Shared Flashcard Set

Details

ADHD
CBN III
18
Medical
Graduate
02/15/2011

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Cards

Term
what % of grade school children have ADHD?
Definition
20%
Term
what characterizes the symptoms of ADHD?
Definition
they involve both inattention and motor hyperactivity. they interfere w/regular school and home life routines (2 different settings).
Term
what age is the cut off point for determining if a pt has ADHD vs just being a kid?
Definition
7 y/o
Term
what characterizes the incidence of ADHD?
Definition
it has been in in the literature since 1900. more prevalent in boys. more prevalent in families.
Term
what is the etiology of ADHD?
Definition
genetics, possible prenatal infection/brain trauma. there appears to be a deficit in the adrenergic/dopaminergic systems. there is a difference in the frontal lobe activity (inhibition) seen on PET scans. children raised w/a sense of emotional deprivation also are more likely to present w/ADHD.
Term
how is the ADHD dx made?
Definition
largely by hx. ADHD pts are characterized as fidgety, constant motor activity, squirming, and lack of impulse control. brief attention span. irritable, explosive, throw things in frustration. stand out in classroom (more w/hyperactive child). relationship with peers is troublesome.
Term
what is on the conners teaching rating scale (for ADHD)?
Definition
this evaluates a child’s observed behavior, taking note of: hyperactivity, making noises, sensitivity, inattentiveness, relationships w/peers, destructive tendencies, problems in peer groups, problems w/authority. scored 0-3. >1.8 avg is more positive for ADHD. there is a parent's version as well noting: activity during meals, TV, and sleep (need to maintain routine).
Term
what characterizes development of ADHD children?
Definition
from age 7-adolescence: their identity is the troublemaker, don't play well w/other kids, worse self-image, and poor student.
Term
would ADHD be a misdx?
Definition
yes, sleep-deprived children are also hyperactive.
Term
what is the progression of ADHD?
Definition
75% will carry the disorder to adolescence. 40-80% will carry it to adult years. however, ADHD becomes more inattention, less hyperactive starting in adolescence. teens w/ADHD may be more likely to have issues w/substance abuse, social relationships and impulse control.
Term
what characterizes the adult w/ADHD?
Definition
more problems w/concentration than w/hyperactivity. may have other behavioral problems such as: labile mood, disorganization, bad toleration of stress, and impulsivity. co-morbid conditions w/ADHD: bipolar, depression (poor self image), anxiety disorders, substance abuse, personality disorders, tourette's, and OCD.
Term
what characterizes inattention in a child vs adult ADHD pt?
Definition
*child: difficulty paying attention to details, may not follow all you say, doesn't usually complete homework, loses things, forgetful. *adult: lots of things are started (not finished), may not follow everything you say, difficulty w/multiple step projects, awareness of losing things (may create routines to compensate), forget appointments, social commitments, work deadlines.
Term
what characterizes hyperactivity in a child vs adult ADHD pt?
Definition
*child: can't sit through a whole class, impulsive situations/behavior, and talkative. *adult: repetitive finger/toe tapping, legs cross/uncross, difficulty staying in a meeting, risk-taking activity and talkative.
Term
what characterizes impulsivity in a child vs adult ADHD pt?
Definition
child: blurts out answer, difficulty waiting turn. adult: interrupts others' conversations, finishes other sentences, and difficulty waiting in line/traffic.
Term
how do ADHD and major depression compare?
Definition
similar: poor concentration, problems w/memory and task completion. difference: depression has sleep and appetite problems as well as anhedonia.
Term
how do ADHD and bipolar compare?
Definition
similar: hyperactive w/mood swings. difference: mood swings w/ADHD are not as prolonged.
Term
what are the stimulant medications for ADHD?
Definition
amphetamines (increase DA): lysine dextro-amphetamine, mixed amphetamine salts, dexmethylphenidate, and methylphenidate. ADRs: rare sudden death, structural cardiac disease, and appetite suppressing (have to monitor weight/height/pulse/BP every 3 mos).
Term
what are the non-stimulant medications for ADHD?
Definition
NE reuptake inhibitor: atomoxetine. alpha 2A receptor agonists: guanfacine (similar to clonidine). anti-depressants: bupropion, desipramine (TCA).
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