CH 16 Pedi and Adolescent

  1. Vanderbilt used for what and by who?
    • for ADHD
    • used by parent and teacher
  2. Babble
    at 5-7mo
  3. Sits alone for 30 seconds
  4. Stranger anxiety
  5. Says mamma or dadda
  6. walks solo
  7. Can kick ball
  8. 2 word sentences
  9. 75% of speech able to be understood by others
  10. Infant assessment & young children interview used what?
    • Puppets or obs of play
    • Denver test
  11. School-age assessment used how?
    • do they know why they are at visit? NOT in trouble
    • Use a doll or draw
    • Direct question to doll and ask child how they think they would feel
  12. 3 phases of adolescents
    • Early 10-13
    • Middle 14-17
    • Late 18-21
  13. Psychosocial assessment tools
    • Home
    • Education (skipping, grades)
    • Activities (tv<2hours)
    • Drugs (normalize, "many of my pts...)
    • Drinking
    • Sex & Sexuality
    • Suicidality
  14. Screening test for adolescents substance abuse
    • CRAFFT--> pos if 2+ yes answers
    • Car-ever been in a car with someone who was high/etoh
    • Relax-use it to relax
    • Alone-use while byself
    • Forget-forget things
    • Friends-tell you to cut down
    • Trouble- ever been in trouble
  15. At what age can substance abuse tx occur without parents
  16. STD tx without parents
  17. gender ratio for boys and girls
    then adults
    • 2:1 boys vs girls
    • 1:1 in adults
  18. Neurochemicals involved in ADHD and what area of the brian
    • Dopamine and NE
    • prefrontal coretex
  19. When CAN remission occur
  20. Types of ADHD and criteria
    • inattentive, hyperactive/impulsive, and combined
    • 6 sxs for 6mo+ in 2 or more settings
  21. For tic disorder what do we went to avoid regarding meds
    high doses of dextroamphetamine
  22. 1st line meds for ADHD; class and MOA
    • CNS stimulants:
    • methylphenidate to increase DA and NE
    • dextroamphetamine/amp salts to release DA, NE, and 5HT
  23. When are stimulants contraindicated
    Cardiac abnorm, hx of drug abuse, glaucoma, concurrent use with MAOI, hyperthyroid, HTN, tics, and anxiety
  24. What med used if substance abuse
  25. Therapy used first at what age
    <5yo or minimal sxs
  26. Management of ADHD
    wait and watch, growth charts, 1-2 weeks then 1-3 months
  27. When do we do a drug holiday?
    • if ht or wt cross 2% lines
    • small growth risks
  28. ODD onset
    early as 3yo and about 8yo
  29. Conduct disorder onset
    Prior to 10yo
  30. ODD risk factors
    controlling or overreation by parents
  31. ODD criteria
    4+ sxs for 6 mo
  32. Conduct disorder criteria
    • 4 criteria aggression to animals, des to property, theft, serious violation of rules
    • basic rights 6-12 months
  33. ODD treatment
    therapy best --> meds for ADHD
  34. Conduct disorder tx
    • SGA AP (clonidine)
    • maybe SSRIs and ADHD meds
  35. Disruptive Mood Dysregulation criteria and onset
    • chronic 12mo+
    • severe tempers of 3x/wk
    • onset before 10yo
  36. Intellectual disability IQ and borderline
    • <70
    • 71-84
  37. Autism criteria
    • 2 core domains
    • social-emotional, non-verbal comm, relationships, repetitive movements, fixated interest
  38. Overall tx and Pharm tx for ASD
    • comorbid psych disorder
    • start low & go slow
    • Atypical AP: Risperidone and Aripriprazole
  39. Reactive attachment disorder criteria
    • emotionally withdrawal towards adults caregivers
    • rarely seeks comfort
    • min social
  40. Disinhibited social engagement disorder
    • interacts with unfam adults
    • over familiar of verbal/physical behavior
  41. Criteria for anorexia
    • refusal to maintain weight, fear of gaining weight, dis of body image, amenorrhea 3 cycles
    • 2 subtypes: restrictive no binging or purging
    • binge eating:regular
  42. Criteria for bulimia
    • eating excessive amount of food in small time frame
    • lack of control for over eating in episode
    • laxative, exercise, diuretics

    2x/wk for 3 months
  43. Binge eating disorder criteria
    3sxs for 1/wk for 3 months
  44. Medical complications for anorexia but no bulimia
    hypothermia, lanugo, dependent edema, cardiac, amenorrhea
  45. Medical com in both anorexia and bulimia
    electrolytes, bradycardia, hypotension
  46. Highest mortality rate
    anorexia ~18% of all psych disorders
  47. Meds for bulimia and anorexia and what time for initiation
    SSRIs and after wt gain is achieved
  48. Avoid what med in eating disorders and what meds not indicated or used often
    • Bupropion
    • tcas and MAOIs
  49. Tic disorder criteria
    • prior to 18yo
    • wax and wane
    • 1+ year
  50. Tx for tic disorder
    Haloeridol, abilify, clonidine
  51. Encopresis criteria and tx
    • feces after 4yo
    • laxative, CBT
  52. Enuresis criteria and tx
    • bedwetting after 5yo
    • restrict fluids
    • desmopression
  53. most common child psych disorder and 1st line, 2nd line
    • anxiety
    • therapy
    • SSRIs and Venlafaxine XR
  54. Separation anxiety disorder
    • 4wks and before 18yo
    • physical sxs
Card Set
CH 16 Pedi and Adolescent
CH 16 Pedi and Adolescent