child and adolescent - mentor & more 3

Question 1

worldwide population prevalence of Autism

Answer 1

1%

Question 2

Comorbidity in ASD

Answer 2

very common about 70%

Question 3

male to female ratio of ASD

Answer 3

4:1

Question 4

ASD heritibility

Answer 4

80-90

Question 5

Monozygotic twin concordance : ASD

Answer 5

60-90%

Question 6

Dizygotic twin concordance : ASD

Answer 6

30%

Question 7

the most consistent risk factors for ASD

Answer 7

• Family history
• Children born to older parents
• Children who are born prematurely or with low birth weight
• Valproate exposure during pregnancy

Question 8

unrelated to risk of ASD

Answer 8

-Vaccination
-Maternal smoking -Thimerosal (ethylmercury) exposure
-Assisted reproductive technologies

Question 9

treatment for children and adolescents with ASD and associated irritability,disruptive behaviours, aggression and hyperactivity

Answer 9

Risperidone and aripiprazole

(approved by the FDA)

Question 10

The peak age of onset of bipolar

Answer 10

15-19

Question 11

The peak age of onset of bipolar I

Answer 11

18

Question 12

The peak age of onset of bipolar II

Answer 12

20

Question 13

lifetime prevalence of bipolar I

Answer 13

2.1%

Question 14

The 12-month prevalence of bipolar I

Answer 14

1.5%

Question 15

The 12-month prevalence of bipolar II

Answer 15

.8%

Question 16

Male to female ratio of bipolar I

Answer 16

1:1

Question 17

Male to female ratio of bipolar II

Answer 17

not clear

might be more common in females

Question 18

rapid cycling and mixed states, depressive symptoms

Male or female ?

Answer 18

more in female

Question 19

lifetime risk of suicide in bipolar

Answer 19

15 times more

Question 20

prevalence of suicide attempt biplar I & II

Answer 20

32-34%

Question 21

The number of lifetime episodes

I or II?

Answer 21

I (both mania and depression) more than II’s depression episode

Question 22

interval between mood episodes in the course of bipolar II with age, decrease or increase?

Answer 22

decrease

Question 23

Hypomania is generally thought of as a

Answer 23

less severe form of mania

Question 24

Hypomania is an elevated mood for a minimum of

Answer 24

4 days

Question 25

Mania requires a minimum of

Answer 25

7 days

Question 26

Features which would suggest mania rather than hypomania

Answer 26

* Flight of ideas * Psychotic symptoms * Loss of social inhibitions

Question 27

Bipolar depression differs from unipolar depression

Answer 27

* rapid in onset * more frequent * more severe * shorter * more likely to involve reverse neurovegetative symptoms such as hyperphagia and hypersomnia

Question 28

Neurovegetative symptoms

Answer 28

directly related to the body (e.g., insomnia/hypersomnia, dysregulated eating, fatigue, and decreased energy).

Question 29

Emotional-cognitive symptoms

Answer 29

related to how a person processes information (e.g. suicidal ideation, decreased concentration, feeling worthless, anhedonia, and depressed mood)

Question 30

Rapid cycling

Answer 30

is not a subtype of bipolar disorder but instead is a qualifier (as in Bipolar I with rapid cycling).

Question 31

Definition of rapid cycling

Answer 31

at least four mood episodes in the previous 12 months that meet the criteria for a manic, hypomanic, or major depressive episode.

Question 32

how rapid cycling episodes are demarcated?

Answer 32

either by partial or full remissions of at least 2 months or by a switch to an episode of the opposite polarity (e.g., major depressive episode to manic episode).

Question 33

The rapid cycling specifier can be applied to

Answer 33

bipolar I or bipolar II disorder

Question 34

should rapid cycling be treated differently?

Answer 34

no (NICE: no evidence)

Question 35

estimated prevalence of rapid cycling

Answer 35

10-20%

Question 36

Onset and course of the Rapid cycling

Answer 36

late in the course lasts less than 2 years in 50%

Question 37

does Rapid cycling increases the risk fo suicide?

Answer 37

yes (controversial though)

Question 38

Compared with non-rapid-cycling bipolar disorder, rapid cycling is

Answer 38

* More common in women * Associated with an earlier age at onset * Associated with a greater illness burden * Associated with higher treatment resistance

Question 39

Rapid cycling precipitated by

Answer 39

life events, alcohol abuse, use of antidepressants, and medical disorders

Question 40

Medical disorders associated with rapid cycling

Answer 40

- Hypothyroidism - Grave's -SAH -Stroke -Head Injury -MS -Drugs

Question 41

Drugs that cause rapid cycling

Answer 41

propranolol LEvadopa Cyproheptadine

Question 42

subtypes of bipolar disorder

Answer 42

* Bipolar I - full blown manic episode (depression not required) * Bipolar II - a less severe manic episodes (hypomania) with periods of depression. * Cyclothymic disorder - numerous periods of subthreshold hypomanic and depressive symptoms over a two-year period

Question 43

Bipolar I

Answer 43

One manic episode in a lifetime, marked by a distinct period of persistently elevated or irritable mood and increased goal-directed activity, lasting at least one week or any duration if hospitalization is needed. This requires at least three additional symptoms (four if the mood is irritable).

Question 44

additional bipolar I symptoms

Answer 44

* grandiosity * flight of ideas * decreased need for sleep * more talkative than usual * Distractibility * increase in goal-directed activity or psychomotor agitation * excessive involvement in high-risk activities

Question 45

not required for the diagnosis of bipolar I disorder

Answer 45

Major depressive episodes

Question 46

Bipolar II:

Answer 46

-Requires at least one, current or past, hypomanic episode and one episode, current or past, of a major depressive episode. -Lasting at least 4 consecutive days and present most of the day, nearly every day -Accompanied by 3 or more (four if the mood is only irritable) additional symptoms

Question 47

The episode severity in bipolar II?

Answer 47

must not be severe enough to cause marked impairment

Question 48

what if hypomania is accompanied by psychosis?

Answer 48

then, it is mania, not hypomania!! Kapish?

Question 49

treating moderate to severe manic episodes in adolescents

Answer 49

* Aripiprazole (licenced in adolescents aged 13 and above)

Question 50

* Do not offer what in mania?

Answer 50

valproate to children, girls or young women of childbearing age (unless no other option present)

Question 51

Bipolar depression 1st _____ rx

Answer 51

- structured psychological intervention (for 4-6 weeks)

Question 52

Bipolar depression 2nd _____ rx

Answer 52

alternative psychological or family therapy

Question 53

Moderate to sever bipolar depression 1st ____ pharma Rx?

Answer 53

Quetiapine and olanzapine SSRI might be considered alongside either but not alone

Question 54

Long-term (once in remission) Rx of bipolar depression?

Answer 54

Lithium (alternative or addition ot SGA)