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Psych > 2/14: Child Psychiatry > Flashcards

2/14: Child Psychiatry Flashcards

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1
Q

differences b/w adult and child psychiatry

A

consideration of developmental level, techniques of assessment, involvement of family, inc role of non-physicians in the health care team, freq occurrence of psychiatric comorbidity

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2
Q

Intellectual disability

A

significantly sub-avg intellectual fxing (IQ)

  • signif limitations in adaptive fxing: communication, self-care, life skills, health and safety skills
  • have to have limitations in both intellectual and adaptive
  • affects 1-2% of population
  • MC males
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3
Q

mild intellectual disability

A

55-70

  • educable w/special ed assistance
  • read, write, simple math
  • concrete thinker
  • expect to be able to hold a job and live indep
  • 85% of ID pts
  • MC in lower SES
  • no identifiable cause
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4
Q

moderate intellectual disability

A

40-55

  • talk, recogn name, basic hygiene, do laundry, handle small change
  • minimal academic progress
  • live w/family or in supervised group home
  • cannot live independently
  • part of supervised activities, sheltered work
  • 10% of ID pts
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5
Q

severe intellectual disability

A

25-40

  • unable to complete self-help
  • will need care in institutionalized setting
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6
Q

profound intellectual disability

A

<40

  • unable to complete self-help
  • will need care in institutionalized setting
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7
Q

avg IQ

A

85-115

below 2SDs= intellectual disability

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8
Q

MC Intellectual disability

A

fetal alcohol syndrome

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9
Q

MC chromosomal cause

A

Down syndrome

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10
Q

MC heritable form of mental retardation

A

Fragile X syndrome

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11
Q

Intellectual disability: prenatal factors

A

substance abuse/use, maternal malnutr and illness, mutagen exposure

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12
Q

Intellectual disability: perinatal and early postnatal factors

A

traumatic delivery/brain injury, infx, heady injury, exposure to toxins, malnutrition

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13
Q

Intellectual disability: tx

A

cannot “cure” it:

tx problematic beh, comorbid conditions, independent living skills, provide special education assistance

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14
Q

learning disorder

A

inability to achieve in a particular academic area at the level predicted by an individual’s cognitive abilities
-generally borderline IQ or above

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15
Q

learning disorder: dx

A

requires standardized IQ (2SD below in that area) and achievement testing,
tx=special ed services

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16
Q

learning disorder: types

A

reading, math, written expression

MC in males, 2-8% of kids

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17
Q

learning disorder: comorbidities

A

ADHD, mood disorder, truancy, school refusal, substance abuse

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18
Q

communication disorders

A
  • expressive lang DO
  • mixed receptive-expressive language DO
  • phonological DO
  • stuttering DO
  • communication disorders NOS
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19
Q

language disorders

A

impairment in the comprehension and/or use of spoken, written, or other verbal symbol system

  • receptive=taking info in
  • expressive= getting info out
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20
Q

phonological DO

A

poor articulation or pronunciation

-substitution (wight–>right), distortions (crat–>cat), omissions (oke–> joke), additions

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21
Q

stuttering DO

A

reptition and prolongation of sound, syllables or words, that interrupt the flow of speech,
occasional 2˚ characteristics or tics, such as stamping foot or throwing the head out to get the sound out

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22
Q

assessment issues in speech

A

concomitant retardation or learning disability, dialect, regionalism, facial structure (e.g. cleft palate)

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23
Q

autistic disorder

A

qualitative impairment in social intrx and communication,

  • restrictive repetitive and stereotyped patterns of behavior, interests, activities
  • delays or abnormal fxing in at least one of the following areas: social intrx, language as used in social communication, symbolic or imaginative play
  • onset prior to age 3
  • dont response to cuddling, smile, no eye contact, no language dev`
24
Q

autistic disorder epid

A

25% have comorbid seizure DO, MC in males, universal screening at 18 m.

25
Q

autistic DO: tx

A

special ed, speech/lang therapy, social skills training, sensorimotor therapies, intensive ben thereby, pharmacotherapy (for sx, antipsychotics, SSRIs, stimulants, anticonvulsant, alpha adren agonists)

26
Q

asperger’s DO

A

milder version of autistic DO, high fxing, like autism but NO LANGUAGE/COGNITIVE dev delay, now part of autism spectrum

27
Q

ADHD types

A

combined, inattentive, hyperactive, NOS

28
Q

ADHD

A

signif diff focusing and maintaining attention, hyperactivity and impulsivity, present for >6 months, onset <7y/o, impairment in at least two settings

29
Q

ADHD–inattentive

A

-freq makes mistakes/failure to pay attention, difficulty sustaining attention, doesn’t listen when spoken directly to, fails to finish work/does not follow instructions, lacks organizational skills, avoids sustained mental effort, misplaces items, easily distracted, forgetful

30
Q

ADHD–hyperactive

A

fidget or squirms, leaves seat, difficulty being quiet, talks excessively, shouts, runs instead of walking, difficulty waiting for turn, interrupts/intrudes, always on the go
-dx after age 5

31
Q

executive fxing deficits in ADHD

A

planning, organizing, starting and stopping activity, managing behavior, persisting on tasks, problem solving, working memory

32
Q

ADHD epid

A

males

33
Q

ADHD: assoc w/inc incidence of?

A

academic failure, relationship probs, legal difficulties, smoking and substance abuse, injuries, MVAs, occupations/vocations prob

34
Q

ADHD: familial etiology

A

girls>boys,
familial mood/learning/antisocial personality DO, substance abuse,
genes related to dopamine

35
Q

ADHD: nongenetic etiology

A

maternal smoking, alcohol and drug abuse, cx w/delivery, exposure to toxins, viral infx, maternal malnutrition

36
Q

ADHD comorbidity

A

oppositional defiant DO, anxiety DO, depressive DO, learning SO, conduct DO, substance use DO

37
Q

ADHD tx

A

beh modification w/kid and parents, classroom/work accommodations, Rx

38
Q

Rx for ADHD

A

stimulants: dec risk for substance abuse

39
Q

potential SEs of ADHD meds

A

stimulations: dec appetite (anorexia, MC SE), growth retardation, Tics, BBW for high abuse potential and serious CV adverse events and sudden death
atomoxetine: abd pain, induction of mania, BBW for inc risk of suicidality

40
Q

oppositional defiant DO

A

pattern of negativistic, hostile, and defiant behavior lasting at least 6 months, during which 4+ are present:
-temper, argues, defies, deli annoys, blames, touchy, easily annoyed, angry/resentful, spiteful/vindicative

41
Q

ODD epid

A

male, comorbid w/ADHD, dx <8 y

42
Q

conduct DO

A

repetitive and persistent pattern of behavior in which the basic rights of other or major-age approp societal norms are violated
3+ criteria in the past 12 m, at least one present past 6 months, childhood onset type begins prior to age 10
1)agression to ppl and animals
2) destruction of prop, deceitfulness or theft, serious defiance of rules

43
Q

conduct DO etiology

A

males

robbery, minor theft, status offenses

44
Q

conduct DO comorbidity

A

learning DO, ADHD, mood DO, substance abuse

45
Q

risk factors for disruptive beh DO

A

inconsistent discipline, poor supervision, low IQ, high family conflict, low family warmth/support, low parental acceptance and affection, parental criminality/alcoholism/drug abuse, parental psychopathology

46
Q

disruptive beh DO: tx

A

beh management training for kids AND parents, social skills training, problem solving skills, conflict management, multi systemic therapy (MST)

47
Q

feeding and eating DOs

A

pica, rumination DO, feeding disorder of infancy or early childhood

48
Q

pica

A

persistent eating of non-nutritive substances for a period of at least 1 m

49
Q

rumination DO

A

repeated regurgitation and rechewing of food for a period of at least 1 m following a period of normal fxing

50
Q

tic DOs

A

tourettes DO (both motor and vocal tic), chronic motor or vocal tic DO (either motor or vocal tic), transient tic DO (has a tic, but not long enough for tourettes)

51
Q

tourettes DO

A

tics: many times per day nearly everyday or intermittently throughout a period of more than 1 yr, and during this period there was never a tic free period >3 m, onset <18, not due to substances or medical condition

52
Q

tic

A

sudden, rapid, recurrent, nonrhymic, stereotyped motor movement or vocalization

53
Q

tourettes DO: epid

A

b/w 6-17 y/o, males, motor tics begin b/w 3-8 y/o, several yrs later come vocal tics, sx peak in adolescence, remission in 20s

54
Q

tourettes DO tx

A

alpha adren agents, neuroleptics (haldol, pimozide)

55
Q

elimination DOs

A

enuresis, encopresis

56
Q

enuresis

A

for at least 5 y old, pee too much w/o restraint,

Psych (17 decks)

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