ADHD

Question 1

7 yo child is brought in by parents who report he’s been hyperactive since age 4, talks constantly, interrupts, has trouble sitting still to do homework, will not play quietly outdoors. What else do you need to make the diagnosis of ADHD?

Answer 1

teacher report

Question 2

Studies show effective intervention for children with ADHD is to involve their parents in what part of treatment?

Answer 2

behavioral management

Question 3

Child with ADHD has ineffective tx with methylphenidate. What is the next step in management?

Answer 3

dextroamphetamine

Question 4

Child with ADHD does not respond to methylphenidate IR. What med should be tried next?

Answer 4

mixed amphetamine salts

Question 5

What aspect of ADHD is most likely to improve as child age?

Answer 5

hyperactivity

Question 6

Atomoxetine’s principal mechanism of action exerts a therapeutic action because it:

Answer 6

is a selective norepinephrine reuptake inhibitor

Question 7

Atomoxetine is most likely to be considered as initial tx for ADHD in adolescents with:

Answer 7

substance use disorder

Question 8

The multimodal tx study of children with ADHD examined the comparative responses over 14 months of children to medication and intense psychosocial interventions. What did the findings of the study reveal with respect to ADHD symptom changes?

Answer 8

medication management is superior to community care treatment

Question 9

The component of ADHD that is most likely to remain in adulthood:

Answer 9

inattention

Question 10

Which perinatal factor is specifically associated with development of ADHD?

Answer 10

maternal tobacco use prenatally

Question 11

Best neuropsych test of sustained attention:

Answer 11

conner’s continuous performance test

Question 12

Which DSM-V diagnosis requires symptoms to be present in 2 or more settings?

Answer 12

attention-deficit hyperactivity disorder (ADHD)

Question 13

Current thinking about relationship between ADHD in children and adults:

Answer 13

significant number of children will go onto become adults with ADHD

Question 14

8 yo boy with ADHD, oppositional defiant disorder, and chronic motor tic disorder has worsening of his tics on a good dose of a stimulant that seems to control his ADHD. How do you manage this further in trying to improve the tics?

Answer 14

monitor the tics only

Question 15

Which comorbid diagnosis of childhood ADHD worsens the prognosis into adolescence and adulthood to the greatest degree?

Answer 15

conduct disorder

Question 16

32 yo with ADHD mixed type as a child. As an adult, still has symptoms. Treatment?

Answer 16

methylphenidate

Question 17

Which med would you prescribe for a 20 yo college student being worried over his grades? He complains that he has not been able to focus on studying and that his mind wanders frequently during classes. His energy level is low. He sleeps well and his appetite is good. History indicates he was treated with stimulants since second grade.

Answer 17

methylphenidate

Question 18

10 yo with ADHD and aggressive outburst is started on a moderate dose of a stimulant. ADHD symptoms have improved, but aggression has not. In addition to behavioral intervention, what is the next best step to manage both the ADHD and aggression?

Answer 18

maximize dosage of long acting stimulant

Question 19

Which psychiatric disorder is comorbid with ADHD?

Answer 19

disruptive behavior disorders

Question 20

Which of the following side effects can result from stimulant medication treatment and warrants immediate discontinuation of the medication and a reassessment of the treatment plan?

Answer 20

hallucinations

Question 21

Abnormal LFTs would be most commonly associated with what medication used to treat ADHD in children/adolescents?

Answer 21

pemoline

Question 22

One of ADHD comorbid disorder:

Answer 22

depression

Question 23

These non-stimulant meds have empirical support to treat ADHD:

Answer 23

clonidine, bupropion, imipramine, atomoxetine

Question 24

What procedure is necessary to diagnose childhood ADHD?

Answer 24

clinical interview of parents and child

Question 25

Parents bring their 10 yo child for an evaluation due to concerns about the child’s reported difficulty paying attention in a class and completing assignments on time. Parents report that the child has trouble staying on task while doing homework and they are concerned that the child has an attention disorder. At the completion of the evaluation, the psychiatrist requests that both a parent and a teacher fill out a rating scale. The parent ratings fall into the clinical range but the teacher’s ratings do not meet criteria for a clinical problem. How should the psychiatrist account for the differences in observed ratings?

Answer 25

rating discrepancies by different observers are common in clinical practice

Question 26

Antidepressant for ADHD?

Answer 26

bupropion

Question 27

With respect to ADHD symptoms, the 1999 multimodal treatment study of children with ADHD was most notable for demonstrating which of the following?

Answer 27

the equivalence of combined methylphenidate and psychosocial treatment compared to medication alone

Question 28

Which of the instruments is the most helpful in the assessment of children suspected of having ADHD?

Answer 28

conner’s teacher rating scale

Question 29

What med used for ADHD has been associated with liver damage?

Answer 29

atomoxetine (Strattera)

Question 30

11 yo with reading disability. Most likely comorbid diagnosis:

Answer 30

ADHD