em@3am

A 15-year-old female with no reported past medical history presents with lower abdominal pain and possible STI symptoms. She reports living with a “friend” but cannot provide an address, does not attend school regularly, and is accompanied by an adult male who claims he’s “just a family friend” but refuses to leave her side and answers all questions for her. She is alert and oriented but appears fatigued, with mildly matted hair. She avoids eye contact with the clinician and nurse, and her story has changed multiple times since arrival. What are you concerned about outside of the abdominal pain?

A 3-month-old previously healthy male is brought to the ED by his parents. His father says he rolled off the couch onto a hardwood floor, started crying immediately, and then seemed sleepy and more fussy than usual. On exam, the patient is minimally consolable with a small bruise on his left forehead. Vitals are stable. There are no palpable skull fractures. Due to the age and mechanism, you obtain a head CT which shows a subdural hematoma without midline shift. You obtain a skeletal survey which shows a healing posterior rib fracture. What is the diagnosis?