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Psych 9 Peds Psych
Pediatric Psychiatry
Question | Answer |
---|---|
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. |