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Old Peds > Lecture 10/10 > Flashcards

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
Q

DDx for bipolar

A

physical or sexual abuse
domestic violence
organic disorders

26
Q

Treatment for bipolar

A

Lithium

27
Q

What is the only agent approved by FDA for depression/ suicidal ideation

A

fluoxetine (prozac)

28
Q

most commonly used method for suicide

A

firearms

29
Q

what are suicides most commonly associated with?

A

Mood disorders

high achievers anxious about a failure

30
Q

who has the highest risk of suicide?

A

white adolescent males

31
Q

When is the onset of schizophrenia?

A

middle teens- early 30s

more common in boys, high family risk

32
Q

What should you do is a child is exhibiting psychotic symptoms.

A

medical evaluation for neurologic disease (MRI, EEG), metabolic disease, wilsons disease

33
Q

Who is OCD most common in?

A

boys in children

girls in adolescence

34
Q

In adolescence what can schizophrenia be confused with?

A

Mania

35
Q

How do you treat schizophrenia?

A

antipsychotics

36
Q

what has a lot of overlap with ADHD?

A

conduct disorders

37
Q

Presents with truancy, aggression, defiance, fighting, theft, sexual perpetration, substance abuse.
Commonly a boy in a bad home

A

Conduct disorders

38
Q

How do you treat OCD?

A

CBT

SSRI

39
Q

What infection is commonly associated w/ OCD?

A

Group A Streptococcal infection

40
Q

Must do this to relieve a feeling of anxiety

A

Compulsions

41
Q

what is PANDA?

A 
pediatric 
autoimmune
neuropsychiatric
disorder
associated w/ strep
42
Q

How do you treat general anxiety disorder?

A

CBT

SSRI

43
Q

These are an example of what : Handwashing, ordering, checking, counting, repeating words silently, hoarding?

A

Compulsions

44
Q

A child experiencing this probably has what : Fear, anxiety, hypervigilance. May regress developmentally. Nightmares

A

PTSD

45
Q

How do you treat PTSD?

A

individual and family psychotherapy

drugs (don’t need to know specifics)

46
Q

Many people with GAD have what qualities

A

perfectionist

overly concerned w/ approval of others

47
Q

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

A

Somatoform disorders

48
Q

Who are somatoform disorders common in?

A

Girls
lower socioeconomic status
hx of sexual trauma, physical threats

49
Q

phobias often occur along with what?

A

anxiety disorders

50
Q

treatment for somatoform disorders

A

CBT

some also with SSRI

51
Q

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.

A

Autism

52
Q

What are some hallmarks of Autism spectrum disorders?

A

Impaired communication
impaired social interaction
stereotypic behavior, interests, activities
MR is common

53
Q

tx for autism

A 
Occupational therapy
Sensory integration services
Behavioral therapy ( self care, linguistics)
54
Q

treatment for non autistic pervasive development disorder

A

cognitive-behavioral approach

55
Q

impairment in social interaction and restricted interest/repetitive behaviors
Not delayed in cognitive, language or self help

A

Asperger

56
Q

Impairment in reciprocal social interaction
Impairment in communication skills
Restricted interests and repetitive behaviors
(don’t meet full criteria for autism – mild sx)

A

PPD-NOS

57
Q

Genetic, due to mutation on X chrom
Almost exclusively girls
Regression in skills in the first year of life
Characteristic handwringing

A

Rett Syndrome

58
Q

tests for mental retardation

A

Bayley for young kids

Wechsler intelligence for older (and stanford binnet)

59
Q

3 major characteristics of ADHD

A

impulsivity
hyperactivity
inattention

60
Q

3 subtypes of ADHD

A

Hyperactive Impulsive : 10% . Can pay attention
Inattentive :30-40% (old ADD term)
Combined : 50-60%

61
Q

What is a scale for ADHD?

A

Vanderbilt Assessment Scales for AD/HD

62
Q

What is a main finding with the cortex of a child with ADHD?

A

same overall pattern of brain development, but everything tends to be delayed (especially frontal cortex)

Old Peds (15 decks)

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