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LMCC Study - Peds > ADHD > Flashcards

ADHD Flashcards

1
Q

Why do girls tend to be underdiagnosed with ADHD when compared to boys?

A
  • Girls tend to have inattentive/distractible symptoms which are less disruptive and boys tend to display impulsive/hyperactive symptoms which are noticed.
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2
Q

How heritable is ADHD?

A
  • Very (75%)
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3
Q

What else would be on your DDX for a child being investigated for ADHD?

A
  • Learning disorder
  • Hearing/Vision disorder
  • Hyperthyroidism
  • Congenital problems (FASD, Fragile X)
  • Lead poisoning (only if history dictates)
  • Previous head injury
  • Normal response to traumatic events
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4
Q

What are the symptoms of inattention? (9)

A
  • Careless mistake
  • Can’t sustain attention in tasks or play
  • Not listening when directly spoken to
  • Fails to complete tasks
  • Disorganized
  • Avoids, dislikes tasks needing sustained mental effort
  • Loses things needed for tasks or activities
  • Distractable
  • Forgetful
  • I like to categorize based on
    1) Things hard to do because of inattention
    2) Things they avoid because inattention makes harder and they are bad at
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5
Q

What are the symptoms of hyperactivity? (6)

A
  • Fidgits or squirms in seat
  • Leaves seat when shouldn’t
  • Runs or climbs ++
  • Can’t play quietly
  • “Driven by motor” on the go
  • Talks excessively
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6
Q

What are the symptoms of impulsivity? (4)

A
  • Blurts out answers before question finished
  • Difficulty waiting turn
  • Interrupts others
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7
Q

Why is ADHD very difficult to diagnose in children under 4 years?

A
  • In this young age group normal behaviour is highly variable
  • Often identified upon school entry
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8
Q

When children are not treated for ADHD, what problems do they have more commonly as adults?

A

1) Academic
- increased drop out
- lower grades
2) Social fx and self esteem
- Child too distracted observe social norms
3) Health and Injury
- Increase risk of mental illness and substance abuse
- Impulsivity increases risk of traumatic injury
4) Criminality
- Impulsivity increases risk
5) Sexual behaviour
- more likely to partake in risky behaviour

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9
Q

What are some non-pharmacological treatment options for ADHD?

A

Behaviour Modification

  • Positive reinforcement (reward/privilege)
  • Negative consequences
  • Small class size
  • Structure
  • Appropriate seating arrangement at school
  • Exercise / Extracurricular
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10
Q

What are the first line Pharmacological treatment options for ADHD?

A

First Line: Stimulants

  • Methylphenidate
  • Amphetamine salts
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11
Q

What is second line pharma treatment for ADHD? Third line?

A

2nd: Atomoxetine
- NE reuptake inhibitor
3rd: Alpha agonists (clonidine, guanfacine) & NDRI (buproprion)

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12
Q

What are common side effects of stimulant medications?

A
  • Decreased appetite
  • Sleep problems
  • Delayed growth
  • Tachy/Palpitations
  • Headache
  • Irritability/Anxiety
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13
Q

What percentage of children with ADHD will have symptoms continue into adolescence? Adulthood?

A
  • Adolescence (70-80%) but hyperactivity tends to settle

- 65% continue

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14
Q

What is ADHD in a general sense?

A
  • Attention deficit hyperactivity disorder

- Developmentally inappropriate inattentiveness, hyperactivity, and impulsivity

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15
Q

What percentage of school age children are affected by ADHD?

A

3-10%

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16
Q

Why is psychological and developmental testing part of the ADHD evaluation?

A
  • Psychological and learning disorders are common in the ADHD population
17
Q

What are the most common coexisting psychiatric disorders in children with ADHD?

A
  • Oppositional defiant disorder (35%)
  • Conduct disorder (25%)
  • Anxiety disorder (25%)
  • Depressive disorder (18%)
18
Q

What is required for a diagnosis of Combined type ADHD?

A
  • 6+ symptoms of hyperactivity/impulsivity
  • AND 6+ symptoms of inattention
  • 6+ months
  • symptoms interfering with function
  • Occur in 2+ settings
  • Occur before age 12
  • Not due to other medical issue
19
Q

What is required for Inattentive type ADHD diagnosis?

A
  • 6+ symptoms of inattention
  • 6+ months
  • symptoms interfering with function
  • Occur in 2+ settings
  • occur before age 12
  • Not due to other medical issue
20
Q

What is required for a diagnosis of hyperactive/impulsive type ADHD?

A

6+ symptoms of hyperactivity/impulsive

  • 6+ months
  • symptoms interfering with function
  • Occur in 2+ settings
  • Occur before age 12
  • Not due to other medical issue
21
Q

The criteria for diagnosis of ADHD changes slightly after a certain age. What age is this and what is the change?

A
  • Age 17
  • After which 5+ features will result in a diagnosis along with meeting remaining criteria
  • Symptoms should have been present before the age of 12

LMCC Study - Peds (12 decks)

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