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Board Studying. > neurodevelopmental > Flashcards

neurodevelopmental Flashcards

1
Q

prevalence of ASD

A

1/1000

medical condiitons are identifed in less than 5% of cases. 
Rett 
Fragile X
Tuberous sclerosis
Chrom 15 abnormailities
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2
Q

functional neurological sx disorder

A

aka conversion

sx are invol

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3
Q

prevalence of childhood onset fluencey DO

A

5%

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4
Q

percentage of school aged kids with ADHD

A

9-12%

2: 1 male to female
1. 6-1 ratio in adults

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5
Q

percentage of individuals with specific learning do who are male

A

60-80%

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6
Q

features of fetal alcohol syndrome

A

flat upper lip, flattened philtrum, flat midface

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7
Q

features of serotonin syndrome

A

brisk reflexes, htn, hyperthermia

MDMA/ecstasy can cause this

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8
Q

can mimic ADHD

A

beta agonist side effect ie albuterol
lead poisoning
anxiety and depresion
BPD

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9
Q

can cause steven johnson in kids

A

modafinil, not fda approved

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10
Q

selective mutism

A

an anxiety DO

needs 1 mo of sx, not due to other condition

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11
Q

Williams syndrome

A

microdeletion on chromosome 7
IDD, unique personality traits, distinctive facial features, cardiovascular problems.
elfin facies, starburst irises, short stature
very outgoing with cocktail party personality.
can have supravalvular aortic stenosis, MC cardiac anomaly

outgoing cocktail personality

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12
Q

Prader Willi

A

paternal absense of expression on chrom 15

obesity, developmental delay, feeding difficulties in infancy, short stature,, small hands and feet, hypogonadism

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13
Q

Tourette’s pathology

A

deficits in frontal cortex caudate nucleus, putamen, and thalamus

deficits in density in both neuronal and non neuronal cells ie glial cells

reduced levels of choline and N-acetylaspartate in putamen

lower concentration of N acetylaspartate BL
Lower creatining on r side and reduced myoinositol on left

10% yell obsence language (coprolalia)

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14
Q

IDD

A

2 standard deviations or more below population
IQ of 70 or below

mild-able to do self care, maintain home activities and only need support

moderate- academic level, require support to live independently or maintain employment

severe- litle understanding of written language, dependent on others full time

profound- limited ability to communicte, require high intensity supervision in all areas of life

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15
Q

clonidine

A

alpha 2 adrenergic receptor agonist

FDA approved for ADHD and HTN
off label= anxiety, insomnia ,tic disorder, ODD, ptsd, substance use withdrawal

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16
Q

secondary prevention

A

detects disease early when pts are asymtomnatic ie. HIV testing, screening for nutrition and exercise, depression screening, UDS

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17
Q

DiGeorge syndrome

A

deletion on chromosome 22q11

CATCH 22
Cardiac abnormalities
Abnormal facies
Thymic aplasia
Cleft palate
Hypocalcemia

developmental, speech delay

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18
Q

first pass elimination

A

extensive drug extraction and metabolism in liver immediately after gut absorption

19
Q

ASD diagnosis

A

deficits in social communication/interaction + restricted repetitive behaviors

20
Q

discontinuation syndrome with SSRIs

A

dizziness, confusion, nausea, abdominal cramps, sweating, dyesthesias, irritability

21
Q

Fragile X syndrome

A

MC inherited cause of IDD
mutation in FMR1 gene on x chromosome
elongated face, large ears, enlarged testicles

typically mutation is CGG trinucleotide segment repeat

common comorbid ADHD, ASD, Anxiety DO

up to 73% have axis 1 psych disorder

22
Q

common in Down syndrome pts

A

thyroid disorders. Should have FT4, TSH drawn at birth, 6 mo, 12 mo and annually

sleep apnea, 
hearing loss
otitis media 
vision and eye disease
hypodontia
neurologic dysfunction
gastrointestinal atresias
hirschsprung dz
hip dislocation 
autism
celiac conditions 
hematologic conditions 
atlantoaxial instability
23
Q

rumination syndrome

A

repeated vomiting, chewing, reingesting vomitus

does not occur during sleep
should not respond to standard medical therapy for reflux

24
Q

guanfacine

A

more selctive alpha adrenergic than clonidine
less sedation and longer duration
shows reduced tics and ADHD at doses 0.5mg BID to 1mg TID

25
Q

neurobiological feature of ASD

A

decreased formation of purkinje cells in cerebellum

increased overall head size, accelerated head growth during infancy

26
Q

FDA max doses for methyphenidate stimulants

A

dexmethylphenidate (focalin IR): 20mg

methylin, ritalin (SA, SR), and metadate (ER/CD)- 60mg

methylphenidate-oros (Concerta)- 72mg

methyphenidate patch (Daytrana)- 30mg

27
Q

lithium monitoring

A

q 6 mo

BUN, creatinine, TSH, calcium, lithium, ECG

can increase OR decrease thyroid. either goiter or hypothyroidism

28
Q

metabolic capacity of kid v adult

A

kids is higher
drugs must be given at shorter intervals.
kids have more efficient renal elimination of drugs and will excrete drugs faster
have greater extracellular water

29
Q

percentage of ODD that will go to CD

A

30%

30
Q

consequence of infantile anorexia

A

food refusal by infant leads to failure to develop somatopsychological differentiation, the abilty to differentiate sensations in the body

between 6mo and 3 years of age

feeding is directed by his or her emotinal needs instead of psysiological sensatios of hunger and satiety

31
Q

atomoxetine

A

selectively inhibits presynaptic norepi reuptake

p450 2d6

CI: pheocromocytoma, MAOIs, glaucoma

32
Q

TCAs

A

inhibit 5HT and norepi uptake

33
Q

kids v adults metabolism

A

higher metabolic capacity in kids

drugs in kids have to be given at shorter intervals

peds have more efficinet renal elimination, will excrete drugs faster.

greater vol of extracellular water in peds patints , drugs like litium will have lower plasma concentration compared to adults

34
Q

avoid this med in IDD

A

potent anticholinergic due to cognitive blunting

35
Q

SSRIS impact when taken with food

A

peak plasma concentration of prozac is delayed but not decreased

paxil plama conc is inc by 6%

zoloft is inc by 25%fmoda

36
Q

functional behavior

A

a behavior that serves a purpose for the individual that is ongoing

37
Q

amphetamine isomer most rapidly eliminated from the body

A

dextro-isomer in acidified urine

38
Q

depakote

A

inhibits lamimctal through glucuronidation

highly protein bound

can be combined with lithium

levels increased by salicylates

max dose is 60mg/kg/day

39
Q

wellbutrin

A

unicyclic aminoketone
and antidepressant

modulates norepinephrine and dopamine

smoking cessation

40
Q

methylphenidate metabolized through this enzyme

A

CES1A1

41
Q

early onset bipolar is less responsive to..

A

lithium

42
Q

why L-carnitine is effective in treatment of methamphetamine toxicity

A

it prevents formation of free radicals and peroxynitrate in neurons

43
Q

neurodegen disorder that has lower level of coenzyme q

A

Parkinsons

coQ studies have shown improved heart falilaure, migraines, dec BP

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