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1. How would you tell the difference between abuse and neglect in an elderly patient? What are signs of neglect in an elderly patient? What are signs of abuse?
2. If a patient has signs of neglect but not abuse, can this still be abuse? Why or why not?
3. The history describes a fall. In general, what patterns of injury would support that story? What patterns of injury go along more with abuse?
4. If the family tells you the patient was unable to walk and was bedridden, how does that change your understanding of the case?
5. If the family tells you the patient was ambulatory, how does that change your understanding of the case?
6. If the patient was verbal before the fall and non-verbal after, what’s your differential diagnosis?
7. View the physical exam and summarize the findings.
8. What about the pattern of injury supports the story? Is there anything about the pattern of injury that suggests a different story?
9. What additional injuries might cause you to challenge the history?
10. What’s your differential diagnosis for cause of death in this patient who died one week after a fall (see history)?
11. If you were called to the scene for a patient with these injuries and history of a fall, how would transfer or transport the patient for emergency care?
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