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PEDIATRICS > ATTENTION DEFICIT HYPERACTIVITY DISORDER (ADHD) based on Trans > Flashcards

ATTENTION DEFICIT HYPERACTIVITY DISORDER (ADHD) based on Trans Flashcards

1
Q

What is ADHD?

A

ADHD is a neurobehavioral syndrome characterized by developmentally inappropriate levels of inattention

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2
Q

Why do parents often delay consultation for ADHD?

A

Parents believe their children will eventually outgrow ADHD or fear that ADHD may limit their potential.

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3
Q

What are the three core symptoms of ADHD?

A

(IHI)
Inattention
Hyperactivity
Impulsivity

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4
Q

What must be consistent for an ADHD diagnosis?

A

The behavior must persist in at least two or more settings

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5
Q

Is ADHD a disease?

A

No

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6
Q

What are common complaints of teachers about ADHD children?

A

The child cannot sit still, interrupts conversations, blurts out answers, and distracts classmates.

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7
Q

What are common complaints of parents about ADHD children?

A

The child loses items, doesn’t follow directions, makes careless mistakes, and struggles with social interactions.

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8
Q

What misconceptions lead to delays in ADHD consultation?

A

Beliefs that ADHD is temporary, caused by poor parenting, or is a result of laziness or boredom.

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9
Q

What evidence supports ADHD as a brain-based condition?

A

Genetic studies, brain imaging, fetal/infant symptoms, and consistent responses to stimulant medications.

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10
Q

What is the role of heredity in ADHD?

A

25% of first-degree relatives of ADHD children also have ADHD

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11
Q

What neurological issues are linked to ADHD?

A

Problems in brain maturation. structure, and function

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12
Q

What are the clinical subtypes of ADHD?

A

PREDOMINANTLY INATTENTIVE TYPE

PREDOMINANTLY HYPERACTIVE-IMPULSIVE
TYPE

COMBINED TYPE (INATTENTIVE AND
HYPERACTIVE IMPULSIVE)

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13
Q

What characterizes the predominantly inattentive type of ADHD?

A

Easily distracted

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14
Q

What characterizes the predominantly hyperactive-impulsive type of ADHD?

A

Extremely hyperactive and impulsive

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15
Q

What characterizes the combined type of ADHD?

A

All three core symptoms are present
50-75%
● Most patients

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16
Q

What percentage of school-aged children are affected by ADHD?

A

Approximately 3-5%.

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17
Q

Who is more likely to have ADHD

A

More frequent in boys than girls (6:1)

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18
Q

Does ADHD occur across all levels of intelligence and socioeconomic status?

A

Yes

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19
Q

How does ADHD manifest in adults?

A

Adults with ADHD may face difficulties with focus, career challenges, low self-esteem, and relationship problems.

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20
Q

What is the comorbidity rate in ADHD?

A

Around 70% of ADHD cases have comorbid conditions like ODD

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21
Q

What are early indicators of ADHD in infancy?

A

Unpredictable behavior, shrill crying, irritability, and overactivity.

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22
Q

What are early indicators of ADHD in preschool?

A

Rapid mood changes

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23
Q

When should ADHD be suspected in a child?

A

If behaviors are developmentally inappropriate, cause chronic daily problems, and are not due to external factors.

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24
Q

What environmental factors can influence ADHD development?

A

Trauma, infections, and severe conditions like septicemia can disrupt brain function.

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25
Q

What does ADHD research suggest about genetic influence?

A

ADHD may represent a genetic tendency rather than a pathological condition.

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26
Q

What neurotransmitter imbalances contribute to ADHD symptoms?

A

Imbalances in the prefrontal cortex, basal ganglia, and cerebellum lead to hyperactivity and impulsivity.

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27
Q

What are common clinical presentations of ADHD in school-aged children (6-12 years old)?

A

Work is careless, doesn’t complete work, blurts out answers, disruptive, interrupts or intrudes, can’t wait turn in games, poor peer relationships.

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28
Q

What are common clinical presentations of ADHD in adolescents (13-18 years old)?

A

Poorly organized, restless, poor follow-through on tasks, doesn’t cooperate with peers, fails to complete independent academic work, engages in risky behaviors.

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29
Q

What is the most common complaint teachers have about students with ADHD?

A

Students do not focus during lessons, are easily distracted, talk to classmates instead of listening, and rarely look at the teacher during explanations.

30
Q

Why is there an apparent increase in children diagnosed with ADHD?

A

Increased awareness due to the internet, more demanding school environments making symptoms observable, prevalence remains stable at 6-9% of school-aged children.

31
Q

What is the primary method for diagnosing ADHD?

A

Detailed history from multiple sources/informants; based on specific behaviors inappropriate for age; no confirmatory lab test exists.

32
Q

According to DSM-5, how many symptoms are required to diagnose inattention in children and adults with ADHD?

A

Children require **6 or more symptoms for 6 months, **
adults require 5 or more symptoms.

children - 6-6
adult - 5

33
Q

What are common symptoms of inattention in ADHD?

A

Careless mistakes, difficulty sustaining attention, doesn’t seem to listen, fails to follow through on tasks, difficulty organizing, avoids sustained mental effort, loses necessary items, easily distracted, forgetful in daily activities.

34
Q

What are common symptoms of hyperactivity and impulsivity in ADHD?

A

Fidgeting, leaves seat when inappropriate, runs/climbs inappropriately, unable to play quietly, ‘on the go,’ talks excessively, blurts out answers, difficulty waiting turn, interrupts others.

35
Q

What are common ADHD symptoms in preschool-aged children?

A

Language delay, extreme separation anxiety, difficulty adjusting to nursery or kindergarten.

36
Q

What are common ADHD symptoms in elementary-aged children?

A

Inconsistent performance, peer difficulties, writing problems.

37
Q

What are common ADHD symptoms in adolescents?

A

School maladaptation or failure, restlessness, increased risk-taking behaviors, antisocial behaviors.

38
Q

What are common ADHD symptoms in adults?

A

Difficulty holding stable jobs, setting goals, completing tasks, and antisocial personality disorders.

39
Q

What is the first-line pharmacologic treatment for ADHD?

A

Psychostimulants such as Methylphenidate (Ritalin, Concerta) and Amphetamine compounds.

40
Q

What is the second-line pharmacologic treatment for ADHD?

A

**Noradrenergic reuptake inhibitors **such as Atomoxetine (Strattera).

41
Q

What are third-line pharmacologic treatments for ADHD?

A

Antidepressants (Bupropion, Tricyclics, Venlafaxine), Antihypertensives (Guanfacine, Clonidine), and Arousal agents (Modafinil).

42
Q

What are common side effects of ADHD medications?

A

Anorexia, nausea, weight loss, somnolence or insomnia, abdominal pain.

43
Q

When should ADHD medications be prescribed?

A

When behavioral therapy fails, ADHD symptoms worsen, significant social/academic impairments exist, no contraindications, and with parental and patient consent.

44
Q

What are the positive effects of ADHD medications?

A

Improved core symptoms, functional and social outcomes, and academic performance through behavior improvement.

45
Q

How does ADHD affect the individual?

A

Adversely affects academic performance, interpersonal skills, self-esteem, long-term social relationships, and increases risk of school dropout, accidents, delinquency, and low occupational status.

46
Q

How does ADHD affect the family?

A

Causes parental stress, self-blame, social isolation, depression, marital discord, sibling concerns, family dysfunction, and economic burdens.

47
Q

What non-pharmacologic treatments are available for ADHD?

A

Behavior management strategies, clinical behavioral therapy, cognitive behavioral therapy, remedial education, parental and family counseling, environmental modification, routine establishment.

48
Q

What interdisciplinary referrals may be needed for ADHD?

A

Occupational therapy,
speech-language therapy,
reading assessment, neuropsychological evaluation,
regular specialist follow-ups.

49
Q

What is the role of the interdisciplinary team in ADHD management?

A

To provide a combination of therapeutic interventions tailored to the child’s needs, ensuring better outcomes for the patient and family.

50
Q

What role do schools play in helping students with ADHD?

A

“Schools provide behavioral and academic support and educate teachers on handling students with ADHD.”

51
Q

What teacher:student ratio is ideal for students with ADHD?

A

“1:10 or 1:15

52
Q

Where should a child with ADHD be seated in class?

A

“In the** ‘teacher feedback zone**, away from windows/ doors”

53
Q

What happens to untreated ADHD patients?

A

○ Oppositional defiant disorder
○ Conduct disorders
○ Anti-social behaviors
○ Antisocial personality disorder
○ Anxiety disorders
○ Major depression

54
Q

What percentage of adolescents diagnosed with ADHD in elementary school still exhibit symptoms?

A

“70-80% of adolescents

55
Q

How much of a lag in self-regulation persists in ADHD patients throughout life?

A

“A 30% lag persists
age 30 years - acts like (18-20 years old)

56
Q

What are the common outcomes in undiagnosed or unmanaged ADHD cases?

A

● School failure / Drop out of school.
● Substance abuse
● Juvenile delinquents
● Criminal behavior
● Divorce / separation
● Unable to succeed in work/ career.

57
Q

What are the outcomes in well-managed ADHD cases?

A

● Highly creative passionate individuals.
● Prime-movers, shakers.
● Multi-tasking productive professionals.
● Successful and fulfilled careers.

58
Q

What should be evaluated in a child suspected of having ADHD?

A

“Symptoms persisting for at least 6 months and evidence from parents

59
Q

What does ADHD assessment include?

A

“Evaluation for co-existing conditions such as language disorders and learning disabilities.”

60
Q

What is the role of diagnostic tests in ADHD evaluation?

A

not necessary

61
Q

What is the goal of early ADHD treatment?

A

“To prevent adverse effects on academic performance

62
Q

How can pharmacological treatment for ADHD progress?

A

“It depends on symptom progression/regression and is not always lifelong.”

63
Q

Should children with ADHD be enrolled in SPED schools automatically?

A

“No

64
Q

What is the preferred first-line medication for ADHD patients?

A

“Ritalin (methylphenidate) due to its extensive research and proven efficacy.”

65
Q

What is the concern with using amphetamine for ADHD treatment?

A

“Possible addiction and lack of certainty in its inclusion as a first- or second-line treatment.”

66
Q

How should drugs for ADHD treatment be evaluated?

A

“Based on evidence from journal articles and thorough appraisal for safety and effectiveness.”

67
Q

Why should teachers modify their approach for students with ADHD?

A

“To make tasks simple

68
Q

What impact does ADHD have on the family?

A

“Stress

69
Q

What positive outcomes can medication achieve in ADHD patients?

A

“Improves core symptoms

70
Q

When should ADHD medication be given?

A

“When behavioral therapy fails

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