13. ADHD Flashcards
What are the clinical features of ADHD
TRIAD = inattention, hyperactivity + impulsivety (DSM5 Dx criteria)
- Over-active, fidgety and disruptive
- Impaired attention and concentration
- Easily distracted and does not listen
- Impulsive, no sense of danger
- Unable to tolerate frustration or defer gratification
How should suspected ADHD be Ix?
Connors questionnaire
School reports
Organic causes = bloods (TFT, bone profile, LFT, U+E, anaemia screen, lipids), urine analysis
Exam = neurocutaneous features, dimorphism, growth (height, weight, HC)
How is ADHD managed?
Pre-school:
- Behavioural management
- Parent training and support
School-goers:
- CBT
- Educational support
- Medication = Methylphenidate (ritalin) - need to explore cardiac problems, syncope, FH (SE = tachy, prolong QT, BP, lack of appetite, weight loss, effected sleep)
- do not give at weekends/holidays due to reduced appetite and therefore suppressed growth
Outline the aetiology of ADHD
Genetic = twin and adoption studies indicate predisposition
Neurochemical = abnormality in dopaminergic pathway
Neurodevel = abnormalities in pre-frontal cortex (hypothesis based on Sx of recklessness, inattention, LD)
Social = social deprivation, family conflict, parental cannabis/alcohol exposure
Give a DDx for ADHD
LD/dyslexia
Oppositional defiant disorder
Conduct disorder
Autism
Sleep disorders
Mood disorders (particularly bipolar)
Anxiety disorder
Hearing impairment
