AssessmentsPhysical and sexual abuse
Physical and sexual abuse
USMLE® Step 1 style questions USMLE
USMLE® Step 2 style questions USMLE
A 1-year old male infant is brought to the emergency department by his foster mother. She claims that the child has been acting strangely since this morning. His medical history is noncontributory. On physical examination, the baby looks lethargic and has alcohol and cigarette body odor. Skin examination reveals multiple bruises over shoulders, head, and buttocks. Lower limb exam shows a limited range of movement on his left leg. Fundoscopic exam shows bilateral retinal hemorrhages. His temperature is 36.7°C (98°F), pulse is 150/min, respirations are 50/min, blood pressure is 110/70 mmHg. Before finishing the medical exam, the foster mother wants to leave and asks how much longer is the visit going to take. When she is explained about the presumptive diagnosis, she gets angry and denies any form of treatment for the baby. Which of the following is the best immediate next step in management?