SM_104b: ADHD Flashcards

1
Q

ADHD is a ____ that presents as ____, ____, and ____

A

ADHD is a neurobiological developmental disorder of focus / attention / organization, hyperactivity, and impulsivity that presents as behavioral issues, problems with academics / work, and social issues

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2
Q

Describe DSM-5 criteria for ADHD

A

ADHD DSM-5 criteria

  • Persistent pattern of inattention and/or hyperactactivity-impulsivity that interferes with functioning or development AND has persisted for 6 months
  • Six or more symptoms in one/both categories: inattention, hyperactivity/impulsivity
  • Several symptoms must appear before age 12 years
  • Several symptoms must occur in at least 2 settings
  • Symptoms interfere with or reduce quality of social, academic, or occupational functioning
  • Symptoms are not better explained by another psychiatric disorder
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3
Q

Describe inattentive symptoms of ADHD

A

Inattentive symptoms of ADHD

  • Often fails to give close attention to detail or makes careless mistakes
  • Difficulty sustaining attention in tasks or activities
  • Does not seem to listen when spoken to directly
  • Does not follow through or finish schoolwork, chores, or duties at work
  • Difficulty organizing
  • Avoids or dislikes tasks that require sustained mental effort
  • Often loses things necessary for tasks or activities
  • Easily distracted by extraneous stimuli or unrelated thoughts
  • Forgetful
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4
Q

Describe hyperactive/impulsive symptoms of ADHD

  • Often figdgets with or taps hands/feet or squirms in seat
  • Often leaves seat in situations when remaining seated is expected
  • Runs / climbs in situations where it is inappropriate or limited to feeling restless in adolescents or adults
  • Difficulty playing or engaging in leisure activities quietly
  • Often on the go, acts as if driven by a motor
  • Talks excessively
  • Blurts out answers or completes others’ sentences
  • Difficulty waiting for one’s turn or waiting in line
  • Interrupts / intrudes on others
A
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5
Q

Predominantly inattentive presentation of ADHD requires ____

A

Predominantly inattentive presentation of ADHD requires at least 6 of 9 criteria of inattention

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6
Q

Predominantly hyperactive/impulsive presentation of ADHD requires ____

A

Predominantly hyperactive/impulsive presentation of ADHD requires at least 6 of 9 criteria of hyperactivity/impulsivity

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7
Q

Combined presentation of ADHD requires ____

A

Combined presentation of ADHD requires at least 6 of 9 criteria of both the inattentive and hyperactivity/impulsivity subsets

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8
Q

____ symptoms of ADHD usually abate through adolescence but many individuals continue to have symptoms into adulthood

A

Hyperactive/impulsive symptoms of ADHD usually abate through adolescence but many individuals continue to have symptoms into adulthood

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9
Q

Almost 2/3 of children with ADHD have at least one ____

A

Almost 2/3 of children with ADHD have at least one other mental, emotional, or behavioral disorder

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10
Q

Etiology of ADHD is ____ but also involves ____ risk factors

A

Etiology of ADHD is strongly genetic but also involves environmental risk factors

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11
Q

Environmental risk factors for ADHD include ____, ____, ____, and ____

A

Environmental risk factors for ADHD include smoking / alcohol / drugs during pregnancy, lead exposure, brain injury, and premature delivery and low birth weight

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12
Q

People with ADHD have structural and functional differences in the ____ and ____ compared to controls

A

People with ADHD have structural and functional differences in the prefrontal cortex and striatum compared to controls

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13
Q

Prefrontal cortex is involved in ____ including ____, ____, and ____

A

Prefrontal cortex is involved in executive function including planning, prioritizing, and decision making

(differences in ADHD)

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14
Q

Striatum is involved in ____ including ____, ____, and ____

A

Striatum is involved in emotional executive function including risk / reward, reinforcement, and motivation

(differences in ADHD)

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15
Q

People with ADHD have ____ total brain volumes, for all four lobes, and the cerebellum

A

People with ADHD have smaller total brain volumes, for all four lobes, and the cerebellum

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16
Q

Describe diagnosis of ADHD

A

Diagnosis of ADHD

  • Patient interview
  • Parent interview
  • Rating scales from parents and teachers
  • Complete medical history
  • Physical examination in the past year
  • Vision and hearing tests in children
  • Neuropsychological testing by a psychologist
  • Speech and language assessment
17
Q

Neuroimaging tests are ____ in evaluation of ADHD

A

Neuroimaging tests are NOT used in the evaluation of ADHD

18
Q

____ is the best treatment for core ADHD symptoms

A

Medication alone (stimulant) with or without therapy is the best treatment for core ADHD symptoms

(combination treatment with meds and behavioral therapy better for other areas of functioning)

19
Q

____ are first-line medications for ADHD

A

Stimulants are first-line medications for ADHD

20
Q

Stimulant classes for ADHD are ____ and ____

A

Stimulant classes for ADHD are methylphenidate and amphetamine mixed salts

(short-acting and long-acting in each)

21
Q
A
22
Q

Ritalin (regular) is a ____ used to treat ADHD

A

Ritalin (regular) is a short-acting methylphenidate used to treat ADHD

23
Q

Adderal is a ____ used to treat ADHD

A

Adderal is a short-acting amphetamine mixed salt used to treat ADHD

24
Q

Stimulants for ADHD act by ____ and ____

A

Stimulants for ADHD act by stimulating portions of the brain that are underactive and increasing available dopamine and norepinephrine by blocking reuptake transporters and facilitating release into synapse

25
Q

Atomexetine is a non-stimulant used for ADHD that acts as a ____

A

Atomexetine is a non-stimulant used for ADHD that acts as a selective norepinephrine reuptake inhibitor

26
Q

____ and ____ are non-stimulant alpha agonists used to treat ADHD

A

Guanfacine and clonidine are non-stimulant alpha agonists used to treat ADHD

(reduce CNS activation)

27
Q

Guanfacine is an ____ used to treat ADHD that ____

A

Guanfacine is an alpha agonist used to treat ADHD that reduces CNS activation

(non-stimulant)

28
Q

Clonidine is an ____ used to treat ADHD that ____

A

Clonidine is an alpha agonist used to treat ADHD that reduces CNS activation

(non-stimulant)

29
Q

Common side effects of stimulants for ADHD are ____, ____, ____, and ____

A

Common side effects of stimulants for ADHD are decreased appetite, insomnia, headache, and nausea

30
Q

Common side effects of guanfacine and clonidine for ADHD are ____, ____, and ____

A

Common side effects of guanfacine and clonidine for ADHD are sedation, drowsiness, and depression

31
Q

Common side effects of atomexetine for ADHD are ____, ____, and ____

A

Common side effects of atomexetine for ADHD are nausea, stomach pain, and mood swings / irritability

32
Q

Non-medical treatments for ADHD include ____ and ____

A

Non-medical treatments for ADHD include behavior modification / parent training and academic accomodations (504 plan or IEP)

33
Q

Behavior therapy techniques for ADHD include ____, ____, ____, and ____

A

Behavior therapy techniques for ADHD include

  • Positive reinforcement
  • Time-out
  • Response cost
  • Token economy
34
Q

Describe the significance of ADHD

A

Significance of ADHD: lifelong problems with behavior in

  • School / work
  • Relationships
  • Substance use