HY 4/ Flashcards
If seeing pt in ED and onset of behavioral changes suggests intoxication, withdrawal, or delirium related to substance use urine toxicology needs to be included in the first series of tests. It would also be reasonable to assess for depression as it is often co-morbid with substance use however completing a urine toxicology screen would be prudent to complete ___.
first
A ___ assessment is the first step when evaluating any type of communication disorder. The ___ assessment precedes formal assessment in all language, speech, and communication disorders.
hearing
The most common inherited cause of intellectual disability is ___, from a mutation on the X chromosome, occurring in 1 of 1,000 males and 1 of 2,000 females. ___ is caused by a CGG trinucleotide expansion of the FMR gene on the X chromosome. ___ is characterized by developmental delay, seizures, hyperactivity, and characteristic facies, including a long face, prominent jaw, and flat feet. This is an X linked dominantly inherited syndrome.
Down syndrome (trisomy 21) is the most common cause of genetic intellectual disability, occurring in 1 of every 700 births in the United States.
fragile X syndrome
___ is calculated using True Positives / (True Positives + False Positive)
Positive predictive value
___ is associated with deletions of genetic material located on the long arm of chromosome 7 (7q11.23) Children have typical elfin like facies with post-natal growth failure and hypercalcemia. The most common cardiac defect in these patients is supravalvular aortic stenosis. Familial cases have been reported and it is thought that, in these cases, the syndrome is inherited as an autosomal dominant trait.
Williams Syndrome
___ parents are responsive and warm but are strong and disciplined. The parents provide constant supervision and have rules to implement discipline in the children. ___ parents are demanding and firm but positively influence the child’s competencies and academic achievements later in life.
Authoritative
The additional effect of CBT added to SSRI antidepressants is modest, but occurs despite reduced SSRI use in teens that are initially on both. Teens on the combination utilize ___ health services despite having the same symptom level as teens on SSRIs alone. There is no clear evidence that CBT reduces SSRI-associated suicidality.
fewer
In accordance with the nonmaleficence principle (first, do no harm) physicians are obligated to decline a patient’s demand if the risks of harm ___ benefits and patient preference.
outweigh
___ is considered to play a role in the development of depression. This is found through increased levels of interleukin-6 and C-reactive protein. Increased levels of pro-inflammatory cytokine IFN-γ, has also been found in depressed adolescents as well as in adolescents with a history of childhood trauma. High levels of basal and urinary cortisol are found in youth likely to experience recurrences of depression. Cortisol levels among depressed adolescents in response to a social stressor have been found to be elevated and slower to return to baseline compared to non-depressed adolescents. Studies including subjects in mid- to late adolescence generally have found significant associations between cortisol levels and depression typically yield significant associations. However, these associations were not found in studies with pre-adolescent aged subject.
Inflammation
Psychosis due to Wilson’s disease is indicated by low levels of cellular plasma and copper in blood, and high levels of copper in ___. Hypodense basal ganglia is the typical finding on MRI brain scan of patients experiencing psychosis due to Wilson’s disease.
urine
___ refers to a cognitive error where a person takes responsibility for undesirable or unhealthy external events that are out of their control.
Personalization
___ refers to a belief that one specific outcome can be generalized to all other circumstances even though there is no sound basis for that generalization. For example, a person who fails at one test starts believing they are going to fail every test in their life.
Overgeneralization
___, also known as black and white thinking, refers to the belief that all events are either totally good or totally bad and that no other outcome is possible. Individuals with this distortion find it hard to accept outcomes that are less than ideal and often use words such as “never” and “always.” For example, a person who gets one question wrong on a test believes they are a failure and that they will never succeed in life.
Absolutism
In the ___ cognitive distortion, people view things out of context while focusing on only the negatives of a situation.
selective abstraction
___ involves placing undue importance on the outcome of one event. Individuals with this cognitive distortion expect the most terrible outcomes on the basis of a single negative event.
Catastrophizing
ASD is one of the most strongly ___ of neuropsychiatric conditions, as attested by the high concordance rates of monozygotic twins (schizophrenia is only 50%). The risk of 3% to 15% in dizygotic twins still suggests a significant risk, as suggested by observed familial clustering of ASD. The vast majority of cases of ASD are not due to causal genetic defects or mutations and instead are due to the weak contribution of multiple risk genes.
genetic
The milestones can count up to 10, can write name, and can use future tense are seen in children who are ___ years old
5
The 3-word sentences milestone is seen in children who are ___ years old.
3
At ___ years old, the expected milestones include climbing the stairs with alternating feet without support, skipping on one foot, drawing a person with at least 3 body parts, or a simple cross, use 4-word sentences, and use words that are 100% intelligible to patients.
4
Substantial loss of memory for extended time periods, usually in the setting of stress or trauma, is the hallmark of ___. It is not diagnosed during the course of dissociative identity disorder, PTSD, acute stress disorder, or somatic symptom disorder, and is not due to substance ingestion or a neurological condition. The symptoms cause clinically significant distress or impairment in function.
dissociative amnesia
Autism spectrum disorder is associated with decreased DNA methylation of several genes leading to dysregulated ___ of gene products involved in the glial-cell dependent synaptic pruning.
Examples of ___ of gene products involved in the glial-cell dependent synaptic pruning include the complement opsonin C1q, CR3, TNF, IRF8.
overexpression
Second generation antipsychotic-induced metabolic syndrome includes obesity, diabetes, hyperlipidemia, and ___.
hypertension
Asthma medications of several classes have high rates of ___ symptoms as adverse effects of the medications. For example, beta 2 adrenergic agonists, such as albuterol, increase are associated with anxiety symptoms. Theophylline, another bronchodilator, is chemically related to caffeine and often triggers anxiety symptoms. Even the anticholinergics, such as ipratropium, can in some cases lead to anxiety.
anxiety
An epidemiological study of a representative sample of children born in the US found that the prevalence of DEVELOPMENTAL DISABILITIES in children 3-17 was ___ in the years 2015-2017.
17.8%
Epicanthal folds, microcephaly, low nasal bridge, thin upper lip, flat philtrum are physical anomalies characteristic of one possessing ___.
fetal alcohol syndrome (FAS)
Past case reports have shown variable courses and prognoses for patients who have received diagnoses of autism spectrum disorder, without accompanying intellectual or language impairment. The factors associated with a good prognosis are a ___ IQ and high-level social skills.
normal
___ is a tic consisting of involuntarily performing obscene or forbidden gestures (eg, flipping the bird), or inappropriate touching. ___ comes from the Greek κόπρος (kópros), meaning “feces”, and πρᾶξις (prâxis), meaning “action”. ___ is a rare characteristic of Tourette syndrome.
Copropraxia
Clinical course of Tourette’s Syndrome involves facial tics, head and neck tics, body tics, and vocal tics with gradual ___ (typically rostrocaudal) and complexity which dissipates at 20 years of age in two-thirds of patients
progression
IDEA formerly defined a specific learning disorder using the discrepancy model. A child, especially, was required to demonstrate normal IQ and poor performance on psychoeducational tests (such as reading and math) therefore, a discrepancy between the 2 tests. The DSM-5 continues to define a learning disorder this way. However, according to the latest revision of the IDEA in October 2006, the new definition of a learning disability is the response to ___ model (i.e., the situation where a child does not learn as expected with standard quality academic instruction).
intervention
Parent management training and child ___ skills training have the best evidence base for the treatment of oppositional defiant disorder. In parent management training, parents are taught how to provide appropriate reinforcement of positive behaviors and how not to reinforce negative behaviors. In addition, education is given regarding behaviors and behavior management. Child ___ skills training involves teaching the child alternative means of solving problems, so that the child does not engage in oppositional and ineffective behaviors.
problem-solving
The following are true of ___:
1) Parents attend group meetings where they learn to apply behavioral management techniques during the meetings and apply it between sessions, as well as share their experiences in the following sessions.
2) Typically lasts between 9 and 20 sessions, including didactic presentations in clinics
3) Parent-child interaction therapy (PCIT) has evidence for support in control of ADHD symptoms with children with conduct disorder
parent management training
Topiramate is cleared by the kidney markedly ___.
unchanged
___ or egocentric speech used by children aged 3 to 7. It is directed to self rather than others and its main function is to guide and aid young children in the process of thinking and acting on different tasks.
According to Vygotsky, there are 3 forms of language, one of them is the inner speech which usually develops after the age of 7 years and is the hidden or covert speech. It is connected with thoughts and not as expressive as private speech.
Social speech is the language used by children around age 2 for social interaction and to communicate their needs to their caregivers. It is used to simply express thoughts of hunger, pleasure or pain so that their immediate concerns are resolved. Social or external speech is the most primitive language used by toddlers to communicate their needs.
Private
According to a randomized double-blind placebo-controlled clinical trial, ___ showed significant reductions in substance use disorder and also clinical symptom ratings after 6 weeks of treatment in adolescents with bipolar disorder and co-morbid substance use disorder.
lithium
Abnormal social ___ is amongst one of the hallmarks of autism spectrum disorder, in addition to communication, motor, and behavioral abnormalities.
reciprocity
Irritability, pallor, vomiting, constipation, and weight loss are common prodromal symptoms of elevated ___ levels, whereas convulsions, lethargy, sixth nerve palsy, and ataxia are characteristic of overt ___ poisoning.
lead
Bedwetting is normal before age ___. Actually, enuresis cannot be diagnosed before age ___.
5
Evidence shows that in 98.5% of ordinary children, maturation of bladder has occurred by 5 years of age. There is a high rate of spontaneous resolution; approximately 15% per year. Enuresis may occur due to anxiety, often transient, during the third year of life, which is apparently not only a “sensitive” period for the emergence of nocturnal bladder control but also a “vulnerable” period in which stresses often interfere with emergence of this behavior. Diagnosis of primary nocturnal enuresis occurs once a child is old enough to stay dry but still occurs, on average, at least ___ nights per week for three consecutive months. There must be no long periods of dryness. Primary nocturnal enuresis is the most common form of bedwetting. Secondary nocturnal enuresis is diagnosed when a patient has gone through a period of dryness at night of roughly 6 months or more and then returns to wetting the bed.
two
The p-value measures the probability of an observed difference occurring due to a random ___. A lower p-value represents a greater statistical significance regarding the observed difference.
chance
___ independent variable is a variable that cannot be manipulated. Age, ethnicity, and gender are examples of it. Some of the surrounding environment aspects also cannot be manipulated and are used as ___ variables.
Attribute
