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Child physical abuse — MCCQE Part 1 MCQ

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HardTraumaChild physical abuseMCCQE Part 1

A non-mobile 7-month-old has a femoral fracture and bruises on the ears and torso. The caregiver’s explanation changes twice. The child is stable, and no single finding yet proves inflicted injury. What is the physician’s immediate duty?

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Correct answer: A — Protect the child, document findings and report the reasonable suspicion

Require forensic confirmation before submitting a child-protection report: The evidentiary standard for a report is deliberately lower than the criminal standard. Seek a caregiver confession before documenting the injury mechanism: Aggressive confrontation can compromise safety and investigation and is not the clinician’s role. Protect the child, document findings and report the reasonable suspicion: Objective diagrams, photographs where authorized, skeletal evaluation and prompt reporting protect the child without requiring the clinician to determine guilt. Discharge with fracture follow-up while accidental trauma remains possible: Possible accident does not neutralize multiple high-risk features in a non-mobile infant. Ask extended family to investigate before involving child-protection services: Informal family investigation delays statutory safeguarding and may expose the child to further harm.

Reference: https://cps.ca/en/documents/position/medical-assessment-of-bruising