A 3-year-old female child with repeated admissions as bleeding tendency in a form of spontaneous ecchymosis and bleeding through the nose and urine
belongs to book: MCQs in Pediatrics Review of Nelson Textbook of Pediatrics|Zuhair M Almusawi, Hasanein Ghali|20th edition| Chapter number:5| Question number:5.14
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(C) The presentation of medical child abuse (MCA) formerly called Munchausen syndromeby proxy;may vary in nature and severity. Consideration of MCA should be triggered when the reported symptoms are repeatedly noted by only one parent, appropriate testing fails to confirma diagnosis,and seemingly appropriate treatment is ineffective. Drug level for warfarln may solve the problem in this case, the mother is staff nurse and she is familial with medical issues,the social history given issuggestive of disturb relationship between parents
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