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MRCPSYCH Paper B _ Mainly general Adult (mentor&more) > child and adolescent - mentor & more 6 > Flashcards

child and adolescent - mentor & more 6 Flashcards

1
Q

what is encopresis

A
    • Frequent stool accidents in children over four.
    • Behavior can be involuntary or intentional, lasting 3 months with monthly occurrences, not due to substances or medical issues.
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2
Q

what can lead to ecopresis

A

1- Unsuccessful toilet training (primary encopresis)

2- occur after a period of normal bowel control (secondary encopresis).

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3
Q

Faecal soiling

A

to the involuntary escape of faeces around a constipated mass of stool

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4
Q

Fecal soiling can occur due to

A

no or an underlying organic cause

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5
Q

most common cause of faecal inontinence?

A

80% constipation

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6
Q

situations where encopresis can happen?

A

in a child where there is no evidence of stool retention (non-retentive).

a child who has psychological retention of faeces with secondary over flow (retentive).

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7
Q

which encopresis situation is more common, retentive or non-retentive?

A

retentive (not well-known)

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8
Q

encpresis is more common in boys than girls?

A

boys

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9
Q

in Western cultures what percentage of children achieve bowel control by their 4th birthday

A

95% (99% BY 5TH)

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10
Q

Causes OF ENCOPRESISI

A
  • PREVIOUS PASSAGE OF PAINFUL STOOL
  • INADEQUATE TOILET TRAINING
  • SEXUAL ABUSE (LINKED BUT NOT EXCLUSIVELY)
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11
Q

prevalence of encopresis in 4 year olds

A

3%

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12
Q

prevalence of encopresis in 10 years old

A

1.6%

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13
Q
A
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14
Q

behavioural therapy in incopresis?

A

parental education and a reward based system of toilet training

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15
Q

Causes of constipation in children

A

Anal lesions
Systematic disease:

Hypothyroidism
Diabetes mellitus and insipidus
Hypo and hypercalcemia
Neurological disease:

Cerebral palsy
Spinal cord lesions
Hirschsprung disease
Drugs:

Iron
Codeine
Antacids
Dietary:

Inadequate fibre

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16
Q

Hirschsprung’s disease happens as a result of

A

absence of parasympathetic ganglion cells in rectum, (sometimes also involving the colon and small intestine). This leads to an aganglionic segment which is unable to relax, leading to a colonic obstruction.

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17
Q

half of Hirschsprung’s disease is diagnosed

A

in the first year of life and, by the age of 2, most have been diagnosed.

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18
Q

15% of patients with Hirschsprung’s disease also had ————

A

Down’s syndrome.

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19
Q

Nearly half of all infants with Hirschsprung’s disease do not pass meconium within ——–

A

36 hours

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20
Q

nearly ——- of the infants with the delayed first passage of meconium have Hirschsprung’s disease.

A

half

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21
Q

Hirschsprung’s is ——– as common in boys than in girls.

A

twice

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22
Q

empathy and deafness

A

Deaf preadolescents have more difficulty with empathy development than hearing children, and this ability is related to onset of deafness.

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23
Q

empathy skills are most likely to be delayed in

A

deaf children of hearing parents

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24
Q

Fragile X is a genetic syndrome characterised by

A

mental retardation, an elongated face, large protruding ears, and large testicles (in men).

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25
who tend to be shy, avoid eye contact, and have difficulties reading facial expressions. They often display stereotypic movements such as hand flapping.
Fragile X
26
Fragile X tend to be
shy, avoid eye contact, and have difficulties reading facial expressions. They often display stereotypic movements such as hand flapping.
27
the most common genetic cause of learning disability
Fragile x
28
cluttered speech ( abnormal fluency, flow)
Fragile x
29
speech problem in fragile x?
cluttered speech ( abnormal fluency, flow)
30
Fragile x genetics
- X-linked dominant disorder. - CGG repeat in 5' untranslated region of FMR1 gene. - CGG repeats disrupt fragile X protein (FMRP) synthesis. - FMRP is essential for brain function and growth. - Gene located at Xq27.
31
trinucleotide repeat disorders
Huntington's, myotonic dystrophy, Friedreich's ataxia, and spinocerebellar ataxia
32
The fragile X phenotype typically involves a variety of psychiatric symptoms, including
features of autism, attention deficit/hyperactivity disorder, anxiety, and aggression.
33
male or female affected by fragile x?
Females as well as males are affected Males are more severely affected because they have only one X chromosome.
34
Genomic imprinting
refers to a situation where a piece of DNA can behave differently depending on whether it is inherited from the mother or the father. . The two classic examples in psychiatry include Prader-Willi and Angelman syndrome.
35
Prader-Willi (remember as P = Paternal) syndrome results from
the deletion or silencing of genetic material from the chromosome 15 inherited of paternal origin, and is a classic example of imprinting.
36
Typical features of Prader-Willi
* Hyperphagia (excessive eating) and obesity * Short stature * Delayed puberty, hypogonadism, and infertility * Learning difficulties * Compulsive behaviour (e.g., skin picking)
37
The most critical genes involved in PWS include:
* SNRPN (small nuclear ribonucleoprotein polypeptide N) * NDN (necdin) * MKRN3 (makorin ring finger protein 3) * MAGEL2 (MAGE family member L2)
38
Angelman syndrome (Happy puppet syndrome) is due to
a deletion or silencing of the UBE3A gene at 15q11-q13 when inherited from the mother.
39
Angelman syndrome (Happy puppet syndrome) characterized by
* An unusually happy demeanour with frequent laughter * Developmental delay * Severe speech impairment * Intellectual disability * Seizures, which are often difficult to control * Sleep disturbances * Jerky, puppet-like hand movements * Ataxia (impaired balance and coordination) * Microcephaly (small head size) in some cases * Hyperactivity and a short attention span
40
Angelman syndrome (Happy puppet syndrome) physiology
maternal chromosome does not express the UBE3A gene correctly, or mutations in the UBE3A gene itself. the UBE3A gene is essential for normal synaptic function and plasticity, which are critical for learning, memory, and overall cognitive development.
41
Kleine-Levin syndrome is normally seen in
adolescent boys
42
Kleine-levin syndrome typically presents with
- Increased need for sleep - Tendency to eat in excess - Associated with emotional issues: - Irritability - Aggression
43
Kleine-levin syndrome prognosis
- appears abruptily -Remain for a few days to weeks -then disappears until next episode followed by normal period prognosis is good
44
what is kleine-levin syndrome known by in media
'Sleeping Beauty' syndrome.
45
Developmental abilities - 0-6 months
Reacts to loud noises, vocalises pleasure and displeasure (laughs, cries)
46
Developmental abilities - 6-12 months
Responds to own name, responds appropriately to angry and friendly tones, babbles* (says ba-ba-ba)
47
Developmental abilities - 12-18 months
Uses single words with meaning (referred to as the 'holophrastic' stage), understands simple instructions, tries to imitate simple words
48
Developmental abilities - 18-24 months
Has a vocabulary of up to 40-50 words (mainly nouns and pronunciation often unclear), knows simple body parts, understands simple verbs (eat, sleep), starts to combine words (e.g. More play) referred to as the telegraphic stage*
49
Developmental abilities - 24-36 months
Able to name a number of objects, vocabulary of 150-300 words, able to combine words into short sentences, begins to use prepositions, answers simple questions
50
Developmental abilities - 36-48 months
Has a vocabulary of 900-1000 words, begins to use plurals and past tense, handles three word sentences easily, groups objects such (e.g. Food, animals), strangers will understand most of what is said
51
40-50 words
18-24 months
52
telegraphic stage*
18-24 months
53
150-300 words
24-36 months
54
combine words into short sentences, begins to use prepositions,
24-36 months
55
900-1000 words
36-48 months
56
The period of birth to 12 months is often referred to
Pre-linguistic period
57
The telegraphic stage / period is marked by
- Early sentence formation is economic, omitting details like tense, verb endings, prepositions, conjunctions, and articles. - Examples: 'go park', 'daddy home'. - This stage occurs between 18 months to 3 years. - The term originates from telegrams, which had to be concise due to Morse code limitations.
58
A number of risk factors are associated with delayed speech and language
* Family history * Male gender * Twins * Lower maternal education * Childhood illness * Being born late in the family order * Young mother at birth * Low socioeconomic status
59
The most reliable risk factor for delayed speech is thought to be
family history
60
Lennox-Gastaut syndrome
is characterised by frequent seizures and different seizure types. It is often accompanied by developmental delay and psychological and behavioural problems.
61
aLennox-Gastaut syndrome onset age
5-6 year of life
62
Lyonization
- The X chromosome has over 1,000 essential genes for development and cell viability. - Females have two X chromosomes, risking a double dose of X-linked genes. - Lyonization (X-inactivation) corrects this by silencing one X chromosome. - The inactivated X condenses into a Barr body, remaining silent.
63
The inactivated X in the Lyonization process condenses into a ---------, remaining silent.
Barr body
64
The process of X-inactivation is ----
random (when the dividing conceptus is about 16-32 cells big)
65

MRCPSYCH Paper B _ Mainly general Adult (mentor&more) (90 decks)

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