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CAM 2 > ADHD > Flashcards

ADHD Flashcards

1
Q

DSM

A

3 ADD 1980
3R ADD becomes ADHD 1987
4 ADHD (hyperactive, inattentive, combined subtypes) 1994

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2
Q

classic triad of ADHD

A

inattention
hyperactivity
impulsitivity

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3
Q

changes in DSM-5

A
  1. examples have been added
  2. cross-situational requirement has been strengthened
  3. onset changed to age 12
  4. presentation specifiers
  5. comorbid diagnosis with ASD
  6. symptom threshold change has been made for adults
  7. replaced in the neurodevelopmental disorders chapter
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4
Q

DSM functional criteria

A
  1. 6 or 9 symptoms in either or both categories of inattention and hyperactivity
  2. inattentive; hyperactive-impulsive; or combined type
  3. persisting for at least 6 months
  4. some symptoms present bef 12 y/o
  5. impairment in 2 or more settings: social/academic/occupational impairment
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5
Q

differential diagnosis psychiatric

A

mood or psychotic disorder
anxiety disorder
LD
mental retardation/ borderline IQ
ODD/ conduct behavior
pervasive developmental disorder
substance abuse
axis II disorders
psychosocial Cx eg abuse parenting etc

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6
Q

differential diagnosis medical

A

seizure disorder
chronic otitis media
hyperthyroidism
sleep apnea
drug-induced inattentional syndrome
head injury
hepatic illness
toxic exposure
narcolepsy

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7
Q

chronic otitis media

A

middle ear infection

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8
Q

hepatic illness

A

liver disease

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9
Q

narcolepsy

A

loss of the brain’s ability to regulate sleep wake cycle

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10
Q

epidemiology - percentage

A

most common diagnosed
3-7% of school children

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11
Q

epidemiology - ratio

A

male : famale.
[2 - 9] : [1]

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12
Q

girl vs boy

A

girls typically show less hyperactivity, fewer conduct problems, and less externalizing behavior
HOWEVER, Combined type: girls show more disruptive behavior

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13
Q

ADHD

A

attention-deficit/hyperactivity disorder

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14
Q

epidemiology - percent for adults

A

at least 30-50% maintain diagnosis for >=15 yrs

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15
Q

strongest predictor of poor prognosis

A

pre-pubertal aggression

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16
Q

worldwide prevalence of ADHD

A

3-7%

17
Q

ADHD is familial

A
  1. sibling risk increases 2-5x
  2. 3-5 increased likelihood that parent is affected 9-35%
18
Q

comorbidity axis 1 disorder

A

2/3 present with >=1 co-morbid axis i disorder

19
Q

comorbidity

A

> =84% of children with ADHD demonstrate psychopathology as adults
educational impairments
substance abuse
employment problems
greater sexual-reproductive risks
greater motor vehicle risks

20
Q

adolescent and adults outcomes of adhd

A

less schooling and lower grades
higher expel rates
worse on exec function tests
fewer friends
lower self-esteem
higher arrest rates
lower occupational rank
higher termination rates

21
Q

rule of thirds

A

1/3 complete resolution
1/3 continued inattn, some impulsitivity
1/3 early ODD/CD, poor academic achievement, substance abuse, antisocial adults

22
Q

age related changes

A

3-5 pre school - hyperactive/ impulsive
6-12 school age - combination symptoms
13-18 adolescence - more inattn w/ restlessness
18+ adult - largely inattn w/ periodic impulsivity

23
Q

brain image

A

smaller brain volumes in all regions
no gender diff
volumetric abnormalities persist with age
correlate with severity of adhd

24
Q

potential non-genetic causes

A

perinatal stress
low birth weight
traumatic brain injury
maternal smoking during pregnancy
severe early deprivation (extreme)

25
Q

loss of inhibition leads to

A

impaired non-verbal, working memory - myopia of time
delayed internalization of speech
impaired regulation of affect and arousal
impaired reconstitution of events

26
Q

neuropsychological testing

A

spatial working memory
CPT d-prime
stroop naming speed
stop task response suppression
full scale IQ
mazes, a planning measure
trails B time

27
Q

convincing diagnosis - important

A

no single test to identify adhd

28
Q

available tests are primarily CPTs

A

TOVA, Conner’s CPT, Gordon computerized diagnostic system, IVA CPT

29
Q

diagnosis must be

A

multi-factorial

30
Q

never diagnoses adhd in a … setting

A

1:1 interview
symptoms in group settings are a must

31
Q

rating scales

A

SNAP,5
Conners
ACTeRS
child behavior checklist
BASC
ADHD rating scale -5
brown ADD scales

32
Q

treatment trial

A

risk of adverse effects is significant
not necessarily diagnostic even if effective
at least 2-3 meds should be attempted bef patient deeemed non-responder
very low placebo response

33
Q

who doesn’t get adhd

A

without insurance
latino and black children

CAM 2 (4 decks)

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