Psychosocial/Mental Health

Question 1

Chronic illness

Answer 1

Disease lasting longer than 3 months

Question 2

Disability

Answer 2

Limitation that hinders a child’s ability to fully participate in society

Question 3

Types of child abuse (5)

Answer 3

Physical, Munchausen syndrome, emotional, neglect, sexual

Question 4

Munchausen syndrome signs

Answer 4

Unexplained, prolonged, or extremely rare illnesses
Discrepancies between history and clinical findings
Unresponsive to treatment
Symptoms only present when parent is there

Question 5

Emotional abuse signs

Answer 5

FTT, enuresis, habit disorders, passive, aggressive, SI

Question 6

Sexual abuse signs

Answer 6

Difficulty walking/sitting
Torn, stained, or bloody underclothes
Trauma in oral, genital, anal regions
Pain, itching, STDs, genital discharge
Pregnancy
Weight loss, eating disorders
<5 y/o - regression in feeding/toileting, frequent underwear changes
5-10 y/o - school problems, night terrors, refusal of physical activity
Adolescents - running away, drugs, alcohol, promiscuity, eating disorders, depression

Question 7

Failure to thrive

Answer 7

Deceleration or arrested physical growth whereby height and weight measurements fall below the 5th percentile, or there is a downward change in growth across two major growth percentiles

Question 8

Death - infants and toddlers

Answer 8

No concept of death but may react to separation and loss
Infants - can cry excessively, resist comfort, eat less, sleep more
Toddlers - may regress, become more aggressive or fearful, changes in eating and sleeping habits

Question 9

Death - preschool

Answer 9

May see death as temporary or reversible
Can believe they caused a death or that death is a punishment or wish fulfillment
May feel terminal illness is contagious
May become aggressive, fear sleeping or have nightmares - magical thinking

Question 10

Death - young school age (6-8)

Answer 10

See death as real, frightening, and violent
May believe they can avoid death by being good
May personify death - ex. boogie man

Question 11

Death - older school age (8-12)

Answer 11

Interested in details of death and funeral

May become sad and lonely

Question 12

Death - adolescents

Answer 12

Grief, unable to prioritize losses

Question 13

Developmental disability

Answer 13

Characterized by significant limitations in both intellectual functioning and adaptive behavior
Originates before age 18 (during developmental period)
Characterized by IQ of <70

Question 14

Mild developmental disability

Answer 14

IQ of 50-70

Question 15

Moderate developmental disability

Answer 15

IQ of 33-55

Question 16

Severe developmental disability

Answer 16

IQ of 20-35

Question 17

Profound developmental disability

Answer 17

IQ below 20

Question 18

Autism spectrum disorder - clinical manifestations

Answer 18

Impaired social interactions, delayed speech and language, abnormal communication (echolalia, using a single word, talking in length on favorite topic, using a word with special meaning), rigid obsessive behaviors, abnormal motor movements, hand flapping, difficulty adapting to new situations, aggression, sleep problems, intellectual disability, GI problems, mental health disorders

Question 19

ALARM

Answer 19

A - autism is prevalent 
L - listen to the parents
A - act early
R - refer
M - monitor

Question 20

Hospitalizations - autism

Answer 20

Keep rituals, bring objects from home, consistent staffing

Question 21

Autism screening

Answer 21

Should be done at 18-24 months, sooner if exhibiting symptoms

Question 22

Attention deficit hyperactivity disorder

Answer 22

Persistent pattern of inattention or hyperactivity with impulsivity
6 or more symptoms of inattention or/and hyperactivity and impulsivity that have persisted for at least 6 months to a degree that is maladaptive and inconsistent with development level

Question 23

ADHD medications (3)

Answer 23

Methylphenidate (Ritalin, Methylin, Focalin), tricyclic antidepressants, atomoxetine (Strattera)

Question 24

Methylphenidate adverse effects

Answer 24

Nervousness, restlessness, dizziness, impaired thinking, headache, loss of appetite, dry mouth

Question 25

Tricyclic antidepressants adverse effect

Answer 25

Dental caries

Question 26

Mood dysregulation disorder

Answer 26

Severe and recurrent temper outbursts that are markedly disproportionate in intensity or duration to the situation
Outbursts occur on average 3 or more times a week for 1 year or more
Between outbursts, child displays persistent irritable mood most of the day nearly every day

Question 27

Depression - infants

Answer 27

Failure to eat and develop

Question 28

Depression - toddlers

Answer 28

Regression

Question 29

Depression - preschool

Answer 29

Decreased play, self-destructive themes

Question 30

Depression - school age

Answer 30

Decreased academic performance, decreased activity, somatic complaints

Question 31

Depression - adolescent

Answer 31

Decreased school performance, sleeping and eating problems, anxiety, aggression, SI

Question 32

SI signs

Answer 32

Lethargy/malaise, inability to sleep or early morning awakening, loss of appetite or overeating, excessive crying, giving away cherished possessions, preoccupation with death themes, statement to commit suicide