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My MRCPsych Paper B > MRCPsych Paper B - Child > Flashcards

MRCPsych Paper B - Child Flashcards

(76 cards)

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1
Q

Heritability of ADHD (%)

A

70-80%
*risk of ADHD in siblings is 2-3x increased

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2
Q

At what age are 99% of children dry by day

A

5yo

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3
Q

Blockade of this receptor leads to reduction of vocal and motor tics in Tourette’s

A

D2

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4
Q

Pediatric manic episodes typically presents as…

A

mixed or atypical features - irritability, labile mood, and behavioral problems

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5
Q

drug treatment of choice for uncomplicated Tourette syndrome in the pediatric age group

A

clonidine

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6
Q

most common psychiatric emergency seen in child and adolescent population

A

suicidal behavior

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7
Q

NICE recommendations for stepped care treatment to pediatric depression

A

First line: fluoxetine, only when psychological therapy is ineffective
Second line: sertraline and citalopram.
AVOID: paroxetine, venlafaxine, TCA

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8
Q

Rett Syndrome inheritance

A

x-linked dominant
almost exclusively female
initially normal development

progressive loss of acquired skills starting 1-4yo
> purposeful hand movements, spoken language, gait disturbance

stereotypical hand movements, autism, ataxia, facial grimacing, teeth-grinding, irregular respiration (apnea, breath holding, hyperventilation), scoliosis, seizures, initial/ intermediate insomnia, excessive daytime sleep

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9
Q

most common psychiatric comorbidity associated with Asperger’s syndrome

A

depression

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10
Q

Pica typically occurs at what age group

A

2-3yo

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11
Q

Pedia patient + uncoordinated movement of limbs + history of fever and sore throat

A

Sydenham chorea
*rheumatic fever, group A strep

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12
Q

most common cause of comorbidity in pediatric bipolar disorder

A

53% ADHD
*
42% ODD
27% conduct disorder
23% anxiety disorder
09% substance use disorder

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13
Q

most common comorbidity in Tourette syndrome

A

ADHD 55% and OCD 50%
*ASD 20%

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14
Q

First line treatment for adolescent inhalant abuse

A

multimodal - psychotherapy and programs. No known pharmacotherapy

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15
Q

First line treatment for OCD in children

A

CBT

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16
Q

First line medication in pediatric ADHD

A

methylphenidate

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17
Q

most common age for school refusal

A

11yo

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18
Q

percentage of school-aged children affected by developmental dyslexia

A

4%

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19
Q

most important predictors of delinquency (Cambridge study)

A

antisocial child behavior
ADHD
low IQ and poor school attainment
family criminality
family poverty
poor parental child rearing behaviour

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20
Q

Pediatric age group where prevalence of depression in males and females are euqivalent

A

prepubertal

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21
Q

genetic aetiology most increases risk of parents having a second child with Down syndrome

A

translocation

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22
Q

rate of self-harm in teenagers who identify as Goth

A

50%

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23
Q

child with developmental disturbance + MRI hypoplasia of cerebellar vermis

A

autism spectrum disorder

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24
Q

most common inherited cause of ID

A

fragile X syndrome

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25
most common positive symptoms found in childhood onset schizophrenia
auditory hallucination 95% *visual hallucinations 80%, delusions 60%
26
most common comorbidities with ASD
80% ID 40-84% anxiety disorders 30-50% ADHD OCD tics
27
most common comorbidities in pediatric ADHD
70% learning disorders 59% ASD 55% tics/ Tourette 50% ODD 50% depression 47% bipolar 35% anxiety disorders 10% conduct disorders
28
very early onset schizophrenia or childhood onset schizophrenia occurs before what age
13yo
29
Heller syndrome - how many years of normal development before marked regression in several areas of functioning
2y *aka Childhood disintegrative
30
scale for epidemiological study as a screening tool of caseness among school children before further diagnostic procedure
Strengths and difficulties questionnaire
31
what part of the sleep cycle does sleep-related bruxism commonly occur
transition to sleep stage 2 sleep during REM sleep
32
most common blood abnormality in adolescents with anorexia nervosa
normocytic normochromic anaemia
33
ASD symptom that tend not to improve over time
ritualistic and repetitive behaviours
34
medication of choice for pediatric ADHD with tics
NE reuptake inhibitor/ atomoxetine
35
best treatment option for pediatric ADHD with substance abuse
NE reuptake inhibitor/ atomoxetine *less abuse potential
36
Medications licensed in the UK for OCD treatment in pediatric population
sertraline (starting age 6y) fluvoxamine (starting age 8y)
37
chief differential medical problem to be excluded in children with encopresis
Hirschsprung disease, aka aganglionic megacolon
38
pediatric ADHD with frequent aggressive outbursts + unresponsive to methylphenidate or gaunfacine
risperidone * psychosocial interventions → add stimulant methylphenidate → atomoxetine/ guanfacine/ clonidine → risperidone (no other antipsychotics are indicated)
39
in children, ADHD medication SE of mild slowing of weight, height, and growth
methylphenidate
40
in children, ADHD medication SE of liver dysfunction
atomoxetine, rare - elevated hepatic enzymes, increased bilirubin with jaundice
41
in children, ADHD medication SE of suicidal ideations
atomoxetine
42
in children, ADHD medication SE of exacerbation of tics
methylphenidate
43
in children, ADHD medication SE of insomnia
methylphenidate
44
in children, ADHD medication SE of psychosis
methylphenidate
45
most important aetiological factor associated with school refusal
youngest child in the family
46
most important aetiological factor associated with adolescent depression
increased cortisol levels
47
most important aetiological factor associated with ADHD
maternal smoking during pregnancy
48
most important aetiological factor associated with conduct disorder
callous traits in parents
49
most important aetiological factor associated with anorexia nervosa
living in the western world
50
Scale helpful in the evaluation of a child with multiple behavioral problems, esp if the child presents with different symptoms in different settings
Child behavioral checklist (CBCL)
51
treatment for pediatric ADHD + tics
atomoxetine → clonidine
52
treatment for pediatric ADHD + depression
TCA - amitriptyline
53
treatment for ADHD + aggressive behavior
behavioural therapy
54
prevention strategies for conduct disorder
preschool child development programmme community programme
55
therapy in which there is assessing and promoting the strengths of the young person and the system is paramount
multimodal systemic therapy
56
therapy that focuses on improving the communication between parent and young person
functional family therapy
57
therapy for conduct problems that includes social skills training and anger management
CBT
58
give 2 first line medications for OCD in children
sertraline, fluoxetine
59
first line management of aggressive and challenging behavior in ASD
risperidone, low dose
60
clinical features of depression in young children (0-5y)
poor feeding, failure to thrive, separation anxiety, tantrums, irritability, aggression, hyperactivity, regressed behavior
61
clinical features of depression in older children (6-10y)
somatisation, school refusal, poor school performance, acting out
62
clinical features of depression in adolescents (10-19y)
low self-esteem, melancholia, suicdal acts, substance misuse, psychotic symptoms
63
essential features of pediatric ASD
severe persistent impairment in social interactions, repetitive behavioral patterns and restricted interests, 70% have mild to moderate learning disability
64
essential features of pediatric Asperger's syndrome
severe persistent impairment in social interactions, repetitive behavioral patterns and restricted interests, IQ and language are normal
65
essential features of pediatric Rett's syndrome
almost exclusively females, abnormal hand movements, first 6mos of life are normal (decline starts at 2yo)
66
essential features of pediatric Heller's syndrome
*aka childhood disintegrative disorder normal development for 2-3 years, loss of acquired skills between 3-4years, disintegrative psychosis
67
essential features of pediatric reading disorder/ dyslexia
deficit in phonological processing skills, male predominance 4:1
68
essential features of pediatric disorders of written expression
difficulties with spelling, syntax, grammar, and composition, male predominance 3:1
69
essential features of pediatric mathematics disorder
often associated with visuospatial deficits (R parietal dysfunction), female predominance
70
stuttering
commonly struggles with initial syllables, treatment includes speech therapy
71
features of authoritarian parenting style
detached and unaffectionate, power imposed and autocratic, yields compliant but withdrawn and dependent children
72
features of permissive parenting style
indulgent and affectionate, associated with immature children who lack purpose, self-control, and self-direction, vulnerable to increased risk of future substance abuse
73
features of authoritative parenting style
uses parental authority and household rules/limits with some explanation, attends to child's view and grant some responsibility to child, yields children who are independent assertive and friendly
74
investigations for the use of methylphenidate
height, weight, BP, HR - every 3mos, then 6mos
75
investigations for the use of atomoxetine
height and weight, BP, HR - every 3mos, then 6mos
76
investigations for the use of valproate
liver function tests - q 6mos, blood count, height and weight

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