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Child Psychiatry Flashcards

1
Q

What is the IQ range for Mild Intellectual Disability?

A

IQ 50-69

85% of learning disability cases fall under this category, with delayed understanding and use of language.

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2
Q

What are the characteristics of Moderate Intellectual Disability?

A

IQ 35-49

Language use and development may be absent, with delays in self-care achievements.

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3
Q

What is the IQ range for Severe Intellectual Disability?

A

IQ 20-34

Characterized by marked motor impairment.

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4
Q

What defines Profound Intellectual Disability?

A

IQ <20

Severe limitations, little or no self-care, and severe mobility restrictions.

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5
Q

What is Down’s syndrome associated with?

A

Trisomy 21

Associated with intellectual disability and Alzheimer’s Disease at age 50, involving chromosome 21.

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6
Q

What percentage of mental retardation in men is due to Fragile X?

A

10-12%

Fragile X is an X-linked disorder and the most common inherited cause of learning disability, associated with autism-like behavior.

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7
Q

What are common behaviors associated with Fragile X?

A

Abnormal play and speech & language delays

Lack of imagination in play is a notable characteristic.

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8
Q

What is the typical IQ range for Turner’s syndrome?

A

Normal IQ, mild learning disability

Individuals may experience some learning challenges.

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9
Q

What genetic abnormality is associated with Prader-Willi syndrome?

A

Deletion of paternal DNA on chromosome 15

Prader-Willi syndrome causes intellectual disability.

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10
Q

What genetic abnormality is associated with Angelman syndrome?

A

Deletion of maternal DNA on chromosome 15

Angelman syndrome also results in intellectual disability.

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11
Q

What is the prevalence of autism in general hospitals?

A

2-3%

Prevalence may vary depending on the setting, with a lower rate seen at specialized institutions.

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12
Q

What is the male-to-female ratio for autism?

A

4:1

This statistic indicates a higher prevalence of autism in males compared to females.

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13
Q

At what age does autism typically onset?

A

3 years old

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14
Q

What percentage of autism cases is attributed to genetic factors?

A

90% heritability

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15
Q

Name a genetic condition associated with autism.

A

Fragile X

Other conditions include Phenylketonuria and Tuberous sclerosis.

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16
Q

What type of brain damage can lead to autism?

A

Massive brain damage

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17
Q

What percentage of individuals with autism have a low IQ?

A

70%

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18
Q

What are the clinical features of autism related to behavior?

A

Restricted repetitive behaviour, restricted interests, routine/ritual bound, motor mannerisms

Examples include playing with parts of objects and engaging in stereotypy.

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19
Q

What communication impairments are commonly seen in autism?

A

Delayed verbal development, cannot sustain conversations, idiosyncratic language

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20
Q

What social interaction problems do individuals with autism experience?

A

Unable to reciprocate emotions, peer relationship issues, poor eye contact

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21
Q

What management strategies are recommended for autism?

A

Applied behaviour analysis, intensive behaviour intervention, hearing tests, speech therapy

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22
Q

What pharmacological treatments are used for autism?

A

SSRIs

Aggression & self harm issues - Valproate, Naltrexone, Risperidone

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23
Q

What is Asperger’s Syndrome classified as?

A

High functioning pervasive development disorder

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24
Q

What is the prevalence of Asperger’s Syndrome?

A

3/1000

The male-to-female ratio for Asperger’s is approximately 9:1.

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25
How does communication in individuals with Asperger's differ from those with classic autism?
Communication is not affected in Asperger's
26
What is a common characteristic of interests in individuals with Asperger's Syndrome?
Restricted interest in specific topics like trains or buses
27
What types of treatments are recommended for Asperger's Syndrome?
SSRI, structured programme oriented treatment, social skill training
28
Fill in the blank: Individuals with autism may engage in _______ behaviour, such as self-injury.
self-injurious
29
What is enuresis?
Repeated involuntary voiding of urine after age of 5 years old ## Footnote Enuresis may be nocturnal or diurnal or both.
30
What are the two types of nocturnal enuresis?
Primary and Secondary ## Footnote Primary enuresis means no period of continence achieved before.
31
What is the prevalence of enuresis at ages 5, 8, and 14?
10% at 5 years old, 4% at 8 years old, 1% at 14 years old
32
What is the male-to-female ratio for enuresis?
2:1
33
What genetic factor is associated with enuresis?
70% have a first degree relative who had enuresis
34
What psychological factors can contribute to enuresis?
* Rigid toilet training * Negative/indifferent attitudes of parents * Stressful events causing anxiety in child
35
What are some non-pharmacological treatments for enuresis?
* Reassurance * Behavioural modification * Enuresis alarm
36
What behavioural modifications can help treat enuresis?
* Restricting fluid before bedtime * Lifting child at night * Star charts
37
What pharmacological treatments are used for enuresis?
* TCA (tricyclic antidepressants) * Desmopressin (synthetic ADH)
38
What is the mechanism of action of TCA in treating enuresis?
Anticholinergic effect - urinary retention
39
Fill in the blank: Enuresis alarm is a type of _______ treatment.
non-pharmacological
40
What is ADHD also known as?
Hyperkinetic disorder
41
According to DSM 5, what are the criteria for ADHD symptoms?
Symptoms present before 12 years old, for at least 6 months, in ≥2 settings
42
What is the estimated prevalence of ADHD in the US?
~9%
43
What is the male-to-female ratio of ADHD diagnosis?
3:1
44
List some environmental factors linked to ADHD.
* Inner cities * Poor rural areas * Lower SES * Children brought up in institutions
45
What are some medical conditions linked to ADHD?
* Low birth weight * Foetal alcohol syndrome * Encephalitis or brain insult during pregnancy
46
Which part of the brain is linked to the pathology of ADHD?
Pre-frontal cortex
47
What neurotransmitters are dysregulated in ADHD?
* Dopamine * Norepinephrine
48
What are the clinical features of inattentiveness in ADHD?
* Start things never finish * Organisation impaired * Lose things * Instruction not followed * Distracted easily
49
What are the clinical features of hyperactivity and impulsivity in ADHD?
* Cannot wait in line * Talks out of turn * Restless * Cannot sit still * Talkative * Fidgety * Blurts out answers * Interrupts others * Loud and noisy
50
What are some self-related impacts of ADHD?
* Peer rejection * Higher injury rates * Drug abuse * Long term adverse effects on academic performance
51
What is considered the gold standard for ADHD investigations?
Clinical assessment
52
What percentage of ADHD patients may overcome symptoms with age?
50%
53
What are some non-pharmacological interventions for ADHD?
* Individual behavioural therapy * Parent management training * Environmental modification * School-based interventions
54
What is the first-line pharmacotherapy for ADHD?
Stimulants (methylphenidate)
55
What are some common side effects of methylphenidate?
* Headache * Loss of appetite * Insomnia
56
What should be monitored every 6 months for patients on methylphenidate?
* Appetite * Weight * Height * BMI
57
What is a potential second-line treatment if methylphenidate is ineffective?
Bupropion
58
True or False: Atomoxetine is still used as a second-line treatment for ADHD.
False
59
Fill in the blank: Omega fish oils require more than ______ mg to potentially affect attention span.
1000
60
What is a limited evidence-based dietary intervention for ADHD?
Removing food dyes and not eating sweets
61
In fetal alcohol syndrome, child has ___ features
Small features - think everything small! Small head, small eyes, short nose, indistinct philtrum, small chin low nasal bridge, minor ear lobe malformations
62
What is Oppositional Defiant Disorder (ODD)?
A subtype of conduct disorder characterized by a genuine unwillingness to cooperate and defiance, commonly seen in children aged 6-9 years old. ## Footnote ODD does not involve curiosity-driven behavior.
63
What are the key distinguishing features of ODD?
* Genuine unwillingness to cooperate * Usually occurs in children aged 6-9 years old * Does not attack people/animals * Does not usually violate major age-appropriate societal norms
64
How does ODD differ from conduct disorder?
* Earlier age of onset * Does not engage in aggressive behavior towards people/animals * Less likely to violate societal norms
65
What is the prevalence of conduct disorder (CD)?
4-5% prevalence, typically in individuals aged 9-15 years old. ## Footnote Higher rates are observed in deprived inner-city areas.
66
What is the male-to-female ratio in conduct disorder?
3:1 ## Footnote This indicates that conduct disorder is more common in males.
67
What are some risk factors associated with conduct disorder?
* Lower socioeconomic status * Large family size * Harsh punishment * Inconsistent parenting * Abuse * Genetic predisposition
68
What are the key symptoms of conduct disorder?
Symptoms can include aggressive behavior, violation of rules, and lack of empathy. ## Footnote A detailed list can typically be found in diagnostic manuals.
69
What is the primary focus of treatment for conduct disorder?
* Child-based interventions * Behavior modification * Individual psychotherapy * Medication (stimulants, SSRIs, mood stabilizers, lithium)
70
What percentage of conduct disorder cases may develop into Anti-Social Personality Disorder (ASPD)?
30% ## Footnote This highlights the potential long-term implications of conduct disorder.
71
What are some risk factors for developing ASPD?
* Overt aggression * Narcissism * Impulsivity * Irresponsibility * ADHD * Enuresis
72
What characterizes severe forms of ASPD, such as psychopathy?
* Planned violence * Grandiosity * Manipulativeness * Self-centeredness * Lack of empathy * Failure to learn from experience or punishment
73
Fill in the blank: The primary age group affected by conduct disorder is _______.
9-15 years old
74
True or False: ODD typically includes violent behavior towards animals.
False
75
What are the common treatment methods for hyperactivity in conduct disorder?
* Stimulant medication * SSRIs * Mood stabilizers * Lithium for explosive outbursts
76
3 categories of features sen in conduct disorder
1) aggression to people & animals 2) destruction of property 3) deceitfulness/theft
77
78
What is the prevalence of Tourette's syndrome in adults?
1/10000 ## Footnote Male to female ratio is 1:1.
79
What is the prevalence of Tourette's syndrome in children?
20/10000 ## Footnote Male to female ratio is 3:2.
80
What is the comorbidity percentage of ADHD in Tourette's syndrome?
50% ## Footnote This indicates a significant overlap between the two conditions.
81
What is the comorbidity percentage of Conduct Disorder (CD) in Tourette's syndrome?
40% ## Footnote This shows a notable association with behavioral issues.
82
What is the genetic transmission pattern associated with Tourette's syndrome?
Autosomal Dominant (AD) transmission ## Footnote This suggests a hereditary component in the condition.
83
What does PANDAS stand for in relation to Tourette's syndrome?
Paediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections ## Footnote This condition can lead to the development of Tourette's or OCD.
84
What can exacerbate Tourette's syndrome symptoms?
Stimulants or anxiety ## Footnote These factors can worsen the presentation of tics.
85
Define motor tics in the context of Tourette's syndrome.
Sudden, rapid, involuntary movement of muscles without purpose ## Footnote Motor tics usually occur before vocal tics.
86
What are vocal tics in Tourette's syndrome?
Grunting, snarling, coprolalia, echolalia ## Footnote Coprolalia refers to involuntary utterance of obscene words, while echolalia is the repetition of another person's speech.
87
What are the diagnostic criteria for Tourette's syndrome?
Both motor and vocal tics, symptoms for at least 1 year, symptoms free <2 months, onset <18 ## Footnote These criteria help in confirming the diagnosis.
88
What is the pharmacological treatment for Tourette's syndrome?
Risperidone and Clonidine ## Footnote Risperidone increases dopamine, while Clonidine reduces noradrenaline.
89
What is a non-pharmacological management strategy for Tourette's syndrome?
Massed practice ## Footnote This involves repeating tics to reduce their occurrence, along with self-esteem building and family therapy.

Psychiatry (7 decks)

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