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Pediatrics Exam 2 > Behavioral Health > Flashcards

Behavioral Health Flashcards

1
Q

Ratio of boys to girls with ADHD (both disorders):

A
  • Hyperactive: Boys x4 more

- Inattentive: Boys x2 more

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2
Q

Neurodevelopmental factor of ADHD:

A

Imbalance between NE and DA in the prefrontal cortex

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3
Q

ADHD heredibility is:

A

Higher than that of cancer and heart disease

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4
Q

What are some dietary influences on ADHD?

A
  • Red food dye
  • Refined sugar
  • Fatty acid deficiency
  • Iron and zinc deficiency
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5
Q

What are some exposures that can contribute to ADHD?

A
  • Cigarette smoke and alcohol
  • Low birth weight
  • Head injury
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6
Q

What are the three forms of ADHD?

A
  • Hyperactive: can’t sit still
  • Inattentive: off task
  • Combined: all the above
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7
Q

To diagnose kids with ADHD what are the DSM-5 criteria for both over the age of 17 and under?

A

<17: 6 or more symptoms

>17 or 17: 5 or more symptoms

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8
Q

The symptoms to diagnose ADHD must (5):

A
  • Occur often
  • Be in more than one setting
  • Present before the age of 12
  • Impair function
  • Be excessive for the development of the child
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9
Q

What three systems should you focus on for ADHD ROS?

A
  • Cardiac
  • Neuro
  • Psych
  • *look for marfan’s as well
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10
Q

What is the problem with ADHD stimulants and cardiac?

A

There is increased risk of sudden cardiac death taking stimulants

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11
Q

If you are going to put a kid with risk factors for cardiac problems on a stimulant you must:

A

ECG full work up or referral to cardiac consult

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12
Q

What two things do stimulants do to the heart?

A

Increase the HR and BP

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13
Q

What are two drugs that can cause CV side effects?

A
  • Albuterol

- Pseudoephedrine

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14
Q

What are the two most common ADHD rating scales? They are NOT __

A
  • Connors
  • Vanderbilt Assessment scale
  • *not diagnostic
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15
Q

What are 5 other tests you should do on a kid that may have ADHD?

A
  • Speech and path
  • Blood lead level
  • Thyroud
  • OSA
  • Neuro problems - absence seizures
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16
Q

What other disorder exists 50-80% of the time with ADHD?

A

Oppositional Defiant Disorder

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17
Q

What exists 33% of the time with ADHD (2)?

A
  • Depression

- Conduct disorder

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18
Q

What is worse, ODD or conduct?

A

Conduct - lying, theft, violation of laws, threatening, aggressive

19
Q

Refusing to go to school is a sign of:

A

Seperational anxiety

20
Q

What kids are at a higher risk for depression?

A

Those with attentional, learning, conduct or anxiety disorders.

21
Q

What is the initial therapy for a kid with ADHD that is school aged?

A
  • Behavioral management
  • Educational intervention
  • Pharmacotherapy
22
Q

What is the initial therapy for a kid that is preschool aged?

A

Behavioral therapy - do not want to medicate them until they are school aged

23
Q

What is the most effective for treating ADHD?

A

Psychostimulants with or without behavioral therapy

24
Q

What are three SE of psychostimulants?

A

Anorexia, insomnia, tics

25
Q

What are the three amphetamine stimulants for ADHD?

A
  • Adderall
  • Vyvanse
  • Dexedrine
26
Q

What are the four Methylpenidate stimulants for ADHD?

A
  • Ritalin
  • Focalin
  • Methylin
  • Concerta
27
Q

What are the lengths of efficacy for stimulants?

A

Short: 3-6 hours
Intermediate: 6-8
Long: 10 - 12+

28
Q

How should you start a kid on a stimulant?

A

In the summer/at home on break at a low dose and titrate up (3-7 day basis)

29
Q

What is the percentage improvement with ADHD medications?

A

70%

30
Q

What type of ADHD is a Drug Holiday most beneficial for?

A

Inattentive type

31
Q

What is a non-stimulant medication for ADHD?

A

Atomoxetine - Increases NE in the brain

32
Q

You cannot do what with a non-sitmulant

A

Take a drug holiday!!!

33
Q

What is second-line non stimulant for ADHD?

A

Alpha agonist: Clonidine, Guanfacine

34
Q

What is the most common SE for an alpha agonist for ADHD?

A

Sleepiness and sedation (good for a kid with insomnia)

35
Q

How many kids with ADHD become adults with ADHD?

A

2/3rds

36
Q

What are the two major areas of deficit when someone has Autism?

A
  • Deficits in social communication

- Restricted repetitive patterns

37
Q

Boys are ___ more likely to have autism than girls.

A

4x

38
Q

Loss of developmental milestones when a child has autism occurs at:

A

12-15 months

39
Q

When do you screen for autism?

A

18 and 24 - Early diagnosis is critical!

40
Q

__ percent of HS students have drank

A

70%

41
Q

What age group is exposed to their parents using:

A

12-14

42
Q

Sons of male alcoholics are __ times more likely to become alcoholics

A

9x

43
Q

What is the goal for a substance case?

A

Harm reduction first than the ultimate goal of sobriety!

Pediatrics Exam 2 (7 decks)

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