Investigations
1st investigations to order
FBC
Test
Assists in the evaluation of other causes of petechiae or bleeding. Excludes platelet abnormalities as a cause of bruising. Identifies other haematological abnormalities (e.g., leukaemia) and highlights presence of anaemia.
Result
normal
platelet function studies
Test
Excludes platelet function abnormalities.
Result
normal
basic metabolic profile (including urea and creatinine)
Test
Unexplained electrolyte abnormalities and presence of volume depletion might suggest abuse.
Result
normal or abnormal electrolyte, urea, and creatinine levels
clinical photograph
Test
Useful to record the extent and site of bruising or wounds.
Result
record of bruises or wounds
x-rays
Test
X-rays should be taken of relevant body parts to detect any fractures.
Multiple fractures or fractures in various stages of healing may signify abuse.
Result
recent or old fractures
Investigations to consider
CT head
Test
Testing has to be based on history and other findings on physical examination.
Routine testing is not likely to be helpful.[47]
Result
normal or positive for abnormalities such as subdural haematoma in the head
CT abdomen
Test
Testing has to be based on history and other findings on physical examination.
Routine testing is not likely to be helpful.[47]
Result
normal or positive for abnormalities such as haematomas, solid organ injury, or perforation of bowels
serum levels of relevant medicines
Test
To test whether levels of prescribed medicines are adequate and to investigate the presence of other non-prescribed drugs.
Result
may be positive or negative
toxicology screen (urine and blood)
Test
Toxicology screening may be indicated to determine if alcohol or illicit substances are contributing to the clinical presentation.
In this situation, a toxicology screen typically involves urinary and blood screening for alcohol, but may also include screening for illicit substances.
Result
may be positive if alcohol or illicit drugs are contributory factors
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