Pediatric Therapies Flashcards Preview

Psychiatry pro +1700 > Pediatric Therapies > Flashcards

Flashcards in Pediatric Therapies Deck (71):
1

What is DMDD?

Disruptive mood dysregulation disorder

2

What, generally, is DMDD?

-Chronic, severe, persistent irritability

3

What is conduct disorder?

a psychological disorder diagnosed in childhood or adolescence that presents itself through a repetitive and persistent pattern of behavior in which the basic rights of others or major age-appropriate norms are violated

4

What is the prognosis for conduct disorder?

Early = leads to sociopathy
Later = better prognosis

5

What is the boy:girl ratio of ADHD? Prevalence?

-4:1 to 9:1
-5%

6

What are the three domains of ADHD?

Inattention
Hyperactivity
Impulsivity

7

ADHD has an onset before what age? What is the duration that is needed to meet criteria? How many setting must this be seen in?

-before age 12
-Duration over 6 months
-At least 2 settings

8

There is a high comorbidity of ADHD with what other disorders?

-ODD
-CD
-learning disorder

9

What is the key difference between learning disability vs ADHD?

ADHD is a global problem vs disability is usually in one specific subject area

10

True or false: ADHD is overdiagnosed

Debateable

11

True or false: most kids will outgrow ADHD

True--frontal lobe grows, and learning strategies improve

12

True or false: TV causes ADHD

Possibly?-- may be related to stimulus

13

True or false: ADHD is associated with eating preservatives and additives

Maybe?

14

True or false: ADHD is a clinical diagnosis

True

15

What must be true of ADHD symptoms in regards to setting?

must be preset at both home and school

16

What are the common side effects of ADHD stimulants?

-GI symptoms
-Decreased appetite
-Blunted affect

17

What is the thinking behind the stimulant prescription for ADHD?

Stimulate the frontal lobe

18

True or false: stimulants have a high efficacy for ADHD

True

19

What can happen to affect with stimulant use that should be monitored for? (3)

Blunts, with flat affect

BP and pulse

20

What may happen with stimulant use in a kid with an underlying psychiatric disorder? Why?

Hallucinations and other psychiatric symptoms--increases dopamine release

21

What are the first line drugs for ADHD?

Methylphenidate--Ritalin

22

Why should amphetamine products be avoided as a first line therapy for ADHD?

Much greater side effect profile

23

How fast do amphetamines work with ADHD?

Hours to days

24

What are the familial disorders of untreated ADHD?

Increased parental divorce and sibling fights

25

What are the societal consequences of untreated ADHD?

Increased Substance abuse

26

What can be done with rebounding off of ADHD meds? (2)

Short acting stimulants or alpha-2 agonists (apraclonidine)

27

What is the only nonstimulant used for ADHD? MOA? Benefit? Downside?

-Atomoxetine
-NE reuptake inhibitor
-No rebounding, but less efficacious

28

What are the major side effects of Atomoxetine?

Hepatotoxic

29

What is the MOA of clonidine? Why use in ADHD?

-Alpha-2 agonists
-treats impulsivity

30

What should be done prior to administering a stimulant for ADHD?

Cardiac exam and ECG if indicated

31

What ADHD get better with behavioral programs alone?

Mostly not

32

Will ADHD meds cause growth suppression?

Small evidence with little effect

33

Will children outgrow ADHD?

50% chance

34

Is ritalin a gateway drug?

No--less impulsivity and increased frontal lobe actually decrease drug use

35

Lining up toys = what mental disorder?

Autism

36

What is the M:F ratio of autism?

4:1

37

What are the three domains of autism?

1. Impairment in social interactions
2. Impairment in communication
3. Restricted pattern of interest and stereotypical behavior

38

What are the qualifications of autism?

With or without:
-Intellectual impairment
-Language impairment
-Known medical conditions

39

What are the levels 1-3 of autism?

1 = high functioning
2 = Needs some support
3 = needs a lot of support

40

When should you refer for suspected autism? (4)

-Language delay
-Lack of nonverbal communication
-Lack of symbolic play
-Stereotypical or self stimulating behaviors

41

What is the trend of incidence of autism?

Increasing

42

What is the treatment for autism?

-PT/OT/speech
-Social skills training
-SSRI

43

What is the pharmacotherapy for autism? (3)

-NMDA antagonists (memantine)
-SSRIs
-Antipsychotics

44

What is the MOA and use of memantine?

-Alzheimer's and maybe autism
-NMDA receptor blocker

45

Are negative or positive s/sx of schizophrenia seen first (usually)?

-Prodromal negative symptoms
-Acute s/sx are positive

46

What are schizophrenic patients often misdiagnosed as early on in the course of the disease? Why?

Depression, since negative s/sx usually come first

47

What type of hallucinations are usually had with schizophrenia: auditory or visual? Are these usually internal or external?

Auditory
External

48

What is the prevalence of schizophrenia?

1%

49

Who usually presents with schizophrenia earlier, men or women

Men

50

IQ can drop how much with psychosis?

Two SDs (30 points)

51

What happen to the brain with schizophrenic patients?

Shrinks

52

What happens to suicide rates post hospitalization for psychotic patients?

increase--thinking clearly leads to suicide

53

Does marijuana have an effect on schizophrenia?

Yes

54

What birth month more commonly has psychosis?

Winter months

55

True or false: schizophrenia is more common in males

False--no gender difference

56

What is the average length of time between the first psychotic break and treatment?

2-3 years

57

True or false: schizophrenia is more common in males

Fales--relatively equal

58

True or false: violence is more common in the schizophrenic population

False

59

True or false: paranoid schizophrenics have the worst prognosis

False--have the best prognosis

60

True or false: language delays can happen with schizophrenic patients

True

61

What happens to the ventricle with schizophrenia?

Enlarge

62

What is the male:female ratio of conduct disorder

5:1

63

What is the major comorbidity with conduct disorder?

ADHD (50% comorbidity)

64

What is the difference in the MOA of amphetamine derived products, compared to methylphenidate?

In addition to blocking reuptake of dopamine, they increase the release of it

65

What is the effect of untreated ADHD on ER visits?

33% increase

66

What is the effect of untreated ADHD on bike accidents?

50% increase

67

What is the effect of untreated ADHD on substance use?

2x risk

68

What is the effect of untreated ADHD on parental absenteeism?

Increased

69

Difficulty with symbolic play = what disease?

Autism

70

True or false: kids with autism often lack the theory of mind

true

71

Which gender appears later with schizophrenia?

Females