common issues in older child Flashcards
4 ways to define enuresis
primary - always
secondary - 6 months of no spills
diurnal - when awake
nocturnal - when sleeping
2 times enursis is worrying
- diurnal in school-agers
2. any secondary
4 gen. causes of diurnal enureisi
- fear
- constipation
- motivation
- disease
2 causes of secondary
- if nocturnal, usually a variant of primary
2. if nociturnal only, rarely disease
what is primary epi
common
- 1% keep til age 15
main cause of promary
sleep too deep
- can’t wake them
- more REM sleep
treatment of primary
just accept and don’t make them feel bad
- no behavioral
- no imipramine
one drug for primary enur
desmopressin (DDAVP)
- only for short term like before sleep-over
- risk of hyponatremic seizures
use for sleep alarms?
bad, wakes everyone else up
- maybe for teens
3 times to treat
- co-bedding
- sleepovers
- failure of non-medical mgmt
epi of ADHD
~5%
- more boys
- children under 12
common ADHD impairments
- school
- social
- family
- driving
- criminal
- job changes
common ADHD comorbidities
ODD, CD, mood, anxiety, BN
associated factors
- low SES
- low birth weight
- maternal smoking
- dysfunctional families
what is heritibility of ADHD
pretty strong - 0.8
- runs in families
env effects on ADHD
perinatal - smoking - alc - LBW port-natal - head injuries - infection - autoimmune
2 main cog. deficits
- exectuve control
2. higher order processing
what is effect of methyphenidate
increased DOPA at synapse
brain structural diffs (2)
- reduced size
2. slower growth, esp prefrontal cotrex
DSM def. of ADHD
either A or B
A - innattention
B - hyperactivity/impulsivity
3 types
- primarily inattentive
- hyperactive
- combined
what is hallmark
inattention
what is very common issue with ADHD
learning diability
10 Ds of ADHD
Distracted Delayed Dyslexic Depressed Dozy Defiant Delinquant Drugged Diseased Disconnected
