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Intimate partner violence and child abuse
Intimate partner violence is common and hidden; the doctor asks privately, believes, documents, assesses danger and builds a safety plan — with a competent adult he acts with her consent, whereas with suspected abuse of a minor or a helpless person reporting is mandatory.
Why it matters in the exam
The exam asks "when intimate partner violence is suspected, what is required of the doctor?", presents a patient describing threats from a partner who owns a gun and suspects infidelity (high risk of homicide), and a woman whose husband curses and humiliates her (emotional abuse is abuse). Other questions describe a toddler with bruises and ask which finding suggests abuse.
Recognise the high-danger signs — a weapon, death threats, past strangulation, escalation, recent separation and pregnancy — which need an immediate safety plan and contact with welfare services.
The family doctor sees all the family members, so he is often the first to notice the signs. Many women will not tell unless asked, so a simple, direct question in private, without the partner in the room, is the most important step. Another question deals with documentation: what is recorded and how privacy is protected.
Key points
- Ask privately, with a direct, non-judgmental question.
- High danger: weapon, death threats, strangulation, escalation, separation, pregnancy.
- Document, assess danger, safety plan and referral to a social worker.
- Emotional abuse is abuse.
- Suspected abuse of a minor or a helpless person — mandatory report.
Summary table
| Topic | What to look for | What to do | Exam note |
|---|---|---|---|
| Recognition | Injuries that do not fit the story, delayed presentation, repeated visits, chronic pain, depression, a controlling partner | Ask privately, with a direct, non-judgmental question | Do not ask in the partner's presence |
| High-danger signs | Weapon, death threats, past strangulation, escalation, recent separation, pregnancy, extreme jealousy | Safety plan, urgent referral to a social worker and a family-violence centre | Risk of homicide |
| Documentation | Description of injuries, quoting the patient, photographs with consent | Accurate notes in the record | Documentation is used in legal proceedings |
| Reporting for a competent adult | — | Referral and help with her consent; no police report without consent, except in immediate danger as the law provides | Children exposed to violence at home — consider the duty to report to a welfare officer |
| Suspected child abuse | Bruises in a baby who does not yet crawl, bruises on the torso, ears and neck, posterior rib fractures, metaphyseal fractures, patterned injury | Work-up (skeletal survey, blood count and clotting) and report | Reporting to a welfare officer or the police — mandatory |
A free exam question
ב ילדים קיימים נגעים בעצמות שיכולים להידמות לנזק שנגרם כתוצאה מהתעללות . איזה מהבאים אינו נמצא באבחנה המבדלת לנזקים בעצמות שנגרמים מהתעללות? (the question as examined, in Hebrew)
- א. הרעלה בויטאמיןA
- ב. חוסר ויטאמיןB1
- ג. טיפול בדילאנטין(phenytoin)
- ד. טיפול במתוטרקסט(methotrexate)
In the full version for subscribers
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Sources
- US Preventive Services Task Force, 2018 — Screening for intimate partner violence, elder abuse, and abuse of vulnerable adults
- World Health Organization, 2013 — Responding to intimate partner violence and sexual violence against women: clinical and policy guidelines
- State of Israel, 1977 (section 368D) and 1991 — Penal Law — duty to report abuse of minors and helpless persons; Prevention of Family Violence Law
Sources are given for further reading; the text is written afresh and not copied from them.
Reviewed by the Examqo AI Professor · 2026-11-06. The text may contain errors; when in doubt, check the source.