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NP - Child & Adolescent Psychiatric Disorders - Nicholas Exam With Complete Solutions
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NP - Child & Adolescent Psychiatric Disorders - NicholasExam With Complete Solutions
Top 10 Pediatric Conditions 2008 - 2010-Answer 2. Acute URI
3. Otitis media
5. Asthma
7. Allergic rhinitis
9. Dermatitis
10. ADD
Youth in Foster Care -Answer - 21-39% receive psychotropic (vs. 5-10% not in foster
care)
Guidelines for Psychotropic Medication in Kids -Answer - lots of info on monotherapy,
not much on combo therapy - try mono 1st!
- psych + pharm therapy
- one medication change at a time (except cross-tapers)
Psychiatric Disorder Categories - Response - Neurodevelopmental
- Disruptive Behavioral
- Mood
- Anxiety
- Schizo
- Tic
- Eliminative
- Eating
,Neurodevelopmental Disorders - Type - Response - ADHD
Disruptive Behavioral Disorders - Response - Oppositional Defiant Disorder
- Conduct Disorder
Mood Disorders - Response - Depressive Disorders
- Bipolar disorder
Mood Disorders - Depressive Disorders - Types - Response - Major
- dysthymic
- Adjustment
Anxiety Disorders - Generalized
- Separation
- Social
Schizophrenia - Very early onset
- Early onset
Eliminative Disorders - Enuresis
- Encopresis
Eating Disorders - Anorexia Nervosa
- Bulimia Nervosa
- Binge-Eating Disorder
ADHD - general - most common childhood psych condition
,- Developmentally inappropriate inattention, impulsivity, &/or hyperactivity
- Sx presence & severity vary
-rare to post signs in every environment, or even same environment on every occasion
ADHD - Epidemiology - Answer - Typically begins by age 3, must do so before 12 y/o
- 4:1 boys:girls
- Sx may be manifestations of other psych illness
CDC 2003 Conclusions - Answer - Males > Females
- Geographic variation in ADHD diagnosis & medication use
- Medication use peaks ~9-12 y/o
ADHD - Diagnosis DSM-V - Answer - onset of Sx must be before 12 y/o
- 6+ Sx present for 6 months
- Sig impairments seen in 2+ settings
- Maladaptive & inconsistent w/developmental level
- Sx documented by parent, teacher, clinician
- Not a disorder accounted for by another diagnosis
ADHD Diagnosis: Inattention - Answer 1) Often fails to give close attention to details or
make careless mistakes in schoolwork or other activities
2) Often has difficulty sustaining attention in tasks or play activities
3) Often has difficulty organizing tasks & activities
4) Avoids tasks that require sustained mental effort
5) Often doesn't seem to listen when spoken to directly
6) Often doesn't follow through on instructions & fails to complete schoolwork, chores
or duties in workplace
7) Easily distracted by extraneous stimuli
, 8) Often forgetful in daily activities
9) Loses things necessary for activities
*6+ present in kids
*5+ present in >17 y/o
ADHD Diagnosis: Hyperactivity - Response 1) Often fidgets w/hands or feet or squirms in
seat
2) Often leaves seat when remaining seated is expected
3) Often runs about or climbs excessively at inappropriate times
4) Often has difficulty playing quietly
5) "On the go" or often acts as if "driven by a motor"
6) Often talks excessively
ADHD Diagnosis - Impulsivity - Response 1) Blurts out answers before question
completed
2) Has difficulty waiting in turn taking situations
3) Often interrupts or intrudes on others
ADHD Diagnosis: Hyperactivity & Impulsivity - #'s present for diagnosis - Answer - 6+ in
kids
- 5+ in >17 y/o
ADHD - Subtypes - Answer - Predominantly Inattentive Types (6/9 Sx of inattentiveness/
<6 of hyperactive impulsive)
- Predominantly Hyperactive-Impulsive Type (6/9 Sx of hyperactive-impulsive)
- Combined Type (*Most common*) (6/9 Sx of inattention & hyperactivity)
American Academy of Pediatrics - Answer - Diagnosis for ADHD must be considered in
any child 4-18 y/o presenting with academic or behavioral problems & Sx of inattention,
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