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Psych 9 Peds Psych

Pediatric Psychiatry

QuestionAnswer
After a minor car accident, a woman wears a neck brace and requests permanent disability. What is the most likely diagnosis? Malingering
In which disease would you find atrophy of the mammillary bodies? Wernicke's encephalopathy
What is MCC of sensorineural hearing loss? Presbycusis
What is the MCC of conductive hearing loss? Otosclerosis
What comorbidities are common with ADHD in children? Give 6. 1. Oppositional Defiant d/o 2. Conduct d/o 3. Learning disability 4. Depression 5. Bipolar d/o 6. Anxiety d/o
How old must a child be before starting them on pharm therapy for ADHD? 6yo
T or F. You should always perform an EKG on a child before prescribing stimulants for ADHD. False
What other medications can be used in the tx of ADHD in children who fail to respond to stimulants or atomoxetine? TCAs, bupropion, clonidine (alpha 2 agonist), limit sugar and caffeine
How can nighttime insomnia be treated in children on ADHD stimulant meds? Clonidine at night (also sleep hygiene, take meds earlier in day, use shorter-acting formula)
What ADHD treatment is best for children with tics? Low-moderate dose methylphenidate (won't aggravate tics)
What should be done if a child on ADHD stimulants develops psychosis or mania? Discontinue meds IMMEDIATELY! No need to taper.
Name 2 risks of atomoxetine (NRI used to treat ADHD). 1. Suicidality 2. Liver injury
How is ADHD diagnosed? At least 6 sx of ADHD in 2+ settings by age 7
Name 3 common agents used to treat Tourette syndrome. 1. Fluphenazine 2. Pimozide 3. Tetrabenazine (Psychotherapy should also be part of tx plan)
What is the difference between conduct d/o and antisocial personality d/o? Conduct is <18yo. Antisocial is >18yo.
What is the difference between conduct d/o and oppositional defiant d/o. Conduct involves violent and illegal behavior that disregards the rights of others. ODD involves resistance to authority, and usually has no violent or illegal activities.
DX?: Child demonstrating otherwise normal intelligence wiht delays in certain academic goals Learing disabilities
During what two time periods do tics usually diminish? Sleep and focused activity
What pathologies must be ruled out in a pt suspected of having a learning disorder? Visual and auditory.
Dx?: Child "living in his own world" with poor eye contact and no social smile. Autism
Prior to what age are autistic sx present? 3yo
Do autistic children have below average, average, or above average intelligence? Below average
What labs should be done in a child suspected of having autism? Metabolic and genetic analyses to r/o medical cause of behavior
What are the characteristic features of Asperger syndrome? Name 4. Social impairment, repetitive activities, behavior and interest abnormalities, and no cognitive or language problems
Dx?: regression of development in multiple areas after a period of at least 2 years of normal development. Childhood Disintegrative Disorder (often associated with an organic condition such as seizures or metabolic d/o)
Which childhood psychiatric d/o matches the following statements?: females only; loss of previously acquired purposeful hand skills btwn 6-30mos Rett d/o
Which childhood psychiatric d/o matches the following statements?: impairments in social interactions, communications, play. Repetitive behaviors Austism
Which childhood psychiatric d/o matches the following statements?: impairment in social interaction, no language delay Asperger syndrome
Which childhood psychiatric d/o matches the following statements?: steriotyped hand movements Rett d/o
Which childhood psychiatric d/o matches the following statements?: characterized by hostility, annoyance, vindictiveness, disobedience, and restlessness ODD
Which childhood psychiatric d/o matches the following statements?: multiple motor and vocal tics Tourette syndrome
Which childhood psychiatric d/o matches the following statements?: impulsive and inattentive ADHD
Which childhood psychiatric d/o matches the following statements?: 7yo that avoids going to school to stay home with parent Separation anxeity d/o
How is Asperger different from autism? Asperger has no language or cognitive delays.
How is childhood disintegrative disorder different than autism? CDD has normal development up to age 2, then regression. Autism never has a period of normal development. CDD may also include loss of bowel/bladder control and motor skills.
Created by: sarah3148