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DSSSB - 29 August 2019 (Shift-2)
Child Health Nursing (Pediatrics)
Easy

When a small child is shaken by the arms or shoulders in a repetitive, violent condition is called?

Appeared in: DSSSB - 29 August 2019 (Shift-2)

Explanation

  • Shaken baby syndrome, or abusive head trauma (AHT), is the medical term for the injuries sustained by an infant or young child who has been subjected to violent, repetitive shaking.
  • The mechanism involves acceleration-deceleration forces that cause the brain to move within the skull, as infants have weak neck muscles and a relatively large head.
  • This trauma leads to a classic triad of injuries: subdural hematoma (bleeding in the brain), retinal hemorrhages (bleeding in the eyes), and encephalopathy (brain swelling/damage).
  • The presentation can be nonspecific, ranging from irritability and vomiting to seizures, unresponsiveness, or death.

Why Other Options Were Wrong

  • Option A: Marfan syndrome is a genetic disorder of the body's connective tissues. It is not caused by trauma or abuse.
  • Option B: Munchausen syndrome is a psychiatric factitious disorder where someone feigns illness. Munchausen syndrome by proxy is a form of abuse where a caregiver fabricates or induces illness in a child, but it does not describe the specific mechanism of shaking.
  • Option C: De Quervain syndrome (also known as 'mother's wrist' or 'gamer's thumb') is a tenosynovitis of the wrist, a repetitive strain injury affecting the tendons on the thumb side. It is not related to child abuse or head trauma.

Related Visual

An illustration showing the mechanism of shaken baby syndrome. It should depict the infants brain moving inside the skull during shaking, highlighting the areas of injury such...
Clinical Relevance
  • Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Identification of Shaken Baby Syndrome (Abusive Head Trauma) as background academic context rather than a clinical decision trigger.
  • Nurses have a critical role in identifying potential cases of child abuse. Recognizing the signs of shaken baby syndrome (e.g., irritability, lethargy, seizures, inconsistent history from caregivers) is a vital patient safety responsibility.
  • In India, as in many countries, healthcare professionals are mandated reporters. If a nurse suspects child abuse, they have a legal and ethical obligation to report it to Child Protective Services and/or local law enforcement to protect the child from further harm.
  • A key nursing intervention is parent education on the dangers of shaking a baby and providing strategies for coping with a crying infant to prevent such tragedies.
How to Approach the Question
  • First, analyze the question stem to identify the core action: a 'small child' is 'shaken' in a 'repetitive, violent' manner.
  • This is a factual recall question that asks for the specific medical term for this action and its consequences.
  • Evaluate each option based on its definition.
  • Option A, Marfan syndrome, is a genetic disorder.
  • Option B, Munchausen syndrome, is a psychiatric disorder involving feigned illness.
  • Option C, De Quervain syndrome, is a wrist tendon inflammation.
Concept Tested & Keywords
  • Concept Tested: Identification of Shaken Baby Syndrome (Abusive Head Trauma)
  • Stem keywords: small child, shaken, repetitive, violent
  • Lead-in keywords: is called
  • Clinical cues: Age/sex group narrows the expected diagnosis, intervention, or normal reference range.

Question ID

Qbkud7iQNSlN3TzIKDdRSW

Reference Book

E6 Nelson Textbook of Pediatrics(2024) — Volume 1 p. 159-161

E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) p. 12981-12983

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