Ppcn3- Mental Health Week 1 Cards

Front 1

what do mentally healthy children tend to do?

Back 1

function well in the home, school and community and have positive QOL

Front 2

ToF: infants reflect their mother's moods

Back 2

TRUE

Front 3

what is a classic signal that there may be a mental health issue

Back 3

have a variety of complaints that don't fit together well

Front 4

what is the definition of functional impairment?

Back 4

disability or impariment that has been defined as limiations in a person's ability to perform activities relevant to daily life including the physical, social and personal domains

Front 5

why is an assessment of functional impairment important?>

Back 5

it is a criterion which must be fulfilled in order to redner a diagnosis

Front 6

ToF: in psychiatric disorders symptom improvement often means treatment success

Back 6

false!

Front 7

what are the challenges to functional impairment assessment>

Back 7

1. defining the concept is hard for pt and families
2. there is cariation across domains and disorders
3. may be situation specific
4. cultural differences must be present

Front 8

__ % of children in primary care need active mental health interventions

Back 8

20

Front 9

suicide is the _leading cause of death in children 15-24

Back 9

3rd

Front 10

1/3 of children with major depressive disorder will be diagnosed with __ in a few years

Back 10

bipolar

Front 11

what is axis I?

Back 11

clinical disorder (all mental health except personality disorders and mental retardation)

Front 12

what is axis II?

Back 12

personality disorder and mental retardation

Front 13

what is axis III?

Back 13

general medical condititions (must be connected to a mental disorder)

Front 14

what is axis IV?

Back 14

psychosocial and enviromental problems

Front 15

what is axis V?

Back 15

global assessment of functioning

Front 16

what are some internalizing behaviors?

Back 16

social withdrawl; depressive symptoms; sleep problems; and somatic probs

Front 17

what are the internalizing disorders?

Back 17

central feature is disordered mood or emotion

Front 18

what are the externalizing behaviors?

Back 18

aggressive; destructive

Front 19

what are the externalizing disorders?

Back 19

central feature is unregulated behavior

Front 20

what are the pediatric externalizing disorders?

Back 20

conduct disorder, oppositional defiant disorder; problems of inattention and impulsivity (ADHD)

Front 21

what are the pediatric internalizing disorders?

Back 21

depression; anxiety (generalized, simple phobia, separation anxiety, OCD, PTSD)

Front 22

what are the pervasive developmental disorders of childhood?

Back 22

autism and schizophrenia

Front 23

what is the median age of onset for axniety?

Back 23

6

Front 24

what is the mediatn age of onset for behavior disorders?

Back 24

11 yo

Front 25

what is the median age of onset for mood disorders?

Back 25

13 hyo

Front 26

what is the median age of onset for substance abuse disorders?

Back 26

15

Front 27

what are the 3 dimensions of stigma associated with pediatric mental illness?

Back 27

stereotypes; discrimination; devaluation

Front 28

who are the contributers to stigma of pediatric mental illness?

Back 28

self; public; instutitutional

Front 29

who are the targets of stigma associated with pediatric mental illness?

Back 29

family; child; services

Front 30

ToF: the classifications schemes of the DSM apply to all cultures

Back 30

FALSE

Front 31

what are the classifications schemes of the DSM largely based on?

Back 31

american research

Front 32

what problems are inadequately addressed by the DSM?

Back 32

cultural bound syndromes; listed in the back of DSM with no explanation

Front 33

what mental illnesses are comorbid with turners?

Back 33

adhd is 18 times higher in turners; social immaturity; anxiety; depression in older girls

Front 34

what are the cognitive features of turners girls?

Back 34

infrequent intellectual impairment; performance IQ is lower than verban IQ; learning dis in math particularly; impaired nonverbal ability; Impaired EXECUTIVE FUNCTIONING SKILLS: impulsivity and processing speed, problem solving ability

Front 35

what are the psychiatric features of children with downs?

Back 35

>50% of ADHD; 30% anxiety and depression; 10% autism spectrum

Front 36

what are the cognitive features of downs?

Back 36

mod to severe intellectual dis with strength in grammer and weaknesses in expressive language; visual processing better than auditory

Front 37

what is the diagnostic testing for Fragile X?>

Back 37

FMR1 PCR and southern blot for CGG repeat length

Front 38

what are the psychiatric features of fragile x?

Back 38

attention dysfunction; hyperarousal; social anxiety; social cognition; communication challenges

Front 39

what are the cognitive features of fragile X?

Back 39

mild to severe cognitive features; difficulty with abstract thinking, sequential cognitive processing, short term memory, math and visual motor processing

Front 40

how is prader willi diagnosed?

Back 40

methylation PCR followed by FISH (15q11-q13)

Front 41

what are the psychiatric features of prader willi?

Back 41

extreme hyperphagia; self injurious behavior; OCD; social cogntion deficitys; cognitive inflexibility with poor affect regulation; depression/mood disorder/psychosis

Front 42

what are the cognitive features of prader willi?

Back 42

mild to borderline intellectual disability; strength visuospatial performance; reading and decoding long term memory are strengths

Front 43

what are the genetic syndromes associated with autism?

Back 43

rett; fragile X; prader willi; angelman; CHARGE

Front 44

what is CHARGE?

Back 44

Coloboma of the eye,
Heart defect,
Atresia of the nasal choanae;
Retardation of growth and or development;
Genital or urinary abnormalities; and
Ear abnormalities and deafness

Front 45

what is the strength of williams syndrome kids

Back 45

auditory rote memory and language

Front 46

what severe cognitive features is seen in williams syndrome?

Back 46

visuospacial construction deficits and language in

Front 47

the intellectual disability of williams syndrome is __-

Back 47

mild

Front 48

what are the psychiatric features of williams syndrome?

Back 48

adaptive behavior is less than expected for IQ; superficial socialbility; externalizing: inattention, attention seaking, temper tantrums, hyperactive; internalizing: OCD, preoccup; fears, anxiety, saddness; ADHD; sleep disturbances

Front 49

what was asthma hisotrically considered?

Back 49

a disease of the CNS

Front 50

panic disorders are higher among ___ children

Back 50

asthmatic

Front 51

what are the psychiatric disorders of asthma kids?

Back 51

internalizing such as anxiety; up to 24% have generalized anxiety disorder

Front 52

if the asthmatic child has an __ disorder, they are more likely to be out of school

Back 52

internalizing

Front 53

there increased links to __ in asthmatic children and adolescents

Back 53

depression

Front 54

___ ___ drug increases autonomic arousal worsening anxiety symptoms

Back 54

B2 adrenergic

Front 55

__ __ use is linked to increasing depression and anxiety, which has the potential to lead to __ or __

Back 55

oral steroid; mania; psychosis

Front 56

IN pediatric epilepsy, what are the cognitive disruptions that occur with hemisphere specific disruptions in termporal lobe epilepsy?

Back 56

1. left sided lesions lower performance on verbal member
2. right sided lesions decrease3d visual memory problems

Front 57

what are the cognitive burdens of cytogenic localized epilepsy?

Back 57

poor alertness and poorer visual long term member and slower central information processing

Front 58

what are the pyschosocial burdens of pediatric epilepsy?

Back 58

28% of children had psychiatric disorders; 3-6 times more likely to develop psychiatric disorders

Front 59

what does conduct problems in childhood often predict in adulthood?

Back 59

both mood disorders and disruptive disorders

Front 60

what did the presence of oppositional defiant disorder predict into adulthood?

Back 60

only mood disorders

Front 61

what did the presence of ADHD in childhood predict as far as adult DMS IV disorders

Back 61

none

Front 62

what are the broad screeners for mental health?

Back 62

RAAPS; Strength and Difficulty questionniare; pediatric symptom checklist

Front 63

what ar the narrow band screens for mental health?

Back 63

depression screen; anxiety screen; OCD screen; substance abuse screen

Front 64

who are the children considered at risk for mental health issues and need screened?

Back 64

traumatic event; change in social hx; other mental/behavioral disorders; parental relationships; parents with mental health disorder; chironic somatic symptoms or change in school performance!

Front 65

what is somatization?

Back 65

constellation of clinical and behavioral features indicating a tendency to experience and communicate distress via bodily symptoms that are unexplained by pathologic findings

Front 66

what are the somatization screeners?

Back 66

Childhood somatization inventory; illness attitude scales; somatic assessment interview; SCARED; RAAP;

Front 67

what is the childhood somatization inventory?

Back 67

24 item version of common physical symptoms experienced over 2 week period; well standardized self rated scale for adolescents

Front 68

what is the illness attitude scales?

Back 68

for somatization: high symptom scores and distrewss about illness; used in adolescents; parents and children tend to believe that there is a disease despite medical evidence to the contrary

Front 69

what are the somatization and psychiatric diseases to occur together>?

Back 69

anxiety is common; depressive are less; stress sensitive

Front 70

what are the risk factors for developing a somatization and psychiatric disease

Back 70

parental over engagement; family clustering; over attention to the child's symptoms

Front 71

why use the RAAP?

Back 71

time efficient; preliminary screening tool; paper and computerized;

Front 72

what is the RAAP developed from?

Back 72

AMA GAPS; CDC's behaviors that contribute to adolescent morbility; abuse screening rec from sexual assual treatment center

Front 73

what is the website to get all the screening tools for mental health?

Back 73

Mass general website

Front 74

the PSC is used for kids __ to __ yrs old

Back 74

4 to 18

Front 75

what does the PSC screen for?

Back 75

both internalizing and externalizing problems

Front 76

what score the PSC suggests a referral for mental health?

Back 76

>28

Front 77

in the PSC, for children ages __ to __ there are several items referring to academic perfomance are omitted and the cutoff for refferal is then __

Back 77

4; 5; 24

Front 78

The strengths and difficulties questionnaire is used on children __ to __

Back 78

3 to 17

Front 79

what does the SDQ measure?

Back 79

social, emotional and behavioral functioning

Front 80

what are the 5 subscales of the SDQ?

Back 80

emotional problems; conduct problems; hyperactivity/inattention; peer relationship problems; prosocial behavior

Front 81

why use the SDQ?

Back 81

strong psychometric qualities

Front 82

what are the depression screening tools?

Back 82

childrens depression inventory; child behavior checklist; center for epideiological studies; depression sclae for children (DES-DC) and short mood and feelings questionnaire

Front 83

what does GLAD-PC stand for?

Back 83

guidelines for adolescent depression in primary care

Front 84

what is the PHQ?

Back 84

patient health quesitonnaire 2 and 9 for depression screnning; readily available and easy scoring

Front 85

in the PHQ, what score needs at least a referral?

Back 85

> 15

Front 86

what is minor depression according to the PHQ?

Back 86

if symptoms present >/= one month or severe funcitonal impairment may need active treatment

Front 87

what is dysthymia according to PHQ?

Back 87

symptoms lasting > 2 years

Front 88

what are the 2 direct questions for suicide risk?

Back 88

1. have you ever thought about killing yourself or wished you were dead?
2. have you ever done anything on purpose to hurt or kill yourself?

Front 89

what is the SCARED questionniare?

Back 89

screen for child anxiety related disorders: 8 and up;

Front 90

what 5 factors are measured with the SCARED?

Back 90

general anxiety; separation anxiety; social phobia; school phobia; and physical symptoms of anxiety

Front 91

what is the SCAS?

Back 91

spence childrens anxiety scale

Front 92

what ages does the SCAS measure?

Back 92

2.5 to 6.5 (preschool version) and (8-12) for both patient and parent

Front 93

what is the RCMAS?

Back 93

revised childrens manifest anxiety scale (don't use it too expensive)

Front 94

ToF: studies find that it is more reliable to screen from parent or child alone

Back 94

false: screen both

Front 95

There is __ screening tool for anxiety for children under age 6

Back 95

one

Front 96

what is a good screening tool for psych NPs to use with prolong interview?

Back 96

anxiety disorders interview schedule for DSM-IV: chidl and parent versions (ADIS-C/P)

Front 97

what is the gold standard assessment scale for OCD?

Back 97

children's yale-brown obsessive compulsive scale (CY-BOCS)

Front 98

what age group can use the CY-BOCS?

Back 98

6 to 14

Front 99

what is the SOCS?

Back 99

short ocd screener: have been recently developed in an attempt to make screening for pediatric OCD easier for the primary care provider (7 items self report system)

Front 100

what are the basic questions of the SOCS?

Back 100

1. do you wash or clean a lot?
2. do you check things a lot?
3. is there any thought that keeps bothering you that you would like to get rid of but can't?
4. do your daily acivities take a long time to finish?
5. are you concerned about orderliness or symmetry?
7. do these problems bother you?

Front 101

what is CRAFFT?

Back 101

C: Have you ever ridden in a CAR drivben by someone who was high or drunk?
R: do you ever use alcohol or drugs to RELAX, feel better about yourself or fit in?
A: do you use alcohol or durgs while you are by yourself or ALONE?
F: do you ever FORGET things you did while using alcohol or drugs?
F:do your FAMILY or FRIENDS ever tell you that you should cut down on your drinking or drug use?
T: have you ever gotten into TROUBLE while you were using alcohol or drugs?

Front 102

what is the POSIT?

Back 102

problem-oriented screening inventory for teenagers

Front 103

what are the 10 areas screened for with the POSIT?

Back 103

1. substance abuse/use
2. phsycial health
3. mental health
4. family relation
5. peer relation
6. educational status
7. vocational status
8. social skills
9. lesure and recreation
10. aggressive behavior/delinquency

Front 104

what is the SCOFF?

Back 104

screening for eating disorders.
S: do you make yourself SICK b/c you feel uncomfortably full?
C: do you worry you have lost CONTROL over your eating?
O: Have you lOst > 1 stone (14lbs) in a 3 month period?
F: do you believe yourself to be FAT when others say you are thin?
F: would you say that FOOD dominantes your life?

Front 105

what family history aspects should be assessed in children with eating disorders?

Back 105

obseity; eating disorders; depression; other mental illnesses

Front 106

what are the physical exam findings for chidlren with eating disorders!!!???

Back 106

1. sinus brady, arrhythmias
2. orthostatic changes (>20 beats/min) or BP(>10mmHg)
3. hypothermia
4. Cachexia; facial wasting 5. cardiac murmur (MVP) 6. Dull, thinning scalp hair 7. sialoadenitis (parotitis most frequent) 8. angular stomatitis; palatal scratches; oral ulcers; dental errosion

Front 107

what are the phsycial assessment findings in the ER for eating disorders?

Back 107

1. dyr, sallow skin
2. lanugo/bruising/abrasians over the spine related to excessive exercise
3. delayed or interrupted pubertal development
4. atrophic breasts, atrophy vaginitis
5. russell sign
6. cold extremities; acrocyanosis; poor perfusion
7. carotenemia
8. edema of exterm
9. flat or anxious affect

Front 108

what is russell sign?

Back 108

callous on knuckles from self-induced emesis

Front 109

what is the website to find mental health professionals in your area?

Back 109

mentalhealth.net

Front 110

85% of youth with ADHD are put on __

Back 110

stimulants

Front 111

what are the mood stabilizers given for bipolar?

Back 111

valproic acid; lamictal; carbamazepine; oxcarbezepine; lithium; atypical antispychs; omega 3 fatty acids

Front 112

__-% of depressed youth are given antidepressants

Back 112

57

Front 113

what are the principles of pharmacologic tx for psych illness in kids?

Back 113

1. ID target symptoms
2. max dosages of meds before adding or discontinuing another
3. change and adjust one drug at a time
4. monitor side effects
5. discontinue the drug that is of the least benefit

Front 114

what are the stimulants?

Back 114

methphenidate (Ritalin, concerta, adderall, focalin); amphetamine based (dexedrine)

Front 115

what are the SNRIS?

Back 115

strattera

Front 116

what are the atypical antipsychs?

Back 116

risperidone, quetipaine, olanzapine, aripiprazole)

Front 117

what side effects can occur from anti-depressants?

Back 117

risk of long QT

Front 118

what are the alpha-2 agonists?

Back 118

clonidine, guanfacine

Front 119

what are the classes of drugs to treat ADHD?

Back 119

methylphenidate based; amphetamine based; SNRIs; adrengeric agonists

Front 120

what drug does the AAP say to start with for ADHD?

Back 120

ritalin in low doses

Front 121

what is the only FDA approved drug to treat depression in children?

Back 121

fluoxetine (PROZAC)

Front 122

what are the drugs to treat oppositional defiant disorders?

Back 122

lithium; divalproic acid; atypicals (most commonly used)

Front 123

what drugs are most often used to treat anxiety disorders in children?

Back 123

SSRIs: sertraline (zoloft); fluoxetine (prozac); fluoxamine (Luvox); Clomipramine (anafranil)ages 10 and older

Front 124

ToF: the FDA approved med for PTSD in children is propanolol

Back 124

false; no FDA approved, but it is used

Front 125

lithium can be used in childre that are ages ___ and older

Back 125

12

Front 126

ToF: placebo has been found just as effective as atypicals for treating manic or mixed state disorders

Back 126

false: atypicals more effective

Front 127

for manic and mixed state disorders __ and __ can be used on children 10-17 yrs old

Back 127

ariaprazole (abilify) and respirodone

Front 128

what are the 5 disorders that are no longer in DSM 5?

Back 128

1. disorders of written expression
2. learning disorder not otherwise specified
3. childhood disintegrative disorder
4. aspergers
5. pervasive developmental disorder not otherwise specified

Front 129

anticonvulsants have been used off label for children with ___ disease

Back 129

bipolar