Behavioral Disorders Flashcards
ADHD is more common in the {{BLANK}} gender
Male
Especially if they have a 1st degree relative
What is the brief characterization of ADHD?
- Poor task attention
- Impulsivity
- Over activity
What is the Dx criteria for ADHD?
- Present < 12 yo
- Present ≥ 6 months
- Occur in 2 ≥ environments
- Impact functioning (e.g., academic, social, occupational)
What is true of study findings regarding the treatment of ADHD?
Pharmacologic & combination (CBT + pharmacotherapy) are more effective than CBT alone or routine community care
Due to the MOA of ADHD pharmacotherapies, you should perform {{BLANK}} to monitor all patients.
EKG/ECHO
If a pediatric patient is known to start fires what should you do?
refer to mental health professional
When does breath holding typically occur?
Infants & Toddlers
What scary thing can happen when a child performs breath holding?
Seizures
A pediatric patient of 3 yo is brought into your office by their mother. The mother complains that the child is holding their breath and was not concerned until yesterday when they experienced a seizure. What is your recommended treatment?
Ignore the episodes
Toddler will D/C activity eventually
When do temper tantrums usually occur?
18 mo to 3 yo
What is the treatment for temper tantrums?
- Verbal resolution
- Time out
When does lying usually occur?
2-4 yo
Conduct disorder can be characterized by various behaviors including?
Anti-Social Behaviors
* Stealing
* Lying
* Fire setting
* Property destruction
* Cruelty to animals
* Running away
* Weapon use
What is the treatment for conduct disorder?
E.g., weapon use, running away, stealing, etc.
Individual or Group Therapy
Enuresis is typically present in the {{BLANK}} gender
Male
M:F = 7%, 3% at 5 yo
Pica typically occurs at what age?
1-2 yo
What should you do/monitor for in pica?
- Lead poisoning
- Parasitic infestation
Typically, self-limiting, gone by 2 yo
Rumination disorder can be fatal due to?
Failure-to-thrive or weight loss due to repeated regurgitation of food
The {{BLANK}} gender predominates rumination disorder
Male
Rumination disorder typically presents at what age?
3-14 mo
Nocturnal enuresis can typically be treated by?
- Behavioral modifications
- Fluid restriction
- Conditioning devices
- Imipramine 25 mg qd
How is functional fecal incontinence (FFI) defined?
AKA, Encopresis
- Repeated involuntary passage of stool in underwear after toilet training
- Typically, > 4 yo
- Absence of NMSK anorectal dysfunction
How is FFI diagnosed?
- ≥ 2 of the following: < 2 bowel movements/week, passing hard/painful stools, retentive posturing/stool retention (excessive), large stools blocking toilet, large rectal fecal mass, ≥ 1 episode per week
- Duration of ≥ 1 month
- Absence of organic disease
You should perform further investigation in those suspected of FFI because…
90% of constipation is functional (e.g., hypothyroidism, Hirschsprung, Celiac, MEN-2)
What is the DOC for FFI?
PEG 1-1.5 g/kg/day in 10 mL/kg H2O
A {{BLANK}} diet should be followed along with limiting milk consumption to {{BLANK}} per day in those with FFI
- High-fiber diet
- Limit milk to ≤ 18 oz/day
{{BLANK}} affects stage 3 or 4 sleep in 10-15% of school aged children
Somnambulism
Sleep walking
{{BLANK}} happens more often in preschool kids in non-REM sleep around stage 4 (arousal)
Night terrors
{{BLANK}} versus night terrors happen in REM phase of sleep with an association with anxiety and affective disorders
Nightmares
{{BLANK}} is defined as frequent daytime naps, cataplexy, sleep paralysis, and hypnogogic hallucinations
Frequently seen in adolescence
Narcolepsy
What is the Tx for narcolepsy?
- Sleep studies
- Sometimes Antidepressants
Gilles de la Tourette syndrome typically manifests by 7 yo and is characterized by?
Compulsive barking, grunting, and shouting obscence words
