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Flashcards in Behavioral/Psych Deck (58):
1

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

yes

2

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

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

3

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

true

4

repetitive, fast, unconscious movements or vocalizations

tic disorder

5

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

1:1 C
1:2 YA

6

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

16%

7

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

40-70%

8

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

yes

9

Is weight usually in normal range for bulimia?

yes

10

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

12-50%

11

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

prevents bloating after meals

12

screening tool for substance abuse?

CRAFFT

13

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

suicide

1/3 of all BPD kids will attempt

14

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

15

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

5% C
10-20% A

16

MDD must have which of the following:

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

1. anhedonia

17

MDD in school age children often misdiagnosed as

ADHD

18

most common time of onset for tic disorders is __ years

6-8

19

What SSRI is FDA approved in ages 12-adults?

Escitalopram (Lexapro)

20

__% of kids with ADHD have learning disabilities

25-35%

21

Characteristic pattern for BPD

manic episodes before or after major depressive episodes

22

Key lab findings for bulimia (2)

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

23

Common side effects of SSRIS (7)

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

24

Onset for anorexia associated with ?

stressful event

25

management of OCD (3 points)

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

26

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

27

tic disorder is ___x more likely in boys than girls

3-5

28

cardiovascular/circulation PE findings associated with anorexia (2)

heart arrhythmia (sinus brady, dysrhythmia)
hypotension/orthostatic

29

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

30

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

SSRI

31

Most commonly diagnosed behavioral problem in childhood

Hyperactivity/Attention disorder

32

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

depression

33

Management of moderate to severe depression

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

34

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

35

Be careful of antidepressants and stimulants with BPD -why?

antidepressants alone may potentiate manic response

stimulants may worsen manic symptoms

36

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

1 year

37

only 2 drugs FDA approved for MDD in kids

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

38

why are the effects of psychotropic meds hard to quantify?

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

39

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

Kleine-Levin syndrome

40

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

suicide

41

What 2 SSRIs are approved in adults

Sertraline (zoloft), Fluvoxamine (Luvox)

42

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

tourette's

43

Bingeing-vomiting is in about ___% of bulimia cases

80-90%

44

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

45

What is the number one predictor or suicide?

degree of hopelessness

46

Medication management for BPD

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

lithium shown to prevent relapse

47

baseline labs before starting any psychiatric med (5)

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

48

Is a definitive cause for BPD known?

no

49

mortality rate for anorexia

10%

50

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

12-18 years

51

Management of mild to moderate depression

CBT or skill building

52

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

MDD

53

Management for anxiety (3 components)

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

54

DSM V criteria for bulimia

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

55

Cardinal 4 features of ADHD

- inattention
- distractable
- impulsive
- overactive

56

Do pts with OCD derive pleasure from ritualistic behavior?

no

57

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

Fluoxetine (Prozac)

58

Peak age onset for anorexia nervosa

17

bimodal (14-18)