PMHS Exam Study guide Questions & Answers
marked anxiety
glaucoma
contraindications to use of MAO within 2 weeks
methylphenidate caution with tic or tourette
Methylphenidate dose range 0.3-1.0 mg/kg/dose
start with Adderall 5mg transition to Adderall xr 10mg. Max dose
using amphetamines 1.5 mg/kg/day or 30 mg/day
increase basal activity of the locus coeruleus noradrenergic cell
alpha-2 agonist mechanism of bodies in patients with adhd may decrease the response of the
action PFC
binds to receptors in prefrontal cortex
improves executive function
takes one to two weeks to see effects
intuniv (extended release off label use
guanfacine) not as helpful for inattention
treatment for mild depression support and monitoring for initial 6-8 weeks
moderate depression
authoritarian
authoritative
baumrinds parenting styes permissive
rejecting/neglecting
Demanding and directive, but not responsive
status oriented
They want obedient children that follow orders
parents provide orderly environment
authoritarian parenting May cause children to internalize probs, low self-esteem. Kids can
be withdrawn and distrustful.
both demanding and responsive
Directs child with rationale
authoritative parenting children are competent, well- adjusted self-reliant
style of parenting in which parent makes few, if any demands on a
child's behavior
permissive parenting children of permissive parents are least self-reliant
a disengaged parenting style that is low in both responsiveness
and demandingness. Rejecting-neglecting parents do not set limits
for or monitor their children's behavior, are not supportive of them,
and sometimes are rejecting or neglectful. They tend to be focused
rejecting-neglecting parenting on their own needs rather than their children's needs.
rejecting-neglecting parenting may cause low self-esteem
SBIRT Screening, Brief Intervention, and Referral to Treatment
1 PMHS Exam Study guide.pdf
, PMHS Exam Study guide Questions & Answers
Thomas and Stella Chess temperament
Ages and Stages Questionnaire (ASQ)
three most widely used screening Parents' Evaluation of Developmental Status (PEDS)
tools in pediatric primary care M-CHAT
ASQ More accurate than PEDS in children over 30 mos.
ASQ-3 2-60 mos
communication
gross motor
fine motor
ASQ-3 problem solving
personal social
Ages and Stages Questionnaire: Social Emotional
7 categories - self-regulation, compliance communication, adaptive
ASQ-SE functioning, autonomy, affect, interaction with people
broad emotional and behavioral screening tool
Time: completed by parents, youth, or staff in 5‐10 m
Cost: Free
Features: Specificity and sensitivity of 0.95 using cutoff scores
Designed to evaluate the psycho‐social functioning of children
Pediatric Symptom Checklist ages 4‐16
There is a youth (>age 11) self‐report version of the PSC
PSC 35 Cutoff Scoring
for children ages 6-18, score greater than 27 impaired
Pediatric Symptom Checklist for younger children , score greater than 24 impaired
(PSC) PSC-Y scores of 30 or higher
Screening for Drug and alcohol CRAFFT (car, relax, alone, forget, friends trouble) (12-18 years)
BASTD (Brief Screener for Tobacco, Alcohol and other Drugs )
use
CRAFFT 12-18 years
Mood and Feeling Questionnaire (MFQ-SI) 7-17 years
DepressionScreener PHQ-Adolescent Version
assessment that evaluates degree of depression
0-4 no depression
5-9 minimal symptoms
10-14 possible dysthymia, mild depression
PHQ-9 15-19 consistent with major depression
>/= 20 severe major depression
2 PMHS Exam Study guide.pdf
, PMHS Exam Study guide Questions & Answers
5 or more of the following symptom for 2 weeks with at least one of
the symptoms being depressed or diminished interest in all
activities
depressed mood most of the day
diminished interest in activities
significant wt loss
insomnia or hypersomnia most days
psychomotor agitation nearly every day
major depressive disorder fatigue or loss of energy
feeling of worthlessnessdecreased ability to think or
concentrate/indecisiveness
recurrent thoughts of death or suicidal ideation
moderate depression in children Prozac (fluoxetine)
Fluoxetine (SSRI)
longest half life
Prozac first line treatment for depression in kids over 8
Fluoxetine (Prozac) for ages 8 dose 10 mg/day up to 10 mg per day
do not take with MAO
and up
GI distress, sexual dysfunction (anorgasmia and decreased libido)
serotonin syndrome
Side effects of SSRIs
fluoxetine Prozac
treatment for children with
depression and ocd longest half life takes 2-4 weeks to achieve steady state
Family Management Measure (FaMM)
assessment of family functioning Columbia Impairment Scale (CIS)
in a child Children Global Assessment Scale (C-GAS)
100-91 superior functioning
Children Global Assessment 50-41 moderate degree of interference in functioning
Scale (C-GAS) 10-1 needs constant supervision
ASQ (Suicide Screening Questions)
Columbia Suicide Severity Rating Scale (C-SSRS)
Suicide Screening Mood and Feeling Questionnaire (MFQ)
PHQ-9
Dx: Any population
Assesses severity of depression, aap use in( 11-21 years
PHQ-9 (Patient Health old)depressive disorder
Questionnaire) Domain: Body Structure and Fxn
3 PMHS Exam Study guide.pdf
, PMHS Exam Study guide Questions & Answers
scoff
eating attitude test-26
EDE questionnaire - not validated in female or adolescent
population.
Female Athletic Screening Tool (FAST)
eating disorders screening tools
Eating Disorders Examination Questionnaire (EDE-Q) - gold
standard
evaluates: executive functioning, learning problems,
defiance/aggression, hyperactivity/impulsivity, peer relations,
inattention
age range 6-18 for teacher and parent report
8-18 self report
Connors scale t score: 70+ very elevated
57-63 borderline
40-59 average concern
landau-kleffner syndrome you will see language regression
screening for developmental at 9, 18 and 30 months
PEDS, ASQ
delay
significant delay in 2 or more domains
usually reserved for children younger than 5
Global Developmental Delay 5 and older can be assessed using IQ
there or new
weakness is central in origin
may relflect muscular disease
think CK to r/o muscular dystrophy
Hypotonia SMA
screen at 9, 18, 30 and 48 months
Early motor delays screen at 9, 18, 30 and 48 mos
rolls to both sides
sits well without support
9 month developmental motor symmetry
milestones should be grasping and transferring objects
sit stand and walk independently
subtle gross motor, fine motor, speech, and oral motor impairments
18 month development may start to emerge
Progressive neuromuscular disorders may start to emerge.
Intellectual disabilities
Communication disorders
Autism Spectrum Disorder
ADHD
neurodevelopmental disorders Specific Learning Disorder
Motor Disorders
4 PMHS Exam Study guide.pdf
marked anxiety
glaucoma
contraindications to use of MAO within 2 weeks
methylphenidate caution with tic or tourette
Methylphenidate dose range 0.3-1.0 mg/kg/dose
start with Adderall 5mg transition to Adderall xr 10mg. Max dose
using amphetamines 1.5 mg/kg/day or 30 mg/day
increase basal activity of the locus coeruleus noradrenergic cell
alpha-2 agonist mechanism of bodies in patients with adhd may decrease the response of the
action PFC
binds to receptors in prefrontal cortex
improves executive function
takes one to two weeks to see effects
intuniv (extended release off label use
guanfacine) not as helpful for inattention
treatment for mild depression support and monitoring for initial 6-8 weeks
moderate depression
authoritarian
authoritative
baumrinds parenting styes permissive
rejecting/neglecting
Demanding and directive, but not responsive
status oriented
They want obedient children that follow orders
parents provide orderly environment
authoritarian parenting May cause children to internalize probs, low self-esteem. Kids can
be withdrawn and distrustful.
both demanding and responsive
Directs child with rationale
authoritative parenting children are competent, well- adjusted self-reliant
style of parenting in which parent makes few, if any demands on a
child's behavior
permissive parenting children of permissive parents are least self-reliant
a disengaged parenting style that is low in both responsiveness
and demandingness. Rejecting-neglecting parents do not set limits
for or monitor their children's behavior, are not supportive of them,
and sometimes are rejecting or neglectful. They tend to be focused
rejecting-neglecting parenting on their own needs rather than their children's needs.
rejecting-neglecting parenting may cause low self-esteem
SBIRT Screening, Brief Intervention, and Referral to Treatment
1 PMHS Exam Study guide.pdf
, PMHS Exam Study guide Questions & Answers
Thomas and Stella Chess temperament
Ages and Stages Questionnaire (ASQ)
three most widely used screening Parents' Evaluation of Developmental Status (PEDS)
tools in pediatric primary care M-CHAT
ASQ More accurate than PEDS in children over 30 mos.
ASQ-3 2-60 mos
communication
gross motor
fine motor
ASQ-3 problem solving
personal social
Ages and Stages Questionnaire: Social Emotional
7 categories - self-regulation, compliance communication, adaptive
ASQ-SE functioning, autonomy, affect, interaction with people
broad emotional and behavioral screening tool
Time: completed by parents, youth, or staff in 5‐10 m
Cost: Free
Features: Specificity and sensitivity of 0.95 using cutoff scores
Designed to evaluate the psycho‐social functioning of children
Pediatric Symptom Checklist ages 4‐16
There is a youth (>age 11) self‐report version of the PSC
PSC 35 Cutoff Scoring
for children ages 6-18, score greater than 27 impaired
Pediatric Symptom Checklist for younger children , score greater than 24 impaired
(PSC) PSC-Y scores of 30 or higher
Screening for Drug and alcohol CRAFFT (car, relax, alone, forget, friends trouble) (12-18 years)
BASTD (Brief Screener for Tobacco, Alcohol and other Drugs )
use
CRAFFT 12-18 years
Mood and Feeling Questionnaire (MFQ-SI) 7-17 years
DepressionScreener PHQ-Adolescent Version
assessment that evaluates degree of depression
0-4 no depression
5-9 minimal symptoms
10-14 possible dysthymia, mild depression
PHQ-9 15-19 consistent with major depression
>/= 20 severe major depression
2 PMHS Exam Study guide.pdf
, PMHS Exam Study guide Questions & Answers
5 or more of the following symptom for 2 weeks with at least one of
the symptoms being depressed or diminished interest in all
activities
depressed mood most of the day
diminished interest in activities
significant wt loss
insomnia or hypersomnia most days
psychomotor agitation nearly every day
major depressive disorder fatigue or loss of energy
feeling of worthlessnessdecreased ability to think or
concentrate/indecisiveness
recurrent thoughts of death or suicidal ideation
moderate depression in children Prozac (fluoxetine)
Fluoxetine (SSRI)
longest half life
Prozac first line treatment for depression in kids over 8
Fluoxetine (Prozac) for ages 8 dose 10 mg/day up to 10 mg per day
do not take with MAO
and up
GI distress, sexual dysfunction (anorgasmia and decreased libido)
serotonin syndrome
Side effects of SSRIs
fluoxetine Prozac
treatment for children with
depression and ocd longest half life takes 2-4 weeks to achieve steady state
Family Management Measure (FaMM)
assessment of family functioning Columbia Impairment Scale (CIS)
in a child Children Global Assessment Scale (C-GAS)
100-91 superior functioning
Children Global Assessment 50-41 moderate degree of interference in functioning
Scale (C-GAS) 10-1 needs constant supervision
ASQ (Suicide Screening Questions)
Columbia Suicide Severity Rating Scale (C-SSRS)
Suicide Screening Mood and Feeling Questionnaire (MFQ)
PHQ-9
Dx: Any population
Assesses severity of depression, aap use in( 11-21 years
PHQ-9 (Patient Health old)depressive disorder
Questionnaire) Domain: Body Structure and Fxn
3 PMHS Exam Study guide.pdf
, PMHS Exam Study guide Questions & Answers
scoff
eating attitude test-26
EDE questionnaire - not validated in female or adolescent
population.
Female Athletic Screening Tool (FAST)
eating disorders screening tools
Eating Disorders Examination Questionnaire (EDE-Q) - gold
standard
evaluates: executive functioning, learning problems,
defiance/aggression, hyperactivity/impulsivity, peer relations,
inattention
age range 6-18 for teacher and parent report
8-18 self report
Connors scale t score: 70+ very elevated
57-63 borderline
40-59 average concern
landau-kleffner syndrome you will see language regression
screening for developmental at 9, 18 and 30 months
PEDS, ASQ
delay
significant delay in 2 or more domains
usually reserved for children younger than 5
Global Developmental Delay 5 and older can be assessed using IQ
there or new
weakness is central in origin
may relflect muscular disease
think CK to r/o muscular dystrophy
Hypotonia SMA
screen at 9, 18, 30 and 48 months
Early motor delays screen at 9, 18, 30 and 48 mos
rolls to both sides
sits well without support
9 month developmental motor symmetry
milestones should be grasping and transferring objects
sit stand and walk independently
subtle gross motor, fine motor, speech, and oral motor impairments
18 month development may start to emerge
Progressive neuromuscular disorders may start to emerge.
Intellectual disabilities
Communication disorders
Autism Spectrum Disorder
ADHD
neurodevelopmental disorders Specific Learning Disorder
Motor Disorders
4 PMHS Exam Study guide.pdf
