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Behavioral 1 disorders
ASD, Asperger, Rett, Childhood disintegrative, ADHD, tourette, separation anxiety, selective mutism
53
Medical
Graduate
10/10/2009

Additional Medical Flashcards

 


 

Cards

Term
failure to acquire, early loss of social skills, difficulty with language, not reversible
Definition
pervasive developmental disorder
Term

problem with communication with normal hearing

, forming social relationship,

repetitive purposeless behavior,

MR,

savant skills,

before 3 years old,

more common in boys,

mom has perinatal complication,

baby has ccerebral dysfunction,

genetic component

Definition
ASD
Term

problem with communication with normal hearing, forming social relationship,

repetitive purposeless behavior,

, normal cognitive development,

no language delay,

Definition
asperger's disease
Term

diminished social,verbal, cognitive development after 4 years,

only in girls,

stereotype hand-wringing movmeent,

hold breath,

MR

Definition
rett disorder
Term

diminished social, verbal, cognitive, mortor development after 2 years of normal function,

MR

Definition
childhood disintegrative disorder
Term
the only disease has no MR in pervasive developmental disorder
Definition
asperger disorder
Term

hyperactive in boys

inattention in girls

before 7 in 2 setting such as home and school

genetic

antisocial personality disorder + smoking + lead poisoning

more likely abused by caretaker

 

Definition
ADHD
Term
treatment of ADHD
Definition

early diagnosis

 

CNS stimulant: methylphenidate/ritalin

dextroamphetamine sulfate/dexedrine

adderall

 

TCA

 

alpha 2 agonist: clonidine, guanfacine

Term
most effective treatment for CD and ODD
Definition
family therapy
Term

involuntary movement and vocalization

coprolalia

before 18

start with motor tic at 7 y.o.

then vocal

dysfuncction in caudate nucleus

genetic

M:F=3:1

with ADHD and OCD

Definition
tourette disorder
Term
treatment of tourette disorder
Definition

atypical antipsychotic: riseridone

 

typical antipsychotic: haloperidol

Term

child refuse to go to school

overwhelming fear of loss of major attachment figure, usually mother

complains of physical symptom

at risk for anxiety disorder in adulthood, agoraphobia

Definition
separation anxiety disorder
Term
treatment of separation anxiety disorder
Definition
management: have mom accompany child to school and gradually decrease her time spent at school.
Term

child, more girls

speak at home but not at school,

whisper or communicate with hand gesture.

Definition
selective mutism
Term

primary disturbance in internal emotional state,

M: 5-12%

F: 10-20%

recurrent episode of depression

at least 2 weeks

excessive guilt

anhedonia

decrease appetite or over eat/sleep

Definition
Major depression disorder
Term

1% overall, no sex difference

elevated mood,

grnadiosity, expansiveness

disinhibition-ask doc out

flight of ideas

pressured speech

impaired judgement

delusion

genetic

 

Definition
mania
Term

both mania and depression

 

vs.

 

both hypomania and depression

Definition

bipolar 1

 

bipolar 2

Term

highest risk factor is previous suicidal behavior

1/3 attempt try again, 10% succeed

<3 month

close family mem. cocmmitt suicide

have divorced parents

<11 when parent dies

initial stage of recovery in depression

alcohol, drug

divorced

>65 man

middle age: >55F and >45M

adolescent copycat TV

M>F, W>B

no religion, jewish, protestant

access to gun

Definition
increased suicide
Term
strongest genetic association in mood disorder
Definition
bipolar
Term

treatment for mood disorder

 

untreated for depression? mania?

 

treatment successful?

 

% sought treatment?

 

Sex sought treatment?

 

most effective treatment?

Definition

self-limiting: depression 6-12 m, mania 3m

 

yes

 

25% cuz social factor

 

F>M

 

pharmacology

Term
pharmaccology treatment for mood disorder:
Definition

antidepressant agent

 

SSRI

 

MAO

 

Li

 

anticonvulsant

 

atypical antipsychotics

 

sedative agent

Term
best treatment for bipolar disorder
Definition

mood stabilizers:

 

Li

 

anticonvulsant: carbamazepine, divalproex

Term
treatment for depression
Definition

heterocyclic antidepressant

 

electroconvulsive therapy

 

MAO I

 

psychotherapy

Term
medication with what is more effective than 1 treatment
Definition
psychological treatment + medication
Term

primary indication is major depressive disorder when symptoms do not respond to antidepressant medication,

elderly patients

rapid resolution is needed or patient turn suicidal

Definition
ECT: electroconvulsive therapy
Term

enlarge bladder capacity in 2 y.o

voluntary control of sphincter muscle in 3 y.o

voluntarily learns to suppress micturition reflex

Definition

1st 2 years voiding is reflex

 

develop continence 3 stages:

Term

repeated voiding of urine during day, at night in bed, clothing

2x/week

3 consecutive month

impaire social/academic functioning

at least 5 years old

genetic, 75%, ENUR1, 2.

Definition

enuresis

 

primary: patient never achieve continence

 

2ndary: regression from stress, severe neglect from 6 month of total potty training.

 

diurnal vs. nocturnal.

Term

repeated passage of feces in inappropriate places

1 / month

at least 3 months

at least 4 years.

Definition

encopresis

 

most common: with constipation + overflow incontinence

 

or without constipation

Term
treatment of enuresis
Definition

behavior:

education: do not push

1st line if fam cooporative: bell and pad,

bladder biofeedback: not effective.

 

pharmacological:

Imipramine most effective, use when years of conditioning fails
DDAVP: synthetic diuretic for short duration, rare side effect

 

Term

what to do?

 

enuresis,

 

daytime wetting, abnormal voiding such as posturing, discomfort, straining, poor urine stream

 

UTI

 

genital abnormalities

Definition
urology referral
Term

repeated passage of feces into inappropriate places

attept to prevent involuntary passage of liquid faces

 

kids ostrecized by stink

 

increase amount of retained feces

weakens internal anal sphincter with rectal distention

loose awareness of passage stool

Definition
encopresis with constipation and overflow incontinence
Term

intentional depositing or smearing of fecs in prominent location b/c tries to clean or hide feces passed involuntarily

 

risk of ODD+risk

 

primary: risk in boys with enuresis

Definition
encopresis without constipation
Term

treatment of encopresis with constipation and overflow incontinence

 

encopresis without constipation

Definition

pcp with bowel regimens

 

behavioral:

education

sitting on toilet after medication

reward accident free day

pharmacological:

bowel evacuation

laxative

fibers

Term

recurrent pulling out of one's hair

noticeable hair loss

increase sense of tension immediately before pulling out or when attept to resist

show pleasure, gratification, or relief when pulling out of hair

oral fixation

F>M, G=B

risk with mood, anxiety, personality disorders, stress.

fam has tic disorder

NOT a derm problem or other mental problem

NOTcausing social/occupational distress.

Definition

trichotillomania

 

early onset <6 remit easier

late onset >13 is chronic

Term
treatment of trichotillomania
Definition

refer to psychiatry and derm together

 

SSRI

hydroxyzine: anxiolytic + antihistaminic

antipsychotic: orap

Li

insite oriented psychotherapy, hypnosis.

Term

highly reactive/crying attached infants becoming cautious, introverted avoidant school-aged kid,
behaviorally inhibited
approach novel situation with distress, restraint, avoidance
most risk in anxious mother's fear of going out alone
parents 80% psychiatric illness

Definition
anxiety disorder in kids
Term

marked disturbed and developmentally inappropriate social relatedness before age 5

 

fail to initiate response in most social interaction

 

diffuse attachments by indistriminate sociability and exhibit appropriate selective attachment.

 

due to grossly pathogenic care.

Definition
reactive attachment disorder
Term

most at risk: those can't see solution to problem

feeling down, ''cant just snap out of it'

trouble paying attention

feel mad

tires easily

feeling of worthlessness, bored

sleep problem

appetite problem

stay in room instead of go out

decreased interest or pleasure

thought of death

 

school age: B=G

adolescent: G>B

 

comorbidity: anxiety, ADHD, LD

Definition
childhood depression
Term

2 affective problems

 

G w/ ADHD more common than B

Definition

anxiety

 

depression

Term

i feel like a bad person, i feel rotten inside

 

i won't be a problem for you much longer

 

nothign matters, its no use

 

give away fav. possession

clean room

throw away important belonging

suddenly is cheerful

hallucination/bizarre thoughts

Definition
suicide in kids
Term

most common internalized disorder in kids.

 

can't stop or ignore their worries

Definition
childhood anxiety
Term
differential for childhood anxiety
Definition

separation anxiety disorder

generalized anxiety disorder

social phobia

panic disorder w/ agoraphobia

dogs, spiders

Term

overly clingy, extreme fear of being away from parents

 

being lost,

 

crawl to parents'bed

 

nightmare

 

refuse to go to schoool

Definition
separation anxiety disorder
Term

worries when there is really no problem.

excessive and uncontrollable worry

Definition
generalized anxiety disorder
Term

excessive fear of being negatively evaluated, rejected, humiliated or embarrassed in front of others

 

fear unfamiliar person: difficulty making friends or meet new people

 

painfully shy

Definition
social phobia in kids
Term

shortness of breath, pounding heart, tingling and numbing sensation, hot/cold flushes/terror

 

during panic attack: intense fear or discomfort, impending doom, unreality

 

 fear of being stuck in situation where help or escape is unavailable

 

more common in teens than kids

Definition

panic disorder w/ agoraphobia

 

agoraphobia: fear of being stuck in situation where help or escape is unavailable

Term

diagnosed with ODD

 

IQ > 60, academicc achievement < 60

comorbidity with ADHD, disruptive, MDD,

 

Definition

LD:

 

MR is: both IQ and academic achievement are less.

Term

dyslexia:

distortion, substitution, omission,

slowness, errors in comprehension.

 

most frequent LD

 

comorbid: mathematics disorder + disorder of written expression.

 

 

Definition
reading disorder
Term

dyscalculia/acalculus/gerstmann's syndrome

 

PALM:

perceptual: can't see numerical symbols

attention: observe operational signs

linguistic: can't figure out math

mathematics: can't calculate

 

alone: 1/5 LD

 

Definition
Mathematics disorder
Term

writing skills fall substantially below expected level.

 

not when show only spelling error/poor handwriting

 

dysgraphia, agraphia

 

co-occur w/ other LD

Definition
Disorder of written expression
Term
Tx of LD
Definition

Educational Intervention: special education, remedial programs: F

 

assistive device

 

psycchosocial support

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