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Psychiatry > Child Psych! > Flashcards

Child Psych! Flashcards

1
Q

What is the first line treatment for depression and children and adolescent

A

Psychological intervention especially for mild to moderate depression

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2
Q

What is the Sprucepine antidepressant recommended for treatment of depression in children

A

Prozac

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3
Q

What are the two FDA approved and a depressant for children

A

Prozac and Lexapro

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4
Q

Why do anti-depressants have to sometimes be scheduled twice a day in children

A

Metabolize the antidepressant quickly

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5
Q

What is the efficacy of TCA in children and adolescents

A

Not effective in preview Berto children but there is some marginal Efficacy in adolescence

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6
Q

Is ECT recommended and children under 12

A

No because it is unclear about the effects does ECT on the developing brain

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7
Q

What is the side effect burden of PCAs and children and its relative effect on the heart

A

Vertigo, orthostatic hypotension, summer and dry mouth

It is awesome more cardio toxic and young people and then an adult

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8
Q

What are common side effect seeing with antidepressant in children

A

Sedation, insomnia, gastrointestinal symptoms

Barely at least two leading, serotonin syndrome, activation and mania

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9
Q

What is the evidence associated with suicidality and antidepressant used in children

A

Evidence has found that antidepressants increase the risk of suicidal behavior and aggression in the short term but the studies have not seen completed suicide in these trials

In studies they have also found that a population decreased different question of SSRIs there was an increase in the rate of suicide

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10
Q

What are the first line medications for treating acute mania in children

A

Abilify, olanzapine, quetiapine, risperidone, asenaphine

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11
Q

Recommended first line treatment for bipolar depression

A

Olanzapine and Prozac combo, Seroquel, Latuda

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12
Q

Why are first generation and I psychotics avoided in children

A

They will experience EPS and a lot of sedation more when given fresh generation antipsychotics

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13
Q

What antipsychotics did you try before giving a child clozapine

A

Olanzapine

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14
Q

Which second generation antipsychotic is less effective out of all of them

A

Ziprasidone, their concerns about is cardiac safety as well

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15
Q

Criteria for generalizing Anxiety disorder in children

A

Worrying plus one of the following symptoms: restlessness, fatigue, difficulty concentrating, irritability, muscle tension, sleep disturbances

They tend to worry about school peers etc.

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16
Q

What ratio of males to females are affected by anxiety

A

1 to 2 respectively a.k.a. females are affected more

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17
Q

Typical PRN medication as we used for anxiety

A

BuSpar, Atarax, gabapentin

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18
Q

Common antidepressants we use for anxiety treatment

A

Prozac, Lexapro, Zoloft

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19
Q

What is one of the main reasons why children avoid school

A

High levels of distress or anxiety related to school

Could be related to tests, bullies, Devotie in school, separation anxiety

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20
Q

What is a key unique feature of depression in children

A

Irritability

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21
Q

What are the key features of disruptive mood dysregulation disorder

A

They will experience verbal and or behavioral tantrums out of proportion to a situation and it is also inconsistent with your development

They will have tantrums about three times a week with irritability in between

Dissent does this last for one year without a three month break and typically the symptoms occur before 10 years old

Must be between the ages of six and 18 for this diagnosis

22
Q

How does bipolar typically initially present in children

A

Typically presents first with a depressive episode

23
Q

Why do we typically avoid Paxil in children

A

Increases the risk of suicide

24
Q

What are two medication that we typically don’t use as first line in children

A

Bupropion and mirtazapine

25
Q

Inattentive symptoms of ADHD

A

Mistakes, poor attention, filter finish, loses things, distractible, for organization, avoids effort, forgetful, not listening

26
Q

Hyper active or impulsive symptoms of ADHD

A

Can’t sit, on the go, fidgety, can’t play quietly, talkative, running or climbing, impulsive or blurts out, Can’t wait turn, interupts others

27
Q

How many of the ADHD Criteria is required to be diagnosed with ADHD

A

6+ symptoms for at least six months in two different settings and they have to have some thoughts before the age of 12 years old

28
Q

What type of ADHD are girls more likely to have

A

Inattentive type

29
Q

What are some consequences of untreated ADHD

A

Poor performance in school, social rejection, higher rates of unemployment, higher risk of developing conduct disorder or oppositional defiant disorder, increase risk of developing substance abuse, higher risk for traffic accidents, high risk for accidental injury

30
Q

What percentage of Children continues to have symptoms of ADHD as an adult

A

50%, and attention is more likely to continue then be hyper activity or impulsivity

31
Q

What is the first line treatment for ADHD

A

Stimulants like methylphenidate (Ritalin) or Adderall (amphetamine)

Methylphenidate is typically used in younger children

Stimulus going to be helpful for all symptoms of ADHD

32
Q

What symptoms are alpha agonist like clonidine and guanfacine helpful for when managing ADHD

A

Helpful for management of hyperactivity or impulsivity, models helpful for an attention.

It can also help with sleep

33
Q

What are the less helpful ADHD treatment

A

Animosity and bupropion

34
Q

What are things you want to look for when treating somebody with ADHD

A

Assess for personal family cardiac history and after starting it assessed for low appetite, irritability, sleep difficulties, elevated heart rate and blood pressure

35
Q

What are the different types of methylphenidate

A

Ritalin, Concerta, Focalin

36
Q

What are the different amphetamine derivatives

A

Adderall and Vyvanse

37
Q

What are the key features of OCD, in a way that you can easily describe it

A

The obsessions are intrusive thoughts that lead to anxiety or tension that is relieved by engaging in the compulsions, which can be engaging in a mental act or a physical act

38
Q

Is there a genetic component to OCD

A

Yes, it is a heterogeneous disorder that runs in families. For a firstdegree relative there is a four Fold increased risk of developing OCD

39
Q

What neurotransmitters are thought to play a role in OCD

A

Serotonin and dopamine

40
Q

What can happen to OCD symptoms when treating the patient also for ADHD

A

Bye using a stimulant there may be some exacerbation of OCD symptoms. That is why you were sometimes see the use of dope me an antagonist plus an SSRI to get the best OCD treatment

41
Q

What is OCD typically comorbid with

A

ADHD and take disorders like Tourette’s.

It is also commonly called worried with other anxiety disorders as well

42
Q

What are common clinical features seeing an OCD

A

Fear of dirt germs or disease or harming themselves or others.

Compulsions of cleaning, checking, accounting, repeating behaviors, and arranging items

43
Q

What is the definition of a compulsion

A

A repetitive behavior or mental act ,like praying counting or repeating words silently, that is aimed at preventing or reducing the distress or anxiety

44
Q

Differentiating between severe OCD and psychosis

A

When the patient still has insight and there is still underlying anxiety press it it is most likely to be OCD over psychosis

45
Q

What feature predicts the best outcome for patients with OCD

A

The absence of comorbid disorders Mike take disorder and ADHD depression

46
Q

Any minority of cases what is OCD sometimes a prodrome of

A

A psychotic disorder

47
Q

What medications are FDA approved for treatment of OCD in children

A

Zoloft, Prozac, Luvox

Can also argument with an ETA boy and I psychotic like risperidone if there is only a partial response with the serotonergic medication

48
Q

Which type of temperament and children it’s likely to develop anxiety disorders

A

Children with the Shy temperament who wants that are likely to withdraw and unfamiliar situation

49
Q

What type of attachment increases the risk of a child developing anxiety

A

An insecure attachment, typically seen in anxious mothers

50
Q

How might a parents behavior influence a child developing anxiety

A

Social learning, if they see their parents often times expressing fear they will learn that response ( like cringing when there is a lightning storm)

51
Q

What is first line treatment for anxiety disorders in children

A

Cbt!

Luvox is also approved for anxiety disorder treatment as well as ssri’s

Psychiatry (5 decks)

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