DOB: 9/7/2016 Polly Davis is a 5-year-old, Caucasian female who is brought to you by her father Jeremiah today for conce

[answerhappygod]

DOB: 9/7/2016
Polly Davis is a 5-year-old, Caucasian female who is brought to
you by her father Jeremiah today for concerns of crying with
urination and repeated complaints of “pain down there,” which seems
to be getting worse. Jeremiah is a single father who works nights
at a local warehouse. Polly’s grandmother used to babysit Polly
each night while her dad worked, but she passed away two months
ago. Since that time, Polly’s uncle has been watching Polly
overnight. Jeremiah has noticed that Polly has become unusually
clingy, crying when he leaves for work. He reports that recently
she has been soiling herself, which is a new finding. On exam, you
notice significant vulvovaginitis with some purulent vaginal
discharge; there also appears to be some hymenal tearing along with
some suspicious bruising on her buttocks. You suspect Polly is
being sexually abused.
Questions:
1. What are your immediate concerns for Polly? How would you
address these concerns?
2. If you are required to report suspected pediatric abuse, who
do you report your suspicions to? What is the required
timeline for reporting?
3.How would you conclude this visit? In addition to referring
Polly to the ER, what other types of referrals might you need to
consider as her primary care provider?
4. How would you document this visit?