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Self-Assessment and Quiz

  1. If you were called upon to evaluate Mr. Adam while in custody and one of the detaining police officers was present in the examination room, what should be your initial course of action?
    1. Allow the police officer to remain to ensure your safety
    2. Request the police officer to remain outside the examination room and/or out of earshot
    3. Document the presence and identity of the police office and continue your evaluation
    4. Refuse to conduct the examination
  2. After you complete your evaluation of Mr. Adam in custody, you must provide the attending police officer with a copy of your evaluation.
    1. True
    2. False
  3. It is acceptable for clinicians to examine detainees in hand and leg shackles as long as it is the policy of the detention facility.
    1. True
    2. False
  4. Obtaining information on Mr. Adam’s past medical/psychiatric history is necessary to distinguish pre-existing physical and mental conditions from possible torture-related sequelae.
    1. True
    2. False
  5. The information obtained for Mr. Adam’s psychosocial history is not particularly relevant to the assessment of medical evidence of torture and ill treatment?
    1. True
    2. False
  6. In Mr. Adam’s case, which one of the following factors is most likely to interfere with an accurate recounting of past events:
    1. Blindfolding
    2. Disorientation
    3. Lapses in consciousness
    4. Organic brain damage
    5. Psychological sequelae of abuse
  7. Mr. Adam’s lapses in consciousness warrant which of the following?
    1. Neuropsychological testing
    2. Diagnostic imaging of the brain (CT Scan or MRI)
    3. A complete neurological examination including a mental status examination, cranial nerves, CNS and PNS
    4. Electroencephalogram (EEG)
  8. Mr. Adam spontaneously alleged that he was stripped naked and given electric shocks to his penis while suspended. There is no need, therefore, to inquire about additional forms of sexual assault.
    1. True
    2. False
  9. What is the most likely cause of Mr. Adam’s difficulty having erections?
    1. Psychosomatic
    2. Neurologic damage due to electric shocks
    3. Peripheral vascular disease
    4. None of the above
  10. After you complete your medical evaluation of Mr. Adam, you should order an EMG (electromyogram) study to assess the possibility of a brachial plexus injury
    1. True
    2. False
  11. The absence of penile lesions on examination is inconsistent with Mr. Adam’s allegations electric shock torture.
    1. True
    2. False
  12. What factors may account for the relative paucity of Mr. Adam’s psychological symptoms?
    1. The meaning of his experience in relation to his political beliefs and activities
    2. Fear of reprisals from police
    3. Support from his family members
    4. Lack of exposure to psychological methods of torture
  13. How would you describe the level of consistency between, Mr. Adam’s allegations of cigarette burns and physical examination findings of multiple hyperpigmented circular scars (about 1 cm in diameter) with indistinct margins and no central palor or atrophy?
    1. Not consistent
    2. Consistent with
    3. Highly consistent with
    4. Virtually diagnostic of
  14. It is not possible that Mr. Adam’s cigarette burns were self-inflicted?
    1. True
    2. False
  15. How would you describe the level of consistency between, Mr. Adam’s allegations of “rope burns” from suspension torture and his physical examination findings of hyperpigmented, circumferential scars above both wrists?
    1. Not consistent
    2. Consistent with
    3. Highly consistent with
    4. Virtually diagnostic of
  16. In the course of presenting the following photographic evidence of Mr. Adam in court, the cross examining attorney states that the alleged injuries were, instead, self-inflicted.

    Which of the following may help to explain why the Mr. Adam’s findings are not likely to be the result of self-inflicted?

    1. The “tram-track” marks are characteristic of blunt trauma from significant blows with a rectangular or cylindrical object such as a police baton
    2. The location of the lesions are not consistent with self-inflicted injuries which require considerable force
    3. The repetitive nature of the injuries suggest a common defensive position during beatings and intentional rather than incidental use of force
    4. While it is possible that the injuries could have been inflicted by another person following detention, this is unlikely given all of the physical and psychological evidence in Mr. Adam’s case
    5. All of the above
  17. If you were to note the findings illustrated below on Mr. Adam’s physical examination, and Mr. Adam indicated that he hadn’t noticed the axillary marks until after he was tortured, what would you consider the most likely cause of the findings to be?
    1. Subucutaneous fibrosis resulting from alleged suspension torture
    2. Circumferential abrasions from ligatures
    3. Scars from lacerations
    4. Striae distensae
  18. How would you describe the level of consistency between, Mr. Adam’s allegations of abuse and his psychological evaluation findings?
    1. Not consistent
    2. Consistent with
    3. Highly consistent with
    4. Virtually diagnostic of
  19. Given Mr. Adam’s minimal endorsement of psychological symptoms, the examining clinician should administer psychological instruments for anxiety, Major Depressive Disorder and PTSD.
    1. True
    2. False
  20. Which of the following considerations would support the clinical assessments of Mr. Adam’s credibility and argue against the possibility of malingering or simulation?
    1. Lack of over-endorsement of physical and/or psychological symptoms
    2. Lack of a suspiciousness or defensiveness
    3. Consistency between Mr. Adam’s observed affect and the content of the evaluation
    4. Consistency between Mr. Adam’s pre-torture personality and the meaning he assigns to his torture/ill treatment experiences
    5. All of the above