Pediatric Psych Flashcards

Question

Narrow Band Scales for ADHD

Answer 1

Establish presence of core symptoms | Depends on age of child, scale used, & informant

Answer 2

Internalizing behaviors Externalizing behaviors other than ADHD Identify coexisting condition & narrow DDx

Answer 3

Teacher completes ADHD specific rating scale Narrative summary of classroom behavior & interventions, learning patterns, & functional impairment Copies of report cards & schoolwork Review multidisciplinary evals

Answer 4

6+ symptoms of hyperactivity & impulsivity OR inattention 17+ years is 5+ symptoms of hyperactivity & impulsivity OR inattention

Answer 5

``` Occur often Present in 2+ settings Persist for 6+ months Present before 12 years Impair function in academic, social, or occupational activities Be excessive ```

Answer 6

Predominantly inattentivie Predominantly hyperactive-impulse Combined

Answer 7

Behavioral interventions Medication School-based interventions Psychological interventions alone or in combination

Answer 8

Improved relationships with parents, teachers, siblings, or peers Improved academic performance Improved rule following

Answer 9

Coexisting psychiatric conditions Coexisting neurologic or medical conditions Lack of response to controlled trial of stimulant therapy or atomoxetine

Answer 10

``` Developmental behavioral pediatrician Child neurologist Psychopharmacologist Child psychiatrist Clinical child psychologist ```

Answer 11

``` Confirmation of ADHD 6+ years Parents approval School cooperation No sensitivity to med Normal HR & BP Seizure free Not have Tourette syndrome Not have pervasive developmental delay Not have significant anxiety Substance abuse not a concern ```

Answer 12

``` Dextroamphetamine (S) Methylphenidate (S) Atomoxetine (Strattera) [NS} Buproprion (Wellbutrin) [NS] TCAs [NS] SSRIs [NS] MAOIs [NS] Alpha adrenergic agonists [NS] ```

Answer 13

Comprehensive, CV focused patient hx, family hx, and PE Vitals & assess growth Pretreatment baseline for SE Substance use/abuse Prescribed to help with self-control & ability to focus Review risks & benefits Explanation of process & length of time Frequency of follow-up Information needed at follow up appt. Behaviors/SE that family should monitor

Answer 14

``` Ritalin Methylin Ritalin SR Metadate ER Methylin ER Ritalin LA Metadate CD Concerta Daytrana Dextrostate Dexedrine Spansule Adderall Adderall XR Focalin ```

Answer 15

Atomoxetine (Strattera)

Answer 16

``` Bupropion (Wellbutrin) Imipramine (Tofranil) Desipramine (Norpramin) Clonidine (Catapres) Guanfacine (Tenex) ```

Answer 17

Start with short acting Start low & titrate up "Drug holidays"

Answer 18

Increased risk of sudden death CV problems Drug dependency

Answer 19

``` Appetite suppression Abdominal pain Headache Insomnia Irritability Tics Associated with growth delay ```

Answer 20

Methylphenidate

Answer 21

Autistic disorder Asperger syndrome Pervasive developmental disorder not otherwise specified

Answer 22

1:88 US children | Male > Female

Answer 23

Secondary to environmental, biologic, and genetic factors Prenatal exposure to Valproic acid or thalidomide Prematurity or low birth weight Born to older parents Co-occurs with other developmental, psychiatric, neurologic, chromosomal & genetic diagnosis

Answer 24

Social interaction Communication Behaviors & interests

Answer 25

Development delayed from birth | Sudden loss of social or language skills after normal development

Answer 26

``` Mildest form of autism Boys > Girls 3:1 Interested in single object/topic Impaired social interaction Normal to above average intelligence High risk for anxiety and depression ```

Answer 27

``` Between Autism & Asperger's Symptoms vary Impaired social interaction Fewer repetitive behaviors Later age of onset ```

Answer 28

``` Social functioning Language Repetitive behaviors Mental retardation Seizures ```

Answer 29

``` Sibling with ASD Parent concern Inconsistent hearing Unusual responsiveness Caregiver concern Pediatrician concern ```

Answer 30

Screen specifically at 18-24 months MCHAT- modified checklist for autism in toddlers STAT- screening tool for autism in toddlers & young children

Answer 31

``` 16-48 months Questionnaire Interest in other children Index finger to point/ indicate interest in something Oversensitive to noise Child imitate you ```

Answer 32

``` Regression "In their own world" Lack of showing, sharing interest or enjoyment Using caregivers hands to obtain needs Repetitive movements with objects Lack of appropriate gaze Lack of response to name Unusual prosody/pitch of vocalizations Repetitive movements or posturing ```

Answer 33

Minimize core features Maximum functional independence Maximize QOL Maximize family function

Answer 34

Intervention immediately 25 hours/week year round in "systematically planned, developmentally appropriate educational activities" Low student:teacher ratio Inclusive experience with developing peers

Answer 35

``` Applied behavioral analysis Structured teaching Developmental Relationship focused Speech & language therapy Social skills instruction OT ```

Answer 36

``` Disruption/aggression Self-injurious Eating Sleeping Toileting ```

Answer 37

Challenges in routine health care due to difficulties wit social interaction, communication, & negotiating a new & unfamiliar environment Visit time x2 Strategies in office to promote familiarity

Answer 38

GI: chronic constipation/diarrhea Recurrent abdominal pain Seizures Sleep problems

Answer 39

Psychiatric disorder that is characterized by aggressiveness and tendency to purposefully bother & irritate others Negative, manipulative, hostile, & deviant behavior

Answer 40

Family history

Answer 41

Four symptoms from categories (angry & irritable mood, argumentative & deviant behavior, vindictiveness) Occurs with 1+ individuals who is not a sibling Causes problems at work, school, or home Occurs on its own Lasts at least 6 months

Answer 42

Often loses temper Often touchy or easily annoyed by others Often angry & resentful

Answer 43

Often argues with adults or people in authority Often actively defies or refuses to comply with adults' requests or rules Often deliberately annoys people Often blames others for mistakes or misbehavior

Answer 44

Often spiteful or vindictive | Shown spiteful or vindictive behavior at least twice in 6+ months

Answer 45

Some outgrow this May turn into something else May have without anything else ODD + comorbid anxiety, ADHD, or depressive disorders

Answer 46

Referral to pediatric psychiatrist Meds for co-morbid disorders Behavioral therapy Parental therapy for setting clear boundaries

Answer 47

Group of behavioral and emotional problems in children Significant difficulty following rules & behaving in a socially acceptable way "Bad" kids or delinquents

Answer 48

``` Brain damage Child abuse Neglect Genetic vulnerability School failure Traumatic life experiences ```

Answer 49

Conduct disorder worse version of ODD ODD have worse social skills ODD do better in school CD most serious childhood psychiatric disorder

Answer 50

``` Depression/anxiety disorders PTSD Substance abuse ADHD Learning problems Bipolar disorder Tourette's syndrome ```

Answer 51

Aggression to people & animals Destruction of property (arson) Deceitfulness, lying or stealing Serious violations of the rules

Answer 52

``` Bullies, threatens or intimidates Physical fights Use of weapons to harm others Physically cruel to people or animals Steals Forces others into sexual acts ```

Answer 53

Referral to Psychiatrist for behavioral therapy, psychotherapy, parental support & training, meds for comorbid conditions

Answer 54

Similar problems into adulthood Likely to have personality disorder Abuse of substances 4 years later Cigarett smoking

Answer 55

Depressed mood Diminished interest or loss of pleasure in almost all activities Sleep disturbance Weight change Appetite disturbance Failure to achieve weight gain Decreased concentration or indecisiveness Suicidal ideation Psychomotor agitation or retardation Fatigue or loss of energy Feelings of worthlessness or appropriate guilt

Answer 56

``` Infection Medication Endocrine disorder Tumor Neurologic disorder Misc. disorders ```

Answer 57

SIG E CAPS

Answer 58

``` S- sleep disturbance I- interests G- guilt E- energy C- concentration problems A- appetite change P- pleasure S- suicidal though/actions ```

Answer 59

Psychotherapy Medical therapy Combination of both

Answer 60

Fluoxetine (Prozac) | Escitalopram (Lexapro)

Answer 61

Increase suicide risk | Weigh risks vs. benefit

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Pediatric Psych Flashcards

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