Learning Disability

Question 1

What are the three main features of ADHD?

When ADHD is present in adults, what tends to differ about these features when compared to children?

Answer 1

Inattention

Hyperactivity

Impulsivity

Adults have more prominent inattention, with less hyperactivity and impulsivity

Question 2

The key features of ADHD, co-existing with a cluster of other symptoms relating to self regulation, should be present before what age?

How many of each type of symptom are needed for a diagnosis in children?

How many of each type of symptom are needed for a diagnosis in adults?

Answer 2

Age 5

6 or more symptoms of inattentiveness, and/or 6 or more symptoms of hyperactivity and impulsiveness

5 or more symptoms of inattentivess, and/or 5 or more symptoms of hyperactivity and impulsiveness

Question 3

What are some features of how ADHD can interfere with daily life, mainly in adults?

Answer 3

Underperforming in work/education

Driving dangerously

Difficulty with friendships and relationships

Question 4

In both adults and children with ADHD, there is an increased likelihood of what?

What is there an increase of in adults with ADHD compared to children?

Answer 4

Antisocial behaviour

Psychiatric co-morbidities

Question 5

If parents already have a child who is affected with ADHD, what is the risk of having another one?

What is the function of the genes potentially responsible for causing ADHD?

There is most evidence for what perinatal factor causing ADHD?

In the neurobiology of the condition, there is typically underactivity of which brain lobe?

Answer 5

15%

Dopamine and serotonin transport

Maternal smoking and alcohol use

Frontal lobe

Question 6

What intervention is used in all cases of ADHD, no matter how severe?

What is used in moderate-severe cases only?

Answer 6

Psychosocial interventions

Pharmacological management

Question 7

Give some examples of the 1st line drugs for ADHD, what type of drug are these?

Atomoxetine is a second line drug for ADHD, to which class of drugs does this belong?

Answer 7

Methylphenidate, dexamphetamine - these are stimulants

SNRIs

Question 8

What is the 3rd line drug for ADHD and what is its mechanism?

Give some examples of drugs that can be used 4th line in the treatment of ADHD?

Answer 8

Clonidine - alpha agonist

Anti-depressant e.g. imipramine, anti-psychotic e.g. risperidone

Question 9

Methylphenidate is a drug used to treat ADHD. This increases production of which neurotransmitter(s)?

Dexamphetamine is a drug used to treat ADHD. This increases production of which neurotransmitter(s)?

Answer 9

Dopamine

Dopamine, noradrenaline and potentially serotonin

Question 10

What are the different disorders which are grouped under the term ASD?

Which features of ASD do all of these have in common?

Answer 10

Rett’s syndrome

Asperger’s syndrome

Childhood autism

Pervasive developmental disorder

Difficulties in social communication and social interaction

Question 11

ASD is 5x more common in which gender?

Children with ASD are more likely to have what other problem?

What is the concordance rate in monozygotic twins?

Answer 11

Males

Gender idenity problems

90%

Question 12

What are some screening questionnaires that can be used for ASD?

What is the standardised assessment tool for ASD?

Answer 12

3di / DISCO

Autism diagnostic observation schedule

Question 13

What are some emotional conditions which often occur alongside ASD?

What are some neurodevelopmental disorders that may occur alongside ASD?

Answer 13

Depression, anxiety, eating disorders

Tourette’s/OCD, ADHD, dyslexia/dyspraxia, language impairment

Question 14

70% of people with ASD have an IQ of less than what?

35% have an IQ of less than what?

What are some medical conditions which often occur alongside ASD?

Answer 14

70

50

Hearing and visual impairment, epilepsy, fragile X syndrome, tuberous sclerosis

Question 15

What is a non-pharmacological treatment which can be useful for ASD?

Is there a medical intervention which treats the core symptoms of ASD?

What is a medication that can be used and what is it used for?

Answer 15

Self and family psychoeducation

No

Risperidone - for management of severe aggression and significant self injury

Question 16

What defines a learning disability?

To have a learning disability, a persons IQ must be less than what?

When must developmental delay occur?

What is the most common psychometric analysis used to assess a learning disability?

Answer 16

A condition of arrested or incomplete development of the mind

70

Before age 18

WAIS

Question 17

An IQ of what defines each of the following grades of learning disability:

a) mild?
b) moderate?
c) severe?
d) profound?

Answer 17

a) 50-69
b) 35-49
c) 20-34
d) < 20

Question 18

What is a common organic pathology often seen in moderate-severe learning disabilities?

What are some examples of chromosomal conditions which can cause learning disabilities?

Answer 18

Epilepsy

Down’s syndrome (trisomy 21)

Edward’s syndrome (trisomy 18)

Patau’s syndrome (trisomy 13)

Question 19

Is a learning disability typically a feature of Turner’s syndrome?

Is it a feature of Kleinfelter’s?

What are some other more organic conditions which can cause learning disability?

What is Lesch-Nyhan syndrome?

Answer 19

No

The IQ may be lower than average

Tuberous sclerosis, congenital hypothyroidism, fragile X

A phenotype associated with extreme self harm