NR668 Week 6- Test Questions with Complete
Solutions| Latest Update
Pediatric mental health: Tourette's Disorder ✔️✔️-Most severe form of Tic disorder
-Coprolalia
-Echolalia
-Increased: OCD, ADHD
-Mild cases may not need Tx
-Treatment
• Habit reversal
• Exposure/Response prevention
• Risperdal
Pediatric mental health: ADHD ✔️✔️-Genetic component: 75% Heritable risk
-Parents have increased substance d/o
-Impulsive, emotionally labile, lack focus, can be explosive or irritable
-Treatment
• Meds are first line! Must be carful & aware of cardiac risk of stimulants
• Methylphenidate, Amphetamines
• Nonstimulants: Atomoxetine, Catapres
PTSD in those <21 years old ✔️✔️-Need at least 1 month duration
-Acting scene through play, nightmares
-Dissociative state
-Delayed onset = worse
-Treatment
• Psychotherapy / exposuretherapy / Trauma focused CBT
,• EMDR
• SSRI's
• Prazosin
Pediatric mental health: MDD ✔️✔️-Substitute Irritability for depressed mood
-Angry rather than sad
-Increased somatic complaints
-Children of parents with early onset MDD
-Bereavement
-Treatment
• CBT
• SSRI
• Nonstimulants: Atomoxetine, Catapres
Pediatric mental health: Bipolar Disorder - Early onset ✔️✔️-Peak symptoms begins in teen years
-Substance abuse common
-Treatment
• Lithium ok after 12 years of age
• VPA approved for seizures
• Short term SGA ok
• Hospitalization may be necessary
Pediatric mental health: Schizophrenia ✔️✔️-Preschool children can hallucinate
-Early onset Schizophrenia is rare
-1st degree relatives increase prevalence
-Soft neurologic signs
-Peer relationships
,-Social rejection
-Academic trouble
-Treatment
• Antipsychotics
**Clozaril is dangerous in this population given its vast side effect profile & certainly NOT 1st
line tx
Scoring screening tools: SLUMS ✔️✔️Mental status
-SLUMS (0-30)
• 0-20: dementia
• 21-26: mild
• 27-30: normal
Scoring screening tools: MMSE ✔️✔️Mental status
-MMSE (0-30)
• 0-9: severe
• 10-20: moderate
• 21-24: mild
• 25-30: normal
Scoring screening tools: HAM-D ✔️✔️Depression
-HAM-D (0-76)
• 0-7: normal
• 8-13: mild
• 14-18: moderate
• 19>: severe
, Scoring screening tools: PHQ9 ✔️✔️Depression
-PHQ9 (0-27)
• 0-4: normal
• 5-9: mild
• 10-14: moderate
• 15-19: moderate severe
• 20-27: severe
Scoring screening tools: BECK ✔️✔️Depression
-BECK (0-63)
• 0-13: minimal
• 14-19: mild
• 20-28: moderate
• 29-63: severe
Scoring screening tools: HAM-A ✔️✔️Anxiety
-HAM-A (0-56)
• 0-13: normal
• 14-17: mild
• 18-24: moderate
• 25>: severe
Scoring screening tools: GAD ✔️✔️Anxiety
-GAD (0-21)
• 0-4: normal
• 5-9: mild
• 10-14: moderate
Solutions| Latest Update
Pediatric mental health: Tourette's Disorder ✔️✔️-Most severe form of Tic disorder
-Coprolalia
-Echolalia
-Increased: OCD, ADHD
-Mild cases may not need Tx
-Treatment
• Habit reversal
• Exposure/Response prevention
• Risperdal
Pediatric mental health: ADHD ✔️✔️-Genetic component: 75% Heritable risk
-Parents have increased substance d/o
-Impulsive, emotionally labile, lack focus, can be explosive or irritable
-Treatment
• Meds are first line! Must be carful & aware of cardiac risk of stimulants
• Methylphenidate, Amphetamines
• Nonstimulants: Atomoxetine, Catapres
PTSD in those <21 years old ✔️✔️-Need at least 1 month duration
-Acting scene through play, nightmares
-Dissociative state
-Delayed onset = worse
-Treatment
• Psychotherapy / exposuretherapy / Trauma focused CBT
,• EMDR
• SSRI's
• Prazosin
Pediatric mental health: MDD ✔️✔️-Substitute Irritability for depressed mood
-Angry rather than sad
-Increased somatic complaints
-Children of parents with early onset MDD
-Bereavement
-Treatment
• CBT
• SSRI
• Nonstimulants: Atomoxetine, Catapres
Pediatric mental health: Bipolar Disorder - Early onset ✔️✔️-Peak symptoms begins in teen years
-Substance abuse common
-Treatment
• Lithium ok after 12 years of age
• VPA approved for seizures
• Short term SGA ok
• Hospitalization may be necessary
Pediatric mental health: Schizophrenia ✔️✔️-Preschool children can hallucinate
-Early onset Schizophrenia is rare
-1st degree relatives increase prevalence
-Soft neurologic signs
-Peer relationships
,-Social rejection
-Academic trouble
-Treatment
• Antipsychotics
**Clozaril is dangerous in this population given its vast side effect profile & certainly NOT 1st
line tx
Scoring screening tools: SLUMS ✔️✔️Mental status
-SLUMS (0-30)
• 0-20: dementia
• 21-26: mild
• 27-30: normal
Scoring screening tools: MMSE ✔️✔️Mental status
-MMSE (0-30)
• 0-9: severe
• 10-20: moderate
• 21-24: mild
• 25-30: normal
Scoring screening tools: HAM-D ✔️✔️Depression
-HAM-D (0-76)
• 0-7: normal
• 8-13: mild
• 14-18: moderate
• 19>: severe
, Scoring screening tools: PHQ9 ✔️✔️Depression
-PHQ9 (0-27)
• 0-4: normal
• 5-9: mild
• 10-14: moderate
• 15-19: moderate severe
• 20-27: severe
Scoring screening tools: BECK ✔️✔️Depression
-BECK (0-63)
• 0-13: minimal
• 14-19: mild
• 20-28: moderate
• 29-63: severe
Scoring screening tools: HAM-A ✔️✔️Anxiety
-HAM-A (0-56)
• 0-13: normal
• 14-17: mild
• 18-24: moderate
• 25>: severe
Scoring screening tools: GAD ✔️✔️Anxiety
-GAD (0-21)
• 0-4: normal
• 5-9: mild
• 10-14: moderate
