Clinical Topic 5: Child Mental Health

Question 1

ADHD:
How common is it in boys and girls?
When is it commonly diagnosed?

Answer 1

Boys to girls, 4:1 ratio

Commonly diagnosed in ages between 3 and 7

Question 2

What are the treatment options for ADHD for children?

Answer 2

Mainly hollistic, with a 6 week “watch and wait” period. As a last resort, patient may be given from >5 years, Methylphenidate

Question 3

What is the major side-effect of Methylphenidate? What monitoring is required?

Answer 3

Stunted growth, hence must monitor height and weight every 6 months

Question 4

Autism Spectrum Disorder:
How common is it in boys and girls?
When do symptoms commonly present?

Answer 4

Boys to girls, 4:1 ratio

Should always present before age 3

Question 5

What three genetic conditions are liked to Autism Spectrum Disorder?

Answer 5

• Down’s syndrome
• Rett’s syndrome
• Fragile X syndrome

Question 6

What birth-related risk factors are associated with Autism Spectrum Disorder?

Answer 6

• In-utero exposure to alcohol / Sodium valproate
• Premature birth before 35 weeks
• Hypoxia at birth

Question 7

What is mild Autism Spectrum Disorder also known as?

Answer 7

Asperger’s syndrome

Question 8

What are the brain changes visualised in Autism Spectrum Disorder? What does this mean?

Answer 8

Increased connections between cerebral cortex (which regulates thoughts and consciousness) and limbic system. This is thought to cause the extreme emotional response in ASD patients to minor changes

Question 9

What are the three core symptoms of Autism Spectrum Disorder?

Answer 9

• Impairment of language / communication
• Impairment of social interactions
• Abnormal behaviour (ritualistic / compulsive)

Question 10

Aside from social and psychological interventions, what is one medication option for ASD patients?

Answer 10

Low dose Respirodone

Question 11

What is the mechanism of action of Methylphenidate?

Answer 11

Dopamine and Noradrenaline reuptake inhibitor

Question 12

What are the treatment options for children with Enuresis (bedwetting)?

Answer 12

Alarms and bladder training

Desmopressin

Question 13

What are the four clinical features required to diagnose a patient with Anorexia Nervosa?

Answer 13

1. Body weight 15% below expected or <17.5 BMI
2. Weight loss induced by food restriction
3. Distorted body image
4. Endocrine disturbance i.e. Amenorrhoea, delayed puberty