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Psych > Psychiatric disorders of children and adolescents > Flashcards

Psychiatric disorders of children and adolescents Flashcards

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1
Q

What is ADHD?

A

Attention deficit hyperactivity disorder
Persistent inattention and/or situationally excessive motor activity and impulsive behaviour

Symptoms that persist for at least 6 months thats is inconsistent with development level
Impairment has to be seen in 2 or more settings

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2
Q

What is the pathophysiology behind ADHD?

A

Dysregulation in catecholamines circuits in the frontal cortex: Dopamine and noradrenaline transporters (DAT/NET)

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3
Q

What are the 3 subtypes of ADHD?

A
  1. Predominantly inattentive (ADHD -I)
  2. Predominantly hyperactive impulsive (ADHD-HI)
    3 Combined type (ADHD-C)
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4
Q

How would you evaluate if someone has ADHD?

A
  1. Intelligence test
  2. Achievement test
  3. Langauge skills
  4. Tests of attention and executive functioning
  5. Measure of social and emotional functioning
  6. ADHD dating scales
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5
Q

What are ways to manage ADHD?

A

First line: Behavioural therapy

Medications: stimulants/ non stimulants

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6
Q

When should medication be considered for ADHD?

A
  1. When symptoms are pervasive across settings
  2. When symptoms cause significant impairment in academic, social function
  3. After consideration of non pharm management
  4. Following established goals prior to commencing a trial of medical treatment
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7
Q

What are 2 examples of stimulants used for ADHD?

A
  1. Methyphenidate
  2. Dexamphetamine

increase dopamine by blocking DAT

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8
Q

What are side effects common to the use of stimulants? (6)

A
  1. Appetite suppression
  2. Sleep disturbance
  3. Digestive upset
  4. Abdominal discomfort
  5. Mild increase to HR and BP
  6. Abuse potential
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9
Q

What is a example of a non stimulant and S/E associated

A

Atomoxetine
Increases availability of NA by blocking NET

S/E= Decreased appetite
N+V
Dizziness
Fatigue
Mood swings
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10
Q

What other treatment options are available for ADHD besides stimulants?

A
  1. TCA
  2. Other antidepressants
  3. Clonidine
  4. Modafenil

used if other co morbidity exists

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11
Q

What are some risk factors for developing an eating disorder? (7)

A
  1. Female
  2. Repeated dieting
  3. Early puberty
  4. Perfectionism
  5. Teasing about weight
  6. Low self esteem
  7. Losses/ major life events
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12
Q

What BMI is considered anorexic?

A

< 17.5

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13
Q

What complications can arise from anorexia?

A
  1. Cardiovascular
  2. Dermatologic
  3. GI
  4. Haematologic
  5. Renal
  6. Endocrine and metabolic
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14
Q

What long term complication can arise from anorexia?

A
  1. Pubertal delay or arrest
  2. Growth retardation and short stature
  3. Impairment of bone mineral acquisition leading to osteopenia and osteoporosis
  4. Psychological conditions- depress and anxiety
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15
Q

How to treat anorexia?

A
  1. Restoring weight loss
  2. Treating psychological disturbances
  3. Achieving long term remission and rehabilitation
  4. Maintaining adequate vitamin, electrolyte levels
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16
Q

What are 2 subtypes of bulimia?

A
  1. Purging- pt regularly engages in self induce vomiting to misuse of laxatives, diuretics or enemas
  2. Non purging- inappropriate compensating behaviours such as fasting or excessive exercise
17
Q

What are some complications of bulimia?

A
  1. GI
  2. Pulmonary
  3. Cardiac
  4. Endocrine
  5. Metabolic
18
Q

How would you treat bulimia?

A
  1. Reduce/ eliminate binge eating and purging behaviour
    - nutritional rehab, psychosocial intervention, medication management strategies, establish regular non binge meals and exercise, improve attitude
  2. Resolution of co-occurring conditions such as mood or anxiety disorders

Psych (7 decks)

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