<prompt> A baby was vigorously shaken by parents. What do you expect in the baby?Rib fracturesPelvic fractureRuptured spleenSub-dural hematoma  <response>: d. Sub-dural hematomaRef: Nelsons 20e p 239-243, 3067Child abuseShaken baby syndromelnflicted childhood neurotraumaIt occurs secondary to violent, non-accidental, repetitive, unrestrained acceleration-deceleration head neck movements, with or without blunt head trauma in children typically 3 year of age.Inflicted childhood neurotrauma accounts for 10 of all cases of child abuse and carries a mortality rate of up to 25.Retinal hemorrhage multiple, involving 1 layer is the most common ophthalmic finding.Fractures that strongly suggest abuse include classic metaphyseal corner lesions, posterior1st rib fracture, scapularsternal fracture, spinous process fracture. These fractures require more force than would be expected from a minor fall or routine handling and activities of a child.Abusive head trauma AHT results in the most significant morbidity and mortality may be caused by direct impact, asphyxia, or shaking.Subdural hematomas, retinal hemorrhages diffuse axonal injury strongly suggest AHT, especially when they co-occur. 