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Peds:Psychiatry Exam 1
Peds: Psychiatry Exam 1
29
Anatomy
Graduate
02/17/2012

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Term
ADHD triad:
Definition
- impulsivity
- inattention
- hyperactivity
Term
Dx criteria for hyperactive/impulsive ADHD:
Definition
I FED EDD.

- Interrupts and intrudes on others
- Fidgetiness
- Excessive climbing/running
- Difficulty staying seated
- Excessive talking/blurting out answers
- Difficulty staying quiet
- Difficulty waiting turns
Term
Dx criteria for hyperactive/impulsive ADHD:
Definition
I FED EDD.

- Interrupts and intrudes on others
- Fidgetiness
- Excessive climbing/running
- Difficulty staying seated
- Excessive talking/blurting out answers
- Difficulty staying quiet
- Difficulty waiting turns
Term
Dx criteria for inattentive ADHD:
Definition
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- Forgetfullness
- Failure to pay attention to detail
- Failure to listen when directly spoken to
- Failure to follow directions
- Loses materials for tasks
- Easily distracted
- Reluctant to participate
- Difficulty organizing
- Difficulty sustaining attention
Term
Short acting ADHD stimulant drugs:
Definition
- Methylphenidate: Ritalin, Focalin
- Dextroamphetamines: Dexedrine,Adderall

MRF and DDA are BOTH SHORT ACTING.
Term
Long acting stimulant ADHD drugs:
Definition
- Methylphenidate: Ritalin LA, Concerta,Metadate CD,Focalin XR
- Dextroamphetamines- Adderall XR,Vyvanse
Term
Non-stimulant ADHD drugs:
Definition
- Strattera
- Clonidine
- Intuniv/Guanfacine/Tenex
Term
Straterra is a non-stimulant ADHD drug that is a __ __ __. It works better on __ ADHD.Dose is __ mg/kg/day for 3 days and then increase to ___ mg/kg/day everyday or divided BID.
Definition
- norepinephrine reuptake inhibitor
- inattentive
- 0.5 mg/kg/d for 3 days
- 1.2-1.5 mg/kd/day (or divided into two doses/day)
Term
Clonidine is a __ __ __ __ __ that __ norepinephrine levels. This is best for __ ADHD and reduces __. Usually start with __mg tables, __ at bedtime and increase as needed.
Definition
- alpha 2 adrenergic presynaptic agonist
- reduces norepinephrine levels
- hyperactive ADHD
- reduces tics
- 0.1 mg tablets
- half at bedtime
Term
Intuniv/Guanfacine/Tenex is a __ __ _ __ __ __ ___.It is best for __ ADHD. Dosing starts at 1 mg/day, inrased dose by 1mg/day at weekly intevls until respnsed noted, up to 4 mg/dsy.
Definition
- centrally acting alpha 2a adrenergic recepor agonist
- hyperactive/impulsive ADHD
Term
MC SE of stimulant ADHD drugs:
Definition
appetite suppression
Term
straterra MC SE:
Definition
stomach ache
Term
3rd leading cause of death for ages 15-29:
Definition
suicide
Term
Suicide risk factors:
Definition
- Male
- Family History of suicide or attempts
- Gay/bisexual
- Hx of physical/sexual abuse
- Hx of past attempts
- Presence of firearms
- Impaired parent-child relationship
- Living outside the home
- Difficulties in school/bullying
- Neither working/attending school
- Social isolation
- Presence of stressful life event
- Personal mental health problem
Term
Suicide interventions:
Definition
- Don't leave patient alone
- Meet with patient alone and together with family
- Only send home after consulting with mental health expert
- Refer for hospitalization if there is high potential
- Remove risk in house, guns, knives, pills
- Restrict driving 24 hours at least
- Give instructions and numbers for crisis service
Term
Depression clinical symptoms:
Definition
MADFS

- Morbid ideation
- Anhedonia
- Dysphoric mood- irritability and tantrums
- Fatiguability
- Somatic symptoms
Term
drug tmt for depression in peds:
Definition
-for mild-severe depression
- continue meds for 6-9months after remission of symptoms
Term
only SSRI approved for pediatrics:
Definition
Fluoxetine (Prozac) (thought many others are still used)
Term
follow up for peds with depression?
Definition
- weekly for the first four weeks/month
- every other week for the second month
Term
BLACK BOX WARNING FOR SSRIS:
Definition
SUICIDE RISK FOR THOSE ON SSRIS UNDER THE AGE OF 24
Term
3 characteristics of a pervasive developmental disorder:
Definition
- impaired socialization
- impaired verbal/nonverbal communication
- restricted/repetitive patterns of behavior
Term
What are the PDDs?
Definition
PARCA
- PDD-NOS
- Autism
- Rett synddrome
- Childhood Disintegrative Disorder
- Asperger's syndrome
Term
Recommended screening tools for PDD:
Definition
- M-CHAT
- Ages and Stages
- BRIGANCE screens
- Child development inventories
- Parents evaluation of developmental status
Term
Criteria for further eval for PDD:
Definition
- Not babbling by 12 months
- Not gesturing by 12 months
- No single words by 16 month
- No spontaneous 2-word phrases by 24 months
- Loss of any language skills at any age

any of these that met requirefurhter evaluation
Term
social deficits
repetive behaviors
unusual responses to sensory stimuli
1/3-1/2 not enough speech to meet daily needs
Definition
Autism
Term
Preserved linguistic and cognitive development with impaired social interactions
limited empathy with peers
atypical use of speech
specific narrow areas of interest
Definition
Asperger's Syndrome
Term
Rett Syndrome:
Definition
- Normal development until 6-18 months, then regression
- Decelerated head growth, sometimes microcephaly
- Small hands/feet
- Cognitive impairment
- Stereotypic repetitive hand movments
- Problems with socialization
- Scoliosis, 50% of females non-ambulatory
- Seizures in 80%
- No verbal skills usually
Term
Childhood Disintegrative Disorder dx:
Definition
Onset ages 2-10 years
Skills acquired are completely lost in 2 of the following 6 areas: LSRCPM
- Language
- Socail skills and self care
- Receptive language
- Control over bladder/bowel
- Play skills
- Motor skills

In addition, 2 of the 3 following areas are abnormal: SCRI
- Social skills
- Communication skills
- Reptitive behavior
- Interest pattern
Term
atypical autisim fits into what category:
Definition
PDD- NOS
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