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1. Pediatrics > Behavioral and Substance use > Flashcards

Behavioral and Substance use Flashcards

1
Q

[Behavior/Sleep]

Nightmares occur during ___ sleep
Nght terrors occur during ___ sleep
(REM/non-REM sleep)

A

Nightmares REM sleep
Night terrors non-REM sleep

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2
Q

[Behavior/Sleep]

Common Age group for sleep walking?

A

Between 4 and 8 years of age

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3
Q

[Behavior/Tantrum]

Temper tantrums occurs in nearly all ___ to ___ years old
Normally resolves by ___ years of age

A

Nearly all 2-4 years of age
Resolves by 5 years of age

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4
Q

[Behavior/BHS]

Breath-holding spells occur between __ months and __ months and resolves by ___ year of age

A

Between 6 months and 24 months
Resolves by 5 years of age

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5
Q

[Behavior/BHS]

Cyanotic vs pallid breath-holding spells?

  • Several shrill cries then prolonged expiratory apnea
  • Rapidly lose consciousness and become cyanotic
  • Triggered by ‘upset’ events e.g) told no
A

Cyanotic breath-holding spells

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6
Q

[Behavior/BHS]

Cyanotic vs pallid breath-holding spells?

  • Triggered by painful event
  • Injury and stops breathing, loses consciousness, pale and hypotonic
A

Pallid breath-holding spells

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7
Q

[Behavior/BHS]

Condition associated with breath-holding spells? (1)

A

Iron deficiency anemia

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8
Q

[Behavior/Separation anxiety]

Separation anxiety becomes apparent around ___ months of age, prominent at ___ months of age, resolves by ___ years of age.

A

Can start at 6 months of age
Apparent around 9-18 months of age
Lessens by 3 years of age

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9
Q

[Behavior/School refusal]

Distinction between school refusal vs school refusal with truancy

School refusal: parents __
Truancy: parents __
(aware vs unaware)

A

School refusal: parents aware
Truancy: parents unaware

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10
Q

[Behavior/School refusal]

Definition of school absenteeism?

Missing > __% of school days in a year
Often accompanied by __ complaints

A

Missing > 15% of school days in a year
Often accompanied by somatic complaints

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11
Q

[BehaviorDisruptive]

Neurotransmitter changes in aggressive behaviors?

Decreased __ (3)
Increased __ (2)

A

Decreased serotonin, oxytocin, GABA
Increased dopamine, vasopressin

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12
Q

[Behavior/ODD]

Disorders associated with oppositional defiant disorders? (2)

A

ADHD
Learning disabilities

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13
Q

[Behavior/ODD]

Psychological treatment for oppositional defiant disorder? (4)

A

Psychotherapy
Skill training
Cognitive problem-solving training
Parent training
(Rarely medication)

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14
Q

[Behavior/Conduct]

Conduct disorder vs oppositional defiant disorder?

Conduct disorder with __
Oppositional defiant disorder without __

A

Conduct disorder with antisocial activities (lying, stealing, physical aggression, sexual assault)
Oppositional defiant disorder without antisocial activities

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15
Q

[Behavior/ASD]

Medication for autism spectrum and age limit (2)?

A
  1. Risperidone (Risperdal) ≥ 5 years of age
  2. Aripiprazole (Abilify) ≥ 6 years of age
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16
Q

[Behavior/Tourette]

Tourette syndrome onset is around ___ years of age, peaks at ____ years of age, and gradually decreases.

A

Onset around 7 years of age
Severe between 10-12 years of age

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17
Q

[Behavior/Tourette]

DSM-5 criteria for Tourette disorder? (5)
- Tic types
- Duration
- Onset

A

Multiple motor and vocal tics
Persistent for at least 1 year
No tic free interval for > 3 months
Onset prior to 18 years of age
No underlying medical cause

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18
Q

[Behavior/Tourette]

Disorders associated with Tourette syndrome? (3)

A

Attention Deficit Hyperactivity ADHD
Oppositional Defiant ODD
Obsessive Compulsive OCD

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19
Q

[Behavior/Tic]

Management for tic disorder?

Behavioral therapy: __
If severely impairing functions: __
Impulse control: __
Tourette and OCD: __

A

Behavioral therapy: Cognitive behavioral interventions
If severely impairing functions, fluphenazine, pimozide, tetrabenazine
Impulse control: Guanfacine or clonidine
Tourette and OCD: Fluoxetine

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20
Q

[Behavior/Tic]

Name of disorder?

Tourette syndrome like symptoms but < 12 months

A

Provisional tic disorder

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21
Q

[Behavior/ASD/Drug]

Side effects of Risperidone? (4)

A
  1. Increased appetite, weight gain, constipation
  2. Hyperprolactinemia, resultant galactorrhea
  3. Liver function abnormalities, insulin resistance
  4. Somnolence, fatigue, drooling, tremor, dystonia, akathisia
22
Q

[Behavior/Antipsychotic]

FDA approved 2nd generation antipsychotic drugs for children? (3)

A

Aripiprazole (abilify)
Risperidone (Risperdal)
Paliperidone (Invega)

23
Q

[Behavior/Antipsychotic]

Side effects of aripiprazole? (4)

A

Weight gain
Hypercholesterolemia
Prolactin elevation
QTc prolongation

24
Q

[Behavior/Depression]

PHQ9 scores, severity, its management

Normal: __
Mild: __
Moderate: __
Moderately severe: __
Severe: __

A

0-4 normal
5-9 mild: watchful waiting and follow up
10-14 moderate: Review treatment plan
15-19 moderately severe: adjust therapy or consider pharmacotherapy
20-27 severe: focused assessment of safety plan, if emergent, referral for higher level of care

25
Q

[Behavior/Depression]

Diagnostic criteria of depression? (3)
SIG E CAPS

A

≥ 5 symptoms,
≥ 2 consecutive weeks with a change of function
At least 1 of depressed mood or lack of interest

Sleep changes
Interest loss
Guilt or feelings of worthlessness
Energy deficit
Concentration problems
Appetite changes
Psychomotor restriction
Suicidality

26
Q

[Behavior/Depression]

Persistent depressive disorder distinction between major depressive disorder?

A

Not meeting major depressive disorder criteria,
Chronically depressed mood for most of each day > 1 year

27
Q

[Behavior/Depression]

FDA approved SSRI for depression in children (2)?

A

Fluoxetine (Prozac) ≥ 8 years of age
Escitalopram (Lexapro) ≥ 12 years of age

28
Q

[Behavior/Bipolar]

Bipolar type 1 and 2 distinction?

A

Bipolar 1: classic manic-depressive
Bipolar 2: depressive without classic manic (hypomania)

29
Q

[Behavior/Bipolar]

Treatment options for bipolar in children? (3)

A
  1. Risperidone (Risperdal)
  2. Quetiapine (Seroquel)
  3. Lithium
30
Q

[Behavior/Anxiety]

Treatment options for anxiety disorder? (2)

A

Cognitive behavioral therapy
SSRI for severe or non-responsive to CBT

31
Q

[Behavior/PTSD]

Treatment options for PTSD in children?

A

Trauma-focused psychotherapy (>6 years of age)
Child-parent psychotherapy (≤ 6 years of age)

32
Q

[Behavior/OCD]

Treatment options for OCD in children (3)?

A

Expressive and supportive psychotherapy
Behavioral therapy
And/or SSRI (flouxetine, sertraline)

33
Q

[Behavior/ADHD]

Side effects for Stimulant medication for ADHD? (4)

A

Appetite suppression, Insomnia
Headache, abdominal pain
Hypertension, increased heart rate
Potential exacerbation of tic disorder

34
Q

[Behavior/ADHD]

Other medical treatment options for ADHD other than methylphenidate (3)?

A

Atomoxetine (Strattera) for not tolerating stimulant
Guanfacine (Intuniv) for aggressive or hyperaroused behavior
Clonidine (Kapvay) for aggressive or hyperaroused behavior

35
Q

[Behavior/ADHD]

Side effect of clonidine? (3)

A

Sedation
Bradycardia
Hypotension

36
Q

[Substance/Basic]

Urinary toxicology positive time frame?
Majority last ___ hours
Phencyclidine (PCP, angel dust) detected up to ____ days
Chronic marijuana user up to ___ weeks

A

Majority last 24 - 72 hours
PCP detected up to 8-14 days
Chronic marijuana user up to 4-6 weeks

37
Q

[Substance/cannabinoid]

Treatment options for cannabinoid hyperemesis syndrome (3)?

A

Hot showers
Antiemetics, IV fluid
Benzodiazepines

38
Q

[Substance/Psychoactive]

Psychoactive drugs
____ and ____ often used in date rapes, causes retrograde amnesia

A

GHB (gamma-hydroxybutyrate, G, Liquid X)
Flunitrazepam (Rohypnol, Roofies, Roach)

39
Q

[Substance/Psychoactive]

Which substance abuse/intoxication?

Often used in parties
Hyperthermia, rhabdomyolysis, electrolytes imbalance

A

NMDA

40
Q

[Substance/Psychoactive]

Which substance abuse/intoxication?

Tachycardia, dysrhythmias, ventricular irritability, hypertension
Hyperpyrexia, Seizures
Tooth decay

A

Methamphetamine

41
Q

[Substance]

Which chronic substance abuse?

Perioral/perinasal rashes
Nosebleeds
Chronic lower respiratory symptoms

A

Inhalants

42
Q

[Substance/Inhalant]

Which substance acute intoxication?

Euphoria, hallucinations,
Hypotension, cutaneous flushing followed by vasoconstriction, Tachycardia
Dizziness, nystagmus, excessive salivation
EKG: ST depression and inverted T waves

A

Inhalants

43
Q

[Substance/Inhalant]

Which inhalation result in methemoglobinemia

A

Amyl nitrate (popper)

44
Q

[Substance/intoxication]

Which substance intoxication?

Hallucinations, hypertension, tachycardia, dizziness, nausea, vomiting, diarrhea

A

Hallucinogens: LSD (lysergic acid diethylamide) mescaline, psilocybin (magic mushroom),

45
Q

[Substance/intoxication]

Which intoxication?

Over the counter cough syrup
Euphoria, hallucination, mydriasis, diaphoresis

A

Dextromethorphan

46
Q

[Substance/intoxication]

Which substance intoxication?

Euphoria, increased appetite, anxiety, paranoia
Conjunctival injection, dry moith, tachycardia

A

Marijuana

47
Q

[Substance/withdrawal]

Which substance withdrawal?

Anxiety, irritability, decreased appetite, insomnia, depression, somatic pain (abdominal pain)

A

Cannabis withdrawal

48
Q

[Substance/Basic]

Neonatal urine toxicology test detects up to ___
Neonatal meconium test detects around ___ time

A

Urine hours to days
Meconium 2nd and 3rd trimester

49
Q

[Substance/Basic]

False positive drug test with ibuprofen use < 24 hr (3)

A

PCP
Cannabis
Barbiturates or Benzodiazepines

50
Q

[Substance/Basic]

False positive drug test with proton pump inhibitors use (1)

A

Cannabis

51
Q

[Behavioral/antipsychotics]

Which stimulant medication potential side effects of suicidal ideation?

A

Atomoxetine

52
Q

[Behavior/ASD]

M-CHAT-R score and management?

A

Normal: 0-2
2nd stage question: 3-7
Immediate referral: >8 (total 20)

1. Pediatrics (22 decks)

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