Child maltreatment recognition and response — branching viva

Opening question

Examiner: The registrar wants to send this infant home as a minor accidental bruise. Would you? Why? ^[8]

Candidate: No, I would not send the child home on that basis. This is a sentinel injury — a visible minor injury in a pre-mobile infant whose stated mechanism does not fit. A three-month-old who cannot yet roll cannot plausibly bruise the pinna and the cheek on a feed-bottle. Sentinel injuries are the most preventable miss in paediatrics: roughly one in three such infants has occult abuse found on workup, and the injury may precede a fatal event. I would document, examine fully, investigate, and report, in parallel. ^{[8] [9]}