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Psychiatry > Child Psychiatry > Flashcards

Child Psychiatry Flashcards

1
Q

What is the DSM IV criteria for MDD?

A 
Depressed mood
Loss of interest/pleasure
Weight Change
Sleep Disturbance
Psychomotor Agitation 
Fatigue
Guilt or worthless feeling
Dec Concentration
Thoughts of Death/Suicide
Irritable
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2
Q

What is different between CHild and Adult MDD?

A 
Low Frustration tolerance
Somatic Complaints
Separation Anxiety
Behavior Problems
Don't verbalize feelings
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3
Q

What are comorbidities for CHildhood MDD?

A

Substance abuse
Dysthymia
Disruptive disorders

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4
Q

What is Double Depression?

A

Dysthymia coupled with Major Depression

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5
Q

What are risk factors that effect prognosis in Childhood MDD?

A

Severity, Chronicity, Recurrence, Comorbidity, Hopelessness, Residual Symptoms, neg cognitions, family problems, Abuse History

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6
Q

What is the Treatment of Childhood MDD?

A

Therapy versus meds
SSRI/SNRI
TCA
MAOI

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7
Q

What are the Adverse Effects of Antidepressats?

A

Disinhibition, GI symptoms, Headache, BB warning, Seizures(Buproprion), Weight Gain, Bradycardia, Inc in DBP, Arrhythmias

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8
Q

What is Serotonin Syndrome?

A

Autonomic Instibility, delirium, psychosis, myoclonic jerks

ER REFERRAL

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9
Q

What are symptoms of Discontinuation of Antidepressants?

A

Dizziness, Headaches, nausea and emesis, diarrhea, insomnia, tremor, electric shock sensation

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10
Q

WHat is the Back Box warning associated with Antidepressants?

A

Increased rates of Suicide

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11
Q

What are the questions to ask someone with suicidal ideation?

A 
Plan?
Access to follow through?
Intent?
Family Hx?
Previous attempt?
Illicit Drug use
Hopelessness
Lack of social support
Recent stressors
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12
Q

What are the traits of Childhood Bipolar Disorder?

A

More severe and chronic
Mixed with rpid cycling
Non episodic course
Initial episode is Major Depression

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13
Q

What are the Comorbidities associated with Bipolar Disorder?

A

ADHD
Conduct Disorder
Anxiety Disorders

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14
Q

What are the Tx of Bipolar Disorder?

A

Antipsychotics and Mood stabilizers (Lithium and Depakote)

Psychosocial Interventions

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15
Q

What are the Side effects of Antipsychotics?

A

Weight Gain, Mets Abn, Akathesia, Tardive dyskinesia, Inc PROLACTIN (Risperdal)
ORTHOSTATIC HYPOTENSION, PARKINSONIAN SYMP

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16
Q

What needs to be monitored in Lithium use?

A

TSH, Cr, CBC

17
Q

What needs to be monitored in Depakote(Valproic Acid) use?

A

LFT, CBC, PCO

18
Q

What needs to be monitored in Tegretol(Carbamazepine) use?

A

CMP, LFT(Aplastic Anemia, Agranulocytosis)

19
Q

What is the Feared Side effect of Lamictal(Lamotrigine)?

A

Steven Johnson Syndrome

20
Q

What are the adverse events of Lithium?

A

Polyuria, Polydypsia, Hypothyroidism, Acne, Cardiac Arrhythmia, Fine tremor

21
Q

What are clinical pearls for Lithium?

A

Don’t give with Aspirin, or Ibuprofen ( Don’t give meds if dehydrated)

22
Q

What are the 3 domains of ADHD?

A

innatention, Hyperactivity, Inpulsivity

23
Q

What is the difference between a learning disability and ADHD?

A

LD: usually only 1-2 subjects
ADHD: Difficulty in many subjects

24
Q

How is ADHD Diagnosed?

A

Clinical Diagnosis (Sx at home at school)
Objective Scales
Test Attention span (Serial 7s)
Computerized performance task

25
Q

What is the Tx of ADHD?

A

Stimulants.

26
Q

What are the Adverse effects of Stimulants for ADHD?

A

GI symptoms, Dec Appetitie, Insomnia, Headaches, Rebound Sx, BLUNTED AFFECT
Monitor Vitals(BP and Pulse)
Psychosis if at risk

27
Q

How can we know which Stimulant should be used in an ADHD kid?

A

Avoid Amphetamine as 1st line

Methylphenidate

28
Q

What are the Impacts of untreated ADHD?

A 
Inc in MVAccidents
Fired and Expelled more often
Inc Substance abuse 
Inc Parental divorce 
Inc Sibling fights
29
Q

What is the Non-stimulant mediction used for ADHD?

A

Strattera(Atomoxetine): Better for comorbid anxiety
Wellbutrin(Buproprion)- Good for kids with ADHD and MDD
Provigil(Modafanil)- Narcolepsy

30
Q

What are the Alpha 2 agonists used for ADHD?

A

Clonidine and Guanfacine
BP Meds
Use with ADHD kids with Extreme Hyperactivity, Stim appetite

31
Q

What are the three domains in Autism Spectrum Disorder?

A

1) Impairment in social interactions
2) Impairment in communication
3) Restricted pattern of interest and Steriotypical Behavior

32
Q

When should an Autistic Patient be referred?

A

Language Delay
Lack of Non-Verbal Communication
Lack of Symbolic Play
Steriotypic or Self stim Beh

33
Q

What is the Tx of Autism?

A

Holistic Approach
PT/OT/Speech
Social Skills Training
SSRI, Antipsych, Stimulats

34
Q

What are the Positive and Negative Symptoms of Schizophrenia?

A

Pos: Aud and Visual Hallucinations, delusions of persecution
Neg: Lack of Motivation and Socialization, little verbal output, blunted affect

Psychiatry (9 decks)

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