Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Yr 4 - Paediatrics > ADHD & ASD > Flashcards

ADHD & ASD Flashcards

1
Q

Define ADHD

A

A condition incorporating features relating to inattention and/or hyperactivity/impulsivity that are persistent.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How many diagnostic features must be present for a diagnosis of ADHD in children up to 16 y/o?

A

6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How many diagnostic features must be present for a diagnosis of ADHD in children aged ≥17 y/o?

A

5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the 3 cardinal features of ADHD?

A

1) Hyperactivity
2) Inattention
3) Impulsivity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Give some examples of inattention criteria for ADHD

A
  • Easily distracted by extraneous stimuli
  • Forgetful in daily activities
  • Often has difficulty sustaining attention in tasks or play activities
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Give some examples of hyperactivity criteria for ADHD

A
  • Often fidgets with hands or feet or squirms in seat
  • Often talks excessively
  • Is often on the go or often acts as if driven by a motor
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Give some examples of impulsivity criteria for ADHD

A
  • Often has difficulty waiting turn
  • Aften bursts out answers before questions have been completed
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is required for diagnosis of ADHD?

A
  • 5 or 6 diagnostic features (depending on age)
  • Present for at least 6 months
  • Impairment must be present in MORE THAN ONE setting
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are 3 differentials for ADHD

A

1) Auditory processing disorder

2) Oppositional-Defiant Disorder

3) Conduct Disorders

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is auditory processing disorder?

A

This is a disorder in which the brain has difficulty interpreting sounds and the information heard (may coexist with ADHD).

Can present as children having trouble concentrating and following instructions, particularly in the presence of background noise.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Oppositional-defiant disorder and conduct disorders vs ADHD?

A

Conduct disorder: there are marked features of aggression (not usually a feature of ADHD).

Oppositional-defiant disorder: there are features of anger, vindictiveness and being argumentative.

Children with ADHD tend to not want to get in trouble but can’t help themselves, often getting carried away.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

NICE guidelines differentiate management for ADHD into what 3 groups?

A

1) Preschool children

2) Mild-moderate ADHD in school-age children with moderate impairment

3) Severe ADHD in school-age children with severe impairment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the management of ADHD in preschool children?

A

Medication is NOT recommended.

Parents should be offered a parent training/education programme.

Nursery/pre-school teachers should be informed of the child’s diagnosis, severity of impairment, care plan and special educational needs.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Management of mild-moderate ADHD in school-age children with moderate impairment?

A

1st line –> behavioural strategies e.g. parent education sessions, CBT, social skills training.

2nd line –> medication

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Management of severe ADHD in school-age children with severe impairment?

A

1st line –> medication

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the 4 medications lisenced for ADHD?

A

1) Methyphenidate

2) Atomoxetine

3) Lisdexamfetamine

4) Guanfacine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the 1st line ADHD medication in children?

A

Methylphenidate (initially given on a six-week trial basis).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is methylphenidate?

A

A CNS stimulant (which primarily acts as a dopamine/norepinephrine reuptake inhibitor).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Side effects of methylphenidate?

A
  • abdo pain
  • nausea
  • dyspepsia
20
Q

What monitoring is required in children taking methylphenidate?

A

Weight and height monitoring every 6 months

21
Q

If there is an inadequate response to methylphenidate in ADHD, what is 2nd line?

A

lisdexamfetamine

22
Q

What medication can be started in those who have benefited from lisdexamfetamine, but who can’t tolerate its side effects?

A

Dexamfetamine

23
Q

What are the 2 first line medications for ADHD in adults?

A

Methylphenidate or lisdexamfetamine.

Switch between these drugs if no benefit is seen after a trial of the other.

24
Q

What is a key side effects of ADHD medications?

A

Cardiotoxicity

25
Q

What investigation is required for a baseline before starting ADHD medications?

A

ECG

26
Q

Side effects of ADHD meds?

A
  • Raised BP
  • Palpitations (representing potentially dangerous arrhythmias)
  • Disturbed sleep
  • Impaired growth and appetite suppression (common and can be severe enough to stop the child eating and gaining weight)
  • Can be problems with aggression or the child becoming more emotional, anxious or depressed§
27
Q

What adverse outcomes can ADHD be associated with?

A
  • substance abuse
  • more criminal convictions
  • lower educational attainment
  • unemployment
28
Q

What is methylphenidate also known as?

A

Ritalin

29
Q

What is the prevalence of autism spectrum disorder (ASD) in the UK?

A

1%

30
Q

Risk factors for ASD?

A

1) Genetic causes e.g. gene defects and chromosomal anomalies (25%)

2) FH

3) Advanced parental age (maternal ≥40 and paternal ≥50)

4) Environmental factors e.g. toxin exposure, prenatal infections

31
Q

What are some genetic diagnoses commonly associated with ASD?

A

1) Tuberous sclerosis complex

2) Fragile X syndrome

3) Chromosome 15q11-13 duplication syndrome

4) Angelman syndrome

5) Rett’s syndrome

6) Down syndrome

32
Q

What is the sibling recurrence risk of ASD?

A

10%

33
Q

What is the ASD concordance risk in monozygotic twins?

A

36-60%

34
Q

What are the 3 levels of ASD?

A

Level 1 (requiring support)

Level 2 (requiring substantial support), and

Level 3 (requiring very substantial support).

35
Q

What are the key clinical features of ASD?

A

1) Impaired social communication

2) Abnormality of social interaction

3) Repetitive or restrictive behaviours, interests, and activities

Others:
- Sensory issues
- Restrictive diet
- May not tolerate their hair being cut or their teeth being brushed
- May not tolerate loud noises
- High pain threshold
- Self harm e.g. head banging or hitting themselves
- Motor mannerisms e.g. pinching themselves

36
Q

What 2 conditions are commonly seen in children with ASD?

A

ADHD (35%) and epilepsy (18%)

37
Q

How may abnormality of social interaction present in children with ASD?

A
  • Poor eye contact
  • Failure to use facial expression or body language during social interactions (particularly with strangers)
  • Problems making friends with peers
  • Difficulty in reading social situations (such as failing to pick up on others emotions)
38
Q

How may impaired social communication present in children with ASD?

A
  • Delay or failure to develop either spoken language or sign language to communicate with others
  • Failure to initiate or continue conversations
  • Abnormal use of language, either with idiosyncrasy or stereotyped language (e.g. echolalia), abnormal intonation, pitch, rate or rhythm of speech.
39
Q

How may restrictive or repetitive present in children with ASD?

A
  • Preoccupations with unusual subjects e.g. traffic lights
  • Need for routine, with great upset if this is disrupted e.g. certain rituals
  • Abnormal preoccupations with toys and other materials e.g. spinning wheels on cars for the vibration it makes, or licking metal objects.
  • “Motor mannerisms” with the classical hand-flapping or other such repetitive and compulsive movements, which can occur more when the child is excited or upset
40
Q

Indications for specialist referral for further assessment of ASD:

A

1) Refer children younger than 3 years if there is a regression in language or social skills.

2) Concerned about possible ASD based on reported or observed signs and/or symptoms.

3) Factors associated with an increased prevalence of ASD.

4) The likelihood of an alternative diagnosis.

41
Q

Give 4 differentials for ASD

A

1) ADHD

2) Global developmental delay/intellectual disability

3) Developmental language disorder

4) Social (pragmatic) communication disorder

42
Q

How is social attachment affected in ASD?

A

A lack of social attachment

43
Q

How is receptive or expressive speech development affected in ASD?

A

Abnormal/delayed

44
Q

How is symbolic play affected in ASD (e.g. having a pretend tea party)?

A

Abnormal or lack of symbolic play

45
Q
A

Yr 4 - Paediatrics (78 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions