Attention Deficit Hyperactivity Disorder Flashcards Preview

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Flashcards in Attention Deficit Hyperactivity Disorder Deck (40)
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1

Define ADHD

The triad of inattention, hyperactivity, and impulsivity, present for over 6 months before the age of 7 and causing significant distress or social impairment

2

State the criteria for inattention

At least 6 of: failure to sustain attention, failure to complete instructions or work, failure to listen, losing things, careless errors, easy distractibility, avoidance of tasks requiring mental error, forgetfulness and poor planning

3

State the criteria for hyperactivity

At least 3 of: fidgeting or squirming, undue noisiness, leaving seat in class, excess running about, excess motor activity

4

State the criteria for impulsivity

At least 1 of: blurting out answers to questions, excess talking, failure to wait one's turn, poor self-control, interrupting or intruding on others, risk-taking

5

What percentage of patients with ADHD have comorbid conduct disorder?

25-50%

6

What percentage of patients with ADHD have comorbid anxiety disorder?

25%

7

What percentage of patients with ADHD have comorbid learning difficulties?

30%

8

State a difficulty comorbidities pose in diagnosing ADHD

The symptoms often overlap - for example, inattention is a feature of ADHD, depression, anxiety, and autism spectrum disorder

9

State the difference in ADHD prevalence between the UK and US

US: 8.8% diagnosed, 6.1% on medication
UK: 1.7% diagnosed, 0.8% on medication

10

State the ratio of ADHD in males to females

3:1

11

Is there evidence that ADHD incidence is increasing?

No - but the number of individuals presenting to clinic and taking medication has

12

State 3 population groups with higher prevalence of ADHD

Inner cities, lower socio-economic classes, prisons

13

How much more at risk of developing ADHD is the child of a parent with ADHD than the child of a parent without ADHD?

8x

14

What is the ADHD concordance rate between monozygotic twins?

80%

15

State the approximate heritability of ADHD

75%

16

Give at least 2 candidate genes for involvement in ADHD

Tyrosine hydroxylase (involved in DOPA synthesis), dopamine receptors D2, D3, and D5, catecholamine methyl transferase (COMT), nicotinic receptors, SNAP-25 (involved in axonal growth)

17

State a potential prenatal risk factor for ADHD

Maternal smoking, maternal alcohol or substance misuse, maternal stress

18

State a perinatal risk factor for ADHD

Very low birthweight

19

State a potential postnatal risk factor for ADHD

Environmental lead, zinc deficiency, magnesium deficiency, organophosphates

20

State at least 3 psychosocial environmental risk factors for ADHD

High numbers of critical comments, poor encouragement, inconsistent parenting, low sensitivity to child's needs, maltreatment or physical discipline, maternal depression

21

Give 3 examples of executive functions

Planning, flexible strategy, impulse control, orientation to salient stimuli, suppression of inappropriate actions

22

Name 2 tests of impulse control

Wisconsin card sorting test, Stroop test

23

Describe the Stroop test

The words of colours flash up in different colours and the individual has to say the colour instead of the word (e.g. if orange was written in green, say green)

24

Name a gene variant associated with decreased executive function

COMT gene variant val/val159met

25

Describe the differences in the prefrontal cortex of an individual with ADHD on MRI

Decreased brain size (but also seen in non-ADHD siblings) and delay of brain development by 2-3 years

26

Describe the differences in the prefrontal cortex of an individual with ADHD on SPECT MRI

Decreased blood flow (but also seen in non-ADHD siblings)

27

Describe the differences in the prefrontal cortex of an individual with ADHD on fMRI

Increased dopaminergic transporter density, so dopamine is cleared more rapidly from the synapse

28

Describe the differences in the prefrontal cortex of an individual with ADHD on diffusion tensor imaging

Decreased white matter (but also in non-ADHD parents), with connectivity relative to cognitive performance

29

Describe the basal ganglia and cerebellum of ADHD patients on MRI

Reduced in volume, with decreased blood flow to these areas

30

Name a risk gene for ADHD which influences basal ganglia volume

A 7-repeat allele for dopamine transporter 1 (DAT1)