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Clin Med- P > peds: behavior problems > Flashcards

peds: behavior problems Flashcards

1
Q

what are the 5 most common pysch disorders in kids?

A 
ADHD
conduct disorder
depression
pervasive developmental disorders
autism spectrum disorders
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2
Q

history for peds behavior problem: never underestimate _____ ______

A

parents denial

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3
Q

Timmy is 4 years old. He likes to make up stories and act them out with his action figures. His mother encourages his play and listens to his stories. Timmy is likely to successfully master the tasks in which of Erikson’s stages of development?

A

Initiative versus Guilt

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4
Q

stages of development: piaget

A 
0-18mo: sensorimotor 
18mo-3yrs: symbolic (pre-operational) 
3-5 yrs: intuition (per-operational) 
6-12 yrs: concrete operational 
12-18 yrs: formal operational
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5
Q

what is “temperment”?

A

Genetically influenced behavioral disposition – stable over time and age.
Response to external stimulus – how the child interacts with the environment

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6
Q

who describes temperment as “The “how” of behavior, as opposed to the “why” (motivation) and the “what” (ability)”

A

thomas & chess

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7
Q

Temperment: 8 ways they can respond to external stimulus (kinda weeds)

A

Activity level
Rhythmicity (predictability of appetite, bowels, sleeping)
Approach & Withdrawal (responding to new stimulus)
Intensity (responding to a situation – negative or positive)
Adaptability (ease of change)
Sensory Threshold (amount of stimulation required for a child to respond)
Mood (positive or negative)
Distractibility/Attention Span

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8
Q

8 Common Adjustment/Coping/Defense Strategies of Kids (kinda weeds)

A

Attention Getting (e.g. breath holding, tantrums etc.)
Identification (e.g. “I’m big and strong like Daddy.”)
Projection (e.g. “That rug is always tripping me.”)
Regression (e.g. sudden recurrence of bed wetting)
Denial (e.g.“I didn’t do it.”)
Rationalization (e.g. “I broke my bike, but I didn’t like it anyway.”)
Conversion (e.g. “I can’t go to school, my tummy hurts.”)
Fantasizing (e.g. excessive daydreaming to avoid fearful activities/feelings)

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9
Q

what is the biggest help with feeding problems?

A

good food choices by parent example

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10
Q

3 general possible causes of food refusal

A
  1. sign of depression
  2. sign of developmental conflict with caregiver (parent)
  3. medical
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11
Q

when is lowered, sporadic food intake normal?

A

Towards the end of the first year of life

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12
Q

Avoidant/Restrictive Food Intake Disorder (DSM-5)
 (4 parts)

A

an eating or feeding disturbance

  • significant weight loss
  • nutrient deficient
  • Dependence on enteral feeding or oral nutritional supplements.
  • Marked interference with psychosocial functioning.
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13
Q

what is “pica” ? DSM V criteria

A
  • eating non-nutritive, non-food items (lotion, dirt, paper, etc.)
  • inappropriate of development level (>2yo)
  • > 1 month
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14
Q

excessive eating disorder may be indicative of what?

A
  • emotional distress, especially if food is being hidden

- family dynamics

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15
Q

Sleeping habits are often determined as ____

A

infants

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16
Q

parasomnia: define and 4 types

A 
-arousal from sleep
Sleep terrors
Nightmares
Sleepwalking
Sleeptalking
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17
Q

dysomnia: define and 3 parts

A

-going or staying asleep
Sleep onset association disorder
Insomnia
Night waking

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18
Q

nightmare disorder vs sleep terror

A

nightmare disorder: awake with fearful images

sleep terror:Difficult to awaken and have little memory; wake up screaming

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19
Q

nightmare disorder vs sleep terror : occur when in the night?

A

nightmare disorder: last 1/2 of night (in REM)

sleep terror: first 1/3 of night (in stage 4)

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20
Q

nightbare disorder vs sleep terror: inheritance?

A

nightmare disorder: not inherited

sleep terror: familial

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21
Q

mgmt of sleep terrors

A

Scheduled awakenings may help
Avoid sleep deprivation (prolongs deep sleep)
Avoid stress
Reassurance by parents

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22
Q

mgmt of nightmare disorder

A

Usually self-limited and need little treatment

Can be associated with stress, trauma, anxiety

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23
Q

what is Somnambulism?

A

sleepwalking

24
Q

sleepwalking occurs when in the night? do you wake them?

A
  • first 1/3 of the night
  • awakening the sleepwalker can be difficult and leave them briefly disoriented
  • deep sleepers
  • lower incidence of dream reporting
25
Q

mgmt of sleepwalking

A

bell on child’s door; scheduled awakenings if “regular” time; safe environment free of obstacles with locked doors

26
Q

Jimmy is 5 years old. He falls asleep most nights without trouble, at his regular bedtime. However, at least once a week within an hour or two after falling asleep, he sits up in bed screaming, thrashing about, and exhibiting rapid breathing, tachycardia, and sweating. In the mornings, he doesn’t remember it. Jimmy probably has…

A

sleep terrors

27
Q

thumb sucking is normal until when?

A

in the first year of life

28
Q

mgmt of thumb sucking

A

Distraction is the best approach. Aversive thumb coatings usually not helpful.

29
Q

what is Onchophagia?

A

nail biting

30
Q

bedwetting (enuresis) more common in boys or girls?

A

boys

31
Q

mgmt for bedwetting

A

Behavior therapy: regular awakenings and blanket alarms most effective
meds: Imipramine, Oxybutinin, and DDAVP (synthetic antidiuretic hormone) can be helpful

32
Q

what is the term for this? “Repeated passage of stool into inappropriate places” (DSM) – involuntary or intentional

A

Encopresis (Stool Soiling)

33
Q

most common cause of stool soiling

A

constipation

34
Q

what may stool soiling be indicative of?

A

can indicate severe emotional problems (sexual abuse, severe stress, divorce, etc).
-pysch eval if no pathology and > 4yo

35
Q

Anger out of proportion/rage may be an early sign of ______ _______!

A

antisocial behavior and should not be disregarded – refer!

36
Q

disobedience: Almost every child tests limits of independence between age ___ and ___ years.

A

2-4 yo

37
Q

One of the most common cause of physical complaints in the school-aged child?

A

school phobia : Results from separation fears, frustration with schoolwork, and poor self-image.

38
Q

mgmt of school phobia

A

“No fever = no absence” rule may be helpful if parent is unsure.

39
Q

Somatization

A

is a pattern of conversion of overwhelming mental distress into physical complaints.
most common: GI upset
less common: blindness, paralysis, (conversion disorder)

40
Q

illness anxiety disorder: may be caused by what 3 things?

A
  • imitation of adult behavior
  • an attempt to control
  • an expression of unhappiness.
41
Q

oppositional defiant disorder: characterized by what 3 things?

A
  1. angry/irritable
  2. argumentative/ defiant
  3. vindictive/ spiteful
42
Q

oppositional defiant disorder: Dx based on age.

A

Younger than 5: most days for 6 months

Over 5: at least 1x/wk for 6 months

43
Q

conduct disorder : characterized by what 4 things

A 
Aggression to people and animals
Destruction of property
Deceitfulness or theft
Serious violations of rules
* Serious disorder, poor prognosis, earlier the referral (intervention) the better
44
Q

conduct disorder can be a precursor to what ?

A

Precursor to antisocial personality disorder

45
Q

depression: ______ scale is helpful for symptom history:

A

SIG E CAPS

46
Q

what is SIGECAPS? (what do they stand for, how many for a dx? )

A 
Sleep disturbance
Irritable
Guilt
Energy, motivation 
Concentration 
Appetite 
Psychophysical slowing, agitation or pain exacerbation, Suicide risk. 
* Four or more positives makes depression likely.
47
Q

Janey is 12 years old. She often worries that her stomach aches are a sign of cancer, or that if she gets a headache, she has brain cancer. She often asks her mom to make doctor’s appointments for her to make sure she doesn’t have something serious wrong with her. Janey probably has…

A

Illness Anxiety Disorder

48
Q

erikson stage : 0-18 mo

A

trust vs mistrust

49
Q

erikson stage 18mo-3yrs

A

autonomy vs shame/doubt

50
Q

erikson stage 3-5

A

initiative vs guilt

51
Q

erikson stage 6-12

A

industry vs inferiority

52
Q

erikson stage 12-18

A

identity vs role confusion

53
Q

erikson stage: early adulthood

A

intimacy vs isolation

54
Q

erikson stage: adulthood

A

generativity vs stagnation (contribution)

55
Q

erikson stage: old age

A

integrity vs despair

Clin Med- P (124 decks)

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