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Non-accidental injury — MCCQE Part 1 MCQ

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ModerateSeizuresNon-accidental injuryMCCQE Part 1

A 4-month-old has a seizure (rhythmic jerking x 2 min). Temp 36.9. Lethargic with bulging fontanelle. Bilateral retinal haemorrhages. Bruising of varying ages on torso. Most appropriate next step?

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Correct answer: E — Skeletal survey, CT head, and report to child protective services

Seizure + bulging fontanelle + bilateral retinal haemorrhages + bruising in pre-mobile infant = abusive head trauma. CT head + skeletal survey + mandatory reporting to CAS. Healthcare professionals are mandated reporters in Canada.

Reference: CPS Child Abuse Statement / Canadian law