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Self-Assessment and Quiz

  1. In what ways do torturers try to conceal the consequences of their actions?
    1. Using narrow, sharp objects for beatings
    2. The use of wet towels with the electric shocks
    3. Detaining victims until obvious signs of abuse have resolved
    4. Leaving the victim’s shoes on during falanga (beating the soles of the feet)
    5. All of the above
  2. Torturers have been known to change their practices based on the effective documentation of torture by clinicians.
    1. True
    2. False
  3. Which of the following is true of falanga?
    1. It can cause acute pain, swelling and hematoma formation
    2. It can be associated with chronic pain, sensory disturbances and impaired walking
    3. A closed compartment syndrome may develop in the foot
    4. The above findings are considered pathognomonic for falanga
  4. Prompt examination is necessary to detect tympanic membrane ruptures less than 2 millimetres in diameter, which may heal within 10 days.
    1. True
    2. False
  5. “Palestinian” suspension results in posterior hyperextension of the arms and traction on the lower roots of the brachial plexus. This may result in damage to the long thoracic nerve and cause:
    1. Sensory deficit over the scapula
    2. A “winged” scapula: diminished vertebral border when hands are pressed against a wall with outstretched arms
    3. Sensory deficit in the deltoid region
    4. A “winged” scapula: prominent vertebral border when hands are pressed against a wall with outstretched arms
    5. Sensory deficit in the ulnar distribution
  6. Positional forms of torture leave few, if any, external marks or radiological findings, despite subsequent, frequently severe chronic disability.
    1. True
    2. False
  7. Which of the following may be observed with crushing and stretch injuries?
    1. Contusions
    2. Incisions
    3. Abrasions
    4. Chronic musculoskeletal pain and/or disabilities
    5. Rhabdomyolysis and acute renal failure
    6. All of the above
  8. Regarding burn injuries, which of the following statements are accurate?
    1. The pattern of scarring gives a clue to the method used
    2. Caustic or acid burns may leave a trail indicating the victim’s posture
    3. Heated metal rods, branding irons or electrically heated devices such as smoothing irons or soldering irons often leave scars of distinctive shape and, if in multiples, they make accidental injury most unlikely.
    4. Cigarettes are a particularly common torture weapon. The scars they leave depend on the way the cigarettes were applied to the skin. If they were touched lightly or simply brushed against the skin they may leave no scar or something that is indistinguishable from a scar from acne, chicken pox or insect bite. On the other hand, if the cigarettes were deliberately stubbed out and held immobile on the skin, the scar is often characteristically circular about one centimetre in diameter, with a hyperpigmented periphery (usually with a relatively indistinct periphery) and an atrophic, hypopigmented, “tissue paper” centre.
    5. All of the above
  9. Electrical injuries can cause:
    1. Severe pain without subsequent physical signs
    2. Dislocations of joints
    3. Arrhythmias leading to sudden death
    4. Urination and/or defecation
    5. All of the Above
  10. Electric shock torture may result in characteristic physical findings, but often do not.
    1. True
    2. False
  11. Various forms of asphyxiation may cause:
    1. No findings at all
    2. Conjunctivitis or otitis media
    3. Anoxic brain injury
    4. Acute broncho-pulmonary infections
    5. All of the above
  12. Waterboarding may not be considered a method of torture because it has been used successfully in survival training of military personnel.
    1. True
    2. False
  13. Violent shaking can result in:
    1. Cerebral edema and subdural hematoma leading to death
    2. Cognitive impairment
    3. Chronic headaches, disorientation and mental status changes
    4. Neck trauma including cervical spine fracture resulting in quadriplegia
    5. All of the above
  14. Which of the following are true statements about sexual assault?
    1. The term sexual assault should not be used unless an individual has been raped
    2. Sexual assaults are often accompanied by direct or implied threats
    3. Rape is always associated with the risk of developing sexually transmitted diseases, including human immunodeficiency virus (HIV)
    4. Ideally, medical evaluations of alleged sexual assault should include a team of experienced clinical experts.
    5. All of the above
  15. Which of the following are considered torture by the UN Committee Against Torture and/or the Special Rapporteur on Torture?
    1. Prolonged isolation and/or sensory deprivation
    2. Sleep deprivation
    3. Temperature manipulation
    4. Threats of harm
    5. Sensory bombardment
    6. Sexual humiliation
    7. All of the above
  16. Which of the following is/are true about the psychological sequelae of torture and ill treatment?
    1. Everyone who has been tortured develops at least some form of diagnosable mental illness
    2. Major Depression and PTSD are the most common diagnoses among survivors of torture and ill treatment
    3. For many that have survived torture, the symptoms of Major Depression and PTSD may persist and fluctuate for many years
    4. Torture and ill treatment can create a sense of complete confusion, powerlessness, and loss of control which can bring about a shattered understanding of one’s self, of any meaningful existential system and of the predictability of the world
    5. All of the above
  17. An examining clinician should not assume that all forms of torture and ill treatment have the same or similar outcomes because the psychological consequences of torture and ill treatment develop in the context of personal meaning and personality development.
    1. True
    2. False
  18. Standardized instruments and quantitative measurement should be used in all medical evaluations of psychological evidence of torture and ill treatment as they are superior to descriptive methods in establishing correlations between allegations of abuse and the subsequent development of psychological symptoms.
    1. True
    2. False
  19. Psychological outcomes can be influenced by many interrelated factors that include but are not limited to the following:
    1. Circumstances, severity and duration of the torture
    2. Age and developmental phase of the victim
    3. Genetic and biological vulnerabilities of the victim
    4. Perception and interpretation of torture by the victim
    5. Community values and attitudes
    6. Political factors
    7. Prior history of trauma
    8. Pre-existing personality
    9. All of the above
  20. Risk factors for developing mental illness among survivors of torture who are also refugees include:
    1. Migration factors (loss of home, loved ones, possessions, etc)
    2. Acculturation
    3. Poverty
    4. Cultural and linguistic isolation
    5. Absence of adequate support systems
    6. Unemployment or underemployment
    7. All of the above