Child Flashcards
How long should a child be treated with a SSRI for OCD to be an adequate trial?
8 weeks on max dose, 12 weeks in total
Which AD is Health Canada approved for depression?
None
Which AD has a worst risk for increasing SI?
Venlafaxine
Which AP is HC approved in children?
Aripip for <18 in scz
which part of sleep do night terrors occur?
first third of the night (NREM stage 3 or 4)
first line med tx for ADHD
long acting stimulants
Which two “anxiety” d/o are more prevalent in males than females in childhood?
- OCD. 2. Tourettes
list three amphetamine based psychostimulants
- dexedrine. 2. adderal. 3. vyvanse
list three ADHD methylphenidate based psychostimulants
- ritalin. 2. Biphentin. 3. Concerta
before which age cant RAD be diagnosed and before which age does the disturbance need to be evident
9 mo and 5 yrs
what is the average age of onset of tic d/o
4-6 yrs
Do attention difficulties come before or after tics?
before
Does OCD come before or after tics?
After
Before which age is it considered childhood onset CD
10 yrs
Most common maternal infection related cause of a child having a DD
rubella
Most common presenting sign of Tourettes
eye blinking
most common comorbidity of ADHD
ODD (67%)
most common method of completed suicide in children
hanging
which parent is more likely to abuse the child
fathers
at what age do children start to develop theory of mind
4-5 yrs
Children with ADHD and CD are at risk of developing which d/o
SUD
co-morbidity most common with tourettes
ADHD
most common childhood d/o
- Anxiety. 2. MDD
criteria for enuresis
2x/w x 3mo for >4 yrs
most effective tx for enuresis
bell and pad (behavioral therapy)
cerebral palsy and hyperuricemia makes you think off?
Lesch Nyhan
is physical abuse a criteria in RAD
no, more neglect
is physical abuse a criteria in disinhibited social engagement d/o>
no, more neglect
Is encopresis involuntary or intentional?
can be either
best tx for separation anxiety d/o
multimodal (family therapy, psychoed, meds)
when does normative seperation anxiety peak and then diminishes?
9-18 mo then diminishes by 2 yrs
prevalence of psychiatric d/o in children and adolescents
15-20%
Prior to what age must ADHD sx be present
12
For ADHD what the minimum number of settings sx must be present?
two
for ADHD can symptoms vary based on how stimulating the situation is?
yes
when do the first sx of ODD appear?
in preschool years
what is the minimum age to diagnosis ODD or CD
there is none
Below which age does the PTSD criteria get modified for youth?
Age 6 and younger
was is the best behavioral approach to ODD?
“reinforce the positive and ignore the negative” (positive reinforcement and extinction)
suicide attempts occur in what percent of adolescents?
7-11%
what percentage of children with separation anxiety go on to have a psychiatric d/o as adults
33.3%
percentage of ADHD that remits in adolescence
30-40%
separation anxiety and school refusal is more common in which gender
M=F
what is the most common childhood anxiety disorder
separation
which type of attachment is most associated with separation anxiety d.o
insecure
best therapy for a child with an anxiety d.o
CBT
what is the key different in the MDD criteria bw adults and children
for children irritable mood can replace depressed mood
what is the most frequently reported sx of schizophrenia in children
AH
prevalence of CD
6.8%
Is CD associated with higher or lower arousability?
lower
What percent of CD will convert to anti-social PD
ranges from 30-50% (depends on the subtype; childhood onset at higher end )
What was the main conclusion from the Isle of Wight Study by Rutter et al
psychopathology was twice as high in medically unwell children than health kids
over what time period does stuttering generally develop
weeks to months
what age range does stuttering typically occur
18mo - 9 yrs
What is the most common cause of language delay in childhood?
deafness or hearing loss
what are markers for the best prognosis in a child with autism
- IQ > 70 with good adaptive skills. 2. develops language by 5-7 yrs
Percentage of children/youth with autism who have a seizure
25-30%
what is the most common pattern of selective mutism
child will speak at home with the nuclear family but not elsewhere
do individuals with ADHD have an increased or decreased risk for criminal behavior in adulthood?
increased
which features of ADHD are more likely to resolve by adulthood
hyperactivity (the inattention and impulsivity persists)
What is the genetic pattern with highest risk of tourette’s transmission
autosomal dominant
first line med tx for tourette’s
AP (risperidone is most effective, followed by olz and pimozide)
name two evidence based. behavioral interventions for tourette’s
- habit reversal. 2. CBIT
which co-morbidity leads to the worst outcomes in pediatric MDD
OCD
Main conclusion of POTS study
Combo (CBT+SSRI) = CBT > sertraline > placebo (in OCD)
what is the most common comorbid psych d/o among youth with bipolar?
ADHD
two AP to use in aggression in autism
- risp. 2. abilify
main difference bw disruptive mood dysregulation and intermittent explosive d.o
in DMDD they have inter-episode irritability
least common co-morbidity with ADHD
ASD
in ARFID do you need both weight loss and nutritional deficiencies?
no at least one of those OR (psychosocial impairment or oral/enteral supplements)
what are the three reasons an ARFID kid restricts food
- lack of interest in food 2. sensory aversion 3. an aversive experience (i.e. choking)
what is the rate of ADHD in a parent or sibling of a child with ADHD?
2-8x the general population
can ODD be co-morbid with CD?
no
are language disorders specific to spoken speech?
no, also includes issues with writing, sign language, etc
are language disorders deficits in comprehension or speech production?
can be either or both
What is the heritability of ADHD in a monozygotic twin of someone with ADHD
76%
main difference bw the WISC and WIAT
only WIAT assesses school performance (WISC just assesses intelligence which is not sufficient for dx reading d/o)
which psychostimulant is less likely to cause tics
methylphenidate
what is the relationship bw stimulant tx of ADHD and later development of SUD
stimulant tx will reduce or delay onset of SUD in adolescence, but this benefit is lost in adulthood
initial starting dose of atomoxetine
0.5mg/kg/ day (if < 70kg)
which erikson stage coincides with freud’s phallic and piaget’s pre-concrete?
initiative vs guilt
what is the most likely issue for a adolescent male not developing secondary male sex characteristics but experiencing gynecomastia
Klienfelter (47, XXY)
what EEG finding is seen in children with ADHD
elevated beta and theta activity
