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Pediatrics > Psych > Flashcards

Psych Flashcards

1
Q

3 developmental disorders?

A

ADHD
Autism Spectrum disorders
Mental Retardation

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2
Q

Psychiatric disorders? 8

A

Somatoform Disorders
Anxiety , PTSD, phobias, OCD
Depression , Bipolar
Schizophrenia

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3
Q

Pseudoseizures are a symptom of which Disorder?

A

Conversion Disorder

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4
Q

What is the most common depressive mood disorder in children and adolescents?

A

Adjustment Disorder with depressed mood

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5
Q

What is the mainstay of treatment for ADHD

A

Stimulants

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6
Q

what does PSYCH stand for

A

Parent Child interactions
School – academically, behaviorally, socially
Youth – peers, friendships, relationships
Casa – things at home..siblings..stress
Happiness – how would you describe your mood? Your childs mood?

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7
Q

what is PSYCH

A

surveillance you can ask parents and child

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8
Q

what is A characteristic cluster of signs and symptoms that are associated with subjective distress or maladaptive behavior

A

Psych d/o

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9
Q

what presents asLoss of interest, feelings of worthlessness, decreased energy, crying spells, irritability, isolation, low self esteem.

A

depression

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10
Q

can depression present with somatic symptoms

A

yes d/t the inability to tolerate sadness

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11
Q

what May present with running away, self destructive behavior, drug abuse, sexual acting out, delinquency.

A

depression

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12
Q

depression may have change in 4 things

A

attitude, sleep, appetite, friends

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13
Q

what are comorbidities of depression? 4

A

ADHD, conduct disorders, anxiety, substance abuse

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14
Q

what is Beck?

what is Reynolds?

A

Depression rating scales

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15
Q

what should be part of Ddx of depression? 4

A

Hypothyroid
Substance abuse
Eating disorder
2ndary to medical illness

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16
Q

What are complications of depression? 4

A

suicide , school performance, loss of friends, family tension

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17
Q

what are treatments for depression? 3

A

CBT (cognitive behavioral therapy)

Referral for psychotherapy , medications SSRI

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18
Q

what is the most frequent psych d/o in kids?

A

ADHD

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19
Q

what is dysthymic d/o?

A

chronic, milder form of depression, sx present for at least a year

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20
Q

what is the most common depressive mood d/o in kids?

A

Adjustment disorder with depressed mood

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21
Q

what has Symptoms that start within 3 months of an identifiable stressor (e.g., loss of a relationship), with distress in excess of what would be expected and interference with social, occupational, or school functioning. (last less than 6 months)

A

Adjustment disorder with depressed mood

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22
Q

what is Variable course of mood instability combined with aggressive behavior and impulsivity

A

bipolar disorder

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23
Q

what d/o may be dx as a kid but its really BP d/o

A

ADHD

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24
Q

what is Manic or hypomanic moods can be high energy level, difficulty concentrating, hypersexual activity, decreased sleep

A

Bipolar d/o

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25
Q

what is very often comorbid with adhd?

A

bipolar d/o

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26
Q

if kid has Problems with friends, impulsivity, criminal activity, legal difficulties what should you think

A

Bipolar d/o

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27
Q

how do you treat bipolar do

A

mood stabilizers (lithium)

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28
Q

what is the 3rd leading cause of death in adolescent

A

suicide

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29
Q

what is a black box warning of antidepressants

A

suicide

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30
Q

what is the most commonly used method of suicide

A

firearms

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31
Q

what is most commonly associated with mood d/o

A

Suicide

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32
Q

who is at highest risk of suicide

A

white adolescent males

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33
Q

when is the onset of schizophrenia

A

middle to late teens - early 30’s

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34
Q

when do signs of schizophrenia begin?

A

Sx usually begin after puberty

Childhood onset rare, more likely to be boys

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35
Q

1degree relatives have 10X risk of what?

A

schizophrenia

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36
Q

what should psychotic symptoms warrant? - what diseases?2

A

medical evaluation for neurologic disease (MRI, EEG), metabolic disease, wilsons disease

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37
Q

what are psychotic symtoms in children?

A

Children often have learning disorders, delusions, disorganized thoughts

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38
Q

what are psychotic symptoms in adolescents

A

hard to diff from mania

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39
Q

how do you treat schizophrenia

A

with antipsychotic

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40
Q

what helpsreduce hallucinations, delusions in schizophrenia

A

Supportive reality based focus in relationships

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41
Q

what Overlaps with ADHD, substance abuse, learning disabilities, mood disorders, family dysfunction

A

conduct d/o

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42
Q

if there is Boy with a turbulent home life and academic difficulties what should you think

A

conduct d/o

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43
Q

what is associated with truancy, aggression, defiance, fighting, destruction of property, theft …fire setting, sexual perpetration, substance abuse

A

conduct d/o

44
Q

when is oppositional defiant d/o evident?

A

before 8

45
Q

what is panda? associated with what psych d/o?

A

pediatric autoimmune neuropsychiatric disorder assoc w Strep

OCD

46
Q

how do you treat OCD?

A

CBT and SSRI

47
Q

what has signs and symptoms of Somatic, behavioral, emotional
Irritability, poor sleep, poor school, N/V/D
Restlessness and hyperactivity , SOB

A

anxiety

48
Q

what do children with GAD present as

A

perfectionists, overly concerned with approval of others

49
Q

how do you treat anxiety

A

CBT and SSRI

50
Q

what is Contamination, need for orderliness, repeated doubts, aggressive or horrific impulses, sexual imagery

A

obsessions

51
Q

what is Handwashing, ordering, checking, counting, repeating words silently, hoarding

A

compulsions

52
Q

in OCD what predominates in children

A

compulsions

53
Q

what has Very high comorbidity with other mood and anxiety disorders, ADHD, and developmental disorders

A

OCD

54
Q

what has Strong relationships with Tourette’s disorder, body dysmorphic disorder

A

OCD

55
Q

how do you treat OCD

A

CBT and SSRIs

56
Q

what is The term is used to describe a subset of children who have Obsessive Compulsive Disorder (OCD) and/or tic disorders such as Tourette’s Syndrome, and in whom symptoms worsen following strep. infections such as “Strep throat” and Scarlet Fever

A

PANDAS

57
Q

what are the 5 diagnostic criteria for panda?

A

Presence of obsessive-compulsive disorder and/or a tic disorder
Pediatric onset of symptoms (age 3 years to puberty)
Episodic course of symptom severity
Association with group A Beta-hemolytic streptococcal infection (a positive throat culture for strep or history of Scarlet Fever)
Association with neurological abnormalities (motoric hyperactivity, or adventitious movements, such as choreiform movements)

58
Q

what is associated with Fear, anxiety, hypervigilance. May regress developmentally. Nightmares

A

PTSD

59
Q

Individual and family psychotherapy are mainstays of therapy for?

A

PTSD

60
Q

what can you use Sertraline and Clonidine for?

A

aggressive or psychosis in PTSD

61
Q

what has High comorbidity with other anxiety disorders

A

Phobias

62
Q

how do you treat phobias

A

CBT is best. SSRI

63
Q

what are 6 somatoform d/o?

A

Body Dysmorphic disorder, Conversion Reaction, somatization d/o, hypochondriasis, malingering, factious disorder

64
Q

what somatoform d/o has neurologic / GI sx

A

conversion rxn

65
Q

what somatoform d/o seeks fo gain reward?

A

malingering

66
Q

what is equivalent to muchausen syndrome and seeks to attain medical attention

A

factitious disorder

67
Q

what involves a complaint of physical symptoms (pain or loss of function) that suggest a medical condition but are not fully explained by either a medical condition, a pharmacologic effect, or another psychiatric condition

A

somatoform disorders

68
Q

in somatoform d/o are they consciously fabricating the sx

A

nope

69
Q

Hx of: sexual trauma, physical threats
Parental neglect, substance abuse
Depression, Anxiety may have what?

A

somatoform d/o

70
Q

how do you treat somatoform d/o

A

Treat co-morbid illnesses
CBT ( cognitive behavioral therapy)
Some with SSRI (CBT + SSRI)

71
Q

what is unexplained headaches, fibromyalgia, body dysmorphic disorder, pain disorder, Irritable bowel disorder, functional gastrointestinal disorders

A

somatoform d/o

72
Q

how common is Autism spectrum d/o

A

1:150

73
Q

is ASD more common in boys or girls

A

boys 3-4:1

74
Q

can ASD be diagnosed in children before 2

A

yes

75
Q

ASD is Primarily due to a genetic disorder or disease

A

nope

76
Q

ASD pt need referral to early intervention programs

A

yes

77
Q

what is a neurodegenerative disorder

Age of onset: typically between ages 2 and 4 (can be recognized in first 12-18mo)

A

autism

78
Q

what d/o has Consistent failure to orient to one’s name, regard people directly, use gestures, and develop speech.

A

autism

79
Q

what d/o has Delayed or absent social smiling as infant

A

autism

80
Q

what are the 4 hallmarks of autism?

A

Impaired communication
Impaired social interaction
Stereotypic behaviors, interests, activities
MR is common

81
Q

what has Deficits in reciprocal social interaction
Joint attention by 18mo , and functional play
Echolalia and nonsensical speech

A

autistic d/o

82
Q

what can puberty do in autism

A

Puberty can bring worsening of aggression, hyperactivity, self destructive activity (seizures)

83
Q

3 non pharm treatments in autism

A 
Occupational therapy
Sensory integration services
Behavioral therapy ( self care, linguistics)
84
Q

what drugs are used in autism

A

Antipsychotics, antidepressants/mood stabilizers

for symptoms

85
Q

what are 4 Non Autistic Pervasive Developmental Disorders

A

Asperger syndrome, childhood disintegrative disorder, PDD-not otherwise specified and Rett Syndrome

86
Q

what PDDs have bad prognosis?

A

rett and childhood disintegration

87
Q

what has impairment in social interaction and restricted interest/repetitive behaviors
Not delayed in cognitive, language or self help

A

asperger

88
Q

what has Mild Impairment in reciprocal social interaction
Impairment in communication skills
Restricted interests and repetitive behaviors

A

PPD - NOS

89
Q

what has Typical development for at least 2 years, then regression in at least 2 of 3 areas
Social interaction
Communication
Behavior

A

Childhood disintegrative d/o

90
Q

what is Genetic, due to mutation on X chrom

Almost exclusively girls

A

Rett Syndrome

91
Q

what has Regression in skills in the first year of life

Characteristic handwringing

A

Rett Syndrome

92
Q

what has Severe deficits in development of language, motor skills, attention, abstract reasoning, visual-spatial skills, and academic or vocational achievement.

A

Mental retardation

93
Q

what has an IQ<70 and skills more than 2 standard deviations below the mean

A

mental retardation

94
Q

how do you eval mental retardation in 0-31/2 y/o?

A

bayley scales of infant devp

95
Q

how do you eval mental retardation in >3y/o

A

Wechsler Intelligence Scale, Stanford-Binet IV

96
Q

3 subtypes of ADHD

A

Hyperactive Impulsive : 10% . Can pay attention
Inattentive :30-40% (old ADD term)
Combined : 50-60%

97
Q

how do you asses for ADHD

A

Vanderbuilt Assessment Scales for AD/HD

98
Q

when can symptoms of ADHD diminish

A

10-25

99
Q

in ADHD what declines more rapidly? impulsivity, inattentiveness, hyperactivity

A

hyperactivity

100
Q

what are d/o with ADHD - 8

A 
Fragile X
Williams syndrome
Angelman syndrome
XXY Syndrome (kleinfelter syndrome)
Turner Syndrome
FAS
CNS trauma or infection
Prematurity
101
Q

what is the mainstay tx of ADHD

A

Methylphenidate (Ritalin) , Concerta

Dextroamphetamine, Adderall

102
Q

t/f Comorbidity in ADHD increases substance abuse at least 5 fold.

A

T

103
Q

t/f Stimulant treatment of ADHD leads to an increased incidence of later substance abuse.

A

F

104
Q

t/f 25% of unmedicated ADHD patients practice substance abuse.

A

f - 75%

105
Q

t/f Those treated with stimulant drugs commonly abuse their prescribed agents.

A

F - protective

Pediatrics (9 decks)

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