Pediatric psychiatry

Question 1

Features of anxiety disorders [3]

2 eg in pediatric psychiatry

Answer 1

1. Anxious thoughts and feelings
2. Autonomic sx
3. Avoidant behaviour
4. Separation anxiety
5. Social phobia

Question 2

Anxiety disorders

Management [3]

Answer 2

Psychotherapy
Desensitisation
Rx: SSRIs eg fluoxetine

Question 3

Anxiety disorders

Describe 3 psychotherapy approaches

Answer 3

CBT with child and family
Externalisation
Psychoeducation, narrative approaches

Question 4

Autism

Describe 3 aspects of social impairment

Answer 4

Reciprocal conversation
Expressing emotional concern
Non-verbal communication

Question 5

Autism

Describe 3 aspects of repetitive behavior characteristics of autism

Answer 5

Mannerisms, stereotypes
Obsessions, preoccupations, interests
Rigid and inflexible patterns

Question 6

State the 3 aspects of rigid and inflexibility in autism

Answer 6

Routine
Rituals
Play

Question 7

Describe 3 aspects of non-verbal communication that are impaired in autism

Answer 7

Declarative pointing
Modulated eye-contact
Facial expression

Question 8

3 findings characteristic to autism in younger patients or lower IQ

Answer 8

Joint attention
Emotional responses
Movements eg flapping

Question 9

3 findings characteristic to autism in OLDER patients or HIGHER IQ

Answer 9

Conversation
Empathy
Interests

Question 10

Psychiatric issues in autistic children [7]

Answer 10

Learning disabilties
Hyperactivity
Anxiety
Depression
OCD
Agression, temper tantrums
Self injury, self harm, suicidal behavior

Question 11

H2M children
aka…
4 features

Answer 11

H2M aka Oppositional defiant disorder
Features:
Refusal to obey adults request
Relates to temperament
Deliberately annoying others
Spiteful or vindictive

Question 12

H2M children
4 causes
Treatment [4]

Answer 12

Causes:
Learned behaviour
Enacted to obtain a desired result
Impaired parenting
Psychosocial adversity

Treatment
Functional family therapy, child interventions (anger management, behavioural therapy), parent training programs, multi system training

Question 13

Learning disability

Aetiology [4]

Answer 13

Genetic
Infective
Toxins
Trauma

Question 14

Genetic causes of LD [3]

Answer 14

o Single gene: fragile X, PKU, Rett’s syndrome
o Microdeletion or duplication:
- 22q11 deletion syndrome, Prader Willi syndrome, Angelman syndrome
o Chromosomal: T21

Question 15

Infective causes of LD [3]
Toxins that cause LD [3]
Trauma [2]

Answer 15

• Infective: congenital rubella syndrome, meningitis or encephalitis in childhood
• Toxins: fetal alcohol syndrome, valproate, iodine deficiency
• Trauma: birth asphyxia, childhood head injury

Question 16

Classification of LD [4]

Answer 16

• Mild (IQ 50-69)
• Moderate (IQ 35-49)
• Severe (IQ 20-34)
• Profound (IQ <20):

Question 17

Diagnosis of LD [3]

Answer 17

• Intellectual impairment (IQ <70) AND
• Social or adaptive dysfunction in >2 of: communication, self-care, home living, social skills, community use, self-direction, function academics, leisure and work activities AND
• Onset in developmental period (by 18y/o