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CME/CE Test

Can New Guidance Help Distinguish Child Abuse from Bleeding Disorders?

To receive AMA PRA Category 1 Credit™, you must receive a minimum score of 75% on the post-test.

  1. You are a member of the healthcare team for a 7-year-old boy with unexplained arm bruising. According to the clinical report by Anderst and colleagues from the American Academy of Pediatrics (AAP) Council on Child Abuse and Neglect, which of the following statements about current recommendations for distinguishing bruising and bleeding in children with coagulopathies with similar findings in child victims of abuse is correct?
    Every child with bruising/bleeding must be evaluated for bleeding disorders
    Pattern and location of bruising does not help differentiate abuse from bleeding disorders
    Indicated tests may include prothrombin time (PT), activated partial thromboplastin time (aPTT), von Willebrand Factor (VWF) activity; factor VIII activity; factor IX activity; and complete blood count, including platelets
    Still, bleeding disorders can be excluded solely from thorough patient and family history
  2. According to the technical report by Carpenter and colleagues from the AAP Section on Hematology/Oncology, which of the following statements about current evidence comparing bruising and bleeding in children with coagulopathies with similar findings in child victims of abuse is correct?
    If coagulation test specimens are subjected to excessive or prolonged heat, factor levels may be falsely elevated
    Patients with traumatic brain injury often have temporary coagulopathy that does not reflect a congenital disorder
    Vitamin K deficiency bleeding (VKDB) is most common in infants aged 6 to 9 months and in babies who are not breastfed
    Laboratory evidence of coagulopathy excludes child abuse as a cause for bruising/bleeding