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Psych > 8. Psychiatric d/o in children > Flashcards

8. Psychiatric d/o in children Flashcards

1
Q

What is the Kaufman Assessment Battery for Children (K-ABC)?

A

Intelligence test for ages 2-12

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2
Q

What is the Wechsler Intelligence Scale for Children-Revised (WISC-R)?

A

Determines IQ for ages 6-16

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3
Q

What is the criteria for mental retardation/intellectual disability (3)?

A
  • IQ < 70
  • deficits in adaptive skills appropriate for the age group
  • onset before age 18
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4
Q

IQ definition of profound, severe, moderate, and mild MR?

A
  • profound = IQ < 25
  • severe = IQ 25-40
  • moderate = IQ 40-55
  • mild = IQ 55-70
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5
Q

Genetic causes of MR (2 most common)

A

Down syndrome

Fragile X syndrome (M>F)

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6
Q

Other genetic causes of MR (6)

A
  • phenylketonuria
  • familial mental retardation
  • Prader-Willi
  • Williams syndrome
  • Angelman syndrome
  • Tuberous sclerosis
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7
Q

Prenatal cause of mental retardation?

A
  • TORCH infections
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8
Q

Perinatal causes of MR (5)

A
  • anoxia (no O2)
  • prematurity
  • birth trauma
  • meningitis
  • hyperbili
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9
Q

Postnatal causes of MR (5)

A
  • hypothyroidism
  • malnutrition
  • toxin exposure
  • trauma
  • psychosocial causes
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10
Q

What % of MR has no identifiable causes?

A

50%

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11
Q

What is the def of learning disorders?

A

Achievement in reading, math, or written expression that is sig lower than expected for chronological age, level of education, and level of intelligence

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12
Q

Learning disorders are often due to _______?

A

deficits in cognitive processing (ex. abnormal attention, memory, visual perception etc)

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13
Q

What is the most common learning disorder?

A

reading disorder

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14
Q

What is the most common INHERITED form of mental retardation?

A

Fragile X syndrome

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15
Q

Common associated symptom of Fragile X syndrome?

A

large testicles

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16
Q

What are the 2 disruptive behavior disorders?

A

ODD, CD

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17
Q

Unlike conduct disorder, ODD does not involve ___ (2)?

A

physical aggression or violation of basic rights of others

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18
Q

How many months of symptoms qualify for diagnosis of ODD?

A

at least 6 months

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19
Q

What age is ODD usually observed by?

A

age 8

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20
Q

Increased incidence of which comorbid psych illnesses? (4)

A
  • substance abuse
  • mood disorders
  • ADHD
  • in persistent cases, may progress to CD
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21
Q

Difference b/w boys and girls w/ CD

A
  • boys: higher risk of fighting, stealing, fire setting, vandalism
  • girls: higher risk of lying, running away, sexually acting out
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22
Q

Prevalence of CD in boys vs. girls?

A
  • 4-12x more common in boys
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23
Q

Risk factors for CD? (4)

A
  • punitive parenting
  • psychosocial adversity
  • hx of being abused
  • biological predisposition
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24
Q

High incidence of comorbid ____(2)?

A
  • ADHD (up to 70%)

- learning disorders

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25
Q

Up to what % will develop antisocial PD?

A

40%

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26
Q

Which medication can be useful adjunct if aggression is present in CD? (3 classes)

A
  • antipsychotics
  • mood stabilizers
  • SSRIs
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27
Q

How do you distinguish ADHD from learning disorders and MR?

A
  • ADHD do not tend to have lower IQ or have specific difficulty with academic skills
  • but their ADHD symptoms may affect academic performance
28
Q

What are the 3 subcategories of ADHD?

A
  1. Predominantly inattentive type
  2. Predominantly hyperactive-impulsive type
  3. Combined type
29
Q

ADHD must have onset prior to age ___?

A

age 7

30
Q

Prevalence of ADHD in school-age children?

A

5-12%

31
Q

ADHD have high incidence of other comorbid psych illnesses, including? (5)

A
  1. mood disorders
  2. anxiety disorders
  3. personality disorders
  4. conduct disorder (30-50%)
  5. ODD (30-40%)
32
Q

What is 1st line pharm treatment of ADHD?

A

CNS stimulants

33
Q

What can be used if first-line tx of ADHD can’t be used? (due to intolerable s/e or ineffectiveness)?

A

alpha-2 agonists (clonidine, guanfacine)

34
Q

What are pervasive developmental disorders?

A

Conditions that involve problems w/ social skills, language, and behaviors

35
Q

What disorders are included in the PDD class? (4)

A
  • autistic disorder
  • asperger disorder
  • Rett disorder
  • Childhood disintegrative disorder
36
Q

For autistic disorder, symptoms must present by age ___?

A

age 3

37
Q

Autistic disorder is associated with which other syndromes/illnesses? (3)

A
  • fragile X syndrome
  • tuberous sclerosis
  • seizures
38
Q

Siblings of autistic person are at a greater than ____time risk of autism than general population?

A

22x

39
Q

Difference b/w autism and asperger disorder? (note: DSM 5 got rid of asperger disorder. now it’s autism spectrum disorder)

A
  • in asperger d/o, they have normal dev. in spoken/receptive language, cognitive development, self-help skills, and curiosity about environment
40
Q

How is Rett disorder progressed in the first 2-3 years of life?

A
  • normal and physical psychomotor dev during first 5 months after birth
  • followed by DECREASING rate of head growth and LOSS of previously learned purposeful hand skills b/w age 5-30 months
41
Q

Symptoms of Rett disorder (6)

A
  • stereotyped hand mvts (hand wringing, hand washing)
  • impaired language
  • psychomotor retardation
  • problems with gait/trunk mvts
  • cognitive development doesnt progress beyond that of 1st year of life
  • EEG abnormality and seizure common
42
Q

Female vs. male prevalence of Rett d/o

A
  • seen in girls predominantly

- most likely lethal in utero for males

43
Q

What is the gene mutation associated w/ Rett disorder?

A
  • MECP2 gene mutation on X-chrom
44
Q

Treatment for Rett disorder?

A

supportive

45
Q

Diff. between childhood disintegrative d/o and Rett? (2)

A
  • in CDD, head growth does NOT slow

- also, no unusual hand movements

46
Q

Onset of childhood disintegrative d/o vs. Rett?

A
  • CDD = after age 2; usually b/w age 3-4 (MUST be before age 10)
  • Rett = usually b/w age 5 months - 2 yrs
47
Q

Girls vs. boys prevalence of CDD?

A
  • 4-8 x higher incidence in boys
48
Q

What is CDD?

A
  • normal dev in the first 2 yrs of life
  • loss of previously acquired skills before age 10 in at least 2 of following areas (language, social skills, adaptive behavior, bowel/bladder control, play, motor skills)
  • and in at least 2 of these (impaired social interaction, impaired communication, restricted repetitive stereotyped behaviors and interests)
49
Q

Childhood disintegrative disorder has been associated with various general medical conditions such as ___ (5)?

A
  • Landau-Kleffner syndrome (acquired epileptic aphasia)
  • neurolipidoses (ex. Tay Sachs)
  • mitochondrial deficits
  • metachromatic leukodystrophy
  • CNS infection
50
Q

Tourette disorder has onset before age ___ ?

A

age 18

51
Q

Tourette disorder is characterized by?

A
  • multiple daily motor and one or more vocal tics

- both must be present at SOME time during illness, but not necessarily concurrently

52
Q

Time criteria for diagnosis of Tourette?

A

almost every day for over 1 year (with no tic-free period greater than 3 months)

53
Q

When do symptoms peak in severity for Tourette?

A

b/w age 8-12

- symptoms decreases with puberty

54
Q

Tourettes has high comorbidity with which other psych illnesses? (2)

A

OCD (40%), ADHD (50%)

55
Q

Neurochemical factors for the etiology of Tourettes?

A

Impaired regulation of dopamine in the caudate nucleus

56
Q

Pharmacological treatment for Tourettes?

A
  • Atypical neuroleptics (risperidone)
  • alpha-2 agonists (clonidine, guanfacine)
  • typical neuroleptics (haloperidol, pimozide) in severe cases
57
Q

Use of ____ is controversial in ADHD associated w/ tic disorder b/c?

A

stimulants; b/c of concern for exacerbation of tics

58
Q

Tx of OCD pts with comorbid tics?

A

SSRI augmentation of antipsychotics

59
Q

Criteria for diagnosis of enuresis?

A
  • involuntary voiding of urine after age 5
  • at least 2x/week for at least 3 consecutive months
  • or with marked impairment
60
Q

Criteria for diagnosis of encopresis?

A
  • involuntary or intentional passage of feces in inappropriate places by age 4
  • at least 1x/month for at least 3 months
61
Q

What is primary vs. secondary elimination disorders?

A 
primary = never established continence 
secondary = continence achieved for a period and then lost
62
Q

Physiological etiology of encopresis (2)

A
  • lack of sphincter control

- constipation w/ overflow incontinence (75% of cases)

63
Q

Physiological etiology of enuresis (2)

A
  • small bladder

- low nocturnal levels of ADH

64
Q

Childhood separation anxiety disorder may be a risk factor for the development of _____(2) as adult

A
  • panic disorder

- agoraphobia

65
Q

What are the evidences of sexual abuse in a child? (5)

A
  • STDs
  • anal or genital trauma
  • knowledge about specific sexual acts (inappropriate for age)
  • initiation of sexual activity with others
  • sexual play with dolls (inappropriate for age)

Psych (17 decks)

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