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People and Illness Lectures > ADHD > Flashcards

ADHD Flashcards

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People You Should Know flashcards
1
Q

features of Hyperkinetic Disorders

A

Inattention & lack of persistence in activities requiring concentration
Excessive activity
Impulsivity

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2
Q

eitology of Hyperkinetic Disorders

A

More common in males

1-5% of children

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3
Q

5 types of Hyperkinetic Disorders

A 
Disturbance of activity and attention
Hyperkinetic conduct disorder
Other Hyperkinetic disorders
Hyperkinetic disorder
unspecified ADHD
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4
Q

Comorbid associations with ADHD

A 
Sleep disorders
Behavioural difficulties
Specific learning disabilities
Developmental Co-ordination Disorders
lSocial communication difficulties
Anxiety symptoms
Tic disorders e.g. Tourette syndrome 
Mood difficulties
Increased psychosocial factors
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5
Q

Susceptibility ADHD genes

A 
DRD4 Receptor 7-Repeat Alleles 
SLC6A3/DAT1 
DRD5
SLC6A4/5HTT
HTR1B
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6
Q

DRD4 Receptor 7-Repeat Alleles

A

associated with overactivity & impulsivity

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7
Q

SLC6A3/DAT1

A

Dopamine Transporter gene

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8
Q

DRD5

A

Dopamine receptor gene

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9
Q

SLC6A4/5HTT

A

Serotonin Transporter gene (associated with emotional volatility)

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10
Q

HTR1B

A

Serotonin receptor gene (associated with emotional volatility)

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11
Q

ADHD prognosis depends on 2 things

A

Depends on co-morbidity

Factors associated with persistence into adulthooD

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12
Q

assessment for ADHD in school

A

Speak with Education staff
Observation in school setting
Standardised questionnaires for education staff

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13
Q

assessment for ADHD depends on which aspects of a history

A 
History from reliable informants
Systematic Enquiry
Past history, including
A developmental history
medical history 
family history
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14
Q

4 main drugs for ADHD

A

Psychostimulants
Atomoxetine
Clonidine

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15
Q

Psychostimulants

A

act on D1 receptors in the prefrontal cortex & D2 in the striatum

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16
Q

Atomoxetine

A

acts on NA transporter in prefrontal cortex

17
Q

Clonidine

A

α-2 adrenergic receptor agonist

18
Q

Guanfacine

A

α2A adrenergic receptor agonist

19
Q

3 problems ADHD have in adulthood

A

have problems organising and planning
not attain academically as well as expected
find relationships and jobs harder to sustain

20
Q

discuss the debate about giving ADHD children medication

A

ideas of ADHD secondary to bad parenting, etc.
‘drugging’ your child
horror stories from papers/TV – ‘zombie’, etc.

21
Q

how to tackle ADHD medication debate

A

Give info / education / evidence available
no hidden agenda
allow YP/family to decide in their own time
ensure the patient is fully engaged & consents in the process

22
Q

4 clinical requirements for ADHD

A

Apparent before the child is age 7 years
Excessive for the child’s age & development
Pervasive i.e. evident in more than 1 environment e.g. at home and in school
Symptoms may worsen in the afternoon

23
Q

what 3 things need to be monitored in ADHD review

A

Regular review (<6 monthly) but more frequent when titrating meds
Monitor response to medication
Monitor side-effects
Monitor height, weight, pulse & BP

24
Q

how to manage environment of ADHD child

A

Provide a calm environment
Avoid too many distracting stimuli when you want the child to concentrate
Initially, avoid situations that require quiet, still behaviour for long periods
Maintain structure and supervision longer than you think should be necessary

25
Q

how does Elvanse (lisdexamfetamine)

work

A

Acts to increase available DA and NA
Given/adsorbed as a pro-drug (inactive)
Metabolised to dexamphetamine by red blood cells at set rate
Rapid onset of action, lasts 13 hours

26
Q

side effects of Elvanse (lisdexamfetamine)

A

dizziness, drowsiness

27
Q

features of ADHD assessment

A 
Direct Observations in ≥ 1 setting
Psychoeducational Assessment
Structured Questionnaires
Identifying co-morbid (mental) health problem
Developmental history
Develop a formulation
28
Q

Guanfacine

A

Non-stimulant selective central alpha2A-adrenergic receptor agonist

29
Q

is ADHD inheritable

A

linked to twins

Genetic-environment interactions

30
Q

Neurobiological factors of ADHD

A 
ADHD-Associated Executive Difficulties
Organisation
Planning
Working memory
Attention
Response inhibition
Impulse control
31
Q

MRI features of ADHD

A

smaller brain volume – frontal & parietal cortex

smaller basal ganglia

right dorso-lateral prefrontal lobe reduced

smaller cerebellar vermis

Attentional systems involve → Anterior Fronto-striatal networks

posterior parieto-cerebellar circuits

32
Q

Additional assessments

A

hearing and vision screening checks (low threshold)
screening for neurological signs & physical anomalies
Baseline height & weight (record on growth chart)
Baseline blood pressure & heart sounds

33
Q

2 psychostimulants

A

Methylphenidate

Dexamphetamine (DEX)

34
Q

Methylphenidate (MPH)

A

blocks DA & NA re-uptake via transporter

35
Q

Dexamphetamine (DEX)

A

releases DA stored in presynaptic vacuoles

People and Illness Lectures (16 decks)

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