Pediatric Flashcards
What is Intellectual Disability Disorder?
Disorder of cognitive, social and practical functioning
Often, there is no identifiable cause for Intellectual Disability Disorder, but what are some common associations? (3)
Fetal Alcohol Syndrome - preventable
Down Syndrome - chromosomal
Fragile X - inherited
With Intellectual Disability Disorder, patients will have deficiencies in 1 or multiple domains?
Multiple = IQ and Adaptive functioning
The severity of Intellectual Disability Disorder is no longer based on the low IQ but the?
Level of support required for ADLs (activities of daily living)
What is the treatment for Intellectual Disability Disorder?
Special education and social skills classes
Education about prevention/prenatal screenings
What characterizes Autism?
Impaired social communication + Restricted behavior/interests
What characterizes Autism?
Impaired social communication + Restricted behaviors/interests
List examples of impaired social communication with Autism
Impaired socialization, empathy, relationships, ability to understand social cues and low eye contact
List examples of restrictive behavior/interests with Autism
Fixated interests, inflexibility to change, altered response to sensory input
Hand flapping can be present with Autism, what is another syndrome that can have hand-wringing movements and describe it?
Rett Syndrome
= Normal development –> regression + hand-wringing
ADHD has 2 domains of symptoms. What are they?
Inattention
Hyperactivity/Impulsivity
List some inattention symptoms with ADHD
Poor attention to detail, short attention span, difficulty following and completing tasks
List some hyperactivity symptoms with ADHD
Fidgets, interrupts, talks excessively, cannot sit still
At what age must ADHD present before?
Usually before 12/13 years old
How long must symptoms of ADHD be present and what is the other major caveat for diagnosis?
Symptoms > 6 months
Must be present in > 2 settings - home, school, etc.
How long must symptoms of ADHD be present and what is the other major caveat for diagnosis?
Symptoms > 6 months
Must be present in > 2 settings - home, school, etc.
If the child with ADHD is less than 6 years old, what is the best treatment?
Behavior therapy
If the child with ADHD is greater than 6 years old, what is the best treatment?
Stimulants + behavior therapy
What is the first line drug class for ADHD?
Stimulants
ex. Methylphenidate, Dextroamphetamine
What are possible side effects that can occur with the Stimulant drug class to treat ADHD?
Insomnia, anxiety, headaches, weight loss, slow growth
If stimulants do not work for ADHD, what are 3 other medications that can be considered that have a better side effect profile?
Atomoxetine
Clonidine
Guanfacine
If stimulants do not work for ADHD, what is a norepinephrine reuptake inhibitor that can be used?
Atomoxetine
If stimulants do not work for ADHD, what are 2 alpha 2 agonists that can be used?
Clonidine
Guanfacine
What is present with Tourette’s Syndrome?
Both, and usually multiple, motor and vocal tics
When do symptoms usually arise with Tourette’s Syndrome?
< 18 years old
How long must symptoms be present in order to diagnose Tourette’s Syndrome?
> 1 year
How long must symptoms be present in order to diagnose Tourette’s Syndrome?
> 1 year
What 2 conditions are commonly associated with Tourette’s Syndrome?
OCD
ADHD
What is the best initial treatment for Tourette’s Syndrome?
Behavior therapy - habit reversal
If behavior therapy does not work for Tourette’s or it is very disabling, what is the preferred agent to treat?
Tetrabenazine = Dopamine depleting VMAT 2 inhibitor
MOA and use for Tetrabenazine?
VMAT 2 inhibitor = dopamine depleting
- Used for Tourette’s Syndrome
If the first line drug does not work for Tourette’s Syndrome, what is the next drug class?
Dopamine Antagonists - antipsychotics
When is Enuresis normal?
< 7 years old and if they have never made it through the night
What things should be ruled out with Enuresis?
Infection, anatomical defects, meds, abuse
If a child had been making it through the night and now they are wetting the bed, what 2 workup items should be done?
Urinalysis
US
If a child had been making it through the night now they are wetting the bed + regression and they have negative urinalysis/us what should be considered?
Abuse or a new stressor
What is the treatment for a child that has never made it through the night without wetting the bed and they are above 7 years old?
Desmopressin
Conduct disorder has the same symptoms as what personality disorder but what is different?
Anti-Social personality disorder
= < 18 years old!
How long must the symptoms be present with Conduct Disorder?
> 1 year
What is the difference between Conduct Disorder and Oppositional Defiant Disorder?
Conduct disorder – hurts peers/animals/etc.
Oppositional Defiant Disorder – teen acting out but not harming anyone
How long must the symptoms be present with Oppositional Defiant Disorder?
> 6 months
What is the best treatment for Conduct Disorder and Oppositional Defiant Disorder?
Psychotherapy
If Psychotherapy fails with Conduct Disorder, what is the next treatment option?
Juvenile Detention
Oppositional Defiant Disorder is often due to incongruent parenting. What are the main symptoms?
Teen acting out and fighting authority
Signs of Conduct Disorder?
CRIMINAL
- lacks remorse for hurting others, breaks the law, etc.
