ADHD and ASD

Question 1

what does ADHD stand for

Answer 1

attention deficit hyperactivity disorder

Question 2

what are the triad of difficulties in ADHD

Answer 2

inattentiveness
impulsivity
hyperactivity

Question 3

what is ADHD

Answer 3

disorder of self regulation + inflexible adaptability

Question 4

criteria for ADHD

Answer 4

developmentally inappropriate
impairing function
pervasive across all settings
longstanding from age 5

Question 5

impact of ADHD on childhood

Answer 5

parenting difficulties 
school difficulties 
home stress
barrier to learning 
constantly being in a healthcare environment

Question 6

impact of ADHD on adulthood

Answer 6

increased risk of psychiatric conditions 
criminality 
antisocial behaviour
substance misuse
criminality

Question 7

causes of ADHD

Answer 7

genetic predisposition
perinatal precipitants
psychological adversity

Question 8

what are genetic components in ADHD

Answer 8

FH, strong clustering

dopamine + 5HT transporter genes implicated

Question 9

what are perinatal precipitants in ADHD

Answer 9

tobacco smoking, alcohol

significant prematurity and hypoxia

Question 10

what are psychological adversities in ADHD

Answer 10

inconsistent parenting 
low socioeconomic class 
large families 
criminality 
trauma

Question 11

what do scans of the brain show in ADHD

Answer 11

under activity in a large portion of the brain

Question 12

in ADHD, there is a high/low concentration of dopamine transporters and more/less dopamine

Answer 12

high conc of dopamine transporters

less dopamine

Question 13

low dopamine causes children to increase in risk taking behaviours to seek reward in ADHD, true or false

Answer 13

true

Question 14

in ADHD there are high/low levels of dopamine, 5HT, noradrenaline

Answer 14

low

Question 15

what are the diagnostic criteria for ADHD in a child

Answer 15

6 or more symptoms of inattentiveness and or hyperactivity + impulsivity
present before age of 5
reported by parents, school
disrupts daily life

Question 16

what are the diagnostic criteria for ADHD in an adult

Answer 16

5 or more symptoms of inattentiveness and or hyperactivity + impulsivity
historical concerns since young age
underachieving
dangerous driving
difficulty establishing and maintaining relationships

Question 17

methods of treatment for ADHD

Answer 17

psychosocial

pharmacological

Question 18

types of psychosocial therapy for ADHD

Answer 18

parent training
social skills training
sleep and diet

Question 19

list medications for ADHD

Answer 19

1st line - stimulants
2nd line - SNRIs
3rd line - a agonists
4th line - imipramine/risperidone

Question 20

function of stimulants in ADHD and some examples

Answer 20

increase dopamine levels

methylphenidate, dexamfetamine, lisdexamfetamine

Question 21

function of SNRIs in ADHD and some examples

Answer 21

increase NA and improve concentration

atomoxetine

Question 22

examples of a agonists in ADHD

Answer 22

clonidine

guanfacine

Question 23

risks of medications in ADHD

Answer 23

suppression of appetite

therefore monitor growth

Question 24

what are the core triad of features of autism spectrum disorder ASD

Answer 24

impairment of:
social communication 
social interaction 
imagination/flexibility of thought 
(repetitive behaviours)

Question 25

features of impairment of social communication in ASD

Answer 25

``` pedantic about language and grammar americanised voice monotonous hard to grasp underlying meaning difficulty sharing thoughts and feelings ```

Question 26

features of impaired social interaction in ASD

Answer 26

self focussed | lack empathy

Question 27

features of impaired flexibility of thought in ASD

Answer 27

take things literally | dont understand metaphors

Question 28

features of repetitive behaviours in ASD

Answer 28

repetitive motor movements insist on routine ritualised behaviours are comforting fixated interests

Question 29

who is more affected by ASD, boys or girls

Answer 29

boys

Question 30

what is the cause of ASD

Answer 30

multifactorial genetics environmental - teratogens perinatal - foetal distress

Question 31

ASD is strongly heritable, true or false

Answer 31

true

Question 32

in ASD where is the neuroanatomy pathology

Answer 32

frontal lobe amygdala cerebellum

Question 33

which molecules are implicated in ASD

Answer 33

glutamate GABA 5HT

Question 34

suggestive features of ASD in children

Answer 34

``` dont babble tend to play alone lack awareness of other children lack of empathy no imaginative play routine ```

Question 35

suggestive features of ASD in adults

Answer 35

``` hard to pick up on cues difficulty with eye contact shy hard to fit in appear rude/blunt takes things very literally ```

Question 36

what is sensory processing difficulty

Answer 36

any of the senses can be over/under stimulated | eg flavours too strong, overpowering smell, muddled noise, painful touch

Question 37

what screening questionnaires can be used in ASD

Answer 37

3di | DISCO

Question 38

what standardised assessment tool can be used in ASD

Answer 38

ADOS

Question 39

what are essential criteria for ASD

Answer 39

symptoms present in early developmental period causes significant impairment of functioning not better explained by any other diagnosis

Question 40

comorbidity is very high/low in ASD

Answer 40

very high

Question 41

non pharmacological management of ASD

Answer 41

psychoeducation S+LT social skills training family and school based support

Question 42

pharmacological management of ASD

Answer 42

risperidone only for severe aggression | does nothing for core symptoms