Ped Misc Flashcards
When compared to adol, 8-12 y/o children with depression most often show which symptom? (3x)
SOMATIC COMPLAINTS
AACAP Diagnosis of Bipolar I in children requires (3x)?
A DISTINCT PERIOD OF ABNORMAL MOOD AND EPISODIC SYMPTOMS
Which of the following is the initial treatment of choice for mild anxiety disorders in children? (2x)
PSYCHOTHERAPY ALONE
Instead of depressed mood, children w MDD may primarily show: (2x)
IRRITABILITY
The treatment for adolescents with depression study recommended which of the following treatments for patients with moderate to severe depression? (2x)
FLUOXETINE AND CBT
16 y/o boy treated as outpatient for Schizophrenia after recent inpatient first break. Parents concerned re: anhedonia, withdrawn. No psychosis. Goal of outpatient eval: (2x)
ADDRESS PT’S FEELINGS OF DEPRESSION AND SCREEN FOR SI
When compared with adult-onset schizophrenia, children with schizophrenia have: (2x)
SIMILAR DEFICITS IN ATTENTION, LEARNING AND ABSTRACTION
Longitudinal studies have shown that obesity in later childhood, adol and adulthood can be predicted most commonly by presence of which psychiatric d/o in childhood and adol? (2x)
DEPRESSIVE
Primary advantage of treating childhood enuresis with behavioral methods vs desmopressin (2x)
LOWER RATES OF RELAPSE
Which concerns is the most common reason for referral of children and adol (6-16 y/o) to mental health professionals? (2x)
DISRUPTIVE BEHAVIOR
Most distinguishable aspect of childhood separation anxiety d/o when compared to other childhood anxiety disorders (2x)
FEAR THAT SOMETHING BAD WILL HAPPEN TO THEM OR THEIR PRIMARY CARETAKER
Most commonly reported SE of stimulants in kids (2x)
APPETITE SUPPRESSION AND SLEEP DISTURBANCES
An association has been reported in adol with BPD between serotonin dysregulation, suicidal behavior, aggression and (2x)
IMPULSIVITY
8yo p/w “always worried” and fearing getting lost or being kidnapped, frequently insisting on sleeping in parents room (does well academically & interacts with circle of friends, but frequently c/o HA and visiting school nurse office to call parent) (2x)
SEPARATION ANXIETY DISORDER
9 yo with prior urinary continence at 4 years starts wetting bed at 6, he is difficult to arouse and has enuresis at different times, male relatives wet bed until 10 year old, clue to psychiatric comorbidity
HAVING PREVIOUS PERIOD OF CONTINENCE
Dx for 9yo boy w/ irritability and aggression, failing grades, and hearing a voice saying he is bad.
MDD
7yo child w/ emotional outbursts at school and stomachaches, reluctance, and complaining at school time, but well-behaved at home, without stressors. Next step?
PERMISSION TO SPEAK WITH TEACHER
Schizophrenia with onset in childhood is different from adult-onset because
IT IS MORE LIKELY TO HAVE A GRADUAL ONSET
What are the characteristics of childhood-onset schizophrenia?
CHRONIC COURSE, UNFAVORABLE PROGNOSIS, HALLUCINATIONS, DELUSIONS
Not a likely characteristic of childhood-onset schizophrenia:
ACUTE ONSET
9 y/o is evaluated for bedwetting several times a week. Child has never been completely dry. Which Tx modality is likely to be most effective?
BELL AND PAD
Psychiatrist is evaluating a 5 y/o child in kindergarten. Child does well with puzzles and other performance activities. Teacher reports that the child has a limited vocabulary and immature grammar in comparison to the other children. Child interacts well with other children. The child also seems to have some trouble understanding questions. Child’s hearing and vision are normal. Explanation?
MIXED RECEPTIVE & EXPRESSIVE LANGUAGE D/O
12 y/o F not attending school for fear her mom may die in accident. Management?
RETURNING THE GIRL TO HER CURRENT CLASSROOM
7 y/o referred for psych eval due to learning probs. Most helpful info would be family’s approach to and hx
READING WITH THE CHILD
Childhood-onset schizophrenia typically have a course described as:
CHRONIC AND UNREMITTING
In preschool-age children isolated hallucinations are common with:
ANXIETY
A preschooler presents to psychiatrist after being placed on psychotropic med by a PCP. Parents note that since med was started, child has shown irritability, skin picking, decreased appetite, social withdrawal, insomnia. Which med is child taking?
DEXTROAMPHETAMINE
10 y/o child with 2-month h/o irritability, inattention, sleep disturbance, and withdrawal. Child attempted to run in front of a car. No family h/o psychiatric d/o. On examination, no eye contact and has psychomotor agitation. What med?
SSRI
First-line Tx for 9 y/o w/ depression
SERTRALINE
First-line Tx for adolescents w/ major depression
FLUOXETINE
Child must have depressed or irritable mood for what length of time in order to meet criteria for dysthymic do?
ONE YEAR
9 y/o w/ increased irritability and aggression for 3 mons. Used to be easygoing. Grades dropping. No insomnia or poor appetite. AH of voice telling him he is bad. Most likely Dx:
MDD
What is first line tx for PTSD in children and adolescents?
CBT
7 y/o girl dislikes going to her friend’s house, preferring her friends come to her home. She has recently had a stomach ache in the morning before attending school and sometimes cries uncontrollably if her mother insists she attends. Teachers reports after her mom leave she usually settles down and does academically well. Dx?
SEPARATION ANXIETY DISORDER
7 y/o M w/ poor social skills, cognitive, but language wnl. Dx
ASPERGER’S SYNDROME
Adopted children who have a biological parent with alcohol dependence are at increased risk of developing alcohol dependence when compared to their adoptive siblings. This is evidence for which of the following models of substance abuse?
DISEASE MODEL
14 y/o pt with a long-standing h/o of perfectionism has recently developed a fear of talking in class after forgetting her lines in a school play. Pt says, “I don’t like talking to other kids” and practices reading aloud over and over so “I remember what I am saying.” Dx:
SOCIAL PHOBIA
The Child-Adolescent Anxiety Multimodal Study (CAMS) compared sertraline, CBT, and combination therapy in children/adolescents with moderate/severe GAD, SAD, and Social Phobia. Primary findings?
COMBINATION TREATMENT SUPERIOR TO MONOTHERAPY
6 y/o child generally healthy throws a fit every time family goes hiking. Exposure to snake on one hike led child to become loud, agitated. Now child has intense distress when hiking, pleads to stay with parents at all times. Dx?
SPECIFIC PHOBIA
Diagnose a child who persistently refuses to attend school or sleep in bed alone, complaining of somatic symptoms with no physiological origin?
SEPARATION ANXIETY
Which of the following is a manifestation of unresolved grief in a school-age child who has experience the loss of a sibling?
SEPARATION ANXIETY FROM PARENTS
Childhood disorder with greatest genetic association for adult onset panic attacks?
SEPARATION ANXIETY DISORDER
A child w/ selective mutism is most likely to have difficulties in which area?
AT SCHOOL
A 5 year-old bilingual child has progressive refusal to speak in public, being very talkative at home and refusing to speak throughout the day in his kindergarten class. He is diagnosed with selective mutism. What is the appropriate intervention?
BEHAVIORAL TREATMENT TO INCREASE THE CHILD’S TOLERANCE FOR SPEAKING IN PUBLIC
One controversy about pediatric bipolar disorder is whether severe irritability and emotional dysregulation are:
PREDICTIVE OF CLASSIC BIPOLAR DISORDER IN ADULTHOOD
What is considered to be the determining component underlying the sx of selective mutism?
AVOIDANT BEHAVIOR
Which of the following infant and toddler temperamental styles has been shown to have the greatest association with the eventual onset of anxiety symptoms in childhood? (2x)
INHIBITED
Differential Dx in a 6 y/o with daily fecal soiling includes:
ANAL STENOSIS, HYPOTHYROIDISM, HIRSCHSPRUNG’S DZ, SMOOTH MUSCLE DZ
Which med has FDA approval for tx of mania in children 12 years of age or older?
LITHIUM
Unlike adults with bipolar disorder, prepubertal children with bipolar disorder are believed to have:
PREDOMINANTLY CHRONIC MIXED MANIC STATES
Child OCD. Which comorbid diagnosis is associated with poor response to SSRI?
TIC DISORDER
Which of the following is the initial treatment of choice for children with OCD?
CBT ALONE
What infectious agent can exacerbate or cause initial manifestation of OCD in children?
GROUP A BETA-HEMOLYTIC STREPTOCOCCUS
Presence of what disorder puts a child at greatest risk for developing panic disorder as an adult?
SEPARATION ANXIETY DISORDER
10 y/o is seen in outpt clinic w/ hx of extreme fear of using the bathroom at school. He states to be afraid that other children will laugh if they hear or smell him in the bathroom. Dx?
SOCIAL PHOBIA
Principal aim of treatment of child with school phobia is:
RETURN CHILD TO SCHOOL
9 y/o child w apathy, decreased appetite, irritability, dizziness, confusion, ataxia, and HA. Recently moved to older house in an industrial city. Which lab test helpful for dx?
LEAD SERUM LEVELS
High social economic status parents of a 16 year old who has met normal developmental milestones are worried that their child is using social media and texting to communicate with peers. They found text messages w/ romantic partners and visits to sexual health related websites. What is the most likely consequence of the adolescents reliance on electronic forms of communication?
CONTINUED SOCIALIZATION WITHIN THE CURRENT PEER GROUP
