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Pediatrics > Pediatric Psychiatry > Flashcards

Pediatric Psychiatry Flashcards

1
Q

What is the USPSTF’s recommendation for screening for major depressive disorder in adolescents?

What is the standardized screening tool?

A

Recommend screening in adolescents aged 12 to 18

PHQ9 or Beck Depression Inventory

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2
Q

Is the same PHQ9 used in adults used in pediatrics?

What score is indicative of mod-severe depression?

A

Yes, with the same scoring system

15-19

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3
Q

On the PHQ9, a score of

1-4 is indicative of what level of depression

5-9 is indicative of what level of depression

15-19 is indicative of what level of depression

A

Minimal Depression

Mild Depression

Moderate to Severe Depression

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4
Q

What score on the PHQ9 would be concerning for severe depression?

A

20-27

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5
Q

What is the presenting symptoms of depression in adolescents and included in the DSM-5 criteria?

How many presenting catagories need to be present for diagnosis?

What is the acronym of the presenting symptom catagories?

A
  • Sleep: increased sleep, hard to awaken, often late for school
  • Interest: decrease interest in music/events/etc. apathy about activities
  • Guilt: ruminate about small insults, no return call/text, “all my fault”, low self-esteem
  • Energy: decreased energy, inability to mobilize, lead feat
  • Concentration: can’t read a page or remeber content, decline in grades
  • Appetite: decreased appetitie, weight loss
  • Psychomotor: aggressive, irritable, get into fights, disagreements
  • Suicidal: red glag, lack of rational thoughts, impuslive

5 of the above catagories

SIGE CAPS

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6
Q

What physical sources should be ruled out before diagnosing depression?

A
  • Hyperglycemia
  • Hypothyroid
  • OSA
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7
Q

What is the first line treatment of depression in adolscents?

Then what can be considered second line?

A

Therapy
* Psychotherapy
* Family therapy
* Cognitive behavioral therapy

SSRI’s

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8
Q

What is a black box warning associated with SSRI utilization in adolescents?

A

Increased suicide ideation and attepts

Informed consent is required

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9
Q

Anxiety and worry are associated with 1 (or more) of the following 6 symptoms?

How long do they need to be present to classify as generalized anxiety?

What is the acronym associated with generalized anxiety disorder (GAD)?

A
  • Sleep distrubance
  • Tension in muscles
  • Restless, or feeling keyed-up and on edge
  • Easily fatigued
  • Sour, irritable
  • Scattered, difficulty concentrating or mind goin blank

6 months

STRESS

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10
Q

What is the cornerstone of treatment for GAD?

What is the second line treatment in GAD in adolescents?

A

Therapy
* School intervention
* Cognitive behavioral therapy, most proven benefit
* Family therapy

SSRI’s

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11
Q

Do boys or girls develop OCD like behaviors earlier/younger?

A

Males

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12
Q

What are the four types of OCD Presentations?

A
  • Contamination
  • Pathologic doubt
  • Summetry/prescision (ordering)
  • Intrusive thoughts
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13
Q

What screening tool can be used to diagnose OCD?

A

yale-Brown Obsessive-Compuslive Scale (YBOC)

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14
Q

What is the treatment of OCD in adolescents?

What is the treatment of OCD in adults?

A

Therapy and mood stabalizers (Fluoxetine, Fluvoxamine, Serraline)

CBT and SSRI’s (Fluvoxamine first line)

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15
Q

What symptoms are associated with Bipolar Disorder in adolscents?

How many need to be present to classify as Bipolar Disorder?

A
  • Distractability
  • Impulsivity
  • Grandiosity
  • Flight of ideas
  • Activity increase
  • Sleep decreased
  • Talkative or pressure to keep talking

3+

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16
Q

What is the DSM-V Criteria for Bipolar II in Adolescents?

What lab tests should be ordered to rule out physiologic cause?

A
  • Episodes of major depression and hypomania lasting at least 4 days
  • No full manic or mixed episodes

TSH and free T4

17
Q

What is the treatment of Bipolar Disorder in Adolescents?

What type of therapy is specific to Bipolar?

A

Combnination of therapy and medications

ECT

18
Q

Is Oppositional Defiant Disorder (ODD) associated with violent actions?

What are the clinical features

A

No, it is characterized by defiant behaviors (negative and hostile)

Argumentive, short tempered, blames others, deliberately annoys others

19
Q

What is the treatment of ODD?

A
  • Refer for confimation and therapy: ped psych, psychologist

Psychotherapy with individual and family, parent education

20
Q

Onset of ADHD has to be before what age?

A

12

21
Q

What are the subtypes of ADHD?

A
  • Inattention
  • Combined
  • Hyperactive-impulsive
22
Q

What are the narrow band ADHD Screening Tools?

A
  • Vanderbilt scales
  • Conners’ scales
23
Q

What are the broad band ADHD screening tools?

A
  • Archenbach Child Behavior Checklist (CBCL)
  • Behavior Assissment Scale for Children (BASC)
  • Brown Attention Deficit Disorder Scales (BADDS)
24
Q

What two ADHD screening tools are validated with normal values?

A
  • Conners’
  • ASEBA

Pediatrics (16 decks)

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