Module 19 behavior/mental health childhood disorders Flashcards

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1
Q

risk factors for anxiety

A

genetics
temperamental disposition for behavioral inhibition and/or shyness
social environment or life circumstances

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2
Q

Clinical findings of GAD

A
  • worry about future events
  • preoccupation with past behavior
  • poor-quality sleep and unexplained fatigue
  • irritability and tantrums in young
  • over concern about competence and marked preoccupation with performance
  • self-consciousness, unusual need for reassurance
  • restless, difficulty concentrating
  • somatic complaints without physical basis
  • comorbidity: other anxiety, ADHD, mood disorder
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3
Q

PTSD screen TRAUMA

A

T: trauma: known traumatic experience
R: re-experience: flashbacks, nightmares
A: avoidance, avoids stimuli
U: unable to function
M: month or longer
A: arousal: hypervigilant, sleep disturbances, concentration difficulties, exaggerated startle

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4
Q

depression common findings

A
mood: sad, blue, down, angry, bored
loss of interest in usual activities
change in appetite or wt
insomnia or hypersomnia
low energy and fatigue
difficulty concentrating, indecision
feelings of worthlessness
inappropriate or excessive guilt
recurrent thoughts of death or SI
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5
Q

Warning signs for suicide change in behavior

A
accident prone or risk taking
drug/ETOH
physical violence
loss of appetite
sudden alienation
worsening performance at work or school
putting personal affairs in order
loss of interest in personal appearance
disposal of possessions
writing notes/letter/poems with suicidal content
buying a gun or weapon
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6
Q

warning signs for suicide changes in mood

A
expression of hopelessness or impending doom
explosive rage
dramatic swings in affect
crying spells
sleep disorders
talking about suicide
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7
Q

warning signs for suicide changes in thinking

A
preoccupation with death
difficulty concentrating
irrational speech
hearing voices, seeing visions
sudden interest, or loss of interest, in religion
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8
Q

warning signs for suicide major life changes

A
death of a family member or friend
separation or divorce
public humiliation or failure
serious illness or trauma
loss of financial security
recent relationship loss
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9
Q

dyslexia

A

difficulties with word recognition, decoding, and spelling
difficulties in writing
- spelling, punctuation, grammar, organization, clarity of written expression

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10
Q

dysgraphia

A

difficulty with handwriting

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11
Q

dyscalculia

A

difficulties with learning math facts and performing calculations

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12
Q

eating disorder with highest mortality rate

A

anorexia

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13
Q

risk factors for developing eating disorder

A
athletes
- especially those who compete in sports that are based on wt 
middle to high socioeconomic status
divorced families
chronic disease
recent wt loss in a previously obese person
personality disorders
strong will
hx of child abuse
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14
Q

Dx criteria for anorexia

A
  • refusal to maintain body weight at least 85% expected for age and ht, or failure to gain wt during growth periods
  • intense fear of wt gain or being fat
  • body dysmorphism
  • binge eating/purging subtype
    • assoc. with purging though binging is rare
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15
Q

Dx criteria for bulimia

A
  • consuming large quantities of food in a short period of time (2 hours)
  • loss of control during binge episodes
  • engaging in repeated behaviors to lose wt, including purging, excessive exercise, fasting
  • bingeing or purging behaviors that occur at least once a week x 3months
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16
Q

wt and eating disorders

A

anorexia: underwt
bulimia: average wt or overwt

17
Q

SCOFF

A

screening to detect red flags regarding wt

  • S: do you make yourself SICK because you feel so full
  • C: Do you worry you have lost CONTROL over what you eat?
  • O: Have you lost OVER 10 lbs in the last 3 months
  • F: do you believe you are FAT when others say you are thin?
  • F: would you say FOOD dominates your life?
18
Q

comorbidities associated with eating disorders

A
depression
anxiety
suicidality 
risk of physical harm 
menstrual irregularity
body dysmorphism 
pre-occupation with food
desire to lose wt, hx of dieting
wt fluctuation
guilt about eating
social isolation, mood changes
fixed, highly structured schedule, inflexible
cold intolerance, fatigue, myalgias, 
GI distress
sore throat
dizzy, syncope
substance abuse, self-harm
19
Q

common physical findings with eating disorder

A
altered growth
parotid gland enlargement
fluid retention -> facial edema
thin body type, low temp
hypoTN, bradycardia, orthostatic hypoTN, shallow resp
dental enamel erosion, dental caries
russell sign: knuckle cuts/callus from inducing vomiting 
thinning hair, alopecia, dec. DTR
abd. distention, altered bowel sounds
lanugo, dry skin
muscle atrophy
mental torpor
20
Q

substance abuse

A

maladaptive pattern of the use of ETOH or drugs manifested in significant impairment or distress

21
Q

substance abuse contributing factors

A
genetic vulnerability
parental substance use
dysfunctional family relationships
negative life events
psych conditions
low self-esteem/body image
ineffective coping skills
poor sleep hygiene
school failure
low religiosity
competitive athleticism
22
Q

CRAFFT questionnaire

A

2 or more positive responses

-> high likelihood for substance abuse and merits further evaluation and tx

23
Q

substance abuse behavioral changes infants and young children

A
excessive crying
poor feeding
FTT
irritability
jitteriness
excessive lethargy 
poor eye contact 
sleep disorders
24
Q

substance abuse behavioral changes older children and adolescents

A
dec. school performance
lethargy
hyperactivity or agitation
hypervigilance
dec. attention
deviant or risk taking behavior
repeated absences or suspensions
loss of interest
withdrawal from family and friends
fighting, acting out
hypersexuality
exaggerated mood swings
sleep pattern changes
nightmares
altered menstruation
25
Q

substance abuse physical signs

A
  • wt loss
  • red eyes with inhaled substances
  • hoarseness, chronic cough, wheezing, freq. colds or allergy s/s, epistasix, perforations of nasal septum with cocaine and inhalant
  • accidents, trauma, injuries
  • intoxication
  • complete or partial amnesia
  • dilated or constricted pupils
  • gynecomastia, irregular periods, small testes with marijuana
  • needle tracks with IM or IV use
  • generalized pruritus with opiate use
  • reflux, diarrhea, gastritis and consitpations with opiate and ETOH
  • perioral sores or pyodermas from huffing and bagging