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Part 3 – PM3B COPY T > (PM3B) ADHD & Autism > Flashcards

(PM3B) ADHD & Autism Flashcards

1
Q

What is ADHD?

A

Attention Deficit Hyperactivity Disorder

Persistent pattern of inattention or hyperactivity

More frequently displayed than other individuals at a similar level of development

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2
Q

When does ADHD tend to start?

A

Early childhood

<7 years old

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3
Q

Is there a higher incidence of ADHD in boys or girls?

A

Boys

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4
Q

What is the prevalence of ADHD in children?

A

2-10%

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5
Q

What tools are used to diagnose ADHD?

A

(1) DSM-V

(2) ICD-10

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6
Q

How can ADHD be diagnosed?

A

Assessment of information collected from:

  • Parent
  • School
  • Young person themselves (if old enough)

Using Conner’s Comprehensive Behavior Rating Scalesassessment

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7
Q

Which part of the brain is responsible for ADHD?

A

Global cognitive effects – (many areas of the brain)

(1) Frontoparietal circuits
(2) Dorsal frontal parietal circuits
(3) Mesocorticolimbic circuits

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8
Q

What are some of the genetic risk factors for ADHD?

A

(1) Dopamine transporter – D4 receptor
(2) Dopamine beta-hydroxylase
(3) MAOA
(4) Catecholine-methyl transferase
(5) SLC6A4
(6) 5HT2A
(7) 5HT1B
(8) DAT1 gene
(9) DRD4 gene

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9
Q

What are some of the environmental risk factors for ADHD?

A

(1) Lead exposure

(2) Smoking/ alcohol in pregnancy

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10
Q

Why are animal models used in ADHD?

A

(1) To model behavioural characteristics
(2) Testing therapeutic compounds
(3) Testing genetic associations
(4) Identification of novel ADHD candidate genes

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11
Q

What is the treatment for ADHD?

A

(1) Stimulants – ADHD children require more stimulation to maintain attention
- e.g. methylphenidate/ dexamfetamine/ atomoxetine

(2) Antipsychotics are specifically NOT recommended

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12
Q

When is atomoxetine considered first line treatment for ADHD?

A

When there is risk of drug abuse

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13
Q

What is the mechanism of action of methylphenidate?

A

Norepinephrine–dopamine reuptake inhibitor

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14
Q

What is normally considered the first line treatment for ADHD in children and young people?

A

Drug treatment is NOT indicated

Drug treatment reserved for those with severe symptoms

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15
Q

What is normally considered the first line treatment for ADHD in adults?

A

Drug treatment is first line for moderate or severe ADHD

Methylphenidate is first line
- Atomoxetine or dexamfetamine can be tried if ineffective/ unacceptable

Cognitive Behavioural Therapy (CBT) may be considered

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16
Q

What is Asperger’s syndrome?

A

Higher intellectual function

Autistic psychopathy in childhood

17
Q

What is autism spectrum disorder?

A

Lifelong, developmental disability

Affects how a person communicates with and relates to other people, and how they experience the world around them

Presents from early childhood

18
Q

What is the prevalence of autism spectrum disorder?

A

~1.5%

19
Q

What co-occurring conditions are common with autism spectrum disorder?

A

(1) Epilepsy
(2) ADHD
(3) Mental health problems
(4) Genetic associations

20
Q

What is ASD?

A

Autism Spectrum Disorder

21
Q

Is autism spectrum disorder more common in males or females?

A

Males

Ratio of M:F is 4:1

22
Q

What are some of the common symptoms that present in autism spectrum disorder?

A

(1) Difficulty with social communication
(2) Patterns of interests/ behaviours
(3) Obsessive interests in hobbies
(4) High dependence of routines and predictability

23
Q

What are some of the less common symptoms that present in autism spectrum disorder?

A

(1) Sensory interests
(2) Sensitivity –sometimes experienced as physically painful
(3) Emotional disregulation – strong emotions + difficulty managing responses
(4) Specific motor mannerisms

24
Q

How does autism spectrum disorder present in adults?

A

Outcome in adulthood is generally poor

Often a requirement for daily support

Social vulnerability – bullying

25
Q

Describe the neuroanatomical development of brain size in those with autism spectrum disorder.

A

At birth – have an increased brain size

Postnatal – very similar size to normal

Adolescence – very similar size to normal

Old age – some possibility of decline/ deterioration

26
Q

What are some environmental or social risk factors for development of autism spectrum disorder?

A

(1) Parental age at time of conception
(2) Factors during pregnancy – weight gain/ metabolic conditions
(3) Maternal medication use – e.g. valproate increases his of development of autism spectrum disorder

27
Q

What are some genetic risk factors for development of autism spectrum disorder?

A

(1) Individual genetic variants

(2) 74-93% of autism spectrum disorder is inherited

28
Q

What is the recommended treatment for autism spectrum disorder by NICE?

A

(1) Non-pharmacological treatments
(2) Psychosocial interventions
(3) Antipsychotics –complex cases ONLY

29
Q

What are some recommended psychosocial interventions, and their reasons, for individuals with autism spectrum disorder?

A

(1) Play-based strategies
- Increasing joint attention + engagement

(2) Adjustment of understanding of parents, carers, teachers or peers
(3) Should be delivered by a trained professional

30
Q

How are animal models used for autism spectrum disorder?

A

(1) Genetic mutation for ASD inserted into rat host DNA
(2) Growth of ASD rat
(3) Development of therapeutic candidates on ASD rat

31
Q

What is the ‘Refrigerator Mother’ theory?

A

The theory that autism spectrum disorder is caused b a lack of maternal warmth of her child

32
Q

Does the ‘Refrigerator Mother’ theory have any clinical basis?

A

No

33
Q

What evidence is there to support dietary interventions in the prevention and management of autism spectrum disorder?

A

None

34
Q

What is the curative treatment for autism spectrum disorder?

A

There is not one

35
Q

Name two complex neurodevelopmental disorders.

A

(1) ADHD – attention deficit hyperactivity disorder

(2) ASD – autism spectrum disorder

36
Q

What do the NICE treatment recommendations focus on in the management of autism spectrum disorder in children?

A

Non-pharmacological strategies

Part 3 – PM3B COPY T (33 decks)

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