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Lecture 10/10 Flashcards

1
Q

Pseudoseizures are most common in what condition

A

Conversion rxn

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2
Q

What is the most common depressive mood disorder in children

A

Adjustment disorder

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3
Q

mainstay treatment in ADHD

A

Stimulants

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4
Q

where are most of peds with mental illness managed?

A

PCP

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5
Q

__ percentage of peds office visits involve behaviors, psychoscoial or educational concerns

A

50%

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6
Q

Do PCPs identify most kids with emotional/ behavioral problems?

A

No, <20% are identified

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7
Q

When are Ages and Stages Socio-emotional surveys done?

A

Infants and young children

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8
Q

What does a child have if they present with

Loss of interest, feelings of worthlessness, decreased energy, crying spells, irritability, isolation, low self esteem.

A

Depression

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9
Q

What does P.S.Y.C.H stand for?

A

Parent Child interactions
School – academically, behaviorally, socially
Youth – peers, friendships, relationships
Casa – things at home..siblings..stress
Happiness – how would you describe your mood? Your childs mood?

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10
Q

Common comorbidities with depression

A

ADHD, conduct disorders, anxiety, substance abuse,

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11
Q

DDx for depression

A

Hypothyroid
Substance abuse
Eating disorder
2ndary to medical illness

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12
Q

tx for depression

A

CBT- cognitive behavioral therapy
referral to psychotherapy
SSRI (black box warning- suicide)

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13
Q

What are some hallmark symptoms of depression in kids

A

Irritability/ lashing outs
apathy
persistent sadness

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14
Q

Why may kids present with somatic symptoms due to depression?

A

Inability to tolerate sadness

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15
Q 
Disorder with
decreased interesting or participation
feelings of inadequacy, low self esteem
social withdrawl
irritability
decrease in sleep/ appetitie
Less severe than those of a major depressive disorder but are more persistent, lasting for at least 1 year.
A

Dysthymic Disorder

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16
Q

Symptoms of major depressive disorder in infants

A

Failure to thrive, speech and motor delays
Poor attachment
Repetitive self-soothing behaviors
Loss of previously learned skills

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17
Q

Middle childhood presentation of this disorder
Persistently irritable mood, aggressive and uncontrollable outbursts, extreme fluctuations in mood, reckless behavior, inappropriate sexual behavior.

A

Bipolar disorder

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18
Q

the most common depressive mood disorder in children and adolescents. Symptoms start within 3 months of an identifiable stressor, usually lasts less than 6 months

A

Adjustment disorder with depressed mood

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19
Q

In adolescence.
Agitated behaviors, pressured speech, racing throughs. Reckless behavior, illicit activities, psychotic symptoms (hallucinations, delusions, irrational thought)

A

Bipolar

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20
Q

Is bipolar a true diagnosis in someone younger than puberty?

A

Usually not

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21
Q

When does depression become more common in girls?

A

During and after puberty

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22
Q

What is a scale for pediatric depression

A

Beck

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23
Q

Complications with depression

A

suicide ,
school performance,
loss of friends,
family tension

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24
Q

type of bipolar with a little less mania

A

Bipolar II

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25
DDx for bipolar
physical or sexual abuse domestic violence organic disorders
26
Treatment for bipolar
Lithium
27
What is the only agent approved by FDA for depression/ suicidal ideation
fluoxetine (prozac)
28
most commonly used method for suicide
firearms
29
what are suicides most commonly associated with?
Mood disorders | high achievers anxious about a failure
30
who has the highest risk of suicide?
white adolescent males
31
When is the onset of schizophrenia?
middle teens- early 30s | more common in boys, high family risk
32
What should you do is a child is exhibiting psychotic symptoms.
medical evaluation for neurologic disease (MRI, EEG), metabolic disease, wilsons disease
33
Who is OCD most common in?
boys in children | girls in adolescence
34
In adolescence what can schizophrenia be confused with?
Mania
35
How do you treat schizophrenia?
antipsychotics
36
what has a lot of overlap with ADHD?
conduct disorders
37
Presents with truancy, aggression, defiance, fighting, theft, sexual perpetration, substance abuse. Commonly a boy in a bad home
Conduct disorders
38
How do you treat OCD?
CBT | SSRI
39
What infection is commonly associated w/ OCD?
Group A Streptococcal infection
40
Must do this to relieve a feeling of anxiety
Compulsions
41
what is PANDA?
``` pediatric autoimmune neuropsychiatric disorder associated w/ strep ```
42
How do you treat general anxiety disorder?
CBT | SSRI
43
These are an example of what : Handwashing, ordering, checking, counting, repeating words silently, hoarding?
Compulsions
44
A child experiencing this probably has what : Fear, anxiety, hypervigilance. May regress developmentally. Nightmares
PTSD
45
How do you treat PTSD?
individual and family psychotherapy | drugs (don't need to know specifics)
46
Many people with GAD have what qualities
perfectionist | overly concerned w/ approval of others
47
disorders involve a complaint of physical symptoms (pain or loss of function) that suggest a medical condition but are not fully explained by either a medical condition, a pharmacologic effect, or another psychiatric condition 
Somatoform disorders
48
Who are somatoform disorders common in?
Girls lower socioeconomic status hx of sexual trauma, physical threats
49
phobias often occur along with what?
anxiety disorders
50
treatment for somatoform disorders
CBT | some also with SSRI
51
A neurodegenerative disorder Age of onset: typically between ages 2 and 4 (can be recognized in first 12-18mo) Consistent failure to orient to one’s name, regard people directly, use gestures, and develop speech.
Autism
52
What are some hallmarks of Autism spectrum disorders?
Impaired communication impaired social interaction stereotypic behavior, interests, activities MR is common
53
tx for autism
``` Occupational therapy Sensory integration services Behavioral therapy ( self care, linguistics) ```
54
treatment for non autistic pervasive development disorder
cognitive-behavioral approach
55
impairment in social interaction and restricted interest/repetitive behaviors Not delayed in cognitive, language or self help
Asperger
56
Impairment in reciprocal social interaction Impairment in communication skills Restricted interests and repetitive behaviors (don’t meet full criteria for autism – mild sx)
PPD-NOS
57
Genetic, due to mutation on X chrom Almost exclusively girls Regression in skills in the first year of life Characteristic handwringing
Rett Syndrome
58
tests for mental retardation
Bayley for young kids | Wechsler intelligence for older (and stanford binnet)
59
3 major characteristics of ADHD
impulsivity hyperactivity inattention
60
3 subtypes of ADHD
Hyperactive Impulsive : 10% . Can pay attention Inattentive :30-40% (old ADD term) Combined : 50-60%
61
What is a scale for ADHD?
Vanderbilt Assessment Scales for AD/HD
62
What is a main finding with the cortex of a child with ADHD?
same overall pattern of brain development, but everything tends to be delayed (especially frontal cortex)

Old Peds (15 decks)

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