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Case Files Psychiatry > ADHD > Flashcards

ADHD Flashcards

1
Q

Which sex is most affected by inattentive ADHD?

A

Female

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2
Q

How many symptoms are required to make a diagnosis of ADHD?

A

6+

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3
Q

Before what age do the symptoms need to be present and how long do they need to be present for?

A

12

6 months

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4
Q

When is atomoxetine (Strattera) considered the first line therapy for ADHD?

A

When family history of substance abuse is present
Patient currently has tics
Patient has a comorbid anxiety disorder

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5
Q

What are some second line options for treating ADHD?

A

Clonidine
Guanfacine
(Alpha-2 agonists)

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6
Q

What are some third line agents?

A

Bupropion- NE/DA reuptake inhibitor

Imipramine- TCA

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7
Q

What type of psychotherapy is beneficial for these patients once their symptoms are under control?

A

Behavioral parenting training

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8
Q

What are the key components of ADHD?

A

Inattention
Hyperactivity
Impulsivity

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9
Q

What is the incidence of ADHD?

A

3 to 5 percent

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10
Q

Which neurotransmitters are lacking in patients with ADHD? Which part of the brain are they predominatily missing?

A

DA and NE

Prefrontal cortex

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11
Q

Which aspect of the brain is responsible for selecting what an individual focuses on?

A

Dorsal anterior cingulate gyrus

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12
Q

Which part of the brain is responsible for sustaining attention on a topic?

A

Dorsolateral prefrontal cortex

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13
Q

Impairment in what cortex appears to be resbonsible for hyperactivity?

A

Prefrontal motor cortex

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14
Q

Impairment of which cortex results in impulsivity?

A

Orbitofrontal cortex

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15
Q

What other conditions must a child with ADHD be evaluated for?

A

Oppositional defiant disorder

Conduct disorder

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16
Q

What 3 things will medication help with, if the child WANTS to do them?

A
  1. Sitting still
  2. Focusing
  3. Think before they act
17
Q

What will medicaiton not help a patient do?

A

Make good decisions

18
Q

What would distinguish early onset bipolar-disorder from ADHD? Both have restlessness and distractibility.

A

Bipolar patients will have an affective component

19
Q

Blood levels of what mineral should also be checked?

A

Lead

20
Q

Which seizure disorder should be evaluated?

A

Petit mal seizures

Absences seizures

21
Q

What are some signs it could be a seizure disorder?

A

Child has staring spells

Child will not be “thinking” of something else

22
Q

What condition has a very similar presentaiton to a patient with ADHD and ODD?

A

Bipolar disorder

23
Q

What is the first line medication for ADHD?

A

Stimulants

24
Q

What are the two classes of stimulants used to treat ADHD?

A

Methyphenidate

Amphetamine

25
Q

What are the common adverse effects of stimulants?

A 
Decreased appetite
Insomnia
Irritablity
Dysphoria 
Headacht
Tics
26
Q

What is the benefit of using stimulants?

A

Rapid onset

Wear off by the end of the day

27
Q

What is the MOA of atomoxetine?

A

Selective inhibitor of presynaptic NE transporter

28
Q

What are the disadvantages of atomoxetine?

A

Slower onset

24 hr duration of action

29
Q

Both atomoxetine can decrease a patient’s appetite, what medications can be prescribed with may help increase appetite as well as sleep?

A

Clonidine

Guanfacine

30
Q

If imipramine is prescribed what two things must be monitored in the patient?

A

Blood levels

ECGs- QT prolongation

31
Q

In what conditions is bupropion contraindicated?

A

Seizure disorders

May also exacerbate tics

32
Q

How with the inattentiveness of a patient with anxiety differ from a patient with ADHD?

A 
ADHD
- External stimuli
- Pleasurable behaviors
Anxiety
- Internally focused
- Ruminative and worried
33
Q

What are the two types of presentation for ADHD?

A
  1. Inattentive presentation

2. Hyperactive/Impulsive presentation

Case Files Psychiatry (10 decks)

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