ADHD / ASD

Question 1

What triad of symptoms is considered diagnostic in ADHD?

Answer 1

Inattention
Hyperactivity
Impulsivity

Question 2

How long must the triad of symptoms go on to allow for diagnosis?

Answer 2

> 6 months

Question 3

By what age should ADHD have presented t be considered diagnostic?

Answer 3

9 years old
most present around 5 y/o
Age 7 for diagnosis

Question 4

Are males or females more commonly affected in ADHD/ ASD?

Answer 4

Males

Question 5

List some problems that can stem from untreated ADHD

Answer 5

Increased school problems
Higher risk of violence
Higher risk of substance abuse
Higher risk of divorce / young parenting
Increased employment problems
Increased ED trips

Question 6

What is the logic behind adults having some residual symptoms of ADHD but overall no longer ‘diagnostic’.

Answer 6

Maturation of the cortex and cortical thickening

Question 7

What lobe of the brain shows an abnormality in ADHD and what is the abnormality?

Answer 7

Under functioning frontal lobe

Question 8

What is first line treatment for ADHD?

Answer 8

Methylphenidate
Dexamphetamine
Increases reuptake of noradrenaline to reduce hyperactive symptoms

Question 9

What anti-depressant medication is used 2nd line for ADHD?

Answer 9

SNRI –> Atomoxetine

Question 10

What class of drugs are 3rd line in ADHD? 
Give some examples:

Answer 10

Alpha agonist

• Clonidine
• Guanfacine

Question 11

What is the classic triad of symptoms in a patient with Autism?

Answer 11

Social interaction impairment
Communication impairment
Restricted interests / imagination impairment

Question 12

Symptoms must be present in the ______ _______ phase to be diagnostic of Autism

Answer 12

early developmental

Question 13

What % of patients with autism spectrum disorder will have an IQ >70

Answer 13

70%

Question 14

List some of the communication problems commonly seen in Autism

Answer 14

• Good grasp of language but unable to see underlying meanings
• Struggle to grasp idioms, sarcasm, metaphors
• Pedantic speech
• Monotonous voice
• Conversation focused on personal interest (narrow)
• Difficulty communication feelings / initiating speech

Question 15

List some of the social interaction problems commonly seen in autism:

Answer 15

Lack of empathy
Inability to engage with non verbal cues
Routine cannot be disrupted
Can appear self centred
Struggles to maintain personal relationships

Question 16

What other psychiatric disorder is seen 3-4x more commonly in autism than in the general public?

Answer 16

Gender identity dysphoria

Question 17

What areas of the brain can show pathological changes in ASD?

Answer 17

Frontal
Amygdala
Cerebellum

Question 18

How is ASD managed?

Answer 18

Family therapy, additional help at school CBT etc

NO current pharmacological management