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Psychiatry pro +1700 > Pediatric Therapies > Flashcards

Pediatric Therapies Flashcards

1
Q

What is DMDD?

A

Disruptive mood dysregulation disorder

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2
Q

What, generally, is DMDD?

A

-Chronic, severe, persistent irritability

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3
Q

What is conduct disorder?

A

a psychological disorder diagnosed in childhood or adolescence that presents itself through a repetitive and persistent pattern of behavior in which the basic rights of others or major age-appropriate norms are violated

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4
Q

What is the prognosis for conduct disorder?

A 
Early = leads to sociopathy
Later = better prognosis
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5
Q

What is the boy:girl ratio of ADHD? Prevalence?

A
  • 4:1 to 9:1

- 5%

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6
Q

What are the three domains of ADHD?

A

Inattention
Hyperactivity
Impulsivity

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7
Q

ADHD has an onset before what age? What is the duration that is needed to meet criteria? How many setting must this be seen in?

A
  • before age 12
  • Duration over 6 months
  • At least 2 settings
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8
Q

There is a high comorbidity of ADHD with what other disorders?

A
  • ODD
  • CD
  • learning disorder
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9
Q

What is the key difference between learning disability vs ADHD?

A

ADHD is a global problem vs disability is usually in one specific subject area

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10
Q

True or false: ADHD is overdiagnosed

A

Debateable

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11
Q

True or false: most kids will outgrow ADHD

A

True–frontal lobe grows, and learning strategies improve

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12
Q

True or false: TV causes ADHD

A

Possibly?– may be related to stimulus

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13
Q

True or false: ADHD is associated with eating preservatives and additives

A

Maybe?

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14
Q

True or false: ADHD is a clinical diagnosis

A

True

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15
Q

What must be true of ADHD symptoms in regards to setting?

A

must be preset at both home and school

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16
Q

What are the common side effects of ADHD stimulants?

A
  • GI symptoms
  • Decreased appetite
  • Blunted affect
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17
Q

What is the thinking behind the stimulant prescription for ADHD?

A

Stimulate the frontal lobe

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18
Q

True or false: stimulants have a high efficacy for ADHD

A

True

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19
Q

What can happen to affect with stimulant use that should be monitored for? (3)

A

Blunts, with flat affect

BP and pulse

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20
Q

What may happen with stimulant use in a kid with an underlying psychiatric disorder? Why?

A

Hallucinations and other psychiatric symptoms–increases dopamine release

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21
Q

What are the first line drugs for ADHD?

A

Methylphenidate–Ritalin

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22
Q

Why should amphetamine products be avoided as a first line therapy for ADHD?

A

Much greater side effect profile

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23
Q

How fast do amphetamines work with ADHD?

A

Hours to days

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24
Q

What are the familial disorders of untreated ADHD?

A

Increased parental divorce and sibling fights

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25
Q

What are the societal consequences of untreated ADHD?

A

Increased Substance abuse

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26
Q

What can be done with rebounding off of ADHD meds? (2)

A

Short acting stimulants or alpha-2 agonists (apraclonidine)

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27
Q

What is the only nonstimulant used for ADHD? MOA? Benefit? Downside?

A
  • Atomoxetine
  • NE reuptake inhibitor
  • No rebounding, but less efficacious
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28
Q

What are the major side effects of Atomoxetine?

A

Hepatotoxic

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29
Q

What is the MOA of clonidine? Why use in ADHD?

A
  • Alpha-2 agonists

- treats impulsivity

30
Q

What should be done prior to administering a stimulant for ADHD?

A

Cardiac exam and ECG if indicated

31
Q

What ADHD get better with behavioral programs alone?

A

Mostly not

32
Q

Will ADHD meds cause growth suppression?

A

Small evidence with little effect

33
Q

Will children outgrow ADHD?

A

50% chance

34
Q

Is ritalin a gateway drug?

A

No–less impulsivity and increased frontal lobe actually decrease drug use

35
Q

Lining up toys = what mental disorder?

A

Autism

36
Q

What is the M:F ratio of autism?

A

4:1

37
Q

What are the three domains of autism?

A
  1. Impairment in social interactions
  2. Impairment in communication
  3. Restricted pattern of interest and stereotypical behavior
38
Q

What are the qualifications of autism?

A

With or without:

  • Intellectual impairment
  • Language impairment
  • Known medical conditions
39
Q

What are the levels 1-3 of autism?

A 
1 = high functioning
2 = Needs some support
3 = needs a lot of support
40
Q

When should you refer for suspected autism? (4)

A
  • Language delay
  • Lack of nonverbal communication
  • Lack of symbolic play
  • Stereotypical or self stimulating behaviors
41
Q

What is the trend of incidence of autism?

A

Increasing

42
Q

What is the treatment for autism?

A
  • PT/OT/speech
  • Social skills training
  • SSRI
43
Q

What is the pharmacotherapy for autism? (3)

A
  • NMDA antagonists (memantine)
  • SSRIs
  • Antipsychotics
44
Q

What is the MOA and use of memantine?

A
  • Alzheimer’s and maybe autism

- NMDA receptor blocker

45
Q

Are negative or positive s/sx of schizophrenia seen first (usually)?

A
  • Prodromal negative symptoms

- Acute s/sx are positive

46
Q

What are schizophrenic patients often misdiagnosed as early on in the course of the disease? Why?

A

Depression, since negative s/sx usually come first

47
Q

What type of hallucinations are usually had with schizophrenia: auditory or visual? Are these usually internal or external?

A

Auditory

External

48
Q

What is the prevalence of schizophrenia?

A

1%

49
Q

Who usually presents with schizophrenia earlier, men or women

A

Men

50
Q

IQ can drop how much with psychosis?

A

Two SDs (30 points)

51
Q

What happen to the brain with schizophrenic patients?

A

Shrinks

52
Q

What happens to suicide rates post hospitalization for psychotic patients?

A

increase–thinking clearly leads to suicide

53
Q

Does marijuana have an effect on schizophrenia?

A

Yes

54
Q

What birth month more commonly has psychosis?

A

Winter months

55
Q

True or false: schizophrenia is more common in males

A

False–no gender difference

56
Q

What is the average length of time between the first psychotic break and treatment?

A

2-3 years

57
Q

True or false: schizophrenia is more common in males

A

Fales–relatively equal

58
Q

True or false: violence is more common in the schizophrenic population

A

False

59
Q

True or false: paranoid schizophrenics have the worst prognosis

A

False–have the best prognosis

60
Q

True or false: language delays can happen with schizophrenic patients

A

True

61
Q

What happens to the ventricle with schizophrenia?

A

Enlarge

62
Q

What is the male:female ratio of conduct disorder

A

5:1

63
Q

What is the major comorbidity with conduct disorder?

A

ADHD (50% comorbidity)

64
Q

What is the difference in the MOA of amphetamine derived products, compared to methylphenidate?

A

In addition to blocking reuptake of dopamine, they increase the release of it

65
Q

What is the effect of untreated ADHD on ER visits?

A

33% increase

66
Q

What is the effect of untreated ADHD on bike accidents?

A

50% increase

67
Q

What is the effect of untreated ADHD on substance use?

A

2x risk

68
Q

What is the effect of untreated ADHD on parental absenteeism?

A

Increased

69
Q

Difficulty with symbolic play = what disease?

A

Autism

70
Q

True or false: kids with autism often lack the theory of mind

A

true

71
Q

Which gender appears later with schizophrenia?

A

Females

Psychiatry pro +1700 (28 decks)

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