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Flashcards in ADHD Deck (31):
1

What are the 3 components of ADHD?

Inattention

Impulsivity (not having success socially)

Hyperactivity

2

Which one of the 3 components tends to persist in adulthood?

Inattentive

3

Which of the 3 components is most present in preschool/elementary?

Hyperactivity

4

Which of the 3 components is most common in girls?

Inattentive

5

What is occurring physiologically in ADHD?

increased reuptake of dopamine

6

When doing a ROS, what do we need to ask about?

Can they see the board? = eyes

Sleep apnea = pulm

R/O absence seizure = neuro

R/O Anxiety & Depression = psych

Heme = Anemia/Toxic exposure (lead, fetal ETOH)

7

What are some of the comorbid disorders associated with ADHD?

Learning disabilities, oppositional defiant disorder, anxiety, depressive, or bipolar

8

What screening tools can you use when diagnosing ADHD?

Vanderbilt scale & Connors’ rating scale

9

How do you treat ADHD?

Stimulants (Methylphenidate or Amphetamine products)

Meth lasts 4 hours

Adderall lasts 6 hours

Should have 80% improvement with a single stimulant

Don’t forget behavioral treatment! We are MANAGING this disorder, not curing it

10

How do ADHD meds work?

Inhibit reuptake of NE & DA (causing increased release of presynaptic NE/DA)

11

What are some of the S/E of stimulants?

Insomnias, weight loss/decreased appetite, HA, tics!

12

What are the 3 P’s of tics that are triggers for being concerned?

Pain;
Personality (child is teased & ashamed); Performance (like they can’t write well.

13

How do you diagnose PTSD?

Traumatic Re-experiencing (flashbacks), Avoidance, and Increased states of arousal

14

What’s one of the significant symptoms associated with depression?

Lack of interest in things that previously interested them

15

What are the classic sxs of depression?

SIGECAPS
Sleep,
Interests,
Guilt (hopelessness),
Energy,
Concentration,
Appetite,
Psychomotor depression,
Suicidal

16

So does everyone with concentration issues have depression?

No, concentration problems ALL THE TIME = ADHD

Concentration problems happen at a certain time = Depression

17

What are the components of a major depressive episode?

5 or more of the SIGECAPS

With MARKED functional impairment

18

How do depressed sxs present in adults vs. youth?

Irritable or cranky, identification with songs or death = Youth

Depressed mood most of the day = Adults

19

How do MAJOR depression symptoms present in adults vs. youth?

Youth = Loss of interest in sports, video games, and activities. Often complaining of stomach aches, or just focus on fun things (sport, games, etc). Refusal to awake for school. Persistent boredom, increased risk taking behavior. Aggression or suicidal (rather than guilt in adult). Decline in school performance. Anorexia/Bulimia.

20

When we have someone with depression, what do we need to keep on our differentials?

Grief/bereavement; substance abuse; traumatic stress; medical – hypothyroidism, anemia, sleep apnea

21

If a child is depressed, what percentage will attempt a suicide?

50% (boys die by suicide 4x as often as girls; but girls attempt more)
2-3% will actually kill themselves

22

What are the 2 key risk factors for suicide?

1. Presence of 1+ diagnosable mental disorders (depression) occurring alone or co-morbid like alcohol or drug use

2. Prior suicide attempt

23

What meds can we use in kids to treat depression?

Fluoxetine & Escitralopram

24

What meds can you use in kids to treat OCD?

Fluoxetine, sertraline, fluvoxamine, and clomipramine

25

What’s the black box warning with antidepressants (aka SSRI’s)?

Suicide!! So need to follow-up every week for the first 4 weeks

26

What is the single most predictive risk factor of depression?

Genetic family loading

27

How long must you try antidepressants?

6 weeks

28

If a person is responsive to antidepressants, how long should you keep them on for?

4-6 months minimum

29

What is best in combination for treating depression?

CBT

30

How many patients will you treat with an SSRI for depression in order to improve one patient?

10! Thus you might need to try a different anti-depressant or increase the dose

If the patient is getting worse, remember, it’s NOT the med

31

What are the 2 biggest mistakes you can make with anti-depressants?

They don’t try them long enough

Would need to increase the dose after 6 weeks