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child and family > neurology and psychiatry > Flashcards

neurology and psychiatry Flashcards

1
Q

what is reactive attachment disorder

A

Markedly disturbed and developmentally inappropriate social relatedness in most contexts that begins before 5 years

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2
Q

risk factors for reactive attachment disorder

A

adverse childhood events
orphaned at a young age

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3
Q

what are the 2 main subtypes of reactive attachment disorder

A

inhibited and disinhibited

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4
Q

what is inhibited RAD

A

children who continually fail to initiate and respond to social interactions in a developmentally appropriate way

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5
Q

give an example of inhibited RAD

A

a child or infant that does not seek comfort from a parent or caregiver during times of threat, alarm, or distress

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6
Q

what is another name for disinhibited RAD

A

disinhibited social engagement disorder

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7
Q

what is disinhibited RAD

A

a child who has an inability to display appropriate selective attachments

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8
Q

co-morbid disorders of RAD

A

emotional disorders, ADHD, behavioural disorders

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9
Q

investigations for reactive attachment disorder

A

strange situation (1-2 yrs)
modified strange situation (2-4yrs)
story stem attachment profile (4-7yrs)
child attachment interview (7-15) or adult attachment interview

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10
Q

management of RAD

A

parental sensitivity and behaviour training
psychotherapy/CBT for those who have been maltreated

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11
Q

what is conduct disorder

A

repetitive and persistent pattern of behaviour in which major age-appropriate norms or roles are violated

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12
Q

what is conduct disorder referred to in younger children

A

oppositional defiant disorder

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13
Q

what are some causes of conduct disorder

A

brain injury
family circumstances - ACEs
parenting style - inconsistency and lack of rules

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14
Q

what are the 2 main types of conduct disorder

A

mild-moderate and severe

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15
Q

mild-moderate conduct disorder

A

behaviour is restricted to the family environment

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16
Q

what are the 2 types of severe conduct disorder

A

unsocialised and socialised

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17
Q

socialised conduct disorder

A

more covert antisocial acts or better ability to avoid getting involved with the police

18
Q

unsocialised conduct disorder

A

predominantly violent behaviour and more likely to be dealt with by the police

19
Q

name some comorbidities of conduct disorder

A

ADHD
RAD
learning difficulties
depression
substance misuse
deviant sexual behaviour

20
Q

diagnosis of conduct disorder

A

3 of the following in the last 12 months with one in the last 6 months
- Aggression to people or animals
- Destruction of property
- Deceitfulness or theft
- Serious violation of rules

21
Q

pharm management of conduct disorder

A

risperidone for extreme impulsivity and aggression
SSRIs for depression

22
Q

cerebral palsy

A

permanent neurological problems resulting from damage to the brain around the time of birth

23
Q

antenatal causes of cerebral palsy

A

maternal infections
trauma during pregnancy

24
Q

perinatal causes of cerebral palsy

A

birth asphyxia
pre-term birth

25
Q

post natal causes of cerebral palsy

A

meningitis
severe neonatal jaundice
head injury

26
Q

what is duchennes muscular dystrophy

A

a genetic disease what causes muscle weakness and wasting

27
Q

inheritance seen in duchennes muscular dystrophy

A

x-linked recessive

28
Q

pathophysiology of duchennes

A

defective gene for dystrophin on the x chromosome

29
Q

when do people present with duchennes

A

3-5 years

30
Q

clinical presentation of duchennes

A

delay fatigue, difficulty getting up from the floor, walking or talking

31
Q

name 2 typical features of duchennes

A

progressive lordotic posture with marked arching of the back
calf pseudohypertrophy

32
Q

what is gowers sign

A

Children with proximal muscle weakness use a specific technique to stand up from a lying position

33
Q

investigation prior to genetic testing for duchennes

A

creatine kinase > 10,000

34
Q

management of duchennes

A

physio
steroids
surgery
ventilatory support

35
Q

inheritance in spinal muscular atrophy

A

autosomal recessive

36
Q

genetics of spinal muscular atrophy

A

deletion/mutation of both SMN1 genes on 5q

37
Q

what is affected by spinal muscular atrophy

A

proximal legs

38
Q

pathophysiology of spinal muscular atrophy

A

↓SMN protein in spinal cord → degeneration of motor neurones

39
Q

clinical presentation of spinal muscular atrophy

A

hypotonia
progressive weakness
bulbar and intercostal weakness

40
Q

investigation for spinal muscular atrophy

A

genetic testing for SMN1+2

41
Q

what are the 3 main areas of development affected by autism

A

social interaction
communication
behaviour

child and family (11 decks)

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