Brainscape's Knowledge GenomeTM

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


See full index

PEDIATRICS > Attention-Deficit/ Hyperactivity Disorder (ADHD) based on Nelsons > Flashcards

Attention-Deficit/ Hyperactivity Disorder (ADHD) based on Nelsons Flashcards

1
Q

What is ADHD and how is it characterized?

A

ADHD is a common neurobehavioral disorder characterized by inattention, impulsivity, and hyperactivity.

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

What are the DSM-5 diagnostic criteria for ADHD?

A

A persistent pattern of inattention and/or hyperactivity-impulsivity interfering with functioning or development for ≥6 months, present in at least 2 settings, and causing significant impairment.

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

How does ICD-11 differ from DSM-5 in ADHD criteria?

A

ICD-11 describes ADHD features but does not specify age of onset, duration, or a minimum number of symptoms.

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

What is the prevalence of ADHD worldwide?

A

5–10% of school-age children are affected.

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

What is the male-to-female ratio for ADHD presentations?

A

4:1 for hyperactive-impulsive presentation and 2:1 for inattentive presentation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What coexisting conditions are common in children with ADHD?

A

Learning disabilities, mood disorders, and language disorders.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the heritability of ADHD based on twin studies?

A

70–80%.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What structural brain abnormalities are associated with ADHD?

A

Dysregulation of frontal-subcortical circuits, smaller cortical volumes, and abnormalities in the cerebellum.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How do dopamine and norepinephrine play a role in ADHD?

A

Dopamine transporter density is increased, reducing dopamine availability; stimulant medications increase dopamine and norepinephrine at the synapse.

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

What environmental factors increase the risk for ADHD?

A

Prenatal tobacco or alcohol exposure, prematurity, and maternal mental illness.

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

What are the DSM-5 ADHD presentations?

A

Predominantly inattentive, predominantly hyperactive-impulsive, and combined presentations.

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

What are the minimum symptom criteria for ADHD according to DSM-5?

A

At least 6 inattentive symptoms and/or 6 hyperactive-impulsive symptoms.

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

At what age should ADHD symptoms begin to meet DSM-5 criteria?

A

Before age 12 years.

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

In how many settings must ADHD symptoms be present?

A

In at least two settings, such as home and school.

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

What types of symptoms are common in ADHD for preschool children?

A

Motor restlessness and aggressive or disruptive behaviors.

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

What ADHD symptoms tend to persist into adolescence and adulthood?

A

Impulsivity and inattention.

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

Which ADHD presentation is more common in females?

A

Predominantly inattentive presentation.

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

What symptoms are typically associated with ADHD in females?

A

Internalizing symptoms like anxiety and low mood.

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

What information is gathered during an ADHD clinical evaluation?

A

Developmental history, school performance, social skills, mood, sleep patterns, and family history.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What tools are used to collect information about ADHD symptoms?

A

Behavior rating scales from parents, teachers, and other caregivers.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What comorbidities should be screened during an ADHD evaluation?

A

Mental health symptoms, neurodevelopmental or learning problems, and medical history.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What physical assessments are important in ADHD evaluation?

A

Baseline height, weight, blood pressure, pulse, and motor coordination.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

How does ADHD affect academic and social functioning?

A

ADHD may lead to academic underachievement, interpersonal problems, and low self-esteem.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What long-term risks are associated with untreated ADHD?

A

Underemployment, social dysfunction, substance abuse, and increased risk of accidents or suicide.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What role does maternal mental illness play in ADHD risk?

A

Underlying maternal mental illness, rather than treatment, increases the risk for ADHD in offspring.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What dietary factors might affect ADHD symptoms?

A

Diet is not generally a cause, but a small subset of children may be sensitive to certain foods or additives.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

How is ADHD severity categorized?

A

Mild, moderate, or severe, based on symptom intensity and functional impairment.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What are the common ADHD presentations in older adolescents and adults?

A

Disorganized, distractible, and inattentive behaviors.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What are the common coexisting conditions in adults with ADHD?

A

Mood disorders, anxiety, and substance use disorders.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is the recommended minimum age for initiating ADHD evaluation?

A

Age 4 years.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What are the goals of ADHD treatment?

A

Improve functioning, address coexisting conditions, and optimize the child’s strengths and resources.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What is the purpose of behavior rating scales in ADHD assessment?

A

Behavior rating scales help elicit information about ADHD symptoms across contexts (home and school) and assess functional impairment.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What are the two types of Vanderbilt ADHD Rating Scales?

A

Parent and teacher versions.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What specific ADHD symptoms does the Vanderbilt ADHD Rating Scale assess?

A

Inattention and hyperactivity/impulsivity, corresponding to DSM-5 criteria.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What coexisting conditions does the Vanderbilt ADHD Rating Scale screen for?

A

Anxiety/depression and oppositional behaviors/conduct disorder.

36
Q

Name two additional ADHD-specific rating scales.

A

Conners 3 ADHD Index and ADHD Rating Scale 5.

37
Q

What are broadband rating scales useful for in ADHD assessment?

A

Assessing coexisting conditions.

38
Q

Give two examples of broadband rating scales.

A

Achenbach Child Behavior Checklist (CBCL) and Behavioral Assessment Scale for Children (BASC).

39
Q

What is the significance of electronic capture of rating scale information?

A

It facilitates completion and scoring.

40
Q

How should clinicians interpret discrepancies between parent and teacher rating scale results?

A

By assessing the context and level of support in each setting.

41
Q

What percentage decrease in ADHD symptom scores is considered significant improvement?

A

25% or more.

42
Q

Why might functional outcomes be more important than changes in symptom scores?

A

They better reflect the real-world impact of treatment.

43
Q

What is critical to consider when assessing children on medication for ADHD?

A

Whether the medication was active during observation.

44
Q

What features should a physical exam for ADHD include?

A

Cardiac and neurologic evaluations, thyroid, hearing and vision assessments, and checking for dysmorphic features.

45
Q

When might laboratory tests or brain imaging be indicated in ADHD assessment?

A

When there is hypertension, ataxia, asymmetric neurologic findings, or symptoms of sleep, seizure, or thyroid disorders.

46
Q

What role does educational testing play in ADHD assessment?

A

It helps identify specific learning disabilities that often coexist with ADHD.

47
Q

When should intelligence or developmental testing be conducted in ADHD cases?

A

When there are concerns about slow developmental milestones.

48
Q

What are two symptoms that might indicate a need for autism spectrum disorder assessment?

A

Concerns about social communication skills and restricted, repetitive behaviors or interests.

49
Q

What are two psychiatric conditions that can mimic ADHD?

A

Depression and anxiety disorders.

50
Q

What psychiatric condition involves proactive aggression and authority challenges?

A

Oppositional defiant disorder (ODD) or conduct disorder.

51
Q

What medical condition might mimic ADHD due to disrupted sleep?

A

Obstructive sleep apnea or restless legs syndrome.

52
Q

What developmental conditions should be included in the differential diagnosis for ADHD?

A

Low/high cognitive abilities, learning disabilities, communication disorders, and autism spectrum disorder.

53
Q

What medical conditions can overlap with ADHD symptoms?

A

Sleep disorders, hearing or vision impairment, thyroid disorders, genetic syndromes like fragile X, and others.

54
Q

Why is a private interview with adolescents important during ADHD assessment?

A

To screen for mood symptoms, psychosocial stressors, and substance use.

55
Q

What are common triggers for symptoms resembling ADHD?

A

Major life stresses like divorce, family violence, or child abuse/neglect.

56
Q

What are the four general categories of ADHD differential diagnosis?

A

Developmental, psychiatric, medical, and psychosocial.

57
Q

What psychosocial conditions can lead to ADHD-like symptoms?

A

Response to abuse, distress at home, inappropriate expectations or parenting practices, or inappropriate classroom settings.

58
Q

What is the overall treatment approach for ADHD?

A

ADHD is managed as a chronic condition with education, regular follow-up visits, behavioral therapy, school-based supports, and medications. The treatment plan should be developed collaboratively with the child and family.

59
Q

What is the recommended first-line treatment for preschool-age children with ADHD?

A

For children under 6, the first-line treatment is evidence-based parent- and/or teacher-administered behavior therapy. Medication should be considered if there is moderate to severe impairment and behavior interventions are not effective.

60
Q

What is the first-line treatment for school-age children and adolescents with ADHD?

A

For children aged 6 years and older, ADHD medications should be considered first-line, along with behavior and educational interventions.

61
Q

What are behaviorally oriented treatments for ADHD?

A

Behavioral interventions focus on modifying the environment and empowering caregivers with strategies to promote positive behaviors, using reinforcement, clear rules, and consistent enforcement.

62
Q

What is the purpose of behavioral parent training in ADHD?

A

It involves teaching parents behavior modification strategies to address specific behaviors, emphasizing positive reinforcement and appropriate consequences for maladaptive behaviors.

63
Q

What is the role of exercise in ADHD treatment?

A

At least 60 minutes of moderate to vigorous exercise is recommended for children ≥6 years old. Exercise may help reduce ADHD symptoms, in addition to supporting general health.

64
Q

What is the role of cognitive-behavioral therapy (CBT) in ADHD treatment?

A

CBT can be beneficial for children and adolescents with ADHD and coexisting anxiety or depression, addressing symptoms of anxiety or low mood.

65
Q

What types of educational supports may benefit children with ADHD?

A

Children may benefit from preferential seating, motor breaks, frequent teacher check-ins, individualized behavior plans, and a daily report card for regular communication between parents and teachers.

66
Q

What is the purpose of a daily report card in ADHD management?

A

A daily report card includes target problem behaviors, and the teacher provides ratings for each behavior. This report is sent home to be used for home-based rewards for goal achievement.

67
Q

What accommodations might children with ADHD need to support executive functioning?

A

Children with ADHD often need explicit instruction in organization, using tools like an agenda book, color coding, and regular teacher check-ins for organizing tasks.

68
Q

What is an individualized educational plan (IEP) and who qualifies for it?

A

An IEP is designed for children with ADHD and coexisting learning disorders, communication delays, mental health challenges, or autism spectrum disorder, providing specialized educational support.

69
Q

What should be done before initiating medication for ADHD?

A

A history and physical examination should be conducted, including an assessment of baseline sleep, eating, and mood, as these need to be monitored throughout medication treatment.

70
Q

What types of medications are commonly used to treat ADHD?

A

ADHD medications fall into three categories: stimulants, norepinephrine reuptake inhibitors, and α2-adrenergic agonists.

71
Q

What is the first-line medication treatment for ADHD?

A

Stimulants are the first-line medication treatment, with a larger treatment effect size compared to nonstimulants.

72
Q

What is the role of norepinephrine reuptake inhibitors in ADHD treatment?

A

Norepinephrine reuptake inhibitors like atomoxetine and viloxazine may be used when there is a concern for substance use disorder or if a family prefers nonstimulant medication.

73
Q

What is the role of α2-adrenergic agonists in ADHD treatment?

A

α2-adrenergic agonists (guanfacine, clonidine) may be used as monotherapy or adjunctive therapy, especially for children with coexisting tic disorders or sleep problems.

74
Q

What are common side effects of stimulant medications for ADHD?

A

Common side effects include decreased appetite, headaches, stomachaches, difficulty falling asleep, and mood lability.

75
Q

What should be monitored when a child is on stimulant medication for ADHD?

A

Height, weight, pulse, and blood pressure should be periodically monitored. Growth should also be assessed, as stimulants can slightly reduce linear growth.

76
Q

What should be done if a child experiences significant reductions in growth while on stimulant medication?

A

If a child experiences significant reductions in height or weight, the medication should be reconsidered, potentially switching to a different ADHD medication.

77
Q

What should be done before starting stimulant medications for ADHD?

A

Children should be screened for symptoms of cardiomyopathy, coronary artery disease, arrhythmias, or family history of sudden death to ensure safety.

78
Q

What is rebound with stimulant medication?

A

Rebound refers to symptoms like mood lability occurring as the medication wears off. This may be managed by switching to a longer-acting stimulant or adding a low-dose short-acting medication.

79
Q

What is the risk of substance abuse with stimulant medications?

A

Stimulant medications have the potential for misuse, diversion, and abuse, so adolescents should be counseled about safe medication storage and taking medications only as prescribed.

80
Q

How long does it take for norepinephrine reuptake inhibitors to show effectiveness?

A

Atomoxetine and viloxazine may take up to 4 weeks to show effectiveness.

81
Q

What are the common side effects of norepinephrine reuptake inhibitors?

A

Side effects of norepinephrine reuptake inhibitors include fatigue, decreased appetite, nausea, vomiting, irritability, and a rare risk of suicidal thinking.

82
Q

What are the side effects of α2-adrenergic agonists for ADHD?

A

Common side effects of α2-adrenergic agonists include sedation, headaches, hypotension, and they should be stopped gradually to avoid a rapid increase in blood pressure.

83
Q

What is the prognosis for individuals diagnosed with ADHD in childhood?

A

More than half of individuals with ADHD will develop a mental health condition in adulthood. One-third to two-thirds will continue to have significant symptoms of ADHD in adulthood.

84
Q

What long-term risks are associated with ADHD in adolescence and young adulthood?

A

Adolescents with ADHD are at increased risk for risk-taking behaviors, educational underachievement, substance use, psychosis, and relationship difficulties.

85
Q

What are the benefits of consistent treatment for ADHD?

A

Consistent treatment with medication and other therapies can reduce the risks associated with ADHD, including injuries and substance use.

86
Q

What role does parent training play in secondary prevention for ADHD?

A

Parent training can significantly improve ADHD symptoms and oppositional behaviors, leading to better long-term outcomes when ADHD is detected and treated early.

PEDIATRICS (19 decks)

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