Intellectual Disabilities: Basic Sciences, Clinical Features & Management

Question 1

females with a LD have 18 year lower life expectancy than general population - true or false?

Answer 1

true

Question 2

males with LD have 14 year lower life expectancy than general population - true or false?

Answer 2

true

Question 3

PWLD are more likely to have what mental conditions?

Answer 3

epilepsy
severe mental illness
dementia

Question 4

PWLD are more likely to have what physical conditions?

Answer 4

hypothyroidism 
diabetes 
heart failure 
CKD
stroke

Question 5

what is the definition of LD?

Answer 5

condition of arrested or incomplete development of the mind, which is especially characterised by impairment of skills, manifested during the developmental period, which contribute to the overall level of intelligence, i.e. cognitive, language, motor, and social abilities

Question 6

what is the criteria to be diagnosed with LD?

Answer 6

IQ < 70

developmental aetiology (<18 years)

deficits in adaptive functioning

Question 7

what scale is most commonly used to assess adults with LD?

Answer 7

wechsler adult intelligence scale (WAIS)
or
wechsler preschool & primary scale of intelligence (WPPSI)

Question 8

what scale is most commonly used to assess children with LD?

Answer 8

wechsler intelligence scale for children (WISC)

Question 9

what is the IQ for:

a) mild LD?
b) moderate LD?
c) severe LD?
d) profound LD?
e) borderline LD?

Answer 9

a) 50-69
b) 35-49
c) 20-34
d) <20
e) 70+

Question 10

what are symptoms of mild LD?

Answer 10

mental age 9 to under 12 years
most Common
delayed speech - able to use everyday speech
full independence – self care, practical & domestic skills difficulties in reading and writing
capable of unskilled or semi-skilled work
problems of social or emotional immaturity
rarely organic aetiology

Question 11

what are symptoms of moderate LD?

Answer 11

mental age 6 to under 9 years. slow with comprehension and language
limited achievements
delayed self care and motor skills
simple practical tasks - often with supervision
usually fully mobile - physically active
discrepant profiles
majority organic aetiology
epilepsy & physical disability common

Question 12

what are symptoms of severe LD?

Answer 12

mental age 3 to under 6 years.
generally more marked impairment than in moderate LD and achievements more restricted
epilepsy

Question 13

what are symptoms of profound LD?

Answer 13

mental age less than 3 years.
severe limitation in ability to understand or comply with requests or instructions
little or no self-care.
often severe mobility restriction.
basic or simple tasks may be acquired.

Question 14

what chromosomal abnormalities can cause LD?

Answer 14

cri du chat 5P
angelman 15Q
prader-willi 15Q
velo-cardiofacial syndrome 22Q
williams syndrome 7Q
downs syndrome trisomy 21
patau syndrome tisomy 13
edwards syndrome trisomy 18

Question 15

what sex chromosome abnormalities can cause LD?

Answer 15

trisomy 45X (LD rare)
trisomy X 47XXX
klinefelter 47XXY
fragile X (faulty FMR1 gene)

Question 16

what can be genetic causes of LD?

Answer 16

defects of protein (phenylketonuria), carbohydrate (mucopolysaccharides) and lipid metabolism (neurolipidoses)

also tuberous sclerosis, congenital hypothyroidism and lesch nyhan syndrome (x linked)

Question 17

what maternal infections can cause LD?

Answer 17

rubella
CMV
toxoplasmosis

Question 18

what other prenatal factors can cause LD?

Answer 18

exposure to medication or drugs
alcohol (FASD)
poor diet
substance abuse

Question 19

what perinatal factors can cause LD?

Answer 19

neonatal septicaemia 
pneumonia 
meningitis / encephalitis 
birth injury 
newborn complications

Question 20

what postnatal factors can cause LD?

Answer 20

CNS infections, vascular incidents, brain injury, NAI, toxins
congenital hypothyroidism
cerebral palsies, epilepsy, ASD

Question 21

what does the o’brien principles state?

Answer 21

people with LD will continue to grow and develop given an appropriate environment

Question 22

what makes psychiatric diseases more difficult to treat in those with LD?

Answer 22

treatment resistance
susceptibility to side effects
epilepsy

Question 23

what is significant about schizophrenia in LD?

Answer 23

3x more common, earlier onset

main symptom may be behaviour change

Question 24

what are symptoms of schizophrenia in severe LD?

Answer 24

unexplained aggression
bizarre behaviour 
social withdrawal 
mood liability 
increased mannerisms or stereotypies