Child & Adolescent Psychiatry

Question 1

What non-stimulant is approved to treat ADHD when stimulants are ineffective or contraindicated?

Answer 1

Atomoxetine (SSRI)

Question 2

What drugs are approved to treat autism-related irritability in children?

Answer 2

Risperidone & aripiprazole

Question 3

What is the only medication class shown to effectively treat anxiety disorders in children?

Answer 3

SSRIs

Question 4

What is first-line treatment of separation anxiety disorder in children?

Answer 4

CBT, play therapy, treatment of parental anxiety disorders

Question 5

This pediatric psychiatric disorder involves angry, irritable, and/or argumentative mood against an adult or individual of authority.

Answer 5

Oppositional Defiant Disorder

Question 6

What is the neurochemical basis of ADHD?

Answer 6

Dysfunction of the NE and dopaminergic systems

Question 7

This pediatric psychiatric disorder involves repetitive and persistent behaviors that violate social norms of the rights of others.

Answer 7

Conduct disorder - diagnosed before 18yo

Question 8

A 12yo patient presents to the clinic for f/u of major depressive disorder. They were started on fluoxetine 8 weeks ago and report no change in symptoms. What is the next best step?

Answer 8

Consider an alternative treatment strategy - responses are assessed in 4 week intervals with recommended changes in treatment if no response within 8 weeks

Question 9

True/False. Anti-depressants themselves increase the risk of suicide in pediatric patients.

Answer 9

False. Anti-depressants resolve underlying symptoms that may increase the risk of suicide. For example, a suicidal patient may lack the motivational and energy to complete suicide. If these symptoms are resolved before thoughts of suicide, they may be more likely to act upon them

Question 10

Selective mutism is a failure to speak in specific social settings. How long must this last for a diagnosis of a disorder?

Answer 10

One month

Question 11

This pediatric psychiatric disorder is associated with a higher risk of developing antisocial personality disorder.

Answer 11

Conduct disorder

Question 12

What are the criteria for diagnosis of disruptive mood dysregulation disorder?

Answer 12

Before age 10, irritable or angry mood, severe temper outbursts, difficulty functioning, symptoms at least 12 months

Question 13

What is the first-line treatment for selective mutism in children?

Answer 13

Exposure-based therapies

Question 14

What are the criteria for a diagnosis of separation anxiety disorder in children?

Answer 14

At least 3 symptoms for 4+ weeks

Question 15

What is the recommended treatment for a child diagnosed with ADHD <5yo?

Answer 15

Community support - medications reserved until later in childhood

Question 16

What major ADR is associated with stimulants used to treat ADHD?

Answer 16

Increased HR and sudden cardiac death

Question 17

What is the use of Paroxetine in children?

Answer 17

Treatment of specific phobias

Question 18

What are the criteria to diagnose ADHD in children?

Answer 18

6+ symptoms for 6 months in two different settings

Question 19

What medications may be used to treat schizophrenia in children?

Answer 19

12+ - paliperidone

13+ - risperidone, quietiapine, aripiprazole, olanzipine

Question 20

What are the diagnosis criteria for Tourette’s Syndrome in children?

Answer 20

2+ motor tics and one verbal tic for at least one year before 18yo

Question 21

True/False. Selective mutism often progresses to social anxiety disorder and/or social phobia.

Answer 21

True

Question 22

True/False. Autism is more common in females and they are more likely to be severely impaired.

Answer 22

False - ASD is more common in males, but females are more likely to be severely impaired

Question 23

What drugs may be used to treat GAD in children?

Answer 23

Fluvoxamine, Fluoxetine, Sertaline

Question 24

Patients with this pediatric psychiatric condition often have a co-morbid epilepsy diagnosis.

Answer 24

Autism spectrum disorder

Question 25

What is the most common pediatric psychological disorder?

Answer 25

Anxiety disorders - specifically specific phobia

Question 26

Girls most often have what type of ADHD presentation?

Answer 26

Predominantly inattentive ADHD - as such they often go undiagnosed

Question 27

What are the criteria for diagnosis of persistent depressive disorder in children?

Answer 27

At least 3+ symptoms for 1 year