Child Abuse and Neglect Indian Medical PG Practice Questions and MCQs
Practice Indian Medical PG questions for Child Abuse and Neglect. These multiple choice questions (MCQs) cover important concepts and help you prepare for your exams.
Child Abuse and Neglect Indian Medical PG Question 1: Which of the following is not a differential diagnosis of non-accidental injury?
- A. Osteogenesis imperfecta
- B. Scurvy
- C. Caffey's disease
- D. Osteopetrosis (Correct Answer)
Child Abuse and Neglect Explanation: ***Correct: Osteopetrosis***
- Osteopetrosis is a rare genetic disorder characterized by **increased bone density** due to defective osteoclast function
- While it causes bones to be brittle and prone to fracture, it has **distinctive radiological features** including diffuse sclerosis and "bone-within-bone" appearance
- The **increased bone density on X-ray** is pathognomonic and readily distinguishes it from NAI, making it **less likely to be confused** with non-accidental injury in clinical practice
- Fractures occur but the radiological pattern is diagnostic of the underlying metabolic bone disease
*Incorrect: Osteogenesis imperfecta*
- This is a **classic differential** for NAI causing **multiple brittle bone fractures** that can be mistaken for abuse
- Features include **blue sclera**, **dentinogenesis imperfecta**, **wormian bones**, and **family history**
- Often presents with multiple fractures at different stages of healing, mimicking the pattern seen in NAI
*Incorrect: Scurvy*
- Caused by **vitamin C deficiency**, leads to defective collagen synthesis
- Results in **subperiosteal hemorrhages**, **metaphyseal fractures**, and **periosteal elevation** that closely mimic NAI
- Additional features include **gingival bleeding**, **petechiae**, **follicular hyperkeratosis**, and **poor wound healing**
*Incorrect: Caffey's disease*
- Also known as **infantile cortical hyperostosis**, presents in infants under 6 months
- Causes **periosteal reactions**, **bone thickening**, and **soft tissue swelling** in long bones, ribs, and mandible
- The periosteal new bone formation can be mistaken for healing fractures from NAI, making it an important differential
Child Abuse and Neglect Indian Medical PG Question 2: Disputed maternity can be solved by using the following tests, EXCEPT:
- A. Blood grouping
- B. HLA typing
- C. DNA fingerprinting
- D. Precipitin test (Correct Answer)
Child Abuse and Neglect Explanation: ***Precipitin test***
- The **precipitin test** is used to determine the origin of a **blood sample**, specifically whether it is **human or animal blood**, by detecting species-specific proteins. It is not used for assessing maternity.
- This test is primarily employed in **forensic serology** to differentiate between blood from different animal species, making it irrelevant for paternity or maternity disputes.
*Blood grouping*
- **Blood grouping** (e.g., ABO and Rh systems) can be used to **exclude paternity or maternity** by comparing the blood types of the child, mother, and alleged father.
- If the child's blood type is incompatible with the alleged parents based on Mendelian inheritance, one or both can be excluded.
*HLA typing*
- **HLA typing** (Human Leukocyte Antigen) is a more powerful genetic marker system than ABO/Rh for determining paternity or maternity.
- It involves analyzing highly polymorphic genes on chromosome 6 that encode cell surface proteins, providing a more definitive means of **inclusion or exclusion**.
*DNA fingerprinting*
- **DNA fingerprinting** (also known as **DNA profiling**) is the **most accurate and widely accepted method** for resolving paternity and maternity disputes.
- It analyzes highly variable regions of DNA unique to each individual, providing a statistically strong basis for **inclusion or exclusion** by comparing genetic profiles.
Child Abuse and Neglect Indian Medical PG Question 3: Which group is most commonly exploited in instances of pederasty?
- A. Older individuals
- B. Minors (Correct Answer)
- C. Adult individuals
- D. Non-binary individuals
Child Abuse and Neglect Explanation: ***Minors***
- Pederasty specifically refers to sexual acts or relationships between an **adult male** and a **male minor**.
- This term is historically and legally associated with the exploitation of **young males**.
*Older individuals*
- This group is typically **not the target** of pederasty, which focuses on the exploitation of minors.
- While elder abuse can occur, it's a distinct issue from the specific definition of pederasty.
*Adult individuals*
- The definition of pederasty inherently involves a **minor** being exploited, not another adult.
- Consensual sexual relationships between adults do not fall under the definition of pederasty.
*Non-binary individuals*
- While non-binary individuals can be victims of sexual exploitation, the term pederasty specifically denotes the exploitation of **male minors**.
- The focus of pederasty is on age and sex, specifically a male adult exploiting a male minor.
Child Abuse and Neglect Indian Medical PG Question 4: Which of the following medications is contraindicated in head trauma patients?
- A. Furosemide
- B. Thiopentone
- C. Mannitol
- D. Corticosteroids (Correct Answer)
Child Abuse and Neglect Explanation: ***Corticosteroids***
- While previously used, **corticosteroids** are now contraindicated in traumatic brain injury (TBI) due to evidence suggesting they may increase mortality.
- **CRASH trial** showed that corticosteroids increased the risk of death in patients with head injury, possibly by exacerbating secondary brain injury.
*Furosemide*
- **Furosemide** can be used in certain situations to reduce intracranial pressure by inducing diuresis and reducing cerebral edema, especially when combined with mannitol.
- It works by inhibiting the Na-K-2Cl cotransporter in the thick ascending limb of the loop of Henle, leading to increased water excretion.
*Thiopentone*
- **Thiopentone** (a barbiturate) can be used in severe head trauma to reduce cerebral metabolic rate, thereby decreasing cerebral blood flow and intracranial pressure.
- It induces a **pharmacological coma** and provides neuroprotection by scavenging free radicals and stabilizing cell membranes.
*Mannitol*
- **Mannitol** is an osmotic diuretic commonly used to reduce intracranial pressure in head trauma by creating an osmotic gradient that draws water out of the brain parenchyma.
- It is administered intravenously and works rapidly to decrease brain volume and improve cerebral perfusion pressure.
Child Abuse and Neglect Indian Medical PG Question 5: Which of the following is not done in the primary survey of trauma?
- A. Intubation
- B. NCCT head (Correct Answer)
- C. ICD drainage
- D. CXR
Child Abuse and Neglect Explanation: ***NCCT head***
- A **Non-Contrast CT (NCCT) head** is typically performed during the **secondary survey** once the patient is hemodynamically stable and life-threatening conditions have been addressed.
- The primary survey focuses on immediate **life-saving interventions** for airway, breathing, circulation, disability, and exposure.
*Intubation*
- **Intubation** is a critical intervention during the primary survey, specifically under the **'A' (Airway)** component, to establish and secure a patent airway in a compromised patient.
- Failure to establish an airway can rapidly lead to **hypoxia** and death.
*ICD drainage*
- **Intercostal drain (ICD) drainage** is an urgent intervention in the primary survey, falling under **'B' (Breathing)**, to manage conditions like **tension pneumothorax** or massive hemothorax.
- These conditions can severely compromise ventilation and circulation, requiring immediate relief.
*CXR*
- A **Chest X-ray (CXR)** is a rapid and essential diagnostic tool in the primary survey, also under **'B' (Breathing)**, to identify life-threatening thoracic injuries such as pneumothorax, hemothorax, or mediastinal shift.
- It provides quick information crucial for immediate management decisions.
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