ADHD

Question 1

How many kids have ADHD?

Answer 1

Roughly 1 in 10

Question 2

What scenario created a generation of high school drop outs?

Answer 2

ADHD pts who were given barbiturates, became dependent on it and dropped out of school

Question 3

What’s the difference in behavior between young girls and boys regarding ADHD?

Answer 3

Boys are rambunctious/hyperkinetic

Girls have a quiet inattention (harder to see early)

Question 4

Comorbidities w/ ADHD?

Answer 4

Anxiety, learning disorders, intellectual deficiencies

Question 5

What’s an IEP?

Answer 5

Individual educational program

Question 6

Where in the brain does ADHD probably live?

Answer 6

PFC, pre-frontal cortex, where working memory comes from (executive functioning)

PFC is the last part of the brain to myelinate @ 25yo

Question 7

What’s a significant predictor for possible ADHD? Does food play a factor?

Answer 7

Genetics, family history

Environment plays little of a role

Nope! Food isn’t a factor

Question 8

What type of ADHD is the most common?

Answer 8

Combined type (inattentive + hyperactive/impulsive)

Question 9

What age must sxs of ADHD be present by.. in a pt for a proper dg?

Answer 9

12 yo

Question 10

What are some sxs of ADHD (inattention, hyperactivity)?

Answer 10

Inattention variant:
Careless mistakes
Inattentive/day-dreaming
Doesn't seem to listen
Doesn't follow through w/ tasks (turning in completed hw)
Not organized/loses things
Avoids sustained mental effort
Easily distracted

Hyperactivity/impulsivity variant:
Fidgets/squirms
Inappropriately leaves seat
Inappropriately runs or climbs
Difficulty playing quietly
Always "on the go"
Talks excessively/blurts out answers
Difficulty waiting turn/interrupts

Question 11

How long must ADHD sxs be present for a dg to be made?

Answer 11

6 months

Question 12

What are the comorbidities of ADHD?

Answer 12

Learning disorders
Opposition defiant disorder/conduct disorder
Anxiety/mood disorders
Substance abuse
Sleep problems

Question 13

What’s the triad of psychiatry?

Answer 13

ADHD + Tourette’s Syndrome + OCD

Question 14

What are the tx guidelines for ADHD in a pre-schooler?

Answer 14

First-line: behavior management counseling, improve structure of child’s setting

Second-line: stimulant tx

Question 15

What are the tx guidelines for ADHD in a 6-11 yo? 12-17?

Answer 15

First-line: stimulants, behavior management

First-line: stimulants, behavior therapy

Question 16

What percentage of children respond to stimulants?

Answer 16

70-80%, can be higher

Question 17

What benefit do amphetamines have over other stimulants?

Answer 17

Aside from blocking neurotransmitter re-uptake, they also have a secondary mech causing neurotransmitter release

Question 18

What are the side effects of stimulants?

Answer 18

Common:
Dec appetite (so give w/ or after meals)
Difficulty falling asleep
Tics
Stomach aches 
HA

Less common: Zombie effect, wt loss, inc in HR/BP

WARNING: Cardiac risks

Question 19

In the case of ADHD pts, what benefits were seen when on stimulants? Two he mentioned..

Answer 19

Reduced risk of car accidents

Reduced risk of substance abuse

Question 20

What’s a 504 plan?

Answer 20

A non-discrimination act protecting kids w/ disabilities in schools, schools must accommodate these kids