child psych 1 Flashcards
Which of the following is NOT a typical feature of school refusal?
Educational underachievement
Educational underachievement is more associated with truancy than school refusal.
Which childhood psychiatric disorder has the highest heritability factor?
ADHD
Heritability of ADHD is estimated to be around 70-80%.
In adolescents, which clinical feature of depression is more commonly seen compared to children?
Low self esteem
Adolescents may also show symptoms like somatisation and school refusal.
In children with PANDAS, which symptom is least common?
Psychosis
OCD and tics are more common in PANDAS than psychosis.
How many subtests are usually used in the Wechsler intelligence scale for children (WISC-R)?
Ten subtests
Each subtest has a mean score of 10, contributing to a full-scale IQ of 100.
About what percentage of children are dry at night by the age of 5 years?
90%
By 2 years, 50% are dry at night; by 3 years, 75% are dry.
Which feature is seen in truants rather than school refusers?
Antisocial symptoms
School refusers typically exhibit emotional symptoms rather than antisocial behavior.
How is Tourette’s disorder diagnosed?
By having both motor and vocal tics for 12 months
Tics must cause distress and impair function.
Blockade of which receptors can reduce tics in Tourette’s syndrome?
D2 receptors
D2 antagonism at the basal ganglia is effective in reducing tics.
Which condition has less prominent genetic loading?
Conduct disorder
Genetic influences account for 40%-50% of variance in conduct disorder.
Which statement about bipolar disorder in children and adolescents is true?
Manic children typically present with atypical or mixed features
Equal gender distribution is characteristic, unlike MDD.
Which risk factor is associated with autism?
Premature birth
Other associated factors include breech presentation and low Apgar scores.
What treatment is most helpful for treating PTSD in children?
Trauma focussed CBT
TF-CBT improves PTSD and anxiety in children after trauma.
What is the prevalence of ADHD in the UK?
2-5%
Estimates of ADHD prevalence vary, but most lie between 5% and 10% in the US.
In which condition is the sex distribution approximately equal?
School refusal
Separation anxiety disorder is more common in females.
What is the drug treatment of choice for a 7-year-old with uncomplicated Tourette’s syndrome?
Clonidine
Clonidine is a first-line treatment for Tourette’s syndrome.
What percentage of patients with autism has mental retardation?
70%
Approximately one-third have mild to moderate mental retardation.
What is the ratio of prevalence of ADHD in males to females?
4 to 1
Community-based studies show a male-female ratio of about 4:1.
Which is not a characteristic feature of PTSD in children?
Selective amnesia for the event
DSM-5 criteria allow for different expressions of PTSD in children.
What risk factor is associated with the development of ADHD?
Maternal smoking in pregnancy
Maternal smoking has a significant association with offspring ADHD symptoms.
Which scale could be used to assess a 14-year-old boy with psychiatric disease again at the age of 20?
Clinical interview schedule- revised
This structured instrument is suitable for assessing psychiatric morbidity.
What is the Clinical Interview Schedule-Revised (CIS-R) used for?
Assessing minor psychiatric morbidity in the community, general hospital, occupational, and primary care research.
The ICD-10 diagnoses can be derived from CIS-R data using an algorithm based on published diagnostic criteria for research.
What is the most useful clinical instrument to follow up on symptoms in patients diagnosed with depression at age 14?
Child and adolescent functional assessment scale.
This scale assesses the degree of impairment in functioning due to emotional, behavioral, or psychiatric problems.
What blood abnormalities are seen in Anorexia Nervosa?
Normocytic normochromic anaemia.
Other abnormalities include mild leukopenia with relative lymphocytosis and thrombocytopenia.
What is the average age of onset of schizophrenia?
25.
Onset may be delayed in females and earlier in males.
Which statement about suicidal behavior in adolescents is true?
Self-poisoning is the commonest form of parasuicide.
Suicide is the third leading cause of death for adolescents, following accidents and homicides.
What is the prevalence of suicidal ideations in the past year for an adolescent cohort in Britain?
15%.
This was more common in females (22%) than males (8.5%).
What is the most common psychiatric emergency seen in the child and adolescent population?
Suicidal behavior.
Preschoolers and school-age children who stutter exhibit an increased incidence of which condition?
Social anxiety.
Stuttering can lead to social isolation, especially when it persists into adolescence.
What is the overall prevalence of psychiatric problems in adolescence?
16-20%.
Studies suggest 20% of children and adolescents have mental health problems at some point.
What is the medication of choice for a child with ADHD and congenital heart disease?
Atomoxetine.
Stimulants should be avoided in patients with congenital structural heart diseases.
Which autoimmune disorder is associated with OCD in children?
PANDAS syndrome.
This association relates to obsessive-compulsive symptoms following beta-hemolytic streptococcal infection.
When do sibling rivalry disorders usually emerge?
Within 6 months after the birth of the sibling.
What does shaping refer to in child psychiatry?
Gradual reinforcement of behaviors approximating desired outcome.
Introduced by Skinner, shaping involves changing an existing response toward a desired target behavior.
Which drug has the best evidence for use in childhood depression?
Fluoxetine.
It is the only antidepressant approved for use in children and adolescents.
Most children with selective mutism also meet diagnostic criteria for which disorder?
Social phobia.
Which statement about Rett’s syndrome is true?
Characterised by progressive lack of acquired abilities.
Which disorder is characterized by impaired ability to recognize words, slow and inaccurate reading, and poor comprehension?
Reading disorder.
Reactive attachment disorder is generally diagnosed before the age of?
5.
What is the most common psychiatric co-morbidity associated with Asperger’s syndrome?
Depression.
Which factor is a good prognostic factor in children with conduct disorder?
Resilient temperament.
Regarding the aetiology of ADHD, which statement is false?
Predominant serotonin dysregulation is seen in the prefrontal cortex.
The predominant involvement is actually dopamine and norepinephrine dysregulation.
Which factor suggests a diagnosis of bulimia rather than anorexia nervosa?
Poor impulse control.
Pica typically occurs during which age range?
2-3 years of age.
What is the likely cause for uncoordinated movements in a 14-year-old girl with a history of fever and sore throat?
Sydenham’s chorea.
What triggers rheumatic fever 2-4 weeks later in susceptible individuals?
Pharyngeal infection with Lancefield Group A Beta Hemolytic streptococci
This condition affects approximately 2% of the population.
What is the most likely cause for uncoordinated movements in a child with a history of fever and sore throat?
Sydenham’s chorea
Which treatment is not preferred for a child with a hyperkinetic disorder?
Pemoline
Pemoline has been withdrawn in the UK and US due to severe liver toxicity.
Which drug is contraindicated in children and adolescents due to increased risk of suicide?
Paroxetine
What is the most common cause of co-morbidity in children and adolescents with bipolar disorder?
ADHD
Approximately 50-80% of children with bipolar disorder have ADHD.
Where are manifestations of oppositional defiant disorder almost invariably present?
At home
What are the most common co-morbid disorders seen in Tourette’s syndrome?
ADHD and OCD
Which disorder has been found to co-exist in 1/3rd to 2/3rds of children and adolescents with Tourette’s disorder?
OCD
What is the effective treatment for adolescent inhalant abuse?
No known therapy
Which medication is preferred for treating acute manic or mixed episodes in children and adolescents?
Olanzapine
Which neurotransmitter system is commonly involved in the aetiology of Tourette’s syndrome?
Dopamine
Which treatment has confirmed the most evidence for successful treatment of OCD compared to other childhood anxiety disorders?
Combination of both medication and CBT
What is the total sleeping time of a newborn baby?
16-17 hours per day
What is the first line drug in an 8-year-old with uncomplicated ADHD?
Methylphenidate
What may be a long-term effect of prescribing high doses of methylphenidate without drug holidays?
Growth suppression
What is the commonest age of presentation for school refusal?
11 years
Which disorder is reported more commonly in females?
Mathematics disorder
Which of the following is not a risk factor for adolescent suicide?
Female gender
What is a biological risk factor associated with conduct disorder?
Low CSF serotonin
Which symptom is least commonly reported in children with bipolar disorder?
Hypersexuality
What is the term for developmentally inappropriate social relatedness seen before age 5 following prolonged separation from caregivers?
Reactive attachment disorder
What is the prevalence of ADHD among girls between the ages of 5-15 according to DSM-4 criteria?
0-1%
What is the overall prevalence of psychiatric disorders in adolescence?
16-20%
What proportion of adolescents admits to having had suicidal ideas in the UK in the past year?
15%
The percentage of reading difficulties in children in Britain is estimated to be around?
5%
Which symptom is most likely to remit first in a child diagnosed with ADHD?
Hyperactivity
According to the Isle of Wight survey, what is the commonest psychiatric disorder in childhood?
Conduct disorder
Which among the following is not a risk factor identified by the Cambridge study for later delinquent behavior?
Aggression in child
