Psychiatry Flashcards
ADHD
Attention Deficit Hyperactivity Disorder
ADHD involved altered levels of ___ in the brain
Dopamine
How does ADHD affect the brain?
Structural and functional changes in the brain
Is there a genetic component to ADHD?
Yes
Which gender is ADHD more common in?
More common in boys than girls (4:1) this is attributed to girls being able to cover up their symptoms until a later age
__% of children with ADHD also have another co-morbid such as ASD, dyslexia or
depression/anxiety
50
2 Categories of Presentation of ADHD
Inattention + Hyperactivity/Impulsivity
Inattention Symptoms of ADHD
- Does not complete instructions - Does not want to engage in intense tasks - Easily distracted - Difficulty organising tasks - Forgetful - Loses important things
Hyperactivity/Impulsivity Symptoms of ADHD
- Cannot play quietly - Talks excessively - Does not wait their turn - Continuously on the go - Interrupt others - Answers questions prematurely
Diagnosing ADHD in < 16 y/o
child must have at least 6 criteria from either category
Diagnosing ADHD in > 17 y/o
child must have at least 5 criteria from either category
Conditions for the symptoms of ADHD
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
Ix for ADHD
- Conners questionnaire - School observation - Home visit and information from other relatives etc
Non-Medical Management of ADHD
- Care plans from teachers - CBT - Behavioural strategies
Medical Management of ADHD
- FIRST LINE : Methylphenidate - Lisdexamfetamine - Dexamfetamine
Side Effects of Methylphenidate
Cardiotoxic - do a baseline ECG before prescribing
Autism Spectrum Disorder
A neurodevelopmental disorder impacts social interaction, communication and behaviour
Causes of Autism Spectrum Disorder
Genetic with multi gene involvement - Structural changes within the brain
3 Catergories of Presentation of Autism Spectrum Disorder
Abnormal social interaction, impaired social communication, repetitive ideas
Abnormal Social Interaction Presentation of Autism Spectrum Disorder
Poor eye contact - Plays alone - Uninterested in social interaction - Difficulty forming close relationships
Impaired social communication of Autism Spectrum Disorder
Failure to develop spoken language - Failure to initiate conversation - Abnormal rhythm, pitch and tone of speech
Repetitve ideas of Autism Spectrum Disorder
Need for routine/rituals - Motor mannerisms: repetitive compulsive movements - Sensory issues: Only eat certain foods, do not like loud noises
Dx of Autism Spectrum Disorder
Features from all 3 categories plus one of before aged 3
1. Lack of social attachments
2. Abnormal/delayed expression
3. Abnormal symbolic play
Management of Autism Spectrum Disorder
- Education care plans - Applied behaviour analysis - Family support/counselling - MDT approach
What is anorexia nervosa?
Anorexia nervosa is an eating disorder characterized by self-starvation, an intense fear of weight gain, and a distorted body image.
True or False: Anorexia nervosa is more common in adults than in children.
False. Anorexia nervosa can affect individuals of all ages, including children and adolescents
What are common risk factors for developing anorexia nervosa?
- Genetic predisposition
Environmental pressures
Psychological factors such as anxiety disorders
Sociocultural influences promoting thinness
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
C) Self-starvation
Explanation: Children with anorexia nervosa often engage in self-starvation to prevent weight gain.
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
C) Psychological evaluation
Explanation: A comprehensive psychological evaluation is essential for diagnosing anorexia nervosa
What is the primary treatment approach for anorexia nervosa in children?
A) Medication alone
B) Nutritional rehabilitation
C) Psychotherapy
D) Surgery
B) Nutritional rehabilitation
Explanation: Treatment typically involves nutritional rehabilitation, psychotherapy, and medical monitoring.
What are potential complications of anorexia nervosa in children?
Malnutrition
Electrolyte imbalances
Organ damage
Growth retardation
True or False: With early intervention, the prognosis for children with anorexia nervosa is generally good.
True
Explanation: Early recognition and treatment can lead to a favorable outcome for children with anorexia nervosa.
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) Encouraging healthy eating habits
Explanation: Encouraging healthy eating habits and realistic attitudes toward weight and diet can help prevent anorexia nervosa.
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) National Eating Disorders Association (NEDA)
Explanation: NEDA offers resources and support for individuals affected by eating disorders.
What is bulimia nervosa?
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.
Bulimia nervosa involves recurrent episodes of __________ followed by compensatory behaviors to prevent weight gain.
binge eating
True/False:
Q: Bulimia nervosa is more common in females than males.
True.
What is the typical age of onset for bulimia nervosa?
Adolescence or early adulthood, typically between 15 and 25 years.
Which groups are at higher risk for bulimia nervosa?
Females (10:1 female-to-male ratio).
Adolescents and young adults.
Those with a history of dieting or perfectionistic tendencies.
The peak onset of bulimia nervosa is between __________ and __________ years of age.
15;25
What are the core diagnostic features of bulimia nervosa?
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.
To meet the diagnostic criteria for bulimia nervosa, binge eating and compensatory behaviors must occur at least __________ a week for __________ months.
once; three
What physical signs may indicate bulimia nervosa?
Russell’s sign (calluses on knuckles from induced vomiting).
Dental enamel erosion (from acid in vomit).
Swollen parotid glands.
Dehydration and electrolyte imbalances.
What psychological features are associated with bulimia nervosa?
Low self-esteem.
Fear of weight gain.
Obsession with body image.
Mood disturbances (e.g., depression, anxiety).
What are the common medical complications of bulimia nervosa?
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).
Hypokalemia due to excessive vomiting or laxative use can lead to life-threatening __________.
arrhythmias
What tools are used to assess bulimia nervosa?
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.
A __________ is often used to screen for eating disorders in adolescents and includes questions about body image and eating behaviors.
SCOFF questionnaire
What are the key principles of managing bulimia nervosa?
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).
__________ therapy is considered the first-line treatment for bulimia nervosa.
Cognitive-behavioral
True/False:
Q: SSRIs, such as fluoxetine, are effective in reducing binge-purge behaviors in bulimia nervosa.
true.
What factors influence the prognosis of bulimia nervosa?
Early diagnosis and treatment improve outcomes.
Severity of symptoms and comorbid conditions may complicate recovery.
Supportive environment and adherence to therapy enhance recovery.
What conditions should be considered in the differential diagnosis of bulimia nervosa?
Anorexia nervosa (binge-purge subtype).
Binge eating disorder (no compensatory behaviors).
Major depressive disorder (with weight loss).
Gastrointestinal disorders (e.g., GERD causing vomiting).
