child psych 1

Question 1

Which of the following is NOT a typical feature of school refusal?

Answer 1

Educational underachievement

Educational underachievement is more associated with truancy than school refusal.

Question 2

Which childhood psychiatric disorder has the highest heritability factor?

Answer 2

ADHD

Heritability of ADHD is estimated to be around 70-80%.

Question 3

In adolescents, which clinical feature of depression is more commonly seen compared to children?

Answer 3

Low self esteem

Adolescents may also show symptoms like somatisation and school refusal.

Question 4

In children with PANDAS, which symptom is least common?

Answer 4

Psychosis

OCD and tics are more common in PANDAS than psychosis.

Question 5

How many subtests are usually used in the Wechsler intelligence scale for children (WISC-R)?

Answer 5

Ten subtests

Each subtest has a mean score of 10, contributing to a full-scale IQ of 100.

Question 6

About what percentage of children are dry at night by the age of 5 years?

Answer 6

90%

By 2 years, 50% are dry at night; by 3 years, 75% are dry.

Question 7

Which feature is seen in truants rather than school refusers?

Answer 7

Antisocial symptoms

School refusers typically exhibit emotional symptoms rather than antisocial behavior.

Question 8

How is Tourette’s disorder diagnosed?

Answer 8

By having both motor and vocal tics for 12 months

Tics must cause distress and impair function.

Question 9

Blockade of which receptors can reduce tics in Tourette’s syndrome?

Answer 9

D2 receptors

D2 antagonism at the basal ganglia is effective in reducing tics.

Question 10

Which condition has less prominent genetic loading?

Answer 10

Conduct disorder

Genetic influences account for 40%-50% of variance in conduct disorder.

Question 11

Which statement about bipolar disorder in children and adolescents is true?

Answer 11

Manic children typically present with atypical or mixed features

Equal gender distribution is characteristic, unlike MDD.

Question 12

Which risk factor is associated with autism?

Answer 12

Premature birth

Other associated factors include breech presentation and low Apgar scores.

Question 13

What treatment is most helpful for treating PTSD in children?

Answer 13

Trauma focussed CBT

TF-CBT improves PTSD and anxiety in children after trauma.

Question 14

What is the prevalence of ADHD in the UK?

Answer 14

2-5%

Estimates of ADHD prevalence vary, but most lie between 5% and 10% in the US.

Question 15

In which condition is the sex distribution approximately equal?

Answer 15

School refusal

Separation anxiety disorder is more common in females.

Question 16

What is the drug treatment of choice for a 7-year-old with uncomplicated Tourette’s syndrome?

Answer 16

Clonidine

Clonidine is a first-line treatment for Tourette’s syndrome.

Question 17

What percentage of patients with autism has mental retardation?

Answer 17

70%

Approximately one-third have mild to moderate mental retardation.

Question 18

What is the ratio of prevalence of ADHD in males to females?

Answer 18

4 to 1

Community-based studies show a male-female ratio of about 4:1.

Question 19

Which is not a characteristic feature of PTSD in children?

Answer 19

Selective amnesia for the event

DSM-5 criteria allow for different expressions of PTSD in children.

Question 20

What risk factor is associated with the development of ADHD?

Answer 20

Maternal smoking in pregnancy

Maternal smoking has a significant association with offspring ADHD symptoms.

Question 21

Which scale could be used to assess a 14-year-old boy with psychiatric disease again at the age of 20?

Answer 21

Clinical interview schedule- revised

This structured instrument is suitable for assessing psychiatric morbidity.

Question 22

What is the Clinical Interview Schedule-Revised (CIS-R) used for?

Answer 22

Assessing minor psychiatric morbidity in the community, general hospital, occupational, and primary care research.

The ICD-10 diagnoses can be derived from CIS-R data using an algorithm based on published diagnostic criteria for research.

Question 23

What is the most useful clinical instrument to follow up on symptoms in patients diagnosed with depression at age 14?

Answer 23

Child and adolescent functional assessment scale.

This scale assesses the degree of impairment in functioning due to emotional, behavioral, or psychiatric problems.

Question 24

What blood abnormalities are seen in Anorexia Nervosa?

Answer 24

Normocytic normochromic anaemia.

Other abnormalities include mild leukopenia with relative lymphocytosis and thrombocytopenia.

Question 25

What is the average age of onset of schizophrenia?

Answer 25

25. ## Footnote Onset may be delayed in females and earlier in males.

Question 26

Which statement about suicidal behavior in adolescents is true?

Answer 26

Self-poisoning is the commonest form of parasuicide. ## Footnote Suicide is the third leading cause of death for adolescents, following accidents and homicides.

Question 27

What is the prevalence of suicidal ideations in the past year for an adolescent cohort in Britain?

Answer 27

15%. ## Footnote This was more common in females (22%) than males (8.5%).

Question 28

What is the most common psychiatric emergency seen in the child and adolescent population?

Answer 28

Suicidal behavior.

Question 29

Preschoolers and school-age children who stutter exhibit an increased incidence of which condition?

Answer 29

Social anxiety. ## Footnote Stuttering can lead to social isolation, especially when it persists into adolescence.

Question 30

What is the overall prevalence of psychiatric problems in adolescence?

Answer 30

16-20%. ## Footnote Studies suggest 20% of children and adolescents have mental health problems at some point.

Question 31

What is the medication of choice for a child with ADHD and congenital heart disease?

Answer 31

Atomoxetine. ## Footnote Stimulants should be avoided in patients with congenital structural heart diseases.

Question 32

Which autoimmune disorder is associated with OCD in children?

Answer 32

PANDAS syndrome. ## Footnote This association relates to obsessive-compulsive symptoms following beta-hemolytic streptococcal infection.

Question 33

When do sibling rivalry disorders usually emerge?

Answer 33

Within 6 months after the birth of the sibling.

Question 34

What does shaping refer to in child psychiatry?

Answer 34

Gradual reinforcement of behaviors approximating desired outcome. ## Footnote Introduced by Skinner, shaping involves changing an existing response toward a desired target behavior.

Question 35

Which drug has the best evidence for use in childhood depression?

Answer 35

Fluoxetine. ## Footnote It is the only antidepressant approved for use in children and adolescents.

Question 36

Most children with selective mutism also meet diagnostic criteria for which disorder?

Answer 36

Social phobia.

Question 37

Which statement about Rett's syndrome is true?

Answer 37

Characterised by progressive lack of acquired abilities.

Question 38

Which disorder is characterized by impaired ability to recognize words, slow and inaccurate reading, and poor comprehension?

Answer 38

Reading disorder.

Question 39

Reactive attachment disorder is generally diagnosed before the age of?

Answer 39

5.

Question 40

What is the most common psychiatric co-morbidity associated with Asperger's syndrome?

Answer 40

Depression.

Question 41

Which factor is a good prognostic factor in children with conduct disorder?

Answer 41

Resilient temperament.

Question 42

Regarding the aetiology of ADHD, which statement is false?

Answer 42

Predominant serotonin dysregulation is seen in the prefrontal cortex. ## Footnote The predominant involvement is actually dopamine and norepinephrine dysregulation.

Question 43

Which factor suggests a diagnosis of bulimia rather than anorexia nervosa?

Answer 43

Poor impulse control.

Question 44

Pica typically occurs during which age range?

Answer 44

2-3 years of age.

Question 45

What is the likely cause for uncoordinated movements in a 14-year-old girl with a history of fever and sore throat?

Answer 45

Sydenham's chorea.

Question 46

What triggers rheumatic fever 2-4 weeks later in susceptible individuals?

Answer 46

Pharyngeal infection with Lancefield Group A Beta Hemolytic streptococci ## Footnote This condition affects approximately 2% of the population.

Question 47

What is the most likely cause for uncoordinated movements in a child with a history of fever and sore throat?

Answer 47

Sydenham's chorea

Question 48

Which treatment is not preferred for a child with a hyperkinetic disorder?

Answer 48

Pemoline ## Footnote Pemoline has been withdrawn in the UK and US due to severe liver toxicity.

Question 49

Which drug is contraindicated in children and adolescents due to increased risk of suicide?

Answer 49

Paroxetine

Question 50

What is the most common cause of co-morbidity in children and adolescents with bipolar disorder?

Answer 50

ADHD ## Footnote Approximately 50-80% of children with bipolar disorder have ADHD.

Question 51

Where are manifestations of oppositional defiant disorder almost invariably present?

Answer 51

At home

Question 52

What are the most common co-morbid disorders seen in Tourette's syndrome?

Answer 52

ADHD and OCD

Question 53

Which disorder has been found to co-exist in 1/3rd to 2/3rds of children and adolescents with Tourette's disorder?

Answer 53

OCD

Question 54

What is the effective treatment for adolescent inhalant abuse?

Answer 54

No known therapy

Question 55

Which medication is preferred for treating acute manic or mixed episodes in children and adolescents?

Answer 55

Olanzapine

Question 56

Which neurotransmitter system is commonly involved in the aetiology of Tourette's syndrome?

Answer 56

Dopamine

Question 57

Which treatment has confirmed the most evidence for successful treatment of OCD compared to other childhood anxiety disorders?

Answer 57

Combination of both medication and CBT

Question 58

What is the total sleeping time of a newborn baby?

Answer 58

16-17 hours per day

Question 59

What is the first line drug in an 8-year-old with uncomplicated ADHD?

Answer 59

Methylphenidate

Question 60

What may be a long-term effect of prescribing high doses of methylphenidate without drug holidays?

Answer 60

Growth suppression

Question 61

What is the commonest age of presentation for school refusal?

Answer 61

11 years

Question 62

Which disorder is reported more commonly in females?

Answer 62

Mathematics disorder

Question 63

Which of the following is not a risk factor for adolescent suicide?

Answer 63

Female gender

Question 64

What is a biological risk factor associated with conduct disorder?

Answer 64

Low CSF serotonin

Question 65

Which symptom is least commonly reported in children with bipolar disorder?

Answer 65

Hypersexuality

Question 66

What is the term for developmentally inappropriate social relatedness seen before age 5 following prolonged separation from caregivers?

Answer 66

Reactive attachment disorder

Question 67

What is the prevalence of ADHD among girls between the ages of 5-15 according to DSM-4 criteria?

Answer 67

0-1%

Question 68

What is the overall prevalence of psychiatric disorders in adolescence?

Answer 68

16-20%

Question 69

What proportion of adolescents admits to having had suicidal ideas in the UK in the past year?

Answer 69

15%

Question 70

The percentage of reading difficulties in children in Britain is estimated to be around?

Answer 70

5%

Question 71

Which symptom is most likely to remit first in a child diagnosed with ADHD?

Answer 71

Hyperactivity

Question 72

According to the Isle of Wight survey, what is the commonest psychiatric disorder in childhood?

Answer 72

Conduct disorder

Question 73

Which among the following is not a risk factor identified by the Cambridge study for later delinquent behavior?

Answer 73

Aggression in child