10. Child psych Flashcards
Most common inherited form of ID?
Fragile X syndrome
Gene mutation in Fragile X Syndrome?
FMR-1 gene mutation
Most common chromosomal disorder
Down Syndrome
Leading preventable cause of birth defects and ID
Fetal alcohol syndrome
3 features of FAS
- Growth retardation
- CNS involvement
- Facial dysmorphology (smooth philtrum, short palpebral fissures, thin vermillion border)
Risk factors for specific learning disorders
Premature
Very low birth weight
Prenatal nicotine use
Increased risk in first-degree relatives of affected individuals
Difficulty producing articulate, intelligible speech
Phonological disorder
First line therapy in ADHD
Stimulants: methylphenadate, dextroamphetamine, mixed amphetamine salts
Second line for ADHD
Atomoxetine: a NE reuptake inhibitor
Alpha-2 agonists that can be used instead or as adjunctive treatment to stimulants for treatment of ADHD
Clonidine
Guanfacine
Rapid deterioration of social and/or language skills during first 2 years of life is a red flag for?
Autism spectrum disorder
When are symptoms of ASD usually recognized?
Between 12 and 24 months old
What are some etiologies of ASD?
Infections/drugs
Advanced paternal age
Low birth weight
15 % of cases associated with known genetic mutation
What is the most common single gene cause of ASD?
Fragile X Syndrome
What are the 2 most important predictors of adult outcome in ASD patients?
Level of intellectual functioning
Language impairment
What can be used to help reduce disruptive behavior, aggression, and irritability in ASD?
Low dose atypical antipsychotics
How is Tourette’s characterized?
Multiple motor tics and at least one vocal tic lasting for at least 1 year.
What are the most common motor tics in Tourett’s disorder?
Face and head
ex. eye blinking, throat clearing
Coprolalia
Utterance of obscene, taboo words as an abrupt, sharp bark or grunt
Echolalia
Repeating others words
Onset of Tourette’s disorder?
Peak severity?
Onset between 4 and 6 years
Peaks at 10 to 12 years
If a tic becomes impairing, what med is first line for treatment?
Guanfacine (an alpha2 agonist)
How long do the motor tics and vocal tic have to last for the diagnosis of Tourettes?
1 year
Child who can get along with peers but does not comply with rules from parents or teachers
Oppositional defiant disorder
How long do the symptoms have to be present for ODD to be diagnoses?
At least 6 months
What are some of the symptoms of ODD?
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)
ODD often precedes what?
Conduct disorder
*BUT most with ODD do not develop conduct disorder
Conduct disorder
Most serious disruptive behaviors Violate the rights of other humans and animals Physical and sexual violence May lack remorse Lack empathy
LIfetime prevalence of conduct disorder?
9 %
ODD is 3 %
Requierments for diagnosis of enuresis
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
Recurrent defecation into inappropriate places
Dx requirements
Encopresis
Occurs 1 or more times per month for 3 or more months
Greater than 4 years old developmentally
What is a common cause of encopresis?
Constipation/impaction with overflow incontinence
What happens to the majority of enuresis cases?
Spontaneously remit
First-line medication for enuresis?
Desmopressin (ADH analogue)
2nd line for Enuresis?
Impiramine (TCA)
Most common drug of abuse by adolescents?
Alcohol
What percent of girls are exposed to sexual abuse?
25 %
