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Child Health > CAMHS > Flashcards

CAMHS Flashcards

1
Q

Symptoms of depression

A 
Low mood
Anhedonia
Low energy
Anxiety and worry
Cling in Ess.
Irritability 
Avoiding social situations 
Hopelessness about future
Poor sleep
Poor appetite
Poor concentration
Abdominal pain
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2
Q

History of depression

A 
Potential triggers
Home environment 
Relationships: friends, family, sexual 
School situations and pressures
Bullying
Drugs and alcohol 
History of self-harm 
Thoughts of self-harm or suicide
Family history
Parental depression
Parental drug and alcohol abuse
History of abuse or neglect
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3
Q

Management of mild depression

A

Low mood associated with single negative event
Watchful waiting
Advice about healthy habits, healthy diet, exercise, avoiding alcohol and cannabis
Follow up within 2 weeks

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4
Q

Management of moderate to severe depression

CAMHS

A

Full assessment to establish a diagnosis
Psychological therapy as the first line treatment with CBT, non-directive supportive therapy, interpersonal therapy and family therapy
Fluoxetine first line antidepressant in children
Sertraline and citalopram second line
When the child responds to medical treatment, it should continue 6 months after remission is achieved
When the child doesnt respond they may require intensive psychological therapy
Mood and feelings questionnaire

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5
Q

When is admission considered in depression?

A

High risk of self harm, suicide, self-neglect

Immediate safeguarding issue

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6
Q

What is generalised anxiety disorder?

A

Mental health condition that causes excessive and disproportionate anxiety and worry that negatively impacts the person’s everyday activity

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7
Q

Assessment of GAD

A

GAD-7 anxiety questionnaire
Assess for co-morbid mental health conditions like OCD and depression
Assess for environmental triggers and contributors

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8
Q

Management of generalised anxiety disorder

A

Mild: watchful waiting, advice about self-help strategies, diet, exercise, avoiding alcohol, caffeine and drugs

Moderate to severe: counselling, CBT, medical management (SSRI-sertraline)

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9
Q

Obsessions in OCD

A

Unwanted and uncontrolled thoughts and intrusive images that the person finds very difficult to ignore
Overwhelming fear of contamination with dirt or germs or violent or explicit images that keep appearing in their mind

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10
Q

Compulsions in OCD

A

Repetitive actions the person feels they must do, generating anxiety if they are not done

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11
Q

What is OCD associated with?

A 
Anxiety
Depression
ED
ASD
Phobias
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12
Q

Management of significant OCD

A

Referral to CAMHS
Patient and carer education
CBT
SSRI medications

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13
Q

Features of anorexia nervosa

A 
Excessive weight loss
Amenorrhea 
Lanugo hair
Hypokalaemia
Hypotension
Hypothermia
Changes in mood, anxiety and depression
Solitude
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14
Q

Cardiac complications of anorexia

A

Arrhythmia
Cardiac atrophy
Sudden cardiac death

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15
Q

Features of bulimia nervosa

A 
Alkalosis, vomiting HCl
Hypokalaemia
Erosion of teeth 
Swollen salivary glands
Mouth ulcers
GORD and irritation
Russell’s sign: calluses on knuckles
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16
Q

What may binge eating involve?

A 
A planned binge involving binge foods
Eating very quickly
Unrelated to whether they are hungry or not
Becoming uncomfortably full
Eating in a dazed state
17
Q

Management of binge eating

A 
Patient and carer education 
Self-help resources
Counselling
CBT
Addressing other areas of life
Monitor for refeeding syndrome 
SSRI medication
18
Q

What is refeeding syndrome

A

Metabolism in cells slows during prolonged periods of malnutrition
Starved cells use up Mg, K and PO4 while they process glucose, protein and fats
Hypomagnesaemia
Hypokalaemia
Hypophosphataemia

Risk of cardiac arrhythmias, heart failure and fluid overload

19
Q

Management of refeeding syndrome

A

Slowly reintroduction food with restricted calories
Magnesium, potassium, phosphate and glucose
Fluid balance monitoring
ECG monitoring
Supplementation with electrolytes and vitamins, especially B vitamins and thiamine

20
Q

MDT involved in management of children with learning disabilities

A 
Health visitors
Social workers
Schools
Educational psychologists
Paediatricians, GPs and nurses
Occupational therapists
Speech and language therapists
21
Q

Assessing capacity

A

Understand the decision that needs to be made
Retain the information long enough to make the decision
Weigh up the options and the implications of choosing each options
Communicate their decision

22
Q

Sleep problems in childhood

A

Refusal to go to bed
Frequent night waking
Common parasomnias
Medical problems: inte-current illness, chronic illness e.g. asthma, acute/chronic pain

23
Q

Parasomnias

A 
Episodic sleep behaviours
Head banging
Sleep walking
Bruxism 
Nightmares
Night terrors
24
Q

Management of sleep problems

A 
Keep sleep diary
Sleep hygiene
Positive bedtime routine
Controlled crying
Education
Medication: melatonin
25
Q

Non-epileptic behaviours

A 
Simple faint
Breath holding spells
Temper tantrums
Hyperventilation
Infantile colic
Self-stimulatory behaviours
26
Q

Assessment and investigation of problem eaters

A

History and examination
Monitor growth against projected range
Admission for assessment as a last resort
Investigate for organic causes: severe reflux- pH probe or barium swallow

27
Q

Management of problem eaters

A 
Social reinforcement (praise) crucial
Avoid coaxing and forcing
Avoid using preferred foods as a reward 
Family mealtimes
Encourage communal eating with peers
Rejection of new foods can be overcome by repeated exposure to small quantities
28
Q

Causes of soiling child

A

Loose stools: malabsorption, excess fruit juice
Stools normal: faulty toilet training, neglect, other stressors
Combination stool: constipation with overflow diarrhoea

29
Q

Investigations for soiling

A 
Hirschsprung’s disease: rectal biopsy
Hypothyroidism- TFTs
Hypercalcaemia: serum Ca
Lead poisoning; serum lead
Renal tubular disorders- plasma bicarbonate
30
Q

Management of soiling child

A

NICE guidance
Consider neuropathic cause if urinary incontinence coexists
Psychological management

31
Q

Assessment and investigation of ADHD

A

Standard clinical assessment
Consider epilepsy and EEG
Check for fragile X if also global developmental delay

32
Q

Learning disability and ADHD screen

A 
FBC, UE, LFT, Ca, TFT, iron, CK, blood sugar
Karyotyping +/- fragile X
Serum amino acids, urine organic acids 
Urine GAGs
Consider MRI brain

Child Health (20 decks)

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