10. Child psych

Question 1

Most common inherited form of ID?

Answer 1

Fragile X syndrome

Question 2

Gene mutation in Fragile X Syndrome?

Answer 2

FMR-1 gene mutation

Question 3

Most common chromosomal disorder

Answer 3

Down Syndrome

Question 4

Leading preventable cause of birth defects and ID

Answer 4

Fetal alcohol syndrome

Question 5

3 features of FAS

Answer 5

1. Growth retardation
2. CNS involvement
3. Facial dysmorphology (smooth philtrum, short palpebral fissures, thin vermillion border)

Question 6

Risk factors for specific learning disorders

Answer 6

Premature
Very low birth weight
Prenatal nicotine use
Increased risk in first-degree relatives of affected individuals

Question 7

Difficulty producing articulate, intelligible speech

Answer 7

Phonological disorder

Question 8

First line therapy in ADHD

Answer 8

Stimulants: methylphenadate, dextroamphetamine, mixed amphetamine salts

Question 9

Second line for ADHD

Answer 9

Atomoxetine: a NE reuptake inhibitor

Question 10

Alpha-2 agonists that can be used instead or as adjunctive treatment to stimulants for treatment of ADHD

Answer 10

Clonidine

Guanfacine

Question 11

Rapid deterioration of social and/or language skills during first 2 years of life is a red flag for?

Answer 11

Autism spectrum disorder

Question 12

When are symptoms of ASD usually recognized?

Answer 12

Between 12 and 24 months old

Question 13

What are some etiologies of ASD?

Answer 13

Infections/drugs
Advanced paternal age
Low birth weight
15 % of cases associated with known genetic mutation

Question 14

What is the most common single gene cause of ASD?

Answer 14

Fragile X Syndrome

Question 15

What are the 2 most important predictors of adult outcome in ASD patients?

Answer 15

Level of intellectual functioning

Language impairment

Question 16

What can be used to help reduce disruptive behavior, aggression, and irritability in ASD?

Answer 16

Low dose atypical antipsychotics

Question 17

How is Tourette’s characterized?

Answer 17

Multiple motor tics and at least one vocal tic lasting for at least 1 year.

Question 18

What are the most common motor tics in Tourett’s disorder?

Answer 18

Face and head

ex. eye blinking, throat clearing

Question 19

Coprolalia

Answer 19

Utterance of obscene, taboo words as an abrupt, sharp bark or grunt

Question 20

Echolalia

Answer 20

Repeating others words

Question 21

Onset of Tourette’s disorder?

Peak severity?

Answer 21

Onset between 4 and 6 years

Peaks at 10 to 12 years

Question 22

If a tic becomes impairing, what med is first line for treatment?

Answer 22

Guanfacine (an alpha2 agonist)

Question 23

How long do the motor tics and vocal tic have to last for the diagnosis of Tourettes?

Answer 23

1 year

Question 24

Child who can get along with peers but does not comply with rules from parents or teachers

Answer 24

Oppositional defiant disorder

Question 25

How long do the symptoms have to be present for ODD to be diagnoses?

Answer 25

At least 6 months

Question 26

What are some of the symptoms of ODD?

Answer 26

Anger/irritable mood (loses temper, easily annoyed, resentful)
Argumentative/defiant behavior (breaks rules, argues with authority figures, deliberately annoys others, blames others)
Vindictiveness (spiteful at least 2x in past 6 months)

Question 27

ODD often precedes what?

Answer 27

Conduct disorder

*BUT most with ODD do not develop conduct disorder

Question 28

Conduct disorder

Answer 28

Most serious disruptive behaviors
Violate the rights of other humans and animals
Physical and sexual violence
May lack remorse 
Lack empathy

Question 29

LIfetime prevalence of conduct disorder?

Answer 29

9 %

ODD is 3 %

Question 30

Requierments for diagnosis of enuresis

Answer 30

Recurrent urination into clothes or bed-wetting
Occurs 2x/week for 3 or more consecutive months

Greater than 5 years old

Can occur during sleep (nocturnal), during the day (diurnal), or both

Question 31

Recurrent defecation into inappropriate places

Dx requirements

Answer 31

Encopresis

Occurs 1 or more times per month for 3 or more months

Greater than 4 years old developmentally

Question 32

What is a common cause of encopresis?

Answer 32

Constipation/impaction with overflow incontinence

Question 33

What happens to the majority of enuresis cases?

Answer 33

Spontaneously remit

Question 34

First-line medication for enuresis?

Answer 34

Desmopressin (ADH analogue)

Question 35

2nd line for Enuresis?

Answer 35

Impiramine (TCA)

Question 36

Most common drug of abuse by adolescents?

Answer 36

Alcohol

Question 37

What percent of girls are exposed to sexual abuse?

Answer 37

25 %