Attention Deficit Hyperactivity Disorder Flashcards
Is attention deficit hyperactivity disorder (ADHD) classed as a learning disability disorder?
- yes
- children must have evidence of impaired function
Attention deficit hyperactivity disorder (ADHD) is classed as a learning disability disorder. What % of children with a learning disability have ADHD?
1 - 2%
2 - 20%
3 - 40%
4 - >65%
2 - 20%
How should the attention and concentration of a child with attention deficit hyperactivity disorder (ADHD) be judged?
1 - against siblings
2 - against children of similar age
3 - against children of comparable development
3 - against children of comparable development
All of the following are symptoms of a child with attention deficit hyperactivity disorder (ADHD), but which of the following is the most prominent feature?
1 - inattention
2 - impulsivity
3 - social awkwardness
4 - hyperactivity
4 - hyperactivity
Do children who are left undiagnosed with attention deficit hyperactivity disorder (ADHD) do better or worse in education and employment?
- worse
According to the new guidelines set out by ICD-11, what is attention deficit disorder?
1 - attention deficit disorder with and without hyperactivity
2 - child must be hyperactive most of the time
3 - child must have extremes of hyperactivity and under activity
1 - attention deficit disorder with and without hyperactivity
- can be hyperactive
- can be without hyperactivity
To get a diagnosis of attention deficit hyperactivity disorder (ADHD) in accordance with ICD-11, children must have 3 core symptoms, which of the following is NOT one of these?
1 - inattention
2 - impulsivity
3 - social awkwardness
4 - hyperactivity
3 - social awkwardness
- ADHD symptoms must NOT be due to another mental health disorder
To get a diagnosis of attention deficit hyperactivity disorder (ADHD) in accordance with ICD-11, children must have 3 core symptoms, inattention, impulsivity and hyperactivity. At what age must the symptoms have started?
1 - <5 y/o
2 - <7 y/o
3 - <10 y/o
4 - <15 y/o
2 - <7 y/o
- the symptoms must be present in at least 2 settings: school and home
Which 2 of the following neurotransmitters have been linked with the development of ADHD?
1 - glutamate
2 - GABA
3 - dopamine
4 - norepinephrine
3 - dopamine
4 - norepinephrine
- poor evidence for these though
Other comorbidities are often present in patients with attention deficit hyperactivity disorder (ADHD). Which of the following is NOT commonly present?
1 - tics
2 - depression
3 - anxiety
4 - oppositional defiance disorder
5 - eating disorders
6 - substance abuse
7 - autism spectrum disorder
5 - eating disorders
Attention deficit hyperactivity disorder (ADHD) has many differentials, which of the following is most similar?
1 - oppositional defiance disorder
2 - bipolar disorder
3 - anxiety
4 - autism spectrum disorder
2 - bipolar disorder
- bipolar = mania with euphoria and grandiosity that is episodic
- ADHD = longer term, NO euphoria or grandiosity
There are a myriad of risk factors that could cause Attention deficit hyperactivity disorder (ADHD). What is the genetic component of developing ADHD?
1 - 8-9%
2 - 18-19%
3 - 39-49%
4 - 80-90%
4 - 80-90%
- shown in monozygotic twins
- 5x more likely than the general public if you have a 1st degree relative with ADHD
MRI and brain studies have shown development changes in children diagnosed with ADHD. Which of the following has NOT been shown in brain development of children with ADHD matched with age appropriate children?
1 - motor cortex
2 - frontal lobe
3 - striatum
4 - cerebellum
1 - motor cortex
- frontal lobe = cognitive and higher level functions
- striatum = movement and reward
- cerebellum = balance and co-ordination
- worse in adults who haven’t been treated
Although longitudinal studies have shown that 50% of adults will still have symptoms associated with ADHD, what % of patients would still meet the criteria for ADHA in adulthood?
1 - 1.6%
2 - 15%
3 - 36%
4 - 50%
2 - 15%
- impulsiveness, overactivity and self-control all tend to improve after puberty
Impulsiveness, overactivity and self-control all tend to improve after puberty in patients with ADHD. If a child does not have similar reductions in impulsiveness, overactivity and self-control, do they have the same outcomes in life?
- no
- more likely to become juvenile delinquency, conduct disorders and anti-social activities
When assessing a patient with suspected ADHD, is it important to gather information and assess the patient in multiple enviorments?
- for diagnosis purpose AND to see if the patient is the same in all aspects of their lives
When managing a patient with ADHD we have 2 main general measures to try. One of these is psychoeducation. This involves:
- educating child, parents and teachers about ADHD and treatment options
When managing a patient with ADHD we have 2 main general measures to try. One of these is school based interventions. This involves:
- special educational needs coordinator is involved with providing support
- assessment of any co-morbid learning difficulties
All of the following are psychological treatments for ADHD. In patients with mild to moderate ADHD, the first line treatment is what?
1 - parent training and education courses
2 - behavioural therapy
3 - social skill training
4 - cognitive behavioural therapy
1 - parent training and education courses
- courses on how to manage ADHD
- families can meet other similar families
All of the following are psychological treatments for ADHD. Which of the following matches this description: given to younger children to cope with their symptoms more effectively
1 - parent training and education courses
2 - behavioural therapy
3 - social skill training
4 - cognitive behavioural therapy
2 - behavioural therapy
All of the following are psychological treatments for ADHD. Which of the following matches this description: course to help children learn how to function in social settings
1 - parent training and education courses
2 - behavioural therapy
3 - social skill training
4 - cognitive behavioural therapy
3 - social skill training
All of the following are psychological treatments for ADHD. Which of the following matches this description: beneficial for adolescents with low self esteem, anxiety, depression and other comorbidities?
1 - parent training and education courses
2 - behavioural therapy
3 - social skill training
4 - cognitive behavioural therapy
4 - cognitive behavioural therapy
What level of severity are pharmacological therapies used in ADHD?
1 - mild
2 - mild to moderate
3 - moderate to severe
4 - severe
3 - moderate to severe
- failure of psychosocial interventions to reduce ADHD symptoms
- first line therapy in severe ADHD
Stimulant drugs used are methylphenidate and dexamphetamine, which have been shown to reduce overactivity in ADHD. What is the mechanisms of action of these drugs?
1 - selective serotonin reuptake inhibitor
2 - block monoamine transporters and inhibit uptake of dopamine and norepinephrine
3 - norepinephrine selective reuptake inhibitor
4 - GABA agonist
2 - block monoamine transporters and inhibit uptake of dopamine and norepinephrine
Non-stimulant drug used are atomoxetine, which have been shown to reduce symptoms in ADHD. What is the mechanisms of action of this drug?
1 - selective serotonin reuptake inhibitor
2 - block monoamine transporters and inhibit uptake of dopamine and norepinephrine
3 - norepinephrine selective reuptake inhibitor
4 - GABA agonist
3 - norepinephrine selective reuptake inhibitor
Methylphenidate, dexamphetamine and atomoxetine are 3 drugs uses in ADHD providing the meet the following criteria:
- moderate to severe ADHD
- failure of psychosocial interventions to reduce ADHD symptoms
- first line therapy in severe ADHD
Which of these drugs is 1st choice in non-complicated ADHD?
- Methylphenidate
- dexamphetamine is the reserve drug if patients do not respond
Which of the following is NOT a common side effect of stimulant medications for ADHD?
1 - nausea
2 - tachycardia
3 - weight loss
4 - reduced growth
5 - insomnia / headaches
6 - growth pains
2 - tachycardia
If a patient does not respond to psychosocial interventions or Methylphenidate, dexamphetamine and atomoxetine, what would happen next?
1 - admitted to psychiatric hospital
2 - deep brain stimulation
3 - referred to tertiary centre
3 - referred to tertiary centre
- unlicensed medication such as clonidine, modafinil and imipramine may be prescribed
