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Phase 3a - Paediactrics > Psychiatry > Flashcards

Psychiatry Flashcards

1
Q

ADHD

A

Attention Deficit Hyperactivity Disorder

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2
Q

ADHD involved altered levels of ___ in the brain

A

Dopamine

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3
Q

How does ADHD affect the brain?

A

Structural and functional changes in the brain

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4
Q

Is there a genetic component to ADHD?

A

Yes

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5
Q

Which gender is ADHD more common in?

A

More common in boys than girls (4:1) this is attributed to girls being able to cover up their symptoms until a later age

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6
Q

__% of children with ADHD also have another co-morbid such as ASD, dyslexia or
depression/anxiety

A

50

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7
Q

2 Categories of Presentation of ADHD

A

Inattention + Hyperactivity/Impulsivity

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8
Q

Inattention Symptoms of ADHD

A
  • Does not complete instructions - Does not want to engage in intense tasks - Easily distracted - Difficulty organising tasks - Forgetful - Loses important things
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9
Q

Hyperactivity/Impulsivity Symptoms of ADHD

A
  • Cannot play quietly - Talks excessively - Does not wait their turn - Continuously on the go - Interrupt others - Answers questions prematurely
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10
Q

Diagnosing ADHD in < 16 y/o

A

child must have at least 6 criteria from either category

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11
Q

Diagnosing ADHD in > 17 y/o

A

child must have at least 5 criteria from either category

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12
Q

Conditions for the symptoms of ADHD

A

Symptoms must have been present BEFORE 12 years old for > 6 months - Symptoms must be present in more than one setting - Must be evidence of impairment of child’s function but also in line with child’s developmental level

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13
Q

Ix for ADHD

A
  • Conners questionnaire - School observation - Home visit and information from other relatives etc
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14
Q

Non-Medical Management of ADHD

A
  • Care plans from teachers - CBT - Behavioural strategies
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15
Q

Medical Management of ADHD

A
  • FIRST LINE : Methylphenidate - Lisdexamfetamine - Dexamfetamine
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16
Q

Side Effects of Methylphenidate

A

Cardiotoxic - do a baseline ECG before prescribing

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17
Q

Autism Spectrum Disorder

A

A neurodevelopmental disorder impacts social interaction, communication and behaviour

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18
Q

Causes of Autism Spectrum Disorder

A

Genetic with multi gene involvement - Structural changes within the brain

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19
Q

3 Catergories of Presentation of Autism Spectrum Disorder

A

Abnormal social interaction, impaired social communication, repetitive ideas

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20
Q

Abnormal Social Interaction Presentation of Autism Spectrum Disorder

A

Poor eye contact - Plays alone - Uninterested in social interaction - Difficulty forming close relationships

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21
Q

Impaired social communication of Autism Spectrum Disorder

A

Failure to develop spoken language - Failure to initiate conversation - Abnormal rhythm, pitch and tone of speech

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22
Q

Repetitve ideas of Autism Spectrum Disorder

A

Need for routine/rituals - Motor mannerisms: repetitive compulsive movements - Sensory issues: Only eat certain foods, do not like loud noises

23
Q

Dx of Autism Spectrum Disorder

A

Features from all 3 categories plus one of before aged 3 1. Lack of social attachments 2. Abnormal/delayed expression 3. Abnormal symbolic play

24
Q

Management of Autism Spectrum Disorder

A
  • Education care plans - Applied behaviour analysis - Family support/counselling - MDT approach
25
Q

What is anorexia nervosa?

A

Anorexia nervosa is an eating disorder characterized by self-starvation, an intense fear of weight gain, and a distorted body image.

26
Q

True or False: Anorexia nervosa is more common in adults than in children.

A

False. Anorexia nervosa can affect individuals of all ages, including children and adolescents

27
Q

What are common risk factors for developing anorexia nervosa?

A
  • Genetic predisposition

Environmental pressures

Psychological factors such as anxiety disorders

Sociocultural influences promoting thinness

28
Q

Which of the following is a common symptom of anorexia nervosa in children?

A) Excessive weight gain

B) Self-induced vomiting

C) Self-starvation

D) Increased appetite

A

C) Self-starvation

Explanation: Children with anorexia nervosa often engage in self-starvation to prevent weight gain.

29
Q

Which of the following is a common diagnostic method for anorexia nervosa in children?

A) Skin biopsy

B) Blood tests

C) Psychological evaluation

D) Urine analysis

A

C) Psychological evaluation

Explanation: A comprehensive psychological evaluation is essential for diagnosing anorexia nervosa

30
Q

What is the primary treatment approach for anorexia nervosa in children?

A) Medication alone

B) Nutritional rehabilitation

C) Psychotherapy

D) Surgery

A

B) Nutritional rehabilitation

Explanation: Treatment typically involves nutritional rehabilitation, psychotherapy, and medical monitoring.

31
Q

What are potential complications of anorexia nervosa in children?

A

Malnutrition

Electrolyte imbalances

Organ damage

Growth retardation

32
Q

True or False: With early intervention, the prognosis for children with anorexia nervosa is generally good.

A

True

Explanation: Early recognition and treatment can lead to a favorable outcome for children with anorexia nervosa.

33
Q

Which of the following is a preventive measure for anorexia nervosa in children?

A) Encouraging healthy eating habits

B) Promoting dieting

C) Discouraging physical activity

D) Ignoring body image concerns

A

A) Encouraging healthy eating habits

Explanation: Encouraging healthy eating habits and realistic attitudes toward weight and diet can help prevent anorexia nervosa.

34
Q

Which organization provides support for individuals with eating disorders?

A) National Eating Disorders Association (NEDA)

B) American Heart Association

C) American Cancer Society

D) National Institute of Mental Health

A

A) National Eating Disorders Association (NEDA)

Explanation: NEDA offers resources and support for individuals affected by eating disorders.

35
Q

What is bulimia nervosa?

A

Bulimia nervosa is an eating disorder characterized by recurrent episodes of binge eating followed by compensatory behaviors such as self-induced vomiting, excessive exercise, or misuse of laxatives.

36
Q

Bulimia nervosa involves recurrent episodes of __________ followed by compensatory behaviors to prevent weight gain.

A

binge eating

37
Q

True/False:
Q: Bulimia nervosa is more common in females than males.

A

True.

38
Q

What is the typical age of onset for bulimia nervosa?

A

Adolescence or early adulthood, typically between 15 and 25 years.

39
Q

Which groups are at higher risk for bulimia nervosa?

A

Females (10:1 female-to-male ratio).
Adolescents and young adults.
Those with a history of dieting or perfectionistic tendencies.

40
Q

The peak onset of bulimia nervosa is between __________ and __________ years of age.

A

15;25

41
Q

What are the core diagnostic features of bulimia nervosa?

A

Recurrent episodes of binge eating.
Compensatory behaviors to prevent weight gain (e.g., vomiting, laxatives).
Self-esteem unduly influenced by body shape and weight.
Episodes occur at least once a week for 3 months.

42
Q

To meet the diagnostic criteria for bulimia nervosa, binge eating and compensatory behaviors must occur at least __________ a week for __________ months.

A

once; three

43
Q

What physical signs may indicate bulimia nervosa?

A

Russell’s sign (calluses on knuckles from induced vomiting).
Dental enamel erosion (from acid in vomit).
Swollen parotid glands.
Dehydration and electrolyte imbalances.

44
Q

What psychological features are associated with bulimia nervosa?

A

Low self-esteem.
Fear of weight gain.
Obsession with body image.
Mood disturbances (e.g., depression, anxiety).

45
Q

What are the common medical complications of bulimia nervosa?

A

Electrolyte imbalances (e.g., hypokalemia).
Cardiac arrhythmias (e.g., QT prolongation).
Gastrointestinal issues (e.g., esophagitis, Mallory-Weiss tears).
Dehydration and renal impairment.
Dental problems (e.g., enamel erosion, cavities).

46
Q

Hypokalemia due to excessive vomiting or laxative use can lead to life-threatening __________.

A

arrhythmias

47
Q

What tools are used to assess bulimia nervosa?

A

Clinical history (binge and purge patterns, body image concerns).
Physical examination for physical signs (e.g., dental erosion, parotid swelling).
Laboratory tests for electrolyte imbalances and renal function.

48
Q

A __________ is often used to screen for eating disorders in adolescents and includes questions about body image and eating behaviors.

A

SCOFF questionnaire

49
Q

What are the key principles of managing bulimia nervosa?

A

Multidisciplinary approach involving medical, psychological, and nutritional care.
Psychotherapy:
Cognitive-behavioral therapy (CBT) is first-line.
Family-based therapy for adolescents.
Pharmacotherapy:
SSRIs (e.g., fluoxetine) may be used for bulimia and comorbid depression or anxiety.
Medical monitoring for complications (e.g., electrolyte imbalances).

50
Q

__________ therapy is considered the first-line treatment for bulimia nervosa.

A

Cognitive-behavioral

51
Q

True/False:
Q: SSRIs, such as fluoxetine, are effective in reducing binge-purge behaviors in bulimia nervosa.

A

true.

52
Q

What factors influence the prognosis of bulimia nervosa?

A

Early diagnosis and treatment improve outcomes.
Severity of symptoms and comorbid conditions may complicate recovery.
Supportive environment and adherence to therapy enhance recovery.

53
Q

What conditions should be considered in the differential diagnosis of bulimia nervosa?

A

Anorexia nervosa (binge-purge subtype).
Binge eating disorder (no compensatory behaviors).
Major depressive disorder (with weight loss).
Gastrointestinal disorders (e.g., GERD causing vomiting).

Phase 3a - Paediactrics (17 decks)

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