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CP2 PAEDS > Community + Psych Part 2 > Flashcards

Community + Psych Part 2 Flashcards

1
Q

Prevalence autism

A

Around 1/54

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2
Q

When does autism usually present

A

2-4 years

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3
Q

Classic triad in Autism

A

Impaired social interaction
Speech and language disorder
Routines with ritualistic/repetitive behaviour

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4
Q

Examples of impaired social interaction - Autism (4)

A

Can’t form friendship
Own company/no interest in others
Avoids eye contact
Socially inappropriate/ no empathy

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5
Q

Examples of speech and language disorder in Autism (5)

A 
Delayed development 
Limited use of gestures/facial expression 
Pedantic language 
Monotone voice 
Over-literal interpretation of speech
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6
Q

Examples of routines w/ ritualistic behaviour in Autism (4)

A

Violent temper tantrum if disrupted
Lack of imagination in play
Hand-flapping/ tip-toe gait
Peculiar interest

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7
Q

What is Aspergers

A

Milder form of ASD

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8
Q

Pre-natal aetiology ASD/Aspergers (3)

A

Advanced maternal age
Teratogens
Maternal DM

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9
Q

Peri-natal aetiology ASD/Aspergers

A

Low birth Weight

Short gestation length

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10
Q

Post-natal aetiology Asperers/ASD (3)

A

AI disease
Viral infection
Hypoxia

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11
Q

Mx ASD/Aspergers

A 
Applied behavioural analysis 
CBT for anxiety 
OT's - develop motor skills 
Musical therapy 
Dietician 
SALT
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12
Q

Aims of Applied behavioural analysis for ASD (3)

A

Decrease ritualistic behaviour
Develop language/soc skills
Increase play

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13
Q

Prevelance ADHD

A

1-5%

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14
Q

M:F ADHD

A

3:1

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15
Q

By what age must ADHD onset by?

A

7

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16
Q

What are the 3 core Sx in ADHD

A

Innattention
Hyperactivity
Impulsivity

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17
Q

Diagnostic criteria ADHD

A

3 core Sx
In more than one location
For >6months

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18
Q

Mx ADHD - psychological

A

Psychotherapy - bheavioural modification + family education + support

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19
Q

Mx ADHD - social

A

Liason w/ education

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20
Q

Mx ADHD - biological (3)

A

CNS stims e.g. ritaline/dexamfetamine to incr attention
Non stims e.g. Atomoxetine
Monitor BP

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21
Q

What % of ADHD persists into adulhood

A

15%

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22
Q

Factors for worse prognosis ADHD (2)

A

Unstable family

Coexisting conduct disorder

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23
Q

Causes of daytime enuresis (4)

A 
Lack of bladder control b/c: 
UTI
Ectopic ureter 
Neuropathic bladder 
Decreased sensation
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24
Q

Ix daytime enuresis (5)

A 
Check dermatomes + sensation 
Check reflexes+ gait 
Is bladder distended (neuropathic) 
Urine - MCS
USS bladder 
Urodynamics
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25
Def secondary enuresis
Loss of previously achieved continence
26
What is secondary enuresis due to? (3)
Emotional upset UTI Polyuria
27
Which gender suffers from nocturnal enuresis more?
Males
28
Causes nocturnal enuresis (3)
UTI Faecal retention DM/renal disorders
29
At what age is Mx for nocturnal enuresis commended
Aged 6
30
Mx nocturnal enuresis
Star charts Enuresis alarm Desmopressin (short term) Self help groups
31
Mild LD IQ
70-80
32
Moderate LD IQ
50-70
33
Severe LD IQ
35-50
34
Profound LD IQ
<35
35
When would a parent 1st notice a child has a severe/profound LD
Infancy | DUe to marked developmental delay
36
When would a parent 1st notice a child has a mod/ LD
Delay in S+L
37
When would a parents 1st notice a child has a mild LD
School or later
38
Prenatal causes - LD (6)
``` Genetics (Downs/FragileX/hydrocephalus/microcephaly) Vasc - haemorrhage Met - HypoThyroidism, phenylketonuria Terotgens - alcohol/Dx TORCH NCT syndromes - TS/NFM ```
39
Perinatal causes of LD (3)
Extreme prematurity Birth Asphyxia Metabolic
40
Post natal causes of LD (5)
``` Infections (meningitis/encepahlitis) Anoxia Trauma (head injury) Hypoglycaemia Stroke ```
41
Def Dyslexia
Disorder of reading skills disproportionate to iQ | Reading age >2y behind chronological age
42
Dyscalculia
Disorder of calculation
43
Dysgraphia
Disorder of writing skills
44
Diagnostic criteria Dyspraxia
Disorder motor planning/execution No signif findings on neuro exam Disorder higher cortical processes Assoc w/ perception, use of language + putting thoughts together Can impact education progress + self esteem
45
Assessment dyspraxia (2)
OT | SALT
46
Mx dyspraxia
Therapy SALT Maturity
47
PS - physical abuse
Bruises Burns Bites
48
Factors indicating intent physical abuse (7)
``` Hx factors Plausibility of explanation Background of previous abuse Delay in reporting Inconsistent stories Inappropriate reaction to parents Parents are vague, evasive, unconcerned, agitated ```
49
Def neglect
Persistent failure to meet childs basic needs --> serious impairment of health and development
50
When to suspect neglect (13)
``` Consistently misses appts Lacks glasses Lacks imms Seems hungry v Dirty Wearing inapprop clothes abusing Dx/alc 'No one at home' If parent: Indifferent to child Apathetic Irrational behaviour Bizarre behaviour Abusing dx/alc ```
51
Def emotional abuse
Persistent emotional mistreatment of child --> poor emotional development
52
PS - emotional abuse - baby (3)
Apathetic Non-demanding attention seeking
53
PS - emotional abuse - toddler (3)
Violent Apathetic Fearful
54
PS - emotional abuse - school children (3)
Wetting Soiling Relationship difficulties
55
PS - emotinoal abuse - adolescents (3)
Poor attendance Self harm Depression
56
Def sexual abuse
Forcing acts, including prostitution, being made to look at porn/make it
57
PS sexual abuse (7)
``` Child may tell someone ID'd on porn STI Vaginal bleeding/itch/discharge Rectal bleed Pregnancy <13 Behavioural Sx ```
58
Which parent is responsible for Munchausen's by proxy in 80% cases
Mother
59
RF child abuse (10)
``` Child not meeting expectations Disabled/gender Parents mental health Parents Dx/alc abuse Step parents DOmestic biolence Closely spaced children Young parental age SOcial isolation Poverty ```
60
Ix suspected child abuse
XR - # CT head Opthal review Coag screen
61
DDx - NAI/bruising (2)
Coagulation disorder | Mongolion blue spot
62
DDx - NAI/#
Osteogenesis imperfecta
63
DDx - NAI/Scalds (2)
Imeptigo | Scalded skin syndrome
64
Mx abuse (5)
``` Note injuries Note child/parent interaction Decide if child needs immediate protection - admit Safety of other siblings Organise strategy meeting ```
65
Features anorexia nervosa
Low BMI <17.5 Determined attempt to lose weight Evidence generalised endocrine disorder Overvalued ideas
66
Biological Mx anorexia nervosa (6)
``` W restoration Reg weight monitoring Reg bloods monitoring DEXA scan if req ECG Specialist dietician ```
67
Bloods Ix anorexia (11)
``` FBC U+E LFT GLucose PO4 Mg Ca CK Zn B12 Folate ```
68
Psychological Mx anorexia (2)
CBT/Interpersonal therapy/Mindfullness/Arts | Family therapy
69
Social Mx anorexia
Informed loved one for extra support Carer support Incr flexibility
70
WHat are Russels sign
Callusses on back of the hands from induced vomiting
71
Biological Tx Bulimia (5)
SSRIs (fluoxetine) Advise to stop taking laxatives/alcohol Reg W monitoriing Reg blood monitoring esp hypokalaemia
72
Psychological Mx bulimia (3)
Psychoeducation 20 sessions CBT Specialist dietician - focus on balanced eating
73
Social Mx bulimia
Informed loved one for extra suppoort Carer support Encourage extra intake + stop binge/purge cycle Increase involvement in social plans/lifestyle plans
74
Biological impact of chronic illness (5)
``` Delayed puberty Short stature Decr bone mass Malnutrition Localised growth abnormality ```
75
Psychological impact of chronic illness (6)
``` Decr maturity Adopt sick role Impaired sexual development Parental stress Depression Financial problems ```
76
Social impact of chronic illness (6)
``` Decr independence Failure in relationships Social isolation Decr academics Decr self-esteem Vocational failure ```
77
Def school refusal
Inability to attend school due to overwhelming anxiety
78
2 common causes of school refusal
Separation anxiety from parents | Anxiety from other aspect of school
79
Tx school refusal
``` Increase sep fom parents slowly. Early school return Advice + support of parents + school Tx underlying emotional disorder Reward going to school Address any school difficulties ```
80
What age does conduct disorder occur in males
10-12
81
What age does conduct disorder occur in girls
14-16
82
Def conduct disorderr
Repetitive aggressoin to people/animals, destruction of property, theft, violations of approp bheaviours
83
Aetiology of conduct disorer (4)
Abuse Parental psychopathology Education SE status
84
Mx conduct disorder
CBT | Behavioural therapy
85
Are tantrums normal?
Yes | = toddlers response to frustration
86
What must you check for in tatrum children
Medical causes: Global language delay/hearing impairment Dx - bronchodilators, anticonvulsantns
87
Mx tantrums
Distractions Time outs Star charts
88
Features depression in children (6)
``` Sadness Lack of motivation Poor judgement No pleasure Sleep/appetite disturbance Social withdrawal ```
89
Which Tool is used to elicit Self harm Hx in children?
PATHOS tool
90
PATHOS tool
``` Problems for >1month? Alone at the time? Plan to OD for >THREE hrs ? Feeling HOPELESS for futre? SAD before OD? >2 = at risk ```
91
What is Chronic fatigue syndrome?
Persisting high levels of subjective fatigue --> rapid exhaustion on minimal exertion
92
What is ME?
Myalgic encephalopathy
93
Which 3 organisms can cause chronic fatigue syndrome?
EBV Coxsackie B Hep
94
Sx Chronic fatigue syndrome (7)
``` Myalgia Headaches Poor [ ] Stomach pain Scalp tenderness Eye pain Photophobia ```
95
Mx Chronic fatigue syndrome (4)
Graded exercise therapy CBT Maintain normal life Anti-D
96
Mx - difficulty getting child to sleep
Create bedtime routine = cues | Graded sleep pattern
97
When do night terrors occur?
1.5hrs after settling
98
Appearance of child during night terror
``` Sat in bed Eyes open Seemingly awake Obviously disorientated Unresponsive to q ```

CP2 PAEDS (18 decks)

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