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Peds Exam 2 > Lecture 1: Behavioral Medicine > Flashcards

Lecture 1: Behavioral Medicine Flashcards

1
Q

What is the Wessel’s Rule of Three’s for Dxing colic?

A

Crying 3+ hrs a day for 3+ days a week for more than 3 weeks

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2
Q

Paroxysmal, facial grimacing, drawing up of the legs, peaks around 6 wks

A

colic crying

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3
Q

What are the 5 S’s Tx for? What do the 5 S’s stand for?

Note: colic crying is benign condition that is self limiting

A

Tx for Colic

  1. Swaddle
  2. Shush
  3. Swing
  4. Suck
  5. Side/stomach position
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4
Q

what is the MC reported behavioral problem in 2-3 year olds

A

Temper tantrums

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5
Q

What is the typical frequency of temper tantrums, how long do they last and how does that change with age?

A

typically have 1 per week that lasts 2-3 min

duration increases with age

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6
Q

What can parents do to help prevent temper tantrums?

A

prevent hunger, fatigue, loneliness and hyperstimulation, provide reinforcement for good behaviors, remove stress

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7
Q

What is a breath holding spell

Note: temporary phase, most resolve by age 7-8

A

Brief pd when child stops breathing involuntarily

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8
Q

What are breath holding spells often triggered by

can be related to?

What is common result

A

trigger = Emotional upset

+/- related to anemia

result = LOC

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9
Q

What are the 2 types of Breath holding spells

A
  1. Cyanotic

2. Pallod

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10
Q

Main characteristic of Cyanotic Breath holding spells

A

Arched back and stretched out legs

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11
Q

How do Pallod breath holding spells occur

A

child gets startled –> suddenly stops breathing

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12
Q

Although no testing/Dx usu needed for breath holding spells when is EEG and rescue breathing indicated?

A

seizure or not breathing > 2 min

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13
Q

Why is LOC important in breath holding spells

A

resets body to start breathing normally again

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14
Q

Definition of parosomnia

3 Examples

A

ANY abn/usual behavior during sleep

  1. night terrors
  2. nightmares
  3. sleepwalking
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15
Q

Night terrors vs nightmares which:

  1. kids cannot be awakened fully?
  2. kids become oriented quickly?
  3. a/w amnesia of episode
  4. occurs in 2nd half of night
  5. Tx: wake kids just prior to episode to reset sleep cycle
A
  1. kids cannot be awakened fully?
    - night terrors
  2. kids become oriented quickly?
    - nightmares
  3. a/w amnesia of episode
    - night terrors
  4. occurs in 2nd half of night
    - nightmares
  5. Tx: wake kids just prior to episode
    - night terrors
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16
Q

what is diff b/t screening and surveillance

When do developmental screening (3 times)

A

screening = part of surveillance but it is FORMAL TESTING

9, 18, 30 months

17
Q

5 domains of developmental milestones

A
  1. Language (expressive, receptive)
  2. Motor (fine, gross)
  3. Cognitive
  4. Social
  5. Play
18
Q

What type of delay occurs when delay in ONLY 1 area? 3+ areas?

what domain is MC

A

1 area = Isolated dev delay
3+ areas = global

MC domain = speech/language

19
Q

What does atypical delay mean?

What dz is this type of delay a/w?

A

asynchronous or delay out of order

a/w ASD

20
Q

What is splintering

what 2 areas are kids w/ASD deficit in

A

discrepancy of skills

  1. Social communication < other developmental skills
  2. Joint attention
21
Q

When is normal joint attention developed?

A

15-18 months

22
Q

2 main components of DSM-5 criteria for ASD

A
  1. Persistent deficits in social communication & interaction
  2. Restricted, repetitive, sterotyped behavior, interests ad activities
23
Q

Screening for ASD:

  • what ages does specific screening begin at?
  • when refer?
  • score of 1 & child is < 18 mo, what give?
A
  • ASD specific screening b/t 18-24 months
  • refer when score > 2
  • score of 1 & child is < 18 mo –> ASD specific screening tool
24
Q

Screening for ASD:

  • what ages does specific screening begin at?
  • when refer?
  • score of 1 & child is < 18 mo, what give?
A
  • ASD specific screening b/t 18-24 months
  • refer when score > 2
  • score of 1 & child is < 18 mo –> ASD specific screening tool
25
Q

What is an effective non-medical approach for ASD?

what is tx commonly assoc w/?

A

ABA - Applied Behavioral analysis

assoc w/gains in IQ

26
Q

What 4 things indicate an Atypical Variation

A
  1. delays in meeting milestones
  2. not age approp
    - jargon after age 2
  3. not transient
    - stuttering, echolia
  4. intense/odd
    - topic preservation, parody
27
Q

What 4 things indicate an Atypical Variation in development

A
  1. delays in meeting milestones
  2. not age approp
    - jargon after age 2
  3. not transient
    - stuttering, echolia
  4. intense/odd
    - topic preservation, parody
28
Q

3 types of validated ADHD instruments

A
  1. Conners
  2. ADHD Rating Scale 1
  3. NICHQ Vanderbilt Assessment
29
Q

DSM-5 Criteria for ADHD what two categories must you have 6+ of following manifested often

A
  1. Inattention

2. Hyperactivity/Impulsivity

30
Q

What are the 3 ADHD subtypes?

What is MC?
which one Dx earlier?

A
  1. Inattentive type
  2. Hyper/impulsive type = dx earlier
  3. combined type = MC
31
Q

What does the definition of ADHD include (4 main components)

A
  1. 6+ for inattention and/or hyperactivity/impulsivity
  2. Inapprop for age
  3. Several Sxs before age 12
  4. More than 1 setting
32
Q

When should you start w/behavioral therapy for ADHD

why not give stimulant meds?

A

Preschool age

- stimulant meds affect growth

33
Q

What are the 2 approved stimulant meds for ADHD?

A
  1. Methylphenidate

2. Dexmethylphenidate

34
Q

What are the 2 approved non-stimulant med types for ADHD?

A
  1. Atomoxetine
  2. Long acting alpha agonist
    (Guanfacine, Clonidine)
35
Q

How long Tx ADHD for? then what?

A

2 yrs then take off meds and re-evaluate for need

Peds Exam 2 (9 decks)

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