Sexual Assault Mnemonic – Rape Mnemonic
Sexual assault is defined as any sexual act performed by one person on another without consent. It may result from the use of force, the threat of force, or from the victim’s inability or refusal to give consent. Sexual assault victims do not “entice” their assailants; sexual assault is an act of conquest and control.
Having trouble remembering all the important questions to ask during your patient encounter? Then try this Sexual Assault Mnemonic – Rape Mnemonic for USMLE Step 2 CS.
History
Histories must be obtained in a sensitive and supportive manner. Advocates can support patients and help them articulate their needs and questions during the history, but advocates should not respond to questions and care should be taken to avoid asking questions in a leading or suggestive manner.
The following details of the history should be obtained:
- Circumstances of the assault, including date, time, location, use of weapons, force, restraints, or threats.
- Whether or not the victim experienced loss of consciousness or memory loss.
- The assailant’s physical description along with the assailant’s use of drugs or alcohol.
- Specifics regarding oral, vaginal, or anorectal contact or penetration along with presence or absence of ejaculation and/or condom use.
- Areas of trauma should be ascertained focusing especially upon the victim’s mouth, breasts, vagina, and rectum.
- Bleeding on the part of either assailant or victim may be relevant in assessing the risk of hepatitis or HIV transmission. The source of genital bleeding must be ascertained as it can be life threatening.
- Recent consensual sexual activity before or after the assault including details about site of contact (oral, genital, anorectal) and condom use.
Victims should be asked if they have wiped, showered or bathed, changed clothing, eaten, used toothpaste or mouthwash, used enemas, changed or removed a tampon, sanitary pad, or barrier contraceptive device since the assault. Such activities can lower the yield of forensic specimen collection.
PHYSICAL EXAMINATION
NOTE: Make sure to wash your hands or wear gloves before starting your physical examination. Always ask for permission before starting each physical exam. Be sure to use proper draping (don’t forget to tie back patient’s gown after you’re done). Always explain each physical examination in layman’s term to your patient. Do NOT repeat painful maneuvers.
- General appearance: Inspect for any visible trauma
- Head, neck and mouth exam: Inspection, Palpitation (Look for signs of head trauma)
- Cardiovascular exam: Inspection, Auscultation, Palpation, Percussion
- Pulmonary exam: Inspection, Auscultation, Palpation, Percussion, Tactile Fremitus. (Especially in those patient who are experiencing shortness of breath and chest pain)
- Genitourinary exam: You are not required to perform genitourinary exam during your USMLE Step 2 CS exam.
- Abdominal exam: Inspection, Auscultation, Palpation, spleen
- Neurologic exam: Mini Mental Status Exam, Cranial nerves (2-12), Gross Motor & Sensory
- Psychiatric exam: Describe the patient’s emotional state.
- Musculoskeletal exam: Inspection, Palpitation (look for bruises and trauma)
Sexual Assault Mnemonic Rape Mnemonic
DIFFERENTIAL DIAGNOSIS
This section depends on patient’s other Chief Complaints. For example chest pain, abdominal pain, headache, loss of consciousness…
ALWAYS include the following in your Differential Diagnosis:
– Sexually Transmitted Infections
– Pregnancy
Sexual Assault Mnemonic Rape Mnemonic
DIAGNOSTIC WORK UP
- Pelvic exam (you are not required to perform this on your exam)
- Urine Beta-hCG to rule out pregnancy
- Screen for sexually transmitted infections: HIV, Hepatitis B, Syphilis, Chlamydia, Gonorrhea
- Wet mount, KOH prep, Cervical Culture, Vaginal pH
- XR-Skeletal survey
- Chest X-ray if there is signs of chest trauma or if the patient appears to be experiencing shortness of breath
- CBC if there is signs of acute blood loss or there is obvious signs of infection
Sexual Assault Mnemonic Rape Mnemonic
SCORE EXTRA POINTS
- Make sure to show empathy.
- If patient is crying offer tissue and water and do not interrupt while he or she is crying and let them finish crying.
- Support the patient by letting them know that you are here for them and that what happened was not their fault and it could have happened to anyone.
- Encourage patient to report the incident to the police if she/he has not already done so.
- Offer emergency contraceptives.
- Let patient know you are going to let the social worker come and talk to her and provide contact information for support groups and other resources.
- Make a follow-up visit — A follow-up medical visit should occur within one to two weeks of the acute evaluation. This provides an opportunity to review psychosocial supports for the victim and to offer counseling.
Sexual Assault Mnemonic Rape Mnemonic
- BEST Tips on how to Pass USMLE Step 2 CS
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- BLUE SHEET Mnemonic (.pdf file)
- CS Timer
- Official USMLE Step 2 CS Site
- Official Content Description & General Information Booklet (includes the list of abbreviation, you can use on your exam)
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Assault Rape Mnemonic