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Psychiatry > Child + Adolescent > Flashcards

Child + Adolescent Flashcards

1
Q

What is the prevalence of mental health difficulties in children?
What proportion/% of these are in contact with specialist services?

A

Affects 10% children

1/10 in contact with specialist services

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2
Q

Describe the normal social development from newborn to 5yrs

A

Newborn → lack selective attachments/stranger anxiety

9m→ stranger anxiety + selective attachments begin
18m → distressed/anxious behav + proximity seeking
3-4yrs → separates more easily from parents
5y → develop friendship

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3
Q

What are the 3 categories of attachment in infants?

A
  • Secure attachment
  • Anxious-ambivalent insecure attachment
  • Anxious-avoidant insecure attachment
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4
Q

What is the prevalence of ASD - in most severe form?
In all forms?
M:F?

A 
Most severe (Kanner) = 1 in 10,000
All forms = 1 in 100
M 4:1 F
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5
Q

What are the triad of deficits in Autism?

A

Social interaction
Communication
Repetitive behaviour

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6
Q

What are the 3 core symptoms in ADHD?

A
  • Inattention
  • Hyperactivity
  • Impulsivity
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7
Q

What are the common shared causes of ASD/ADHD/Dyslexia (3)

A

BOTH SAME:
Genetics
Neurotransmitters
Brain injury

Psychosocial: affects how pt presents + how copes

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8
Q

What is dyslexia?

What is the incidence (severest/all)?

A

Persistent difficulties processing/producing written material (out of keeping with other abilities)

Most severe 4% gen pop + all forms 10% prevalence

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9
Q

What are some of the medications available for ADHD? (2)

What age should they be commenced?

A

Stimulants: Methylphenidate (Ritalin, Concerta)

Non-stimulants: Atomoxetine

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10
Q

What psychological managements for ADHD? (3)

What social management? (1)

A

Psychological:
Behavioural therapy
Parental training
Cognitive training

Social:
Liaison with education (poss special needs)

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11
Q

In what situations should you disclose info, breaching requested confidentiality of child/YP (3)

A

To prevent harm to public/others

To prevent harm to child/YP who does not have maturity or understanding to make decision about disclosure

When disclosure is required by law

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12
Q

What IQs classed as Mild/Moderate/Severe/Profound Intellectual Disability? + their prevalences in the gen pop?

A

Mild: IQ 50-69 (1.5-3% - 85% all IDs)
Mod: 35-49 (0.5%)
Severe: 20-34 (0.5%)
Profound: <20 (0.05%)

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13
Q

What are some epidemiological associations with intellectual disabilities? (5)

A 
Male
Lower social class
Overcrowding
Poverty
Irregular unskilled employment
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14
Q

What are the 2 most common causes of LDs?

A

Down’s

Fragile X

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15
Q

What chromosomal defect in:
Cri-de-Chat syndrome?
Tuberous Sclerosis
Neurofibromatosis?

A

Cru-de-Chat: Short arm deletion csome5
TS: TSG mutation on csome 9 or 16
NF: csome 17 mutation

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16
Q

List some chromosomal/genetic causes of intellectual disability (6)

A 
Down's
Fragile X
Cri-de-Chat
Tuberous Sclerosis
Neurofibromatosis
PKU
17
Q

List some postnatal causes of LDs

A 
Meningitis/encephalitis
Brain tumour
Head injury
Abuse/neglect
Malnutrition
Chronic lead poisoning
18
Q

What are some of the risks in Intellectual Disability? (6)

A 
Suicide
Self-harm
Harm to others
Harm from others
Property damage
Unsupervised exit
19
Q

What are the main concepts of a Risk Assessment + Management Plan (RAAMP) for children? (4)

A
  • Collecting evidence
  • Identifying triggers and context
  • Plan the consequences
  • Develop strategies to minimise risky behavior
20
Q

What % of Autism children have LDs?

A

> 2/3rds

21
Q

List some presenting features of Autism (12)

A
  • Aloof/unfriendly
  • Repetitive movements
  • Little eye contact
  • Poor non-verbal communication
  • Little /no interaction with mother
  • Do not bring toys to show to mother
  • Do not run to greet parents
  • Do not follow mother around the house
  • No imaginative play
  • Carry same object around
  • Clumsy at copying movements
  • Cannot understand world: temper tantrums
22
Q

List some common features of speech in Autism (3)

A
  • Exact repetition
  • Pronoun reversal
  • Difficulty with abstraction
23
Q

List the common features of Asperger’s (3 Speech + 3 other)

A
  • Good speech (but long winded + literal)
  • Long monologues (regardless of response)
  • Monotonous
  • Lack of common sense in social interactions
  • Physically clumsy
  • Intelligence – at least average if not v intelligent
24
Q

What are some basic principles in the management of Autism (5)

A

o Sufficient /quiet personal space

o Each day organized/explained
o Content of activities not beyond their capabilities

o Treatment of epilepsy + other physical problems

o Behavioural approach to obsessions

25
Q

What behavioural approaches should be taken with Autistic object obsessions?

A

Graded changes (removal) with Positive Reinforcement

Setting limits

26
Q

What other factors e.g. Education (3), Parents (1) can help in the management of Autism

A

Education:
Give framework for routine/structure
Ideally physical prompting / visual demonstration
Precise/specific teaching material

Parents: counselling is v important

27
Q

What is the risk of mental illness in people with LDs?

A

Risk increased x3

+ May present differently

28
Q

What additional features in Depression may be seen in those with LDs? (3)

+ in Mania/Bipolar? (2)

A
  • Diurnal mood or activity variation
  • Agitation → wandering
  • Exaggerated need for sameness

Mania/Bipolar
• Challenging behavior
• Giggling

29
Q

How does presentation of Scz differ in those with LDs? (6)

A

Delusions: less elaborate + persecutory less common
Thought disorder less common
Hallucinations: simpler / repetitive → may respond to unseen stimuli

Earlier age onset
Poverty of thought
Commoner with severe LD

30
Q

List some causes for Challenging Behaviour

A

o Social / env factor (e.g. new environment, new carer)
o Mental illness
o SEs of medication
o Physical e.g. ear/resp inf, dental, UTIs, thyroid

31
Q

What is the prevalence of Epilepsy in normal school-children?
In those with mild LDs?
In those with moderate/worse LDs?
Male:Females?

A

Normal: 0.6%
Mild LDs: 3-6%
Moderate+: 44%

M 4:1 F

Psychiatry (11 decks)

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