ADHD

Question 1

What are the defining criteria for ADHD?

Answer 1

Any combination of the following:

• Excessive inattention
• Hyperactivity
• Impulsivity

Question 2

Some things that commonly get confused with ADHD –that are not part of ADHD’s diagnosis – are _________________.

Answer 2

oppositional behavior, intellectual disability, specific learning disorder, and other sources of inattention such as insomnia, poor nutrition

Question 3

Some people note A&O x 3, but there are actually four criteria: _____________.

Answer 3

person, place, time, and situation

Question 4

What is the prevalence of ADHD among school-age children?

Answer 4

3% - 8%

Question 5

The male:female ratio of ADHD is __________.

Answer 5

between 2:1 and 5:1

Question 6

Girls are less frequently recognized as having ADHD because ___________.

Answer 6

girls tend to have inattentive (“spacy”) symptoms

Question 7

What is Adderall?

Answer 7

Two enantiomers of amphetamine

Question 8

What is Ritalin?

Answer 8

Methylphenidate

Question 9

What are the three types of ADHD listed in the DSM-V?

Answer 9

• Inattentive type
• Hyperactive/impulsive type
• Combined type

Question 10

A teenager presents to your office. Her mother says that she constantly makes careless mistakes and hates doing her homework –it’s “a challenge every night.” When you talk to her, she stares off at the books on the shelf behind you. What kind of ADHD might the child have?

Answer 10

Inattentive type

(Characterized by careless mistakes; not listening when spoken to directly; difficulty sustaining attention; poor follow through; dislike of tasks that require mental effort and thinking; forgetful.)

Question 11

Fidgeting, difficult sitting still, being “driven by a motor,” and excessive talking is characteristic of ___________.

Answer 11

hyperactive/impulsive ADHD

Question 12

There are 18 symptoms listed on the screening form for ADHD. The first 9 are inattentive type; the second 9 are hyperactive type. How many do you need for a diagnosis?

Answer 12

Six of each type for unilateral diagnosis of inattentive or hyperactive, or six of both categories for combined type (only 5 for those older than 17)

Question 13

Symptoms must be present before age ________ to qualify for a diagnosis of ADHD.

Answer 13

12

Question 14

What caveats come with diagnosing ADHD symptoms?

Answer 14

The symptoms must be interfering with life, work, or school; must have been present since before age 12; and the symptoms must be present in multiple life settings.

Question 15

What is the mechanism of guanfacine?

Answer 15

Alpha-2 agonist

Question 16

Vyvanse is _______________.

Answer 16

lisdexamfetamine (a drug that gets metabolized to amphetamines)

Question 17

In general, if an ADHD medication is tolerated but ineffective, what should you do?

Answer 17

Increase the dose. If you increase it to the point where it is not tolerated and ineffective, then switch to the other class of stimulant. If neither class has a drug that is tolerable and effective, then consult psychiatry for a trial of an atypical drug (e.g., bupropion, atomoxetine, alpha agonists).

Question 18

What is the best treatment for oppositional defiant disorder?

Answer 18

Parent management training

Question 19

True or false: most children with ADHD will continue to have symptoms into adulthood.

Answer 19

True (roughly 65%)

Question 20

True or false: there is a strong heritable link with ADHD.

Answer 20

True