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PSYCHIATRY > ADHD > Flashcards

ADHD Flashcards

1
Q

Impact of adult ADHD?

A
  1. increase freq of psychiatric COMORBIDITY
  2. HIGHER levels of CRIMINALITY
  3. higher levels of SUBSTANCE abuse
  4. impairment in OCCUPATIONAL fxn (easily accomodated)
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2
Q

what causes AHDH?

A
  • perinatal percipitants
  • psychosocial adversity
  • genetic predisposition

> all 3 leads to neuroanatomical BRAIN changes > cognitive and behavioural fts of ADHD

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3
Q

What are perinatal factors that cause ADHD?

A
  • use of TOBACCO and ALCOHOL during pregnancy
  • —-ADHD-like kids with fetal alcohol syndrome
  • ADHD a/w signif. premature baby and perinatal HYPOXIA
  • others: fetal distress, forceps delivery, eclampsia, unusally short or long labour
  • exposure to a vital infection
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4
Q

What is meant by psychosocial ?adversity?

A

links to PARENTING styles

—-marital discord, low social class, large family size, paternal criminality, emotional trauma

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5
Q

Which area of the brain is LEAST active in ADHD?

A
  • Prefrontal region of the are

- resp. for EXECUTIVE functioning (making decisions, initiation of actions), inability to self-manage time…

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6
Q

What is the neurochemistry behind ADHD?

A

-appears to be an —excessively EFFICIENT dopamine-removal system

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7
Q

What is the 3 characteristic signs of ADHD?

A

TRIAD of:

  • INATTENTION
  • HYPERACTIVITY
  • IMPULSIVITY
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8
Q

What is essential for the diagnosis of ADHD in adults?

A
  • should have a MODERATE effect on diff. areas on their life —-UNDERACHIEVING at work/school
  • dangerous driving
  • hard to make and keep friends
  • diffic. relationships
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9
Q

What are psychosocial interventions?

A
  • parent training
  • social skills training
  • SLEEP AND DIET (reduce gluten, reduce SUGAR)
  • behvavioural classroom
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10
Q

What is the first line rx for moderate to severe pharmacological rx?

A

-1st line (STIMULANTS): METHYLPHENIDATE, DEXAMFETAMINE, LISDEXAMFETAMINE

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11
Q

How does ADHD affect daily functioning?

A
  • impairs self-regulation
  • impairs executive functioning/ emotional regulation
  • pervasive ACROSS various settings (school, home)
  • LONGSTANDING since 5y,o
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12
Q

How does ADHD differ in adults?

A
  • more INATTENTIVE symptoms

- less obvious HYPERACTIVITY and impulsivity

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13
Q

What is the impact of childhood ADHD?

A
  • hard to parent
  • INCREASED home stress/emotions
  • difficulties in PEER relationships
  • inappr. decision making
  • exclusion from EDUCATION
  • antisocial behaviour
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14
Q

When left untreated, what occurs with ADHD patients?

A
  • 3-5 fold INCR. in divorce risk
  • 60% become suspended from school
  • 50% in MVA
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15
Q

What theory lies in the fact that ADHD symptoms die down with age?

A
  • the maturation of the brain> THICKENING of the cortex allows the brain to COMPENSATE for cognitive deficits
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16
Q

How likely is the offspring of an ADHD pt gonna get ADHD?

A
  • 60%
17
Q

Sibling risk of ADHD?

A

15%

18
Q

What genes are involved in ADHD?

A
  • dopamine and serotonin
19
Q

What forms of psychosocial adversities predisposes one to ADHD?

A
  • severe MARITAL discord
  • low SOCIAL class
  • Large family size
  • paternal criminality
  • maternal mental d.o
  • emotional trauma and maltreatment
20
Q

Briefly state the causal factors and compounding factors of ADHD.

A

Genetic risk is an IMPORTANT precursor; which is COMPOUNDED by ONE or MORE psychosocial risk factors

21
Q

Which part of the brain is UNDERACTIVE in ADHD?

A
  • frontal lobe

needed for EXECUTIVE functioning- reasoning/planning/judgement/social and sexual behavior/ long term memory

22
Q

Wit anxiety, which parts of the brain is underactive?

A
  • A LARGE majority of the brain is underactive

- why you can’t think straight when you suffer from anxiety…

23
Q

What occurs in ADHD neuro-chemically?

A
  • excessively efficient REMOVAL of dopamine (d.t HIGH conc. of DOPAMINE TRANSPORTER)—-therefore LESS dopamine a/w with adhd (REWARD system is not as active—-UNLESS MULTIPLE ACTIVITIES is done at once)
24
Q

ADHD involves the reduction of dopamine and 2 other NTs…what are they?

A
  1. serotonin (influences MOOD, SOCIAL behaviour, SLEEP and MEMORY)
  2. Norepinephrine (affects ATTENTION when acting as a STRESS hormone)
25
Q

What should be presented for the diagnosis of ADHD in children?

A
  • 6 or more symptoms of INATTENTIVENESS
  • 6 or more symptoms of HYPERACTIVITY/IMPULSIVITY
  • present since 5 y.o
  • reported by parents, clinic, school
  • —affects DAILY functioning
26
Q

How diff. is the diagnostic criteria in adults?

A
  • 5 or more symptoms of inattentiveness and/or 5 or more of impulsiveness
27
Q

What are the following lines of therapy for ADHD ?

A
  • 2nd line: SNRI (atomoxetine)
  • 3rd line: Alpha agonist
  • 4 th line: antidepressants, antipsychotics
28
Q

What particular family of drugs help BOOST concentration ?

A

Stimulants - dexamphetamine and methylphenidate
> reduce short term memory; helps FOCUS on the task at hand
- reduces impulsive behaviours

29
Q

How does increasing NE levels help in ADHD?

A

…NONSTIMULANTs (SNRI/Alpha-agonists) reduce sympathetic stimulation; increases NE
- rids HESITATION, DOUBT, Obsession

30
Q

Diminished serotonin levels exacerbates what conditions?

A
  • anxiety
  • confusion
  • restlessness
31
Q

Diminished dopamine is said to add to….

A
  • foggyness
  • compulsion
  • hyperactivity

PSYCHIATRY (32 decks)

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