Community Paeds

Question 1

What are the main features of ADHD?

Answer 1

Triad

• inattention
• hyperactivity
• impulsivity

For >/=6months

Question 2

How to assess for ADHD?

Answer 2

Conners questionnaire
QB test
School input - SENco
Parental input

Question 3

Management of ADHD

Answer 3

Biopsychosocial approach with MDT

Mild
- first line is psychoeducation, parent training and school interventions (give examples)

Severe
- First line is medication (refer to secondary care)
Methylphenidate then lisdexamphetamine then atomoxetine

Melatonin for sleep disturbance

Question 4

What are the S/Es and cautions of CNS stimulants for ADHD?

Answer 4

S/Es
-headaches, insomnia, weight loss, appetite loss

Caution

• check for cardiac conditions: long QT
• monitor weight and height

Question 5

Key features of autism

Answer 5

Asocial - lack of eye contact, lack of interest in others
Behaviour restrictions - rigid routines and doesnt like change, stereotyped or repetitive behaviour
Communication issues - distorted or delayed speech, echolalia

Onset before age 3
+/- intellectual disability, sensory processing difficulties

Question 6

Assessment for ASD

Answer 6

Full developmental assessment 
Hearing tests if required 
Screening tools - CHAT 
GARS, ESRS questionnaires 
Parental input, school input - SENco

Question 7

Management for ASD

Answer 7

Biopsychosocial

Bio

• pharmacological Tx for coexisting disorders
• Melatonin for sleep

Psycho

• psychoeducation: training courses for parents
• maybe CBT
• behavioural management strategies
• stress reduction

Social

• modify environmental Fx
• provide key worker
• Carer support
• Consider special schooling
• Early help referral for children at risk

Question 8

Criteria to be met for a Learning disability diagnosis (3)

Answer 8

Impairment in intelligence
Adaptive functioning
Age of onset - developmental age

Question 9

Categories of LD

Answer 9

Mild: IQ 50-69
Moderate: IQ 35-50
Severe: IQ 20-35
Profound: IQ 20 or less

The more severe, the more impairment in:

• Communication + language
• motor abilities
• self care

Question 10

Turner’s main features (5)

Answer 10

Short stature
Webbed neck
Congenital heart defect - coarctationof aorta
Primary amenorrhea - streak ovaries
Kidney issues - horseshoe kidneys

Question 11

Management of Turner’s

Answer 11

Childhood- growth hormone
Adolescence- sex hormones, oestrogen
IVF for infertility