childhood/early onset disorders Flashcards Preview

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Flashcards in childhood/early onset disorders Deck (22):

infant deprivation effects

- 4Ws: weak, wordless, wary, wanting
- failure to thrive (weak)
- poor language/socialization skills (wordless)
- lack of basic trust (wary)
- reactive attachment disorder: infant withdrawn/unresponsive to comfort
- deprivation for >6m --> irreversible changes
- severe deprivation can cause death


vulnerable child syndrome

- parents irrationally perceive the child as esp susceptible to illness/injury. usually follows serious illness/life-threatening event.



- onset b4 12
- tx: methylphenidate +/- CBT
- alternative tx: atomoxetine, guanfacine, clonidine


Autism spectrum disorder

- poor social interactions, social communication deficits, repetitive/ritualized behaviors, restricted interests
- must present in early childhood
- may be accompanied by intellectual disability
- MC boys
- assoc with increased head/brain size


Rhett Syndrome

- x-linked dominant
- most de novo mutation of MECP2
- seen almost exclusively in girls (affected males die in utero),
- sx apparent around age 4: regressionk loss of development, loss of verbal abilities, intellectual disability, ataxia, stereotyped hand-wringing


conduct disorder

- repetitive and pervasive behavior violating the basic rights of others or societal norms (ie aggression to people/animals, destruction of property, theft)
- after age 18 often reclassified to antisocial personality disorder
- tx: CBT


oppositional defiant disorder

- enduring pattern of hostile, defiant behavior to authority figure in the absence of serious violations of social norms; tx: CBT


disruptive mood dysregulation disorder

- onset b4 10
- severe, recurrent temper outbursts out of proportion to situation
- child constantly angry/irritable btw outbursts
- tx: stimulants, antipsychotics, CBT


dissociative identity disorder

- formerly multiple personality disorder
- presence of 2 (+) distinct identities/personality states
- MC women
- assoc with history of sexual abuse, PTSD, depression, substance abuse, borderline personality, somatoform conditions


depersonalization/derealization disorder

- persistent feelings of detachment/estrangement from one's own body, thoughts, perceptions, and actions (depersonalization) or one's environment (derealization)


causes of reversible dementia

- dementia: decrease in function, not consciousness
- hypothyroidism, depression, vit deficiency (B1, B3, B12), normal pressure hydrocephalus, neurosyphilis
- EEG usually normal
- as opposed to delirium (reversible) where consciousness waxes and wanes, and there is diffuse slowing of EEG


causes of irreversible dementia

- dementia: decrease in function, not consciousness
- alzheimers, lewy body, huntington, pick disease, cerebral infarct, wilson disease, creutzfeldt-jakob disease, chronic substance abuse (due to neurotoxicity), HIV
- EEG usually normal
- as opposed to delirium (reversible) where consciousness waxes and wanes, and there is diffuse slowing of EEG


hypnopompic hallucination

- occurs while waking from sleep
- "pompous upon waking"
- sometimes seen in narcolepsy


visual vs auditory hallucination

- visual MC seen in medical illness (ie drug intox), auditory MC feature of psych illness
- gustatory: rare but seen in epilepsy


Olfactory hallucination

- often occur as aura of temporal lobe epilepsy (ie burning rubber) and in brain tumors


tactile hallucination

- common in alcohol withdrawal and stimulant use
- delusional parasitosis "cocaine crawlies"


hypnagogic hallucination

occurs while going to sleep; sometimes seen in narcolepsy


Decreased in narcolepsy

Caused by decreased hypocretin (Orexin) production in lateral hypothalamus


Night terrors occur during

Slow-wave/deep (N3) sleep. Bc occurs during non-REM sleep there is no memory. Vs nightmares occur in REM.


Refeeding syndrome

Seen in anorexia. Increased insulin —> hypophosphatemia —> heart complications


Physical changes seen in schizophrenia

- increased D activity
- decreased dendritic branching
- ventriculomegaly
- negative sx persist after tax but + disappear


Psychotic disorder vs schizophreniform vs schizoaffective vs schizophrenia

1. Brief psychotic disorder: lasts <1m, usually stress related
2. Schizophreniform: 1-6m
3. Schizophrenia: lasts >6m
4. Schizoaffective disorder: schizophrenia + major mood disorder (major depressive or bipolar). *Pt must have >2 weeks of hallucinations/delusions w/o major mood episode*