Child Flashcards by Natasha Fernandes

How long should a child be treated with a SSRI for OCD to be an adequate trial?

8 weeks on max dose, 12 weeks in total

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Which AD is Health Canada approved for depression?

None

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Which AD has a worst risk for increasing SI?

Venlafaxine

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Which AP is HC approved in children?

Aripip for <18 in scz

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which part of sleep do night terrors occur?

first third of the night (NREM stage 3 or 4)

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first line med tx for ADHD

long acting stimulants

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Which two “anxiety” d/o are more prevalent in males than females in childhood?

OCD. 2. Tourettes

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list three amphetamine based psychostimulants

dexedrine. 2. adderal. 3. vyvanse

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list three ADHD methylphenidate based psychostimulants

ritalin. 2. Biphentin. 3. Concerta

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before which age cant RAD be diagnosed and before which age does the disturbance need to be evident

9 mo and 5 yrs

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what is the average age of onset of tic d/o

4-6 yrs

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Do attention difficulties come before or after tics?

before

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Does OCD come before or after tics?

After

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Before which age is it considered childhood onset CD

10 yrs

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Most common maternal infection related cause of a child having a DD

rubella

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Most common presenting sign of Tourettes

eye blinking

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most common comorbidity of ADHD

ODD (67%)

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most common method of completed suicide in children

hanging

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which parent is more likely to abuse the child

fathers

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at what age do children start to develop theory of mind

4-5 yrs

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Children with ADHD and CD are at risk of developing which d/o

SUD

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co-morbidity most common with tourettes

ADHD

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most common childhood d/o

Anxiety. 2. MDD

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criteria for enuresis

2x/w x 3mo for >4 yrs

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most effective tx for enuresis

bell and pad (behavioral therapy)

cerebral palsy and hyperuricemia makes you think off?

Lesch Nyhan

is physical abuse a criteria in RAD

no, more neglect

is physical abuse a criteria in disinhibited social engagement d/o>

no, more neglect

Is encopresis involuntary or intentional?

can be either

best tx for separation anxiety d/o

multimodal (family therapy, psychoed, meds)

when does normative seperation anxiety peak and then diminishes?

9-18 mo then diminishes by 2 yrs

prevalence of psychiatric d/o in children and adolescents

15-20%

Prior to what age must ADHD sx be present

For ADHD what the minimum number of settings sx must be present?

two

for ADHD can symptoms vary based on how stimulating the situation is?

yes

when do the first sx of ODD appear?

in preschool years

what is the minimum age to diagnosis ODD or CD

there is none

Below which age does the PTSD criteria get modified for youth?

Age 6 and younger

was is the best behavioral approach to ODD?

"reinforce the positive and ignore the negative" (positive reinforcement and extinction)

suicide attempts occur in what percent of adolescents?

7-11%

what percentage of children with separation anxiety go on to have a psychiatric d/o as adults

33.3%

percentage of ADHD that remits in adolescence

30-40%

separation anxiety and school refusal is more common in which gender

M=F

what is the most common childhood anxiety disorder

separation

which type of attachment is most associated with separation anxiety d.o

insecure

best therapy for a child with an anxiety d.o

CBT

what is the key different in the MDD criteria bw adults and children

for children irritable mood can replace depressed mood

what is the most frequently reported sx of schizophrenia in children

prevalence of CD

6.8%

Is CD associated with higher or lower arousability?

lower

What percent of CD will convert to anti-social PD

ranges from 30-50% (depends on the subtype; childhood onset at higher end )

What was the main conclusion from the Isle of Wight Study by Rutter et al

psychopathology was twice as high in medically unwell children than health kids

over what time period does stuttering generally develop

weeks to months

what age range does stuttering typically occur

18mo - 9 yrs

What is the most common cause of language delay in childhood?

deafness or hearing loss

what are markers for the best prognosis in a child with autism

1. IQ > 70 with good adaptive skills. 2. develops language by 5-7 yrs

Percentage of children/youth with autism who have a seizure

25-30%

what is the most common pattern of selective mutism

child will speak at home with the nuclear family but not elsewhere

do individuals with ADHD have an increased or decreased risk for criminal behavior in adulthood?

increased

which features of ADHD are more likely to resolve by adulthood

hyperactivity (the inattention and impulsivity persists)

What is the genetic pattern with highest risk of tourette's transmission

autosomal dominant

first line med tx for tourette's

AP (risperidone is most effective, followed by olz and pimozide)

name two evidence based. behavioral interventions for tourette's

1. habit reversal. 2. CBIT

which co-morbidity leads to the worst outcomes in pediatric MDD

OCD

Main conclusion of POTS study

Combo (CBT+SSRI) = CBT > sertraline > placebo (in OCD)

what is the most common comorbid psych d/o among youth with bipolar?

ADHD

two AP to use in aggression in autism

1. risp. 2. abilify

main difference bw disruptive mood dysregulation and intermittent explosive d.o

in DMDD they have inter-episode irritability

least common co-morbidity with ADHD

ASD

in ARFID do you need both weight loss and nutritional deficiencies?

no at least one of those OR (psychosocial impairment or oral/enteral supplements)

what are the three reasons an ARFID kid restricts food

1. lack of interest in food 2. sensory aversion 3. an aversive experience (i.e. choking)

what is the rate of ADHD in a parent or sibling of a child with ADHD?

2-8x the general population

can ODD be co-morbid with CD?

are language disorders specific to spoken speech?

no, also includes issues with writing, sign language, etc

are language disorders deficits in comprehension or speech production?

can be either or both

What is the heritability of ADHD in a monozygotic twin of someone with ADHD

76%

main difference bw the WISC and WIAT

only WIAT assesses school performance (WISC just assesses intelligence which is not sufficient for dx reading d/o)

which psychostimulant is less likely to cause tics

methylphenidate

what is the relationship bw stimulant tx of ADHD and later development of SUD

stimulant tx will reduce or delay onset of SUD in adolescence, but this benefit is lost in adulthood

initial starting dose of atomoxetine

0.5mg/kg/ day (if < 70kg)

which erikson stage coincides with freud's phallic and piaget's pre-concrete?

initiative vs guilt

what is the most likely issue for a adolescent male not developing secondary male sex characteristics but experiencing gynecomastia

Klienfelter (47, XXY)

what EEG finding is seen in children with ADHD

elevated beta and theta activity