Cooley: Neurodev. Disorders and ADHD

Question 1

Females with ADHD present more commonly with which subtype; why is this a problem?

Answer 1

• Inattentive subtype
• Less disruptive behavior in females may contribute to referral bias causing under identification and lack of tx

Question 2

What is the tourette’s syndrome triad?

How is gender assc?

Answer 2

• Tics
• ADHD
• Obsesseive compuslive sx’s (OCS)

Girls: more likely to have tics and OCS

Boys: more likely to have tics and ADHD

Question 3

Which other disorder needs to be considered in both the initial assessment and ongoing management of children with ADHD?

Answer 3

Chronic Tic Disorder

Question 4

ADHD is an information processing dysfunction in what 2 brain locations?

Primarily due to deficinecy of which 2 NT’s?

Answer 4

• Within prefrontal cortex: executive functioning impairment

- Dorsal anterior midcingulate cortex

• Deficiency of dopamine and norepinephrine

Question 5

According to the DSM-5 how many sx’s should a child vs. patient >17 y/o have for making dx of ADHD?

Answer 5

• Children: should have 6 or more
• Adults: should have at least 5 sx’s

Question 6

According to the DSM-5 what are 9 sx’s of the inattentive type of ADHD?

Answer 6

• Fails to give close attention to details or make careless mistakes
• Difficulty sustaining attention
• Does not appear to listen
• Struggles to follow through on instructions
• Difficult with organization + loses things + easily distracted
• Avoids or dislikes tasks requiring a lot of thinking
• Is forgetful in daily activities

Question 7

According to the DSM-5 what are the sx’s that fit the hyperactive type of of ADHD?

Answer 7

• Fidgets in chair
• Hard time staying seated
• Runs excessively
• Talks excessively
• Blurts out answers
• Hard taking turns

Question 8

What are the clinical practice guidelines for treating preschool-aged children (4-5 years of age) with ADHD?

Answer 8

• Prescribe evidence-based parent- and/or teacher-administered behavior therapy as the 1st line tx
• Prescribe methylphenidate if the child continues to have moderate to severe sx’s

Question 9

What are the clinical practice guidelines for treating elementary school-aged children (6-11 years of age) with ADHD?

Answer 9

• Preferably both medication and behavior therapy should be used together
• Evidnce is particularly strong for stimulant medications

Question 10

What is a potential AE associated with Bupropion?

Answer 10

↑ risk of seizure

Question 11

Which stimulant used for ADHD is a re-uptake inhibitor of catecholamines AND also releases catecholamines?

Answer 11

Amphetamines

Question 12

Dx for pt unable to undergo systematic assesments of intellectual fxn

Answer 12

Global developmental delay

Question 13

Dx of disturbances in nml fluency and motor production of speech. Might have marked recurrences of syllable repetitions.

Answer 13

Childhood-onset fluency (stuttering)

Question 14

Dx for difficulties in the use of language across all modalities: spoken, written, etc.

Answer 14

Language disorder

Question 15

Dx for difficulty with speech sound production that interferes with speech intelligibility

Answer 15

Speech sound disorder

Question 16

Dx for difficulties in social use of communication

Answer 16

Social (pragmatic) communication disorder

Most autistic kids have this

Question 17

What are the 2 FDA approved meds for irritability and aggitation assc w ASD?

Answer 17

1. Risperidone
2. Aripiprazole

Question 18

Which ADHD med binds to DA transporter, inh DA reuptake? For adults only

Answer 18

Modafinil

Question 19

Dx when coordinated motor skills are substantially below pt’s age. Manifests as clumsiness.

Answer 19

Developmental Coordination Disorder

Question 20

Dx for purposeless motor behavior (head banging) that interfers with life activities. Not explained by another neurodevelopmental disorder.

Answer 20

Stereotypic Movement Disorder

Question 21

Tourette’s syndrome meds

Answer 21

1. Antidopaminergic drugs: only approved drugs in USA (haloperidol)
2. DA depleters: inh VMAT2
3. Antipsychotics: fluphenazine and risperidone
4. Alpha agonists: clonidine
5. Botulinum injection
6. Anticonvulsants

Question 22

Dx for vocal OR motor tics (not both) that have lasted for >1yr. Onset before age 18.

Answer 22

Persistent Motor/Vocal Tic Disorder