i human 6 Billy Johnson CASE STUDY

i human 6 Billy Johnson CASE STUDY PSY MISC i-human 6 Billy Johnson Billy Johnson 13 yo “I hate school” With his mother Observations ● Fidgeting ● Warm, dry skin Last Visit One year ago, billy was seen for his well check. He was noted to be a little hyperactive at times; his parents had recently divorced and he was a little irritable and frustrated with having to go between his mother’s and father’s house. Had difficulty following his coach’s directions. Father has a history of cocaine abuse. Differential Diagnosis 1. ADHD - Lead 2. Hyperthyroidism - MnM a. TSH 3. Generalized anxiety disorder 4. Substance use disorder - MnM a. Drug toxicology, urine 5. Depressive disorder - MnM Plan ● Discuss medication as first line treatment ● Consider pretreatment ECG if there is a personal history of heart disease, or a FH of unexplained syncope or sudden cardiac death ● Utilize Conners ratings scales, child behaviour checklist (CBCL), and Vanderbilt ADHD scales at baseline for longitudinal monitoring of treatment response at school. ● Monitor weight, blood pressure, and pulse over time ● Consider a non-stimulant trial if the patient fails to tolerate or benefit from a stimulant trial;, or, if the parent refuses a stimulant for his/her child. ● Suggest parenting training and behavior modification-plans for augmentation of the medication therapy