Georgette Module 3: Questions With Practical Step-by-
Step Answers
What is a decreased effect of the same dose of a medication over time?
Correct Answer - Tolerance
Ex. taking 2 pills of ibuprofen over a period of time so now needing to take 3
pills to achieve the same effect
What is it called when there is a tendency of some regions of the brain to react
to repeated LOW level bioelectrical stimulation by progressively boosting
synaptic discharges thereby lowering seizure thresholds? Correct Answer -
Kindling
Kindling explanation/definition Correct Answer - Process of neuronal
membrane threshold sensitivity dysfunction
-D/t sub-threshold brain stimulation
-Brain is overly sensitive to electrical stimuli
-Neuronal misfiring (occurs w/o stimuli)
Kindling in the context of mood D/O recurrence Correct Answer -
Repeated episodes of mood D/Os lead to greater susceptibility to future
episodes (repeated decline with repeated episodes- Ex. When someone has a
psych disorder, each time they relapse, it may be harder to get them back up
to their baseline)
3 types of ADHD Correct Answer - Inattention
Hyperactivity/impulsivity
Combined type
Dx criteria for ADHD (all 3 types) Correct Answer - -Hyperactivity type,
Inattentive type= 6 for children under 17, 5 for 17+/adults
-Combined type
-6 MONTHS
-BEFORE AGE 12
-****2+ SETTINGS*****
Inattentive ADHD criteria symptoms Correct Answer - "If Unmotivated,
Dig Deep Down And Find Lost Drive"
,a) Inattention to detail/careless mistakes
b) Unable to maintain sustained attention
c) Difficulty listening when spoken to
d) Difficulty following directions
e) Disorganized
f) Avoids sustained mental effort
g) Forgetful
h) Loses things
i) Distractible
Hyperactivity ADHD Criteria symptoms Correct Answer - "Fix Difficulty
Running Down On Treadmill By Doing Intervals"
a) Fidgets
b) Difficultly remaining seated
c) Runs or climbs excessively (feelings restless in adolescents or adults)
d) Difficulty engaging quietly
e) "On the go"; "Driven by a motor"
f) Talks excessively
g) Blurts out answers
h) Difficulty waiting turn
i) Interrupts or intrudes
Basal Ganglia function Correct Answer - -Motor initiation and control
-Muscle tone, posture, common reflexes
-Executive function
-Emotions
Brain Abnormalities Etiology of ADHD Correct Answer - Abnormalities in
fronto-subcortical pathway AKA the Frontal cortex, Basal Ganglia, RAS
RAS (reticular activating system) Correct Answer - Regulates arousal and
sleep-wake transitions, ability to focus, fight-flight response
What neurotransmitter abnormalities are seen in ADHD?? Correct Answer -
Neurotransmitters= **DNS**(DA, NE, 5HT)**
Stimulants for ADHD include and what ages are they approved for?? Correct
Answer - Adderall/dextroamphetamine+amphetamine (3 and up)
Methylphenidate (6 and up)
, What should you assess prior to giving a stimulant for ADHD? why??
Correct Answer - Cardiac hx because they can cause elevated HR & BP,
increase risk of MI/CVA/Aneurysm rupture
Amphetamines are approved for what age?? Correct Answer - ***age 3 and
older***
Methylphenidate is approved for what age?? Correct Answer - **age 6 and
older**
If ADHD med is wearing off too soon, what should you do?**** Correct
Answer - Multiple dosing or change to extended release******
Non-stimulants for ADHD include Correct Answer - 1. Alpha2 agonists=
**Clonidine & Guanfacine** (approved ages 6-17 w/ ADHD)
2. Straterra (atomoxetine) approved for >/= 6yr (NE reuptake inhibitor -->
inc. NE & DA in PFC)
Alpha2-agonists FDA approved for ADHD and at what age Correct Answer -
Guanfacine & Clonidine
ages 6-17 with confirmed dx
Straterra (Atomoxetine) is approved for what age in ADHD Correct Answer
- ages 6+ with ADHD
***Know** that for children <6 years old, what to give for ADHD Correct
Answer - Adderall (FDA approved for ages 3+)
**Know** what to give when children turn 6 for ADHD Correct Answer -
Methylphenidate (FDA approved for ages 6+)
DNS stands for and what is it?? Correct Answer - DA, NE, 5HT
(abnormalities in ADHD and some others)
If choosing between Guanfacine & Clonidine for ADHD, which should you
choose on the test?? why? Correct Answer - Guanfacine, lasts longer & is
less sedating
Step Answers
What is a decreased effect of the same dose of a medication over time?
Correct Answer - Tolerance
Ex. taking 2 pills of ibuprofen over a period of time so now needing to take 3
pills to achieve the same effect
What is it called when there is a tendency of some regions of the brain to react
to repeated LOW level bioelectrical stimulation by progressively boosting
synaptic discharges thereby lowering seizure thresholds? Correct Answer -
Kindling
Kindling explanation/definition Correct Answer - Process of neuronal
membrane threshold sensitivity dysfunction
-D/t sub-threshold brain stimulation
-Brain is overly sensitive to electrical stimuli
-Neuronal misfiring (occurs w/o stimuli)
Kindling in the context of mood D/O recurrence Correct Answer -
Repeated episodes of mood D/Os lead to greater susceptibility to future
episodes (repeated decline with repeated episodes- Ex. When someone has a
psych disorder, each time they relapse, it may be harder to get them back up
to their baseline)
3 types of ADHD Correct Answer - Inattention
Hyperactivity/impulsivity
Combined type
Dx criteria for ADHD (all 3 types) Correct Answer - -Hyperactivity type,
Inattentive type= 6 for children under 17, 5 for 17+/adults
-Combined type
-6 MONTHS
-BEFORE AGE 12
-****2+ SETTINGS*****
Inattentive ADHD criteria symptoms Correct Answer - "If Unmotivated,
Dig Deep Down And Find Lost Drive"
,a) Inattention to detail/careless mistakes
b) Unable to maintain sustained attention
c) Difficulty listening when spoken to
d) Difficulty following directions
e) Disorganized
f) Avoids sustained mental effort
g) Forgetful
h) Loses things
i) Distractible
Hyperactivity ADHD Criteria symptoms Correct Answer - "Fix Difficulty
Running Down On Treadmill By Doing Intervals"
a) Fidgets
b) Difficultly remaining seated
c) Runs or climbs excessively (feelings restless in adolescents or adults)
d) Difficulty engaging quietly
e) "On the go"; "Driven by a motor"
f) Talks excessively
g) Blurts out answers
h) Difficulty waiting turn
i) Interrupts or intrudes
Basal Ganglia function Correct Answer - -Motor initiation and control
-Muscle tone, posture, common reflexes
-Executive function
-Emotions
Brain Abnormalities Etiology of ADHD Correct Answer - Abnormalities in
fronto-subcortical pathway AKA the Frontal cortex, Basal Ganglia, RAS
RAS (reticular activating system) Correct Answer - Regulates arousal and
sleep-wake transitions, ability to focus, fight-flight response
What neurotransmitter abnormalities are seen in ADHD?? Correct Answer -
Neurotransmitters= **DNS**(DA, NE, 5HT)**
Stimulants for ADHD include and what ages are they approved for?? Correct
Answer - Adderall/dextroamphetamine+amphetamine (3 and up)
Methylphenidate (6 and up)
, What should you assess prior to giving a stimulant for ADHD? why??
Correct Answer - Cardiac hx because they can cause elevated HR & BP,
increase risk of MI/CVA/Aneurysm rupture
Amphetamines are approved for what age?? Correct Answer - ***age 3 and
older***
Methylphenidate is approved for what age?? Correct Answer - **age 6 and
older**
If ADHD med is wearing off too soon, what should you do?**** Correct
Answer - Multiple dosing or change to extended release******
Non-stimulants for ADHD include Correct Answer - 1. Alpha2 agonists=
**Clonidine & Guanfacine** (approved ages 6-17 w/ ADHD)
2. Straterra (atomoxetine) approved for >/= 6yr (NE reuptake inhibitor -->
inc. NE & DA in PFC)
Alpha2-agonists FDA approved for ADHD and at what age Correct Answer -
Guanfacine & Clonidine
ages 6-17 with confirmed dx
Straterra (Atomoxetine) is approved for what age in ADHD Correct Answer
- ages 6+ with ADHD
***Know** that for children <6 years old, what to give for ADHD Correct
Answer - Adderall (FDA approved for ages 3+)
**Know** what to give when children turn 6 for ADHD Correct Answer -
Methylphenidate (FDA approved for ages 6+)
DNS stands for and what is it?? Correct Answer - DA, NE, 5HT
(abnormalities in ADHD and some others)
If choosing between Guanfacine & Clonidine for ADHD, which should you
choose on the test?? why? Correct Answer - Guanfacine, lasts longer & is
less sedating
