HY 5/

Question 1

Sleep terror disorder is a parasomnia characterized by sudden arousals during the night associated with screaming and crying. These occur during the deepest stage of non-rapid eye movement (NREM) sleep. Unlike nightmares, the child is confused, disoriented, and unresponsive during these periods of arousal and has no memory of the episode when he wakes up in the morning. Safety measures and behavioral techniques such as scheduled awakenings are the first-line treatments for sleep terrors, but ___ can be used in severe and refractory cases.

Answer 1

Clonazepam

Question 2

___ is the ability of a drug to treat whatever condition it is indicated for.

Answer 2

Efficacy

Question 3

___ is how well the drug works in the real world. ___ encompasses a drug’s efficacy (the ability of the drug to treat whatever condition it is indicated for), but also its ease of use and tolerability. A drug may be efficacious (has ability to treat condition indicated for) but have so many adverse effects and its dosing schedule so complex that its ___ could be poor.

Answer 3

Effectiveness

Question 4

Precocious puberty is defined as sexual development at age 8 years for girls and 9 years for boys. Most cases of precocious puberty are ___ in nature. Idiopathic or central precocious puberty is due to early activation of normal hypothalamic GnRH production. Laboratory results show elevated levels of GnRH, FSH, LH, and estrogen.

Answer 4

idiopathic

Question 5

According to Piaget, newborn babies have a small number of ___ schemas that are the cognitive structures underlying the innate reflexes and are genetically programmed. Piaget called the schema the building blocks of intelligent behavior. These ___ schemas include sucking, grasping, and rooting.

Answer 5

innate

Question 6

___ bias occurs in trials in which the knowledge about what intervention is being given to the participants is known. It can be reduced by blinding the subjects as well as the researchers.

Answer 6

Ascertainment

Question 7

Studies have generally found that children typically come to understand the irreversibility, finality (or nonfunctionality), and universality of death between ___ years of age.

Answer 7

5 and 7

Question 8

There is an increase in the ___ dopamine activity and turnover reaching peak of a lifetime, which is associated with less inhibitory control in adolescents. There is a decrease in the gray matter of adolescent’s brain during development throughout the cerebral cortex due to synaptic pruning. This has been linked with more risk-taking behavior in adolescents. There is also concomitant increase in the white matter in the cortical and subcortical fiber tracts from increased myelination and axon caliber, which is linked with more impulsive behavior. Some areas work to increase although overall still areas where limited but none where it is eliminated There is an increase in the D1 and D2 dopamine receptors in the striatum reaching peak density of a lifetime in early adolescence associated with more novelty preference. There are low number of D1 and D2 dopamine receptors in the prefrontal cortex until young adulthood as compared to the striatum and nucleus accumbens where peak density of these receptors is found in adolescence.

Answer 8

midbrain

Question 9

Parents on average become concerned regarding the delayed or abnormal development of a child subsequently diagnosed with autism spectrum disorder at ___ months of age. Note that this is 19 months from average age of diagnosis, which occurs approximately at 3 years of age.

Answer 9

17

Question 10

One of the significant limitations of direct observation is that it only represents a small sample of the child’s developmental skills, and the clinician might ___ important but infrequent behaviors.

Answer 10

miss

Question 11

Self-___ is characterized by the ability to effectively manage one’s own thoughts, behaviors, and emotions, setting up practical goals and working towards achieving them, taking initiative, stress management, and incorporating discipline and motivating energies into life.

Answer 11

management

Question 12

Self-___ is characterized by the ability to understand one’s emotions and behaviors and linking them to personal growth by identifying self strengths and limitations.

Answer 12

awareness

Question 13

Bulimia nervosa is characterized by the presence of binge eating associated with recurrent use means to avoid gaining weight with the frequency of ___ a week for 3 months. The patient evaluates themselves based on their physical appearance. Cognitive-behavioral therapy is considered the first-line treatment choice for patients with bulimia nervosa as it is associated with a significant decrease in the behaviors of binge eating and compensatory behaviors. Fluoxetine is approved by the FDA for the treatment of bulimia nervosa.

Answer 13

once

Question 14

The diagnosis of premenstrual dysphoric disorder is considered provisional until confirmed by prospective daily ratings during at least how many symptomatic cycles?

Answer 14

Two

Question 15

For the patient suffering from encopresis, ___ periods of toilet sitting after a meal to capitalize on the gastrocolic reflex is encouraged rather than longer periods.

Answer 15

short

Question 16

If mothers have history of unresolved trauma/mental illness history their infants are at higher risk of developing behavior problems and disorganized behavior. Meta-analysis has demonstrated that brief, age-appropriate, carefully tailored, and individualized interventions using ___-aided interventions can improve sensitive responding and other attachment-related parental behaviors. The psychologist then uses these videos to sensitize patients to infant communications and increasing patient enjoyment with their children. There is also modest improvement in the behavior of the children. This program may also be used to improve feeding patterns in mothers with eating disorders.

Answer 16

video

Question 17

Supportive-expressive therapy is used to treat or prevent complicated ___ reactions in children.

Answer 17

grief

Question 18

Angelman syndrome is characterized by intellectual and developmental delay, sleep disturbance, seizures, jerky movements (especially hand-flapping), frequent laughter or smiling, and usually a happy demeanor. Angelman syndrome is caused by ___ genes on chromosome 15 being deleted or inactivated.

Answer 18

maternal

Question 19

Prader-Willi is a rare genetic disorder in which seven genes on chromosome 15 (q 11-13) are deleted or unexpressed on the ___ chromosome. Characteristics are low muscle tone, short stature, incomplete sexual development, cognitive disabilities, problem behaviors, and a chronic feeling of hunger that can lead to excessive eating and life-threatening obesity.

Answer 19

paternal

Question 20

Vomiting starting ___ chemotherapy points to the diagnosis of anticipatory nausea and vomiting (AVN). Benzodiazepines are the drugs of choice. It is a conditioned symptom and does not respond well to conventional antiemetics. Patients respond well to benzodiazepines as well as cognitive-behavioral therapy (CBT). Since cognitive-behavioral therapy will take time to show its effect and she needs to have her chemotherapy session on time, this patient will benefit from benzodiazepines.

Answer 20

before

Question 21

Decreased gray matter in bilateral ___-hippocampus complex and bilateral percuneus and slight increase in volume in middle-inferior frontal gyrus have been implicated in defective social communication found in autistic children.

Answer 21

amygdala

Question 22

To establish the diagnosis of panic disorder, at least one of the attacks must be followed by ___ month (or more) of persistent concern or worry about additional attacks and/or a maladaptive change in behavior related to the attacks.

Answer 22

1

Question 23

___ abnormalities are found in intermittent explosive disorder, particularly in the anterior cingulate and orbitofrontal complex.

Answer 23

Serotonergic

Question 24

Tuberous sclerosis is a genetic disease inherited as an autosomal dominant condition. If one parent has this abnormal gene, then there is a ___ chance of future children having the disease.

Answer 24

50%

Question 25

Type I error occurs when the null hypothesis (of no difference) is ___ when it should have been accepted, “false positive”. This means erroneously concluding that there is a difference between 2 groups when in fact there is no true difference between groups.

Answer 25

rejected

Question 26

Disinhibited social engagement disorder (DSED). DSED is an attachment disorder that is characterized by a pattern of behavior involving culturally inappropriate and excessively familiar behavior with relative strangers. Serious social neglect is one of the criteria required to establish the diagnosis of DSED. Conditions of social neglect are usually present during the first few months of life. There is no evidence that social neglect starting after the age of ___ years is associated with the manifestation of this disorder.

Answer 26

2

Question 27

Children’s attributions or explanations for actions and their results affect self-esteem enormously. “Mastery-oriented attributions” give credit for success to innate ability and explain failure by what is controllable (the need to study harder) or not fundamental (the test was especially tough). Children who attribute failure to a lack of ability may be working from “___ helplessness” and are at risk for “giving up.”

Answer 27

learned

Question 28

Goiter can be an anomaly of concern in the fetus exposed to lithium in the ___ trimester of pregnancy.

Answer 28

later

Question 29

At ~11yo, as opposed to preschool-age children, hallucinations are not likely to be transient or benign, and in the absence of trauma can ___ severe mental illness later in life.

Answer 29

predict

Question 30

At ___ month, the child should be able to lift the chin, have a tight grasp, follow to the midline, make sounds other than crying, and be startled by sounds.

Answer 30

one

Question 31

At ___ months of age, the child should be able to roll on the side, reach for the parent’s face, visually follow a person who is moving across the room, and vocalize when spoken to.

Answer 31

3

Question 32

At ___ months old child should be able to sit propped on hands, roll over, demonstrate beginning stranger anxiety (recognize familiar versus unfamiliar people), smile/vocalize to mirror and transfer objects from hand to hand.

Answer 32

6

Question 33

The child should be able to crawl with all 4 limbs, pull to a stand, use pincer grip, wave, and say mama/dada at ___ months. The child should also demonstrate more fully developed stranger anxiety at 9 months.

Answer 33

9

Question 34

The child walks, uses a mature fine pincer grasp, follows the one-step command with a gesture, imitates others, and says mama/dada discriminately at ___ months.

Answer 34

12

Question 35

The child creeps upstairs, scribbles, builds a two-block tower, and use 4-6 words at ___ months of age.

Answer 35

15

Question 36

Polymorphisms in contactin-associated protein-like 2-gene (CNTNAP2) have been detected in ___ mutism and in social anxiety symptoms and traits. There seems to be a strong heritability in selective mutism with parents or siblings exhibiting either selective mutism or social anxiety traits.

Answer 36

selective

Question 37

Dysfunctional ___-emotion processing found in disruptive mood dysregulation disorder has been attributed to a disturbed amygdala-prefrontal cortex circuitry.

Answer 37

face

Question 38

Bipolar disorder is characterized by alternating episodes of mania and depression. This switch has its own mechanism of action. Catecholaminergic disruption is associated with episodes of mania whereas cholinergic dysfunction is associated with episodes of ___.

Answer 38

depression

Question 39

Long alleles of the MAOA-uVNTR promoter polymorphism have been associated with ___disorder with agoraphobia.

Answer 39

panic

Question 40

Schizophrenia has been attributed to a disturbed cellular balance between excitation and inhibition. This disturbance has been associated with altered function of the ___ receptor.

Answer 40

NMDA

Question 41

The AACAP Practice Parameter for Disaster Preparedness emphasizes that psychological first aid includes children resuming classes and after-school activities as ___ as possible. The primary goals when creating a plan to effectively manage a crisis are to help the school resume a normal routine as quickly as possible and address the needs of students and staff beyond the immediate crisis period. Successful plans involve collaborations with organizations beyond the school, such as departments of health and mental health, law enforcement agencies, and other organizations skilled in crisis response.

Answer 41

soon

Question 42

___ is a known teratogen for the development of intellectual disability and autism spectrum disorder among persons with in utero exposure.

Answer 42

Valproic acid

Question 43

In a normal distribution curve, 68% of the individuals fall within one standard deviation from the mean. In a normal distribution curve, ___ of the individuals fall within two standard deviations from the mean. In a normal distribution curve, 99.7% of the individuals fall within three standard deviations from the mean.

Answer 43

95%

Question 44

to make the diagnosis, some symptoms must be present before the 12th birthday and include at least 6 features of hyperactivity and impulsivity or > 5 features of inattention ( may have 5 features if ___ years old).

Answer 44

17

Question 45

Stimulants have ___ been shown to be effective in ODD without comorbid ADHD.

Answer 45

not

Question 46

No precipitating factors, insidious onset, young onset, mood disorder symptoms (especially depressive disorders), negative symptoms are all ___ prognostic factors for schizophrenia.

Answer 46

poor

Question 47

Check fasting lipids at baseline and 3 months (12 weeks) then annually are the recommended guidelines for the monitoring of lipid concentrations in patients who are getting treated with antipsychotics other than olanzapine and clozapine. According to recommended guidelines, every patient who is being considered to be treated with clozapine and olanzapine should get a fasting lipid profile done at the baseline, then every 3 months for a ___, and then annually because these drugs are specifically notorious in causing hyperlipidemias.

Answer 47

year

Question 48

Stressful life events are often triggers for the onset of school refusal behavior.” The following events were shown associated with the onset of school refusal behavior: conflict at ___ (43%), conflict with peers (34%), academic difficulties (31%), move and/or change of school (25%), change in family composition (21%), and physical illness (20%).

Answer 48

home

Question 49

The incidence of enuresis among children in whom ___ parents were enuretic is found to be 77%. This contrasts with an incidence of enuresis of 44% among children with 1 enuretic parent, and 15% of children without an enuretic parent.

Answer 49

both

Question 50

___ is considered the core psychiatric intervention in the treatment of bulimia nervosa. Many patients additionally benefit from treatment with an SSRI. Fluoxetine has an FDA indication for the treatment of bulimia nervosa.

Answer 50

CBT

Question 51

At 4 months old, the expected gross motor milestones are rolling over from prone to ___ and lifting chest in prone.

Answer 51

supine

Question 52

According to the cognitive-developmental theory, children aged between 2-7 years undergoing the stage of pre-operations cannot deal with abstractions and concepts. Therefore, medical procedures, when explained verbally, usually do not make sense and can induce fear. Explaining the procedures with the use of ___-playing is an effective way of dealing with children at this stage, by imitating the procedures on dolls or bears with toy medical sets.

Answer 52

role

Question 53

___ was a 1979 Supreme Court case that overruled a lower court’s finding that barred the commitment of minors without a prior hearing. This case halted a trend that granted minors increasing constitutional protections. In its decision, the Court ruled that an adversarial hearing is not required for parents to commit a child to a mental-health facility. The Court found that professionals working in the separate units for minors within psychiatric hospitals screened admissions adequately, and reviewed their progress regularly.

Answer 53

Parham vs. J.R

Question 54

In re Winship is a case that found that it is the duty of the government to establish guilt ___ a reasonable doubt.

Answer 54

beyond

Question 55

In Kent vs U.S. the court found that juveniles are entitled to the same ___ as adults are.

Answer 55

due process

Question 56

___ refers to the conceptual framework that people use to reason the mental state of others and themselves. Intuitively, people understand that other’s actions are motivated by goals, desires, feelings, and thoughts, and these states can affect one another.

Answer 56

Theory of mind

Question 57

IDEA is comprised of 4 sections parts A-D. Part ___ is concerned with general provisions of the law.

Answer 57

A

Question 58

IDEA is comprised of 4 sections parts A-D. Part ___ is aimed at providing early interventional support to children with disabilities aged 3 years to 21 years.

Answer 58

B

Question 59

IDEA is comprised of 4 sections parts A-D. Part ___ is concerned with the provision of early intervention to infants and toddlers (from birth to 3 years of age).

Answer 59

C

Question 60

IDEA is comprised of 4 sections parts A-D. Part ___ is concerned with national support programs aimed at personnel development and the improvement of federal systems.

Answer 60

D

Question 61

In Prader Willi syndrome children usually present in infancy with feeding problems, hypotonia, low ___ weight, and later gain a lot of weight. An obese child with typical features (almond shaped eyes, thin upper lip, temper issues) is suggestive of Prader Willi syndrome. They have mild to moderate mental retardation, hypotonia, violent outbursts, and temper issues. It is a genetic disorder caused by a defect on the father’s long arm of chromosome 15.

Answer 61

birth

Question 62

Williams Syndrome is associated with deletions of genetic material located on the long arm of chromosome 7 (7q11.23). Children have typical elfins like facies with post-natal growth failure and hypercalcemia. The most common cardiac defect in these patients is supravalvular aortic ___. Familial cases have been reported and it is thought that, in these cases, the syndrome is inherited as an autosomal dominant trait.

Answer 62

stenosis

Question 63

Fragile X syndrome is caused by a ___ trinucleotide expansion of the FMR gene on the X chromosome. Fragile X syndrome 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

Answer 63

CGG

Question 64

According to DSM-5 criteria, narcolepsy is diagnosed if a patient has a history of hypersomnolence or irrepressible need for sleep 3x per week over the last 3 months along with at least one of the following: cataplexy (a brief loss of muscle tone), ___ rapid eye movement (REM) latency, and low cerebrospinal fluid levels of hypocretin-1. There can be associated hypnagogic or hypnopompic hallucinations.

Answer 64

shortened

Question 65

“Behavioral interventions usually begin with a ___, which involves specifying behaviors (positive behaviors to increase or negative behaviors to decrease) and then identifying each behavior’s antecedents (variables setting the stage for or preceding the behavior) and consequences (variables maintaining the behavior).”

Answer 65

functional behavior analysis

Question 66

According to the DSM- 5 intimidation of others, physical cruelty towards others, and aggression toward people or animals qualifies as criteria for conduct disorder. DSM-5 conduct disorder criteria do ___ comment on the absence or presence of remorse as a criterion.

Answer 66

NOT

Question 67

Parent management training (PMT) is a widely-used model of intervention that incorporates many of the above-mentioned components. This model is based on ___ coercive model of parent/child interactions. The goal of PMT is to alter the interaction pattern between the child and parent, such that “prosocial rather than coercive behavior is directly reinforced and supported within the family.” Specific parent behaviors that are shaped in sessions over time include the following: (1) establishing clear rules for the child to follow; (2) providing positive reinforcement for appropriate behavior; (3) implementing mild punishments to deter inappropriate behavior; and (4) negotiating compromises. These skills are shaped in treatment sessions through practice, feedback, role-plays, and review of in-home implementation with parents on a regular basis. Intervention also sometimes includes coordination with teachers and other service providers.

Answer 67

Patterson’s

Question 68

Behavioral treatments for children with autism spectrum disorders have had very good empirical support for ___ in IQ and Less restrictive interventions/mainstream placements.

Answer 68

improvement

Question 69

ABA techniques include prompting, fading, shaping, task analysis, and backwards chaining.

___ is providing the child with a clear command about what behavior is expected. For example, stating, “What is it?” in reference to a toy to practice language.

Answer 69

Prompting

Question 70

ABA techniques include prompting, fading, shaping, task analysis, and backwards chaining.

___ is making prompts less explicit over time, such that the child more independently engages in a behavior. For example, moving from verbally prompting the child to speak to waiting for the child to initiate language independently.

Answer 70

Fading

Question 71

ABA techniques include prompting, fading, shaping, task analysis, and backwards chaining.

___ is providing reinforcement for successive approximations of a target behavior, rather than initially expecting the child to perform the behavior perfectly. For example, providing reinforcement for saying, “ba” in reference to a ball and reinforcing better approximations of the word over time until the child can say “ball.”

Answer 71

Shaping

Question 72

ABA techniques include prompting, fading, shaping, task analysis, and backwards chaining.

___ is breaking a complex task down into its simpler parts and reinforcing the child for correctly performing each step individually. For example, teaching getting dressed by reinforcing the child after each step (e.g., after putting on a shirt, after putting on pants, etc.).

Answer 72

Task analysis

Question 73

ABA techniques include prompting, fading, shaping, task analysis, and backwards chaining.

___ is teaching a complex behavior by starting with reinforcement for correct performance of the last step and working successively backwards to the beginning until the child is being reinforced for performing the whole behavior. For example, teaching putting on your coat first reinforcing the child for zipping the coat (the final step in the process) while helping the preceding steps, then requiring the child to pull the coat onto his shoulders, then requiring him to put his arms in the sleeves, then requiring him to complete the sequence from the beginning without help.

Answer 73

Backwards chaining

Question 74

___-based (CB) intervention with parent training and support program has the best parental outcomes for parents of children with autism spectrum disorder.

Answer 74

Center

Question 75

Discrete trial training (DTT) and ___ response training (PRT) are two interventions included in ABA.

In adult-based behavioral interventions, application of ABA treatment to autism spectrum disorder focuses on developing attention to task and specific skill acquisition using discrete trial training (DTT).

The goal of the ___ response training (PRT) is to teach certain “pivotal” skills such as responsiveness to multiple cues, motivation, self-management, and self-initiations applicable across a wide variety of contexts with naturally occurring consequences.

Answer 75

pivotal

Question 76

In cases of a confirmed medical error, the first step is not to discuss with pharmacy staff/nursing/etc but to ___ the error to pt/family with an apology because the physician is ethically obligated according to the principle of veracity, to be honest, and truthful to their patients. It is preferable to disclose the error in a timely manner regardless of whether harm has occurred or not.

Answer 76

disclose

Question 77

The Ventral tegmental area (VTA) is the origin of the ___ cell bodies that comprise the mesocorticolimbic dopamine system, which is widely implicated in the drug and natural reward circuitry of the brain, cognition, motivation, drug addiction, and several psychiatric disorders. The VTA contains neurons that project to numerous areas of the brain, from the prefrontal cortex to the caudal brainstem and everywhere in between.

Answer 77

dopaminergic

Question 78

The raphe nuclei are a major source of ___.

Answer 78

serotonin

Question 79

the locust coeruleus is a major source of ___.

Answer 79

norepinephrine

Question 80

In terms of the first step on initial concern in ED of child abuse by parents, it is recommended to ___ the child from parents to ensure the safety of the child before further action could be taken. Next recommended step is to contact social services. Failure to do so is criminal offense. It is then their responsibility to prove or disprove the suspicion of child maltreatment and make arrangements for childcare if suspicion is verified. Physicians should call the police only if child protective service is not available. If a child does not have injuries that require hospitalization, YET, depending on the local child protective services set up, a social services admit to hospital may be provided to keep child safe.

Answer 80

separate

Question 81

Imagery ___ therapy is a treatment for nightmares in children and adolescents. The child is encouraged to modify and rehearse the content of distressing nightmares using mental imagery.

Answer 81

rehearsal

Question 82

Disinhibited social engagement disorder is an attachment disorder that is characterized by a pattern of behavior involving culturally inappropriate and excessively familiar behavior with relative strangers. DSED has been described from the age of 2 years through adolescence. There are a few differences in the manifestations of this disorder from early childhood through adolescence. In adolescents with this disorder, indiscriminate behavior extends to peers. In comparison to healthy adolescents, adolescents with DSED have more peer conflicts and more ___ peer relationships. Young children with this disorder do not show reticence when approaching or interacting with adults. Verbal and social intrusiveness seem most prominent in preschool children with this condition. Overfamiliarity and inauthentic expression of emotion continues through middle childhood. The adult manifestations of this disorder are not known.

Answer 82

superficial

Question 83

Neither relaxation techniques nor psychodynamic therapies have been helpful for childhood onset fluency disorder (stuttering). The majority of current treatments view stuttering as a learned ___ and work directly with the speech difficulty to minimize issues that reinforce it, decrease the severity by reinforcing normal speech, and encourage stutters to speak easily and effortlessly even when symptomatic. Cognitive-behavioral therapy is an example, and another is the parent-driven Lidcombe Program for 3 to 6-year-old children.

Answer 83

behavior

Question 84

SPECT is less expensive than PET scan as it uses isotopes that are much more readily available and have a long-half life that do not require repeated administration. ___-photon emission computed tomography (SPECT) has poor spatial resolution as compared to positron emission tomography (PET). SPECT shows poor contrast images as compared to PET scan images. SPECT uses radioactive isotopes with longer half-lives like technetium-99m as compared to PET that uses short half-lives like fluorine-18. SPECT is nuclear imaging modality that provides metabolic and functional information using a radioisotope tracer similar to PET.

Answer 84

Single

Question 85

There are five categories of play that can be observed in preschool children. ___ play is when children share and swap toys with each other, but each is mainly focused on his or her own play. They do not work towards a shared goal.

On the other hand, nonsocial activity is when children engage in their own solitary play or simply watch others play. Onlooker play is when children linger around other children and watch them play, but they do not try to join in. Parallel play is when children, though they play side by side, interact very little and do not try to influence the other children’s behavior. Lastly, in cooperative play, children collaborate to achieve shared goals.

Answer 85

Associative

Question 86

___ is a rare X-linked recessive metabolic disorder characterized by intellectual disability, early hypotonia and poor muscle control, dystonic movements, compulsive self-injurious behavior with extended aggression towards others, and uric acid overproduction. It results from a mutation in the gene encoding the enzyme hypoxanthine-guanine phosphoribosyltransferase, HGPRT.

Answer 86

Lesch Nyhan syndrome

Question 87

Phenylketonuria is incorrect because it is an autosomal ___ inborn error of metabolism which is characterized by extremely fair skin, lighter hairs, and body fluids with a musty smell. The disorder is usually screened at birth and can be prevented by a restricting diet rich in phenylalanine. If untreated, the disorder may lead to seizures, intellectual disability, and behavioral issues. Evidence of Phenylketonuria usually begins around the age of 6 months with jerky movements of the limbs.

Answer 87

recessive

Question 88

Cornelia de Lange syndrome is incorrect because it is characterized by multiple physical and mental issues. The patient has characteristic facial features with ___ eyebrows, small nose, and smooth philtrum. Often, there is microcephaly. There is pre and post-natal growth restriction, feeding problems in infancy, along with several other medical conditions.

Answer 88

bushy

Question 89

The estimates of prevalence of transient or recurrent motor tics vary widely but may be as high as 6% in boys and 3% in girls, tending to have the highest prevalence and greatest severity towards the end of the first decade of life and early in the second decade, decreasing around the time of ___. Tourette’s is much less prevalent, with estimates of 10 to 100 per 10,000 (which equals 0.1% to 1%), dropping to 4.5 per 10,000 for older teenagers and adults.

Answer 89

puberty

Question 90

___ treats both daytime sleepiness AND cataplexy in narcolepsy. Narcolepsy is a sleep disorder characterized by hypersomnolence, cataplexy, sleep paralysis, and hypnagogic hallucinations. Cataplexy is the sudden loss of tone and presents as weakness and ataxia. When the face is involved, the speech becomes slurred. These attacks are brief, lasting about 1-2 minutes, and are usually triggered by intense emotions, such as laughter, fear, anger, surprise, or excitement.

Answer 90

Sodium oxybate

Question 91

In the case of cognitive disruption in multiple cognitive spheres, a series (i.e., a battery) of tests is indicated. One common battery used is the Halstead-Reitan Neuropsychological Battery. The Luria-Nebraska is another commonly used one. These batteries not only identify ___ of cognitive dysfunction but can help localize the areas of brain dysfunction.

Answer 91

areas

Question 92

The Kaufman Assessment Battery is an assessment of cognitive ___ that is frequently used to assess the abilities of children who are not performing well at school.

Answer 92

abilities

Question 93

The Thematic Apperception Test is useful to identify psychological ___, such as fear of loss, poor self-esteem, or depression as well as psychotic thinking.

Answer 93

themes

Question 94

The Child Behavior Checklist is a ___-report questionnaire on which the child is rated on various behavioral and emotional problems.

Answer 94

parent

Question 95

The Wide Range Achievement Test is a brief achievement test measuring reading recognition, spelling, and ___ computation.

Answer 95

arithmetic

Question 96

The K-Complex is a waveform identified on electroencephalography (EEG), which primarily occurs during Stage ___ of NREM sleep, along with sleep spindles, which make up the two distinct features seen in this stage.

Answer 96

2 (N2)

Question 97

It is appropriate to understand the parent’s concerns ___ a physician can provide guidance. Even when a child’s behavior is normal for the age group, the physician should thoroughly address the parent’s concern first.

Answer 97

before

Question 98

The aversive behavioral conditioning of applying a bitter or sour liquid such as lemon juice to the ___ whenever rumination occurs seems to be an effective therapy.

Answer 98

tongue

Question 99

Often, a question about dying is as much a question about whether pain will be manageable or whether there will be abandonment by family and caregivers. Such concerns should be ___ and reassurance given. While it is important to avoid false reassurances, a sense of hope should be maintained. The child’s own perceptions of the seriousness of their condition should be validated, consistent with their developmental level and capacity for understanding.

Answer 99

explored

Question 100

___ is a highly comorbid disorder. In order of frequency in the USA, the comorbidities are ADHD, OCD, and major depressive disorder.

Answer 100

Tourette’s syndrome