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good paeds > Adolescent/psychiatry > Flashcards

Adolescent/psychiatry Flashcards

1
Q

Most at risk of hip problems

A

Spastic quadriplegic

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2
Q

GMFS stages

A

1: mobilise no limits
2: mobilise limits
3: sit and mobilise with device
4: sit need wheelchair
5: severe, no independent mobility

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3
Q

Imaginative play by what age

A

18m

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4
Q

Drawing development ages

A

2 a line
3 a circle
4 a person (3 part)
5 a person (6 part)

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5
Q

Drugs causing weight loss

A

Stimulant
SSRI
toperimate

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6
Q

Methylphenidate short acting most common SE

A

Insomnia

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7
Q

Tic medication treatment if severe

A

Clonidine (U.K.)

Risperidone

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8
Q

Suicide highest risk factor

A

Previous attempts

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9
Q

Most inherited mental illness and Tx

A 
Bipolar 
Sodium valproate (CMZ, LTG)
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10
Q

Most common conversion disorder

A

Motor

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11
Q

Diencephalic syndrome/Russell syndrome

A

Presents as emancipation due to suprasellar tumour

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12
Q

Retinal haemorrhages not part of

A

SIDS

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13
Q

Striae in adolescence

A

40% male 70% females

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14
Q

Common teratogen meds

A

Epileptics
Acei
MTX

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15
Q

Age highest rate HPV infection

A

20-24

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16
Q

Gardisil

A

Quadrivalent vaccine 6,11,16,18
Virus like particles
Doesn’t lower cervical cancers rates
Not in pregnancy

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17
Q

Gender dysphoria

A

Distress associated with mismatch felt if not able to.live as identified gender

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18
Q

Prevalence of autism and sibling

A

General is 1/150 or 1% 4:1 male ratio

Sibling risk is 20%

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19
Q

Parasomnias o cur in what phase of sleep

A

Non-R.E.M.

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20
Q

Narcolepsy tetras of symptoms

A

Sleep attacks
Cataplexy
Sleep paralysis
Hypnagogic/hypnapompic hallucinations

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21
Q 
Prevelance ADHD (need dx >6m sx)?
Male how much more than female?
A

5% school age children (almost 7% Australia)

Males 5-10x more than females

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22
Q

OCD comorbidity

A

80%
ADHD most common 34-51%
(Tics)

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23
Q

Coprolalia in Tourette’s

A

Uttering obscenities 10%

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24
Q

Management of SS

A

Benzodiazepines for agitation and stiffness
Cyproheptadine for blocking serotonin production
Stop drug causing syndrome
Fluids by IV

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25
Q

Schizophrenia

A

1%
2w at least sx
>6m

26
Q

Psychosis genetic predisposition

A

1 affected parent 10%
2 parents 45%
Monozygotic twin 50%

27
Q

What is akathisia

A

Feeling of inner restlessness and compelling need to b in constant motion

28
Q

Neuroleptic malignant syndrome compared to serotonin syndrome

A

Both: Fever, tachy, HTN, sweaty, coma

Differentiated by NMS normal pupils ‘lead pipe’ rigidity, hyporeflexia

10% mortality in NMS with high WCC and CK

29
Q

Highest mortality rate in which psych d/o

A

Anorexia

30
Q

Prevelance AN

A

2%

10% of cases are makes

31
Q

Exam findings in anorexia/bulemia

A

Peripheral cyanosis, peripheral oedema, rough knuckles (Russell sign) enlarged parotid, dental erosions, evidence self harm

32
Q

Life threatening weight loss in AN

A

Acute weight loss of 15-20% in 3 months

Total body weight under 75% expected

33
Q

Treatment AN

A

Family centred
Food
Support
No role or help with drugs or individual therapy

34
Q

Bulimia tx

A

CBT

SSRI

35
Q

The comorbid diagnosis which is most predictive of poor outcome in AN

A

OCD

36
Q

Acquired diffuse hair loss from stress called

A

Tell Gen effluvium

37
Q

Strongest predictors outcome in autism

A

Language and IQ

38
Q

Adolescent vegan diet risk of deficiency in…

A

B12

39
Q

Gonorrhoea treatment

A

Ceftriaxone 500mg im ( Wth 2ml 1 % lignocaine)
– ( if sensitivity unknown)‐ i.e if dx by SDA (urine)
• (OR Ciprofloxacin 500mg stat
– if known sensitive to this)
Cefotaxime for eye and wash out (presents day 2 of life)
MUST also treat with Azithromycin 1 g stat – To
prevent antibiotic resistance *
• Coinfection chlamydia common‐ up to 40%

40
Q

Heavy period transenamic acid and NSAIDs reduce blood flow by..

A

Treatment with NSAIDs can reduce blood flow by 30%

Transhexamic acid can reduce bleeding by 50%

41
Q

Transgender issues

A

40% significant depressive symptoms
½ had self harmed in previous 12 months
1 in 5 suicide attempt
Nearly 40% unable to access healthcare
1 in 5 experience bullying at school
More than ½ are afraid
3 in 100 gender dysphoria
In NZ prevelance 1/6000 male 6:1

42
Q

Autism predictors of outcome (2)

A

Best predictors of outcome are IQ and speech by 5 years age

43
Q

Tourette’s management

A

• Psychoeducation, support, family work
• CBT – habit reversal therapy
• Medication: antipsychotics at low doses
– Haloperidol and risperidone most established

44
Q

What area is least affected in schizophrenia

A

Orientation

45
Q

Erickson stages development

A

Erikson’s eight stages of psychosocial development include trust vs. mistrust, autonomy vs. shame/doubt, initiative vs. guilt, industry vs. inferiority, identity vs. role confusion, intimacy vs. isolation, generativity vs. stagnation, and integrity vs. despair

46
Q

Schizophrenia sibling risk and if one parent

A

10% if sibling

5% if parent

47
Q

How best to manage temper tantrum toddler

A

Ignoring

48
Q

ID levels

A

Mild under 70
Moderate 40-55
Severe 25-40
Under 25 profound

49
Q

What is working memory?

A

Like temporary files or like short term working memory

50
Q

Comorbidity with ADHD? Name two most common

A

First is ID (50%)

Second is oppositional defiant disorder (40%)

51
Q

Sibling risk ADHD?

A

3O% or 6 x risk

52
Q

Methylphenidate if have emotional liability when start what do you do?

A

Persevere

53
Q

If insomnia or emotional blunting (‘lose spark’) with methylphenidate what do you do?

A

Insomnia decrease dose

Spark then stop

54
Q

Atomoxetine mechanism of action

A

Selective noradrenaline reuptake inhibitor

55
Q

Benefit and downfall of atomoxetine

A

Anti anxiety and anti tic
Once daily
Takes up to 8 weeks to work

56
Q

Mood stabiliser in kids?

A

Valproate

Not lithium usually

57
Q

Clonidine is used for ODD and CD and tics - what is its mechanism of action and side effects

A

Alpha two adrenergic agonist
Sedates
(Irritability)
Taper slow as has rebound HTN

58
Q

Which one favourite SSRI used for anxiety (OCD and GAD) and bad depression in adolescents?

A

Fluoxetine (flu like discontinuation syndrome and watch closely first few weeks as some have ‘activation’ with suicidaility increased)

59
Q

Risperidone works against dopamine (5HTR) and is used for aggression, self injurious behaviour, tics
what is main side effects? (3)

A
  1. Weight gain (7%) (and high lipids and insulin resistance)
  2. High prolactin
  3. Extrapyridial
  4. sedation (can try if not responding to melatonin)
60
Q

Drug to help sleep

A

Melatonin

61
Q

Selective mutism associated with what mental health disorder

A

Anxiety

62
Q

Anorexia part of brain affected

A

Insula

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