Introduction: 

This case study discusses a young woman who presents to the emergency department after experiencing a sexual assault. This case invites learners to consider the appropriate clinical management for sexual assault victims, from initial care and evaluation to long-term follow-up.

Case Profile: 

A 26-year-old woman arrives at the emergency department at 1:00 a.m. She explained that she was working on a project with a colleague who invited her to his house for further discussion. As they were talking, he initiated a kiss, which escalated despite her protests. She reports that she was restrained, undressed, and forced into intercourse. She is visibly distressed, tearful and anxious and reports she had a glass of wine over the course of the evening.

Her past medical history is unremarkable, with no previous hospitalizations, no allergies, and no medications. Her social history reveals that she is a graduate student in Social Sciences, and she does not regularly use drugs or alcohol.

Activity Questions:

• What are the key components of care in this scenario? 
  Hint: Consider the importance of patient care, evidence collection, physical examination, and documentation.
  

• What is the epidemiology of sexual assault? 
  Hint: Discuss the prevalence and patterns of sexual assault and identify populations at higher risk.
  

• What are the risk factors for becoming a perpetrator of sexual assault? 
  Hint: Identify individual and community-level risk factors related to sexual assault perpetration.
  

• What laboratory tests are indicated for this patient? 
  Hint: Consider the role of laboratory tests in evaluating pregnancy, sexually transmitted infections, and baseline tests for diseases with delayed seroconversion.
  

• Which medications should this patient be offered acutely? 
  Hint: Discuss the appropriate prophylactic medications for sexually transmitted infections, emergency contraception, and other potential prophylactic treatments.
  

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