School Aged Children

Question 1

What are the recommendations for TB skin test screening in children?

Answer 1

once before 6 years old and annually with risk factors

Question 2

Concrete Operational thought (school age)

Answer 2

learning, thought processes reversible, classify things, use deductive reasoning, understand concepts of conservation, time, money, and space

Question 3

What is the recommended amount of daily screen time?

Answer 3

Less than 2 hours per day

Question 4

What is the best way to convey sex, drug, and alcohol information to school age (and adolescent) kids?

Answer 4

Reinforcement over time

Question 5

Differential diagnosis for obesity

Answer 5

Endocrine disorders
genetic disorders
medications (antipsychotics)
inactivity and poor diet

Question 6

Definition of obesity in children

Answer 6

BMI is greater than 95th percentile

Question 7

What is the goal of management of obesity in school aged children?

Answer 7

Goal is to stabilize weight. Linear growth will compensate.

Question 8

Types of attention deficit disorder

Answer 8

Predominantly inattentive type
Predominantly hyperactive/impulsive type
Combined type (most common)

Question 9

Risk factors for attention deficit disorder

Answer 9

family history, boys, maternal smoking, fetal insult, lead exposure, diet, chaotic environment, learning disorder

Question 10

Frequent comorbidities with ADD

Answer 10

learning disabilities, anxiety, depression, oppositional defiant disorder (ODD) or conduct disorder

Question 11

Management of ADD

Answer 11

CNS stimulants (first line), structured environment, mental health referral, positive and negative reinforcement

Question 12

What types of CNS stimulants are there?

Answer 12

methylphenidates

amphetamines

Question 13

Prescribing principles for CNS stimulants for ADD

Answer 13

• start at low dose and titrate up at weekly intervals with feedback from parents and teachers
• long acting: 12 hours, short acting: 4 hours
• if no response to higher dose or has intolerable side effect, next step is to switch to another stimulant

Question 14

Cautions/contraindications to CNS stimulant medications

Answer 14

heart disease, hypertension, glaucoma, severe, anxiety, history of drug abuse, depression/suicide risk

Question 15

Side effects of CNS stimulants

Answer 15

insomnia, anorexia and weight loss, tachycardia, temporary decrease in growth and development, tics, tolerance to medication, headaches, stomachaches