examination.
d. A parent, mature child or adolescent requests the collection
of evidence, but does not provide a clear history of sexual assault.
e. All of the above
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6
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Which
of the following is NOT an indication to test for sexually transmitted
diseases? |
a.
The examination is within a few days of a stranger abduction.
b. The findings of genital warts in a child older than
age 3.
c. All children suspected of being sexually abused.
d. The patient is a sexually active adolescent.
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7
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All
of the following are goals in taking the medical history for sexual
abuse EXCEPT: |
a.
To make an assessment of whether a crime has occurred.
b. To evaluate the child’s emotional state in relation
to the abuse.
c. To determine the possible presence of medical symptoms
related to the abuse.
d. To obtain information which will help with assessing
possible trauma or infection to the child.
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8
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Which
of the following represents the most appropriate order of steps
for obtaining a history? |
a.
Building rapport, taking a history from the child, caregiver’s
history.
b. Caregiver’s history, building rapport, taking a history
from the child.
c. Caregiver’s history, taking a history from the child,
building rapport.
d. Taking a history from the child, building rapport, caregiver’s
history.
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9
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When
the medical provider properly builds rapport with a child, the
following should occur: |
a.
The medical provider briefly assesses the child’s cognitive,
developmental and linguistic abilities.
b. The medical
provider may obtain information regarding the abuse that the caregiver
did not relate.
c. The medical
provider begins to build a trusting relationship with the child.
d. All of the above
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10
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Which
one of the following does NOT need to be documented in the medical
record: |
a. The child’s
behavior during the examination.
b. The names of
everyone present during the history and physical.
c. Detailed account
of the state of the child’s bedroom before and after the abuse.
d. The duration
of time between the abuse and the child’s statement regarding
the abuse.
e. The child’s
statement(s) regarding the abuse in quotation marks.
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11
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When
taking a history directly from a child, the medical provider should: |
a. Ask leading questions.
b. Give the child
an opportunity to talk about the abuse in a non-threatening
environment.
c. Always use
interview aids such as anatomic dolls.
d. Promise
that the conversation will be confidential.
e. Ask the child
why this abuse happened.
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12
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Which
of the following may be a skin manifestation resulting from sexual
abuse: |
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Study
the image at Right, and correctly match the letters on the image
with the lables below. Note that there are more letters than there
are labels. |
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| 13 |
Anterior
Commissure |
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| 14 |
Hymen |
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| 15 |
Fossa
Navicularis |
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| 16 |
Labia
Minora |
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| 17 |
Prepuce |
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| 18 |
Posterior
Fourchette |
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| 19 |
Urethral
Orifice |
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| 20 |
Which
of the following is the most common hymenal configuration in a
prepubertal child? |
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Label
the hymenal configurations depicted in the illustration to the
right. You need to type the answer for images A-E in the box provided |
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| 21 |
Type
your answer in the box: |
A
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| 22 |
Type
your answer in the box: |
B
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| 23 |
Type
your answer in the box: |
C
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| 24 |
Type
your answer in the box: |
D
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| 25 |
Type
your answer in the box: |
E
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| 26 |
A
6 year old child with an otherwise normal crescent hymen is
noted to have a small mound on the posterior portion of the
hymen. This is most likely:
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| 27 |
Which
of the following is clear evidence consistent with sexual abuse?
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| 28 |
The
genital examination of a 6 year old girl suspected
of being sexually abused shows a crescent hymen. Which of the
following is the most appropriate documentation for the impression
of the examination?
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a. The
physical examination is normal and is consistent with the given
history of sexual abuse.
b. In
my opinion, despite the normal examination, this child was sexually
abused.
c. There
is no evidence of sexual abuse.
d. The
hymen is intact.
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| 29 |
Of the following, which is NOT a common myth associated
with some cases of sexual abuse: |
a. Females
can be born without a hymen.
b.The use of tampons often causes injury to the hymen.
c. Children usually delay their disclosure about the
abuse.
d. Children who
have been sexually abused usually have evidence of the abuse.
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| 30 |
Which
of the following types of questions are appropriate to ask of
a medical expert witness in direct examination? |
a.
Definitions of medical terms.
b. An
opinion regarding the guilt of the alleged perpetrator
c. An
opinion regarding research in the psychology literature
d. Hypothetical
questions regarding sexual abuse
e. a
and d
f. All
of the above
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