Community Flashcards
What are some commoner features of childhood depression (vs adults)? (7)
Apathy / boredom
Irritable mood
Antisocial behaviour
Decline in school performance
Separation anxiety
Social withdrawal
Hypochondriacal ideas
Which features of adult depression are less seen in children? (5)
How is chilldhood depression managed compared to adults?
Slowed movement/thought Delusional ideas Loss of sleep Loss of appetite/weight Loss of libido
Managed similarly to adults
What are the main 3 psychotic disorders seen in paediatrics?
What Ix can be done into them?
Schizophrenia
Bipolar affective disorder
Organic psychosis
Urine dip - drug screen
Exclusion of medication-induced / medical causes / dementia
What questionnaire tool is used regarding self-harm / drug abuse?
PATHOS P - problems > 1month? A - alone at the time? T - overdose planned for >3 hrs HO - feeling hopeless about the future? S - feeling sad for most of time before overdose?
What are the diff kinds of sleep problems seen in paediatrics? (4)
What age group is it mostly seen in?
What is the main feature noted by the parents?
Difficulty settling
Waking in night
Nightmares
Night terrors
Mainly toddlers
Cannot get to sleep unless parent present
List some reasons for difficulty settling to sleep, that must be asked about in the Hx? (9)
Too much afternoon sleep Evening overstimulation Displaced sleep/wake cycle Poor parental practices (e.g. no bedtime routine) Use of bedroom as punishment
Separation anxiety
Fear of darkness/silence
Chronic physical illness
Kept awake by noisy sibling / neighbours
What advice is given to parents for difficulty settling to sleep?
Introduce bedtime routine
OR
Lengthening periods of time b/wn tucking in bed and returning after mins so child learns how to sleep alone
Whats the difference between nightmares and night terrors?
Nightmare - rarely req medical attention unless frequent/stereotyped in content indicating morbid preoccupation or psychiatric symptoms (e.g. PTSD)
Night terrors occurs approx 1.5hrs after settling
Become disorientated/distressed/unresponsive + will have no recollection in morning
Sim origin to sleep walking
Usually due to erratic sleep schedule
What are some diff types of speech impediment? (6)
Stuttering Lisp Muteness Voice disorders Articulation disorders Dysarthria
What are the main causes of speech impediment? (4)
How are most speech impediments managed?
Congenital health conditions e.g.: Cleft palate Poor hearing Defects of facial bones/muscles Defects of digestive system / larynx
Most can be remediated with speech + lang therapy
Define a stammer/stutter
What age usually seen in?
= flow of speech disrupted by involuntary prolongation/repetition of sounds (vowels), syllables, words or phrases and involuntary silent pauses
Ages 2-5 (most resolve after 5)
What are the main contributing factors towards stammer/stutters (4)
Genetics (approx 60% have FH)
Interruption/competition with siblings
Difficulty in brains language processing areas
Other speech/lang probs or developmental delay
What are some factors in physical injury that may indicate it as NAI? (6)
Hx BG of prev abuse Plausability of explanation Delay reportind accident Inappropriate parents reaction Inconsistent stories from parent/child
What factors in the Hx may indicate neglect? (8)
Lacks immunisations/glasses Frequent DNAs Ravenously hungry Dirty/inadequate clothing Parent/child involved in alc/drugs Parent apathetic/depressed Parent indifferent to child Child says no-ones home
When should emotional abuse be considered?
Born when parental separation/violence
‘Wrong’ gender
How may emotional abuse present in babies?
in toddlers?
in school-age?
in teenagers?
Babies: Apathetic, non-demanding, delayed devel, attention seeking, lack of affection
Toddlers: apathetic, fearful, violent
School-aged: wetting/soiling, relationship difficulties, truancy, antisocial behav
Teenagers: self-harm, depression, aggressive/defensive, minor crimes
What does sexual abuse consist of?
Physical contact and/or non-contact (watch/take porn/pictures)
What may be some physical indicators of sexual abuse? (2)
STI / Pregnancy <13 yrs (= always sexual abuse)
Vaginal bleeding/itching/discharge/rectal bleeding
What may be some behavioural indicators of sexual abuse? (6)
Secondary enuresis Soiling Self-harm Aggressive Sexual Poor school performance
What are some causes of induction in Fabrication + Induced Illness?
XS substances e.g. salt
XS meds
Suffocation
Poisoning
What is the main clue that may suggest Fabrication/Induced Illness?
Presentations only occurring in carer’s presence + no clinical evidence
What features are always seen in Chronic Fatigue Syndrome? (6)
What are some other features commonly (but not always) seen? (5)
Always: Myalgia Migratory arthralgia Headache Difficulty getting to sleep Poor concentration Irritability
Often seen: Stomach pains Scalp tenderness Eye pain Photophobia Tender cervical lymphadenopathy
What viruses may contribute towards chronic fatigue syndrome?
Cocksackie B virus
EBV
Hepatitis
How is chronic fatigue syndrome managed?
Graded exercise
and/or
CBT
Recovery can takes months/years
