Peds psych

Question 1

Anxiety disorders- Eti

Answer 1

• 10% of children

- School refusal, generalized, social, phobias, OCD, PTSD & selective mutism

Question 2

Anxiety disorder- Generalized- Sx

Answer 2

Intense, disproportionate or irrational worry about future events

Question 3

Anxiety disorders- Panic- Sx

Answer 3

• Unprovoked, intense fear with sympathetic hyperarousal, palpitations & hyperventiallation

Question 4

Anxiety disorders- PTSD- Sx

Answer 4

• Fear of recurrence of intense, anxiety providing traumatic experience
• Symp arousal
• Avoidance of reminders
• Re-experiencing event

Question 5

Anxiety disorders- Separation- Sx

Answer 5

• Developmentally inappropriate wish to remain in proximity of caregivers
• Morbid worry
• Intense homesickness

Question 6

Anxiety disorders- Social phobia- Sx

Answer 6

• Painful shyness, self consciousness

- Fear or humiliation with public scrutiny

Question 7

Anxiety disorders- Phobia- Sx

Answer 7

• Avoidance of specific feared stimuli

Question 8

Anxiety disorders- Dx

Answer 8

• DSM criteria

Question 9

Anxiety disorders- Tx

Answer 9

• CBT
• Exposure
• SSRIs

Question 10

Depression- Eti

Answer 10

• Incidence increases with age

- F>M after puberty

Question 11

Depression- Sx

Answer 11

• Dysphoric mood, irritability, depressed appearance persisting for days/ months
• Neurovegitive sx: Change in sleep, appetite, concentration & activity
• Suicidal ideation, hoplessness

Question 12

Depression- Dx

Answer 12

• Begin screening at 12

- PHQ9

Question 13

Depression- Tx

Answer 13

• CBT & family therapy

- Antidepressants

Question 14

Eating disorders- Eti

Answer 14

• Anorexia, bulimia, binge eating, avoidant/ restrictive
• Genetic
• Girls: AN, increasing incidence

Question 15

Eating disorders- Anorexia- Sx

Answer 15

• Abnormal body image
• Secondary amenorrhea
• Wt loss, decreaed temp
• Bradycardia, dizziness, syncope
• Thin brittle hair & nails, increase lanugo

Question 16

Eating disorders- Tx

Answer 16

• Medical nutrition monitoring & therapy

- Family psychotherapy

Question 17

Eating disorders- Bulimia- Sx

Answer 17

• Feel out of control while eating
• Purge to prevent wt gain
• Eating excessive amts of food
• Average to overwt
• GI sx due to purge

Question 18

Eating disorders- Binge eating- Sx

Answer 18

• Overwt & obese
• Recurrent binging
• More rapid, marked distress, feeling disgusted

Question 19

Eating disorders- Avoidant/ restrictive

Answer 19

• Restriction of oral food intake

- Failure to meet nutritional or energy needs

Question 20

Autism spectrum- Eti

Answer 20

• M>F
• Genetic abn: fragile x
• 1:88 children
• Screen at 18 mo, 24-30 mo

Question 21

Autism spectrum- Sx

Answer 21

• Persistant deficits in social communication & interaction across multiple contexts
• Restricted, repetitive patterns of behavior, interests & activities

Question 22

Autism spectrum- Tx

Answer 22

• Intese psychotherapy focusing on social deficits

- Tx other sx with meds

Question 23

Sleep disorders- Eti

Answer 23

• 20-40% in 1st 4 years
• 10-12% in school-aged
• Insomnia most common

Question 24

Sleep disorders- Parasomnias-Eti

Answer 24

• Abn of arousal, partial arousal & transitions
• Night terrors, sleeptalking, and sleepwalking
• NREM

Question 25

Sleep disorders- Night terrors- Sx

Answer 25

• Within 2 hrs of sleep
• Sleepwalking
• 3%
• Thrashing, tachypnea & cardia,
• Incoherent and unresponsive to comforting

Question 26

Sleep disorders- Tx

Answer 26

• Reassure parents

- Regular sleep schedule, avoid stressors

Question 27

Sleep disorders- Nightmares- Sx

Answer 27

• Frightening dreams
• Awaken
• Peaks at 3-5 yrs, 25-50%
• Describe dream
• Comforted by parents