BEHAVIORAL PROBLEMS IN CHILDHOOD

Question 1

9 yo M presents with a two-year history
of angry outbursts both in school and
at home. His mother complains that he
runs around “as if driven by a motor.” His
teacher reports that he cannot sit still in
class, regularly interrupts his classmates,
and has trouble making friends.

Answer 1

Attention-defi cit hyperactivity
disorder (ADHD)
Oppositional defi ant disorder
Manic episode
Conduct disorder

Physical exam
Mental status exam

Question 2

12 yo F presents with a two-month
history of fi ghting in school, truancy, and
breaking curfew. Her parents recently
divorced, and she just started school in a
new district. Before her parents divorced,
she was an average student with no
behavioral problems.

Answer 2

Adjustment disorder
Substance intoxication/abuse/
dependence
Manic episode
Oppositional defi ant disorder
Conduct disorder

Physical exam
Mental status exam
Urine toxicology

Question 3

15 yo M presents with a one-year history
of failing grades, school absenteeism, and
legal problems, including shoplifting.
His parents report that he spends most of
his time alone in his room, adding that
when he does go out, it is with a new set
of friends.

Answer 3

Substance abuse
Conduct disorder
Oppositional defi ant disorder
Adjustment disorder

Urine toxicology
Mental status exam

Question 4

5 yo M presents with a six-month
history of temper tantrums that last
5–10 minutes and immediately follow a
disappointment or a discipline. He has
no trouble sleeping, has had no change
in appetite, and does not display these
behaviors when he is at day care.

Answer 4

Age-appropriate behavior
ADHD
Oppositional defi ant disorder

Physical exam
Mental status exam