child and adolescent - mentor & more 5

Question 1

Conduct disorders are characterised by

Answer 1

a persistent pattern of antisocial, aggressive, or defiant behaviour, more severe than ordinary mischief or adolescent rebelliousness, exceeding isolated acts.

Question 2

ODD vs Conduct

Answer 2

Oppositional defiant disorder (ODD) shares the negative attributes but in a more limited fashion.

Question 3

Conduct disorder in ICD 11

Answer 3

‘Conduct-dissocial disorder’

Question 4

DSM-5 recognises how many separate conditions related to emotional / behavioural problems seen in younger people?

Answer 4

Three
conduct disorder

oppositional defiant disorder,

intermittent explosive disorder.

Question 5

Conduct disorder is about poorly controlled

Answer 5

Behaviours

Question 6

intermittent explosive disorder is about poorly controlled

Answer 6

emotions

Question 7

ODD is in between

Answer 7

conduct and intermitten expl. disorder

Question 8

Conduc-dissocial disorder ICD11

Answer 8

A persistent pattern of behaviour violating others’ rights or age-appropriate social norms. This often includes several behaviours, such as:
-Agreession
-Destruction
-Decitfulness
-Serious violation of rules

Question 9

common features of conduction dissocial disorder

Answer 9

-Agreession
-Destruction
-Decitfulness
-Serious violation of rules

Question 10

how long the history of conduct discosial disorder must be present?

Answer 10

at least 1 year

Question 11

Conduct Disorder in DSM 5 Main criteria

Answer 11

at least three of the following 15 criteria in the past 12 months from any of the categories below, with at least one criterion present in the past 6 months:

Question 12

Oppositional defiant disorder
ICD 11

Definition

Answer 12

A pattern of markedly noncompliant, defiant, and disobedient behaviour that is atypical for individuals of comparable age, developmental level, gender, and sociocultural context.

Question 13

Oppositional defiant disorder
ICD 11

Essential fitures

Answer 13

Persistent difficulty getting along with others

Provocative, spiteful, or vindictive behaviour

Extreme irritability or anger

Question 14

Oppositional defiant disorder
ICD 11

How long?

Answer 14

extended period ( e.g. 6 months or more)

Question 15

Boys to girls

Conduction
ICD 11

Answer 15

more in boys

Question 16

% of boys who develop conduct disorder by 10?

Answer 16

57%

Question 17

The earlier onset ODD the…

Answer 17

worse

Question 18

Onset of conduct disorder for girls

Answer 18

14-16

Question 19

The most frequent co-morbid problem seen with conduct disorder is

Answer 19

hyperactivity (45-70% of those with conduct disorder have hyperactivity).

Question 20

Rx of antisocial behaviour, oppositional defiant disorder and conduct disorders in children and young people

3-11

Answer 20

Group parent based training programs

Question 21

Rx of antisocial behaviour, oppositional defiant disorder and conduct disorders in children and young people

9-14

Answer 21

Child focus programmes

Question 22

Rx of antisocial behaviour, oppositional defiant disorder and conduct disorders in children and young people
11-17

Answer 22

Multimodal interventions with a family focus

Question 23

what should Group parent training programmes in antisocial behaviours, ODD and CD be about?

Answer 23

• be based on a social learning model, using modelling, rehearsal and feedback to improve parenting skills

Question 24

Group parent training programmes in antisocial behaviours, ODD and CD be about?

Length?

Answer 24

• typically consist of 10 to 16 meetings of 90 to 120 minutes’ duration

Question 25

Child-focused programmes should be?

Answer 25

based on a cognitive-behavioural problem-solving model

Question 26

Multimodal interventions should

Answer 26

* have an explicit and supportive family focus * be based on a social learning model with interventions provided at individual, family, school, criminal justice and community levels

Question 27

Multimodal interventions should last how long?

Answer 27

3-4 meetings per week over 3- to 5- month period

Question 28

are midication recommended for ODD, CD or ASB? when

Answer 28

not routinely but Risperidone if very aggressive

Question 29

Potential risks to children of mothers with eating disorders

Answer 29

* Premature birth * Increased perinatal mortality * Cleft lip & cleft palate * Epilepsy * Developmental delays * Abnormal growth * Food fussiness and feeding difficulties * Low birth weight * Microcephaly * Low APGAR scores

Question 30

Associated complications co-occurring with eating disorders in pregnancy

Answer 30

* Inadequate or excessive weight gain * Hyperemesis gravidarum * Hypotension (in anorexia) or hypertension (in bulimia) * Syncope/presyncope from cardiac arrhythmias and electrolyte disturbances * Anemia (in anorexia) * Pregnancy termination (spontaneous or therapeutic) * Small for term infant * Stillbirth * Breech pregnancy * Pre-eclampsia * Cesarean section * Post-episiotomy suture tearing * Vaginal bleeding * Increased rate of perinatal difficulties * Postpartum depression risk * Cardiac changes * Refeeding syndrome (occurs primarily in patients who are aggressively refed)

Question 31

NICE Rx option For adults with anorexia nervosa

Answer 31

* Individual eating-disorder-focused cognitive behavioural therapy (CBT-ED) * Maudsley Anorexia Nervosa Treatment for Adults (MANTRA) * Specialist supportive clinical management (SSCM)

Question 32

what if for E, individual CBT-ED, MANTRA, or SSCM is unacceptable

Answer 32

eating-disorder-focused focal psychodynamic therapy (FPT)

Question 33

NICE Rx option For children and young people (0-18)

Answer 33

Anorexia-nervosa-focused family therapy (FT-AN)

Question 34

If FT-AN is unacceptable in ED (0-18)

Answer 34

Individual CBT-ED Adolescent-focused psychotherapy for anorexia nervosa (AFP-AN)

Question 35

what not to offer as the sole treatment for anorexia nervosa, bulimia and Binge eating disorder?

Answer 35

Medication

Question 36

the first step in Bulimia in adults

Answer 36

evidence-based self-help programme

Question 37

If bulimia-nervosa-focused guided self-help is unacceptable in bulimia -adult

Answer 37

individual eating-disorder focused cognitive behavioural therapy (CBT-ED).

Question 38

Bulimia in children

Answer 38

bulimia-nervosa-focused family therapy (FT-BN)

Question 39

If FT-BN is unacceptable in bulimia children

Answer 39

individual eating-disorder-focused cognitive behavioural therapy (CBT-ED)

Question 40

Binge Eating Disorder (BED) first step

Answer 40

self-help programme

Question 41

if self-help not helpful after 4 week

Answer 41

Group CBT-ED, then individual CBT-ED

Question 42

are guidlines the same for BED in adult and children

Answer 42

yes

Question 43

NICE recommend issuing the following advice to those with ED (who vomit)

Answer 43

avoid brushing teeth immediately after vomiting to rinse with non-acid mouthwash after vomiting avoid highly acidic foods and drinks

Question 44

what not to recommend as part of Rx for eating disorder

Answer 44

physical therapy (such as transcranial magnetic stimulation, acupuncture, weight training, yoga or warming therapy)

Question 45

when Consider a bone mineral density scan in children and young people

Answer 45

- after 1 year of underweight -earlier if they have bone pain or recurrent fractures

Question 46

when Consider a bone mineral density scan in adults

Answer 46

- after 2 years of underweight -earlier if they have bone pain or recurrent fractures

Question 47

when to consider transdermal 17-β-estradiol for young women (13-17) with anorexia?

Answer 47

-long-term low body weight -low bone mineral density with a bone age under 15

Question 48

when to Consider incremental physiological doses of oestrogen in young women (13-17 years) with anorexia nervosa ?

Answer 48

-delayed puberty -long-term low body weight -low bone mineral density with a bone age under 15

Question 49

what to Consider for women (18 years and over) with anorexia nervosa?

Answer 49

bisphosphonates

Question 50

Elimination disorders include

Answer 50

enuresis (lack of control over the bladder) encopresis (lack of control over the bowel)

Question 51

Control over the bladder usually occurs between age ?

Answer 51

1-3

Question 52

Control over the bowel occurs

Answer 52

before control over bladder (most toddlers)

Question 53

Toilet training is affected by

Answer 53

-intellectual capacity -cultural determinants -psychological interactions between the child and their parents

Question 54

urinary continence is ordinarily expected

Answer 54

by 5 years

Question 55

Primary enuresis

Answer 55

the child never having achieved continence

Question 56

2ndary enuresis

Answer 56

if they have previously been dry for at least 6 months

Question 57

frequency bedwetting to meet enuresis criteria

Answer 57

2wice weekly for 3 months

Question 58

the term enuresis is often used to refer to

Answer 58

micturition during sleep

Question 59

incontinence is used

Answer 59

for daytime wetting.

Question 60

Risk factors for enuresis

Answer 60

family history upper airway obstruction (OSA)

Question 61

of 5 year old (enuresis prevalence)

Answer 61

15%

Question 62

of 7 year olds(enuresis prevalence)

Answer 62

7%

Question 63

of age 10 (enuresis prevalence)

Answer 63

5%