Consult Liason Flashcards
A child with ADHD and anxiety would need a Individualized Educational Plan (IEP) instead of a 504 for? (2x)
Holding the student to a different academic standard in challenging subjects.
What is the type of intervention when a school psychiatrist makes recommendation for program after a recent student’s suicide? (2x)
Systems consultation
Most important components to get a school to initiate an IEP eval for a 7yo with ADHD who is struggling to read?
Vision problems ruled out, child has failed high quality interventions to learn to read, emotional factors inhibiting learning have been ruled out by psychiatrist
Interval to reevaluate kids in special education to verify eligibility?
3 year period of time
Psychiatrist reviewing evaluation request from a school, notes that 8 requests are from the same teacher. Next step?
Meeting with teacher and observe the classroom
Psychiatrist calls the school and asks to meet with teachers and learning specialist to discuss needs of patient with ADHD and learning disorder who is not getting adequate services. This action would be considered?
Advocacy
What is the primary evidence for school-based mental health centers?
Clinic attendees have better school attendance
What is the difference between 504 and IEP?
Federal funds support the development of an IEP
Federal funds support the development of an IEP
Point of contact for eligibility of child to receive special education services according to Education for All Handicapped Children Act?
Multidisciplinary school based team
How does a child get an individualized educational program under the Individual w Disabilities Education Act (IDEA)?
Need for specialized instruction
Before conferring IEP, you could conduct a manifestation determination review to determine if?
Patient’s disruptive behaviors are related to disability
Quickest action family can take if they feel child with IEP is inadequately progressing?
Request an IEP review meeting to be held in the upcoming days to weeks
Child with Tourette’s and individualized education plan (IEP) was suspended for swearing. Parents feel this is due to Tourette’s. Appropriate recommendation?
Request manifestation determination review from school
10 yo with acute leukemia has finished chemo and is better, pt has been out of school for 2 months. How to best manage school?
Resume the usual class as much as possible
What is the best approach when helping a school with systemic problems of violence and bullying?
Reviewing the existing school policies and philosophy
Child with psychiatric condition, academic, and social difficulties. Parents want an evaluation for special education but teacher doesn’t feel it is needed. Recommendation to parents?
Submit written request for special education evaluation
Preventative interventions in school have been proven beneficial when applied to students with?
Aggression
High school students screened for subclinical depression and given CBT intervention had low conversion to MDD at one year follow up. Type of prevention?
Indicated
School-based mental health practitioners provide which type of mental health service to students?
Case management, crisis intervention, classroom behavior support, individual evaluation and treatment
In addition to providing services for infants/toddlers with history of abuse or neglect, most recent reauthorization of the Individuals with Disabilities Education Act (IDEA) also covers young children in which circumstance?
Exposure to parental substance abuse
Funding source for school-based mental health programs?
Medicaid and school funding
What is the best treatment approach for a 17 yo w/multiple hospitalizations due to non-adherence to care for a recent diagnosis of diabetes, who feels different from peers?
Work w/school psychologist to encourage peer group involvement.
15 yo pt with declining school performance. What should be addressed in private?
Presence of self-destructive thoughts or behaviors
15 yo w/ sickle cell disease has poor academics. Missed school and changed school. What factor leads to his cognitive decline?
Sickle cell disease
Important guide to provide telepsych to schools?
Family Educational Rights and Privacy
What is afforded to all children with a handicap according to Education for All Handicapped Children Act and the Individuals with Disabilities Education Improvement Act (IDEA)?
Education occurs in least restrictive environment
School refers student for psychiatric consultation, but parents refuse. Next step?
Observe child in school without obstruction and give recs to teacher
What must happen if a child is approved for an IEP by a special education committee at school?
Plan must be developed in 30 days
Responsibility of psychiatrist hired by school as a consultant after a student suicide?
Advise administrators on how to respond
Public policy recs to promote resilience and well being in children in society focused in what system?
Schools
What are the expectations about drug and alcohol use among prospective pediatric liver transplant recipients? (2x)
Infrequent experimental use of alcohol is not an absolute contraindication
What negative thoughts are 6 yo patients more likely to experience, compared to teens, when hospitalized multiple times for medical reasons? (2x)
Thoughts about being punished
What is the best approach for a consulting psychiatrist’s first interaction w/a child who has just been diagnosed w/acute lymphocytic leukemia and has been refusing medical procedures?
Ask how much the child wants to know about the medical procedures.
First step of psychiatrist in doing inpatient pediatric consultation?
Define the referral questions
Psychiatrist consulted on 12 yo with multiple fractures from motor vehicle accident 2 days ago when pt’s father died. The main priority?
Ensure adequate pain management
Neuropsychiatric symptom (along with depression) in a 7 y.o. patient with HIV?
Inattentiveness
Pediatric consult placed for child with concern of somatic symptom disorder. Parents feel they are not being taken seriously. Appropriate response?
Since the mind and body can influence each other, it is important to address both
The 2005 Youth Risk Behavior survey found youth with asthma had higher rates of using what recreational substance?
Tobacco (cigarettes)
3 yo with delirium after surgery. Most important information?
Caregiver reports
Core criteria for delirium diagnosis?
Cognitive changes
Child with ADHD and depression taking melatonin, clonidine, and high doses of cod liver oil, presents with vomiting, headache, increased ICP, hepatosplenomegaly, skin desquamation, abdominal pain, musculoskeletal pain. Type of toxicity?
Vitamin A
Relative contraindication for ECT?
Active pulmonary infection
Adolescent with history of MDD attempts suicide by planned, intentional overdose on tylenol after learning charges were dropped against their rapist. Now says they promise never to attempt suicide again. Plan?
Admit to inpatient psych
Medication that worsens delirium in children?
Diazepam (benzodiazepines)
Child hospitalized for abdominal pain, extensive workup negative, mother insists child is sick, won’t let you interview child alone. Next step?
Obtain outside records from past/present physicians
Most appropriate patient to drug test?
Teen in ER with altered mental status
