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23 Cards in this Set
- Front
- Back
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ADHD/ The "666" of ADHD
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Symptoms of ADHD
Symptom classes: a) inattention b) hyperactivity c) impulsivity Subtypes: INATTENTIVE: inattention = 6+; hyperactive = <6 HYPERACTIVE-IMPULSIVE: inattention = <6; hyperactive = 6+ COMBINED: inattention = 6+; hyperactive = 6+ “666” of ADHD: Onset of symptoms before age 7 (age 6!) Min 6 mos of sx’s Sx’ present in 2 settings Brain = Prefrontal cortex (lower activity in frontal lobe) Inability to focus, concentrate, organize |
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A mother brings her kid in and says my kid has ADHD. What is the first thing a clinician should do?
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Contact the teacher.
(Dx requires 2 settings for dx) |
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ADHD IN ADULTS
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d
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ENURESIS
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Onset 5yrs
BEST TREATMENT OF ENURESIS Bell and pad Other tx’s: Tricyclics Hypnosis Bladder control exercises |
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TOURETTE'S
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TOURETTE'S
1. 1+ vocal/motor tics 2. Onset <18 (+18 can get dx of “NOS”) COMORBIDITY obsessions / compulsions (^OCD) Hyperactivity, impulsivity, destractability = social/school problems Brain: Excessive dopamine hypothesis Treatment (fyi) Anti-psychotics Haloperidol, pimozide (80% of cases effective) Clonidine, desipramine (for attn probs – stimus make worse) |
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ALZHEIMER'S DEMENTIA
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ALZHEIMER'S
50% of all dementias Early tx of choice = Group treatment DX = definitive dx only via autopsy or brain biopsy Monitoring = ongoing neuro-cognitive testing |
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ALZHEIMER'S PROGRESSION
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Stage 1 (anomia) 0-2 yrs
Anterograde amnesia (recent memory) Declarative memory loss Deficits in visuospatial skills (wandering) Indifference, irritability, sadness Stage 2 (paranoia) 2-10 yrs ^Retrograde amnesia Personality changes Flat or labile mood Restless, agitated Delusions, hallucinations Aphasia, apraxia, agnosia Stage 3 (shutting down)8-10+ yrs Apathy Incontinence Limb rigidity (can’t walk or sit) |
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DECLARATIVE v. PROCEDURAL MEMORY
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DECLARATIVE:
Episodic: Events/Anecdotal Semantic: Words, Meaning PROCEDURAL: Implicit memory(eg. Driving car) |
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DEMENTIA v. PSEUDO-DEMENTIA
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insert data here
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HEADACHES (4 types)
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Migraine:
Severe throbbing, unilateral (one side) w/ nausea, vomiting, sensitivity to light. Classic – Aura (less common) Common – no Aura (more common) ** stress, relaxation after stress, foods with teramine (avos, tomatoes, soy, aged cheese, wine), high humidity. ** treated with increased Seratonin Cluster: “4th of July” in head. ^^ burst of pain, non-throbbing pain behind one eye occurs in “clusters” Tension Headaches – non-throbbing pain. Band of pressure around head Sinus: Fullness, tension, or throbbing ache over eyes. Worse if bent over. Worse in am. |
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SEIZURES
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Abnormal discharges of electrical energy in brain
TONIC-CLONIC: “grand mal” Tonic= muscles contract, body stiffens Clonic=rhythmic shaking Post-seizure depression or confusion w/ amnesia of seizure whole body shakes ABSENCE “petite mal” “generalized” brief attack w/loss of consciousness. W/out motor activity PARTIAL SEIZURE Begin in one side of brain and effect one side of body (can develop into generalized seizure on both side of body). SIMPLE partial = w/out loss of consciousness; COMPLEX = some loss of consciousness LOCATION OF COMPLEX-PARTIAL SEIZURES Temporal or frontal lobes |
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HEADACHES (4 types)
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Migraine:
Severe throbbing, unilateral (one side) w/ nausea, vomiting, sensitivity to light. Classic – Aura (less common) Common – no Aura (more common) ** stress, relaxation after stress, foods with teramine (avos, tomatoes, soy, aged cheese, wine), high humidity. ** treated with increased Seratonin Cluster: “4th of July” in head. ^^ burst of pain, non-throbbing pain behind one eye occurs in “clusters” Tension Headaches – non-throbbing pain. Band of pressure around head Sinus: Fullness, tension, or throbbing ache over eyes. Worse if bent over. Worse in am. |
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SEIZURES
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Abnormal discharges of electrical energy in brain
TONIC-CLONIC: “grand mal” Tonic= muscles contract, body stiffens Clonic=rhythmic shaking Post-seizure depression or confusion w/ amnesia of seizure whole body shakes ABSENCE “petite mal” “generalized” brief attack w/loss of consciousness. W/out motor activity PARTIAL SEIZURE Begin in one side of brain and effect one side of body (can develop into generalized seizure on both side of body). SIMPLE partial = w/out loss of consciousness; COMPLEX = some loss of consciousness LOCATION OF COMPLEX-PARTIAL SEIZURES Temporal or frontal lobes |
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OBSESSIVE COMPULSIVE DISORDER (OCD)
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Anxiety d/o spectrum dx. Recurrent obsessions and/or compulsions.
1 hour per day wasted. It is ego-dystonic Brain = Basal ganglia (Caudate neucleus). Associated w/ low seratonin. Tx includes SSRI and in-vivo EXPOSURE tx. |
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Mental Retardation
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DEGREES OF MENTAL RETARDATION
(Borderline Intellectual Functioning = 71-84 range) Mild = IQ 50-70 85% of retarded population Top out at 6th grade ability Can live independently and do semi-skilled jobs Moderate = IQ 35-50 10% of retarded population Top out at 2nd grade ability Need supervision in semi-skilled jobs Severe 20-35 3-4% of retarded population Poor motor skills, limited speech Closely supervised living Profound <20 1-2% of retarded population Severely limited motor and sensory functioning Closely supervised living GEN CRITERIA FOR MENTAL RETARDATION IQ < 70 Impairments in adaptive functioning in at least 2 areas Onset < 18 |
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TOURETTE'S
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1. @ least 1 vocal tic + multiple motor tics
2. Onset <18 (+18 can get dx of “NOS”) |
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Q. LD and Tourette's
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Children with a learning disorder have common co-diagnoses of ADHD (25-30%), Tourette’s disorder and/or a mood disorder.
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Q. Explanation for school/learning difficulties in children w/Tourrettte’s
Commoribitity w/ ADHD sxs: |
hyperactivity, impulsivity, distractablity
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Q. Tourette's-ADHD relationship
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COMORBIDITY
obsessions / compulsions (^OCD) Hyperactivity, impulsivity, destractability = social/school problems Brain: Excessive dopamine hypothesis Treatment (fyi) Anti-psychotics Haloperidol, pimozide (80% of cases effective) Clonidine, desipramine (for attn probs – stimus make worse) |
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Difficulty of diagnosing panic disorder or panic attacks in children
Ages 4-6. |
Children have cognitive limitations that do not let them make catastrophic interpretations of bodily symptoms, however children can be diagnosed with panic disorder.
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Pervasive developmental disorders
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Autistic, Rhetts d/o, childhood degenerative, Aspergers
Problems w/ communication, stereotyped bx’s, social deficits |
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Enuresis
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Effectiveness of tx for enuresis - Bell and Pad vs. tricyclics / antidepressants
A. Bell and pad better in the long-run (less relapse) |
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Disorders with a genetic basis
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(Autosomal)
PKU – autosomal recessive Down syndrome Huntington’s – autosomal dominant |
