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Pediatric Board Prep > Behavioral Science and Substance Abuse > Flashcards

Behavioral Science and Substance Abuse Flashcards

1
Q

What has been shown to increase prenatal risk for ADHD?

A

fetal exposure to alcohol, cocaine and tobacco

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2
Q

What is the most likely diagnosis for pt presenting with GI symptoms, irritability, poor school performance, respiratory depression, cardiac arrhythmia, dilated pupils and eczematiod perio-oral dermatitis?

A

Inhalant abuse

due to hydrocarbons and nitrates, not detected in standard tox screens

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3
Q

Can synthetic cannabis been detected on standard toxicology screens?

A

No

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4
Q

what is the likely diagnosis for pt presenting with generalized apathy, lack of concern about personal appearance, loss of productivity, lethargy, moodiness, difficulty concentration, gynecomastia, and psychomotor retardation?

A

Chronic marijuana use

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5
Q

What is the most likely diagnosis for female pt (18-36 months old) presenting with history of deceleration in head growth at 6 months old, development stagnation followed by regression, stereotypic hand movements, loss of language and purposeful hand movement, and episodes of hyperventilation followed by hypoventilation, and seizures?

A

Rett syndrome

due to mutation in MECP2 gene on X chromosome

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6
Q

What is the most likely diagnosis of adolescent presenting with persistent acne, irritability, anger/ rage outbursts, decreased testicular size and liver dysfunction?

A

Anabolic steroids use

stanozolol, nadrolone

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7
Q

What is a possible treatment for night terrors?

A

preemptive awakening before the usual time of the night terror

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8
Q

what is a common eye finding associated with barbituate intoxications (dizzy/ floating/sleeping feeling, ataxia, poor comprehension, slurred speech, respiratory depression, bradycardia, orthostatic hypotension)?

A

Nystagmus

can get miosis in high doses

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9
Q

What is the best pharamcologic treatment for children with Autism who have severe aggressive or self-injurious behaviors/ irritability?

A
  1. Risperdone (wt gain, prolatin resulting in breast formation)
  2. Aripiprazole (prolactin)
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10
Q

What is the CRAFFT screening test used for?

A

Identify risk of drug and alcohol abuse

score of 2 or more is positive

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11
Q

What is the most likely diagnosis for an adolescent who presents after being found passed out, had a generalized seizure, euphoria, enhanced tactile sensation, hyperthermia, hypoglycemia and found to have hyponatremia?

A

MDMA (3,4 methylenedioxymethamphetamine)

aka Ecstasy, Molly

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12
Q

What are more common adverse side effects of Risperidone? (5)

A
  1. Dyslipidemia
  2. Insulin resistance (hyperglycemia)
  3. Hypertension
  4. EKG changes (prolonged GT)
  5. Prolactin elevation
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13
Q

What is the characteristic age range for breath holding spells?

A

6 months to 6 years old

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14
Q

What is the most likely diagnosis for adolescent presenting to ER with seizure, diaphoresis, tachycardia, HTN, hyperthermia, mydriasis, paranoid and combative/ violent behavior?

A

Bath salts (synthetic cathinones) abuse

tx: psychmotor agitiation with benzo

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15
Q

What are potential lethal complications of cocaine abuse? (4)

A
  1. Cerebral hemorrhage
  2. Stroke
  3. Seizures
  4. Myocardial infarction
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16
Q

What is the most likely diagnosis for an adolescent presenting with perforated nasal septum and history of chronic congestion and nasal discharge?

A

Cocaine abuse

vasoconstrictor

17
Q

What is onychophagia and what is the best treatment?

A

Nail biting

tx: positive reinforcement and praise when not biting nails

18
Q

By what age do infants with colic usually have resolution of their symptoms (paroxysms of inconsolable crying for hours for no apparent reason in an otherwise healthy infant)?

A

3-4 months old

19
Q

What is the most likely diagnosis for adolescent taking OTC medication to induce euphoria, hallucinations altered time perception, hyperexcitable state, ataxia and slurred speech?

A

Dextromethorphan abuse

20
Q

What is a known adverse effect of antidepressants in patients who are predisposed to bipolar disorder?

A

Manic episode

decreased need for sleep, flight of ideas, pressured speech, grandiosity

21
Q

What is the window of detection for marijuana in urine drug screens for infrequency users versus frequent users?

A

infrequent: 2-8 days
Frequent: 4-6 weeks

22
Q

What OTC medication can cause a false-positive urine drug screen for PCP (phencyclidine)?

A

Ibuprofen

23
Q

What is window of detection for PCP (phencyclidine) in urine drug screens?

A

8-14 days following ingestion

all other drugs besides marijuana are 24-48 hours

24
Q

What is a potential complication of anabolic steroid use along with hepatic dysfunction/ neoplasm?

A

Early epiphyseal closure

25
Q

What is the most likely diagnosis for a pt presenting with losing temper, arguing with authority figures, refuses to comply with adults request/ rules, deliberately annoys adults and peers, blames others for mistakes/ misbehaviors and is angry/ resentful/ vindictive for at least 6 months?

A

Oppositional Defiant Disorder

26
Q

Patients with Rett syndrome are at increased risk of sudden death from what?

A

Cardiac arrhythmia

27
Q

What is the best treatment for Tic disorder?

A

Clonidine (alpha 2 agonist)

28
Q

What medical condition is a contraindication for the use of stimulant medications?

A

Structural cardiac abnormalities or arrhythmias

increased risk of sudden death

29
Q

What are the most common pulmonary complications of inhalant abuse?

A

Pneumothroax and pneumomediastinum

30
Q

What is the likely diagnosis of an adolescent presenting with disorientation, unable to recognize family/ friends, anxiety, frightened, drooling, hypotensive, and briefly hyperthermic with nystagmus, hyperreflexia with clonus, and muscle rigidity?

A

Phencyclidine (PCP) abuse

31
Q

What ADHD treatment has a warning about suicidal ideation as possible advserse effect?

A

Atomoxetine (norepinephrine reuptake inhibitor)

32
Q

What mood/ anxiety disorder can be exacerbated by an infection due to Streptococcus pyogenes (group A Strep)?

A

Obsessive-compulsive disorder (OCD) and Tic Disorders

phenomenon known as PANDAS- pediatric autoimmune neuropsychiatric disorder associated with streptococcal infection

33
Q

What is the most serious complication of abrupt withdrawal from benzos?

A

Protracted seizures

34
Q

What is the most likely diagnosis for patient presenting with acute onset excessive yawning, rhinorrhea, dilated pupils, tachycardia, hypertension, and restlessness?

A

Opioid withdrawal

35
Q

What is the first line treatment for obsessive-compulsive disease (OCD)?

A

SSRIs

36
Q

What is the most likely diagnosis of a teen presenting with euphoria, weight loss, dry mouth, tooth decay, increased energy and decreased sleep?

A

Methamphetamine use

37
Q

What is the best initial step in management of patient who has been sexting?

A

report to authorities (anywhere the pictures may have been sent)

38
Q

What is the most likely diagnosis of an unconscious patient presenting with history of agitation, respiratory depression, hypotension, nystagmus, hypotonia and ataxis?

A

Benzo overdose

39
Q

What is the most likely diagnosis of unconscious patient presenting with hyperthermia, respiratory depression, rhabdomyolysis, hyponatremia and hypokalemia?

A

MDMA (ecstasy) use

Pediatric Board Prep (26 decks)

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