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Paediatrics > CAMHS > Flashcards

CAMHS Flashcards

1
Q

What do you need for ADHD Dx

A 
At least 2/3 for 6 months of 
- Hyperactivity / restless
- Impulsitivity
- Inattention 
\+ 6 other features

Must occur more than 1 setting over more than 1 activity and at a level greater than accepted for age

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2
Q

What symptoms suggest hyperactivity and what suggests inactivity

A 
Hyperactivity 
Fidget
Run inappropriately 
Can't play quiet
Talk excessively
Interrupt
Can't wait turn 
Uncontrolled
Disruptive 
Inattention
Short attention span 
Trouble concentrating
Careless msitakes
Can't follow instruction
Easily distracted
Forgetful
Trouble organising
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3
Q

What conditions are associated with ADHD

A 
LD
Motor-coordination e.g. TICS
Subtance misuse
Anxiety and depression
ASD
Conduct disorder
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4
Q

How do you treat ADHD

A 
Healthy diet and exercise 
Behaviour management 
Parenting programme
Methyphindate (Ritalin) = 1st line (CNS stimulant) 
Atomoxetine
Non-stimulant drugs
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5
Q

What do you monitor

A

Baseline ECG as cardiotoxic
Weight + height every 6 months
BP
SE - Abdo pain, nausea, dyspepsia

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6
Q

What is the prognosis

A

50% symptoms into adult
80% into teens
Symptoms will alter

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7
Q

What does ASD encompass

A

Asperger’s = mildest, normal functioning but difficulty in reading emotion etc
Pervasive development disorder
Atypical
Autism

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8
Q

What is ASD

What is triad of impairment

A 
Neurodevlopment disorder
Present from birth
Variation in learning of language
Triad of impairment in ALL 3
- Social communication + language
- Social integration 
- Social imagination
- Flexible behaviour
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9
Q

What is social communication

A 
Use of speech
Understanding
Non-verbal
Delay in language 
Lack of non-verbal communication
Repetitive use of words

Causes high level of anxiety

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10
Q

What is social interaction

A 
Social rules 
Don't understand emotion 
Rigid thinking 
Repetitive behaviour as don't like change 
Lack of smiling 
Lack of eye contact 
Difficult with friendships
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11
Q

What is social imagination

A 
Lack imaginative play 
Do same thing over and over - repetitive movement
Can't predict what will happen next
Don't like new things 
Difficult to prepare for change
Repetition is reassuring
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12
Q

What else do people with ASD have / usually present with this

A 
Special interest - specific + narrow 
Sensory sensitivity in all 5 senses 
Anxiety / depression
School avoidnace
Aggression
OCD
LD
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13
Q

How do you Dx

A 
History
Schol report / observation 
Questionnaires
SALT / physio 
ADOS / API-R
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14
Q

How do you RX

A 
MDT
Parenting programme
Education support 
Autism outreach worker 
Teach social and functional skills
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15
Q

What other tests can you do

A

FBC, U+E, TFT, CK

Microarray – fragile X / Retts

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16
Q

What are co-morbid conditions

A

RUBELLA
TS
DOWNS

17
Q

Complications of autism

A

High levels of anxiety / depression

18
Q

What is ADHD with no hyperactivity

A

ADD

19
Q

SE of ADHD drugs

A 
Appetite
Sleep
BP
HR
Growth
20
Q

What is 1st line ADHD

A

Methyphenidate - CNS stimulant

21
Q

What is 2nd line

A

Atomoxetine - non-stimulant

22
Q

What do you do before stating treatment

A

Watch and wait for 10 weeks

23
Q

What should you ask about

A 
Concentration 
Memory
Impulse
Sleep
School
24
Q

What else should you assess for

A

ASD
Dyslexia
LD

25
Q

What is a conduct disorder

A

Repetitive and persistent anti-social, aggressive or defiant behaviour
>12 months

26
Q

What are symptoms

A

Aggression
Destruction of property
Decietful
Violation of rules

27
Q

What is it associated with

A

Adversity

28
Q

How do you treat

A 
Parent training if <12 
Modify school
Behaviour support
Family therapy
Social skills
Anger management
Treat co-morbid
29
Q

What are complications

A 
Violent death
School exclusion
Poor school 
Unemployment
Criminal activity
Poor mental health and relationships
30
Q

What is Tourette’s

A

Development of tics persistent >1 year

31
Q

What is Tics

A

Involuntary movement or sounds which child performs throughout the day
More prominent if under pressure or excited

32
Q

What can it be associated with

A

OCD

ADHD

33
Q

How do you Rx

A

Mild = reassurance and monitor
Habit reversal training
Exposure with response prevention
Medications - antipsychotic if severe

Paediatrics (35 decks)

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