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Flashcards in Behavioral/Psych Deck (58):
1

__% of kids with ADHD have learning disabilities

25-35%

2

Bingeing-vomiting is in about ___% of bulimia cases

80-90%

3

management for PTSD (4 points)

- social support
- mental health provider
- possible beta blockers effective to treat somatic complaints
- SSRIs for depression/anxiety that's related

4

Is weight usually in normal range for bulimia?

yes

5

most common time of onset for tic disorders is __ years

6-8

6

What is the number one predictor or suicide?

degree of hopelessness

7

M:F ratio for Depression and suicide, childhood and young adult

1:1 C
1:2 YA

8

baseline labs before starting any psychiatric med (5)

- CBC, monospot
- Thyroid
- Liver panel
- Pregnancy
- Kidney functions if med processed through kidneys

9

Management of mild to moderate depression

CBT or skill building

10

Most commonly diagnosed behavioral problem in childhood

Hyperactivity/Attention disorder

11

___% of children and adolescents with depression/suicide have comorbid conditions

40-70%

12

What labs and tests should you do for PE if suicidal ideation/depression? (5)

- thyroid
- TSH
- Free T4
- Urine tox screen
- pregnancy test

13

MMD DSM V criteria - must have how many?

5!

- depressed or irritable mood
- anhedonia (inability to experience pleasure)
- weight loss/gain
- insomnia or hypersomnia
- psychomotor agitation or retardation
- fatigue or energy loss
- feelings of worthlessness
- diminished ability to thinker concentrate
- recurrent thoughts of death
- suicidal ideation

14

What 2 SSRIs are approved in adults

Sertraline (zoloft), Fluvoxamine (Luvox)

15

Characteristic pattern for BPD

manic episodes before or after major depressive episodes

16

True or false: onset of BPD before age 10 is rare

true

17

Medication management for BPD

lithium (mood stabilizer) alone or with an anticonvulsant (valproate)

lithium shown to prevent relapse

18

why are the effects of psychotropic meds hard to quantify?

most don't have biomarkers that can be tested (only lithium)

19

What SSRI is FDA approved for children > or = to 8 years?

Fluoxetine (Prozac)

20

Do pts with OCD derive pleasure from ritualistic behavior?

no

21

What SSRI is FDA approved in ages 12-adults?

Escitalopram (Lexapro)

22

Management of moderate to severe depression

CBT and meds (SSRI)
AVOID TCAs (tricyclic antidepressants)

23

repetitive, fast, unconscious movements or vocalizations

tic disorder

24

Peak age onset for anorexia nervosa

17

bimodal (14-18)

25

DSMV criteria for ADHD (4 main points)

- symptoms occur in 2 or more settings
- persisted for more than 6 months
- child must meet 6 of 9 criteria, adolescent only 5
- some symptoms must be present before age 12

26

Initial symptom of bipolar disorder is what in 20-40% of children?

depression

27

Trial of an SSRI should be used for at least how many weeks? If no improvement consider what?

8-12 week

cross-taper and substitute another SSRI

28

screening tool for substance abuse?

CRAFFT

29

tic disorder is ___x more likely in boys than girls

3-5

30

of adolescents who use alcohol and drugs, __% meet criteria for dependence

16%

31

Key lab findings for bulimia (2)

- fluid and electrolyte imbalances (hypoK, hypoNA, hypoCL)
- metabolic acidosis

32

__% of kids with ADHD have additional psychiatric d/os

12-50%

33

May consider treatment of pt with anorexia with ___ after weight gain

SSRI

34

Do most teens who commit suicide have a history of depression?

yes

35

Depression and suicide affects __% of children, __% of adolescents

5% C
10-20% A

36

Is comorbidity of MDD and anxiety common in school age children?

yes

37

causes of depression (5) - chemical changes in brain

- imbalances in serotonin, dopamine, and/or norepinephrine, excess cortisol
- genetic
- environment (stressful situations)
- depressogenic cognition
- physical disorders

38

Disturbed eating behavior without over concern for weight or image is known as

Kleine-Levin syndrome

39

Onset for anorexia associated with ?

stressful event

40

Common side effects of SSRIS (7)

- excitation
- agitation
- nausea
- vomiting
- diarrhea
- dizziness
- chills

41

2nd leading cause of death in 10-24 year olds?

suicide

42

Is a definitive cause for BPD known?

no

43

mortality rate for anorexia

10%

44

the risk of ___ in BPD is higher than all other psychiatric disorders

suicide

1/3 of all BPD kids will attempt

45

chronic tics, both motor and vocal, lasting more than 1 year

tourette's

46

Be careful of antidepressants and stimulants with BPD -why?

antidepressants alone may potentiate manic response

stimulants may worsen manic symptoms

47

If a patient is overeating without compensatory mechanism, consider what dx?

MDD

48

Management for anxiety (3 components)

- behavioral and family interventions
- therapy, CBT
- meds - SSRI

49

USPSTF (2016) recommends screening for major depressive disorder (MDD) in adolescents aged ____

12-18 years

50

Cardinal 4 features of ADHD

- inattention
- distractable
- impulsive
- overactive

51

cardiovascular/circulation PE findings associated with anorexia (2)

heart arrhythmia (sinus brady, dysrhythmia)
hypotension/orthostatic

52

Antidepressants should be used for how long after resolution of depression?

1 year

53

MDD must have which of the following:

1. anhedonia
2. sadness
3. decreased appetite
4. sleeping more

1. anhedonia

54

management of OCD (3 points)

- defer if symptoms do not cause child harm or distress
- SSRIs
- therapy

55

MDD in school age children often misdiagnosed as

ADHD

56

What is the purpose of using pro-kinetic medications in teens with anorexia nervosa?

prevents bloating after meals

57

only 2 drugs FDA approved for MDD in kids

prozac (over age 7)
lexapro (over age 12)

58

DSM V criteria for bulimia

must occur at least 1x/week for greater than or equal to 3 months