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Child & Adolescent

Child & Adolescent. Most of the questions for general psychiatrists are related to identifying, not treating, these disorders, so that is the focus here. All answers come from DSM-IV-TR or First and Tasman unless otherwise indicated. As of 12Aug08. Written exam.

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Child & Adolescent

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  1. Child & Adolescent Most of the questions for general psychiatrists are related to identifying, not treating, these disorders, so that is the focus here. All answers come from DSM-IV-TR or First and Tasman unless otherwise indicated. As of 12Aug08

  2. Written exam This PowerPoint is unlikely to be relevant for oral adult boards. It does have material that is likely to be on Part I or on the recertification exam.

  3. MR* subtypes Q. IQ level and definition of MR subtypes? * Beginning in 2006, it is becoming more and more “correct” to use “Intellectual Disorder,” “ID,” for this disorder.

  4. MR subtypes Ans. Mental retardation IQ subtypes: Profound mental retardation: below 20-25 Severe mental retardation: 20-25 to 35-40 Moderate mental retardation: 35-40 to 50-55 Mild mental retardation: 50-55 to 70 [borderline intellectual functioning, a V code, 71-84.]

  5. Down’s Q. Characteristics of Down’s?

  6. Down’s Ans. • IQ averages 50. • Upward-slanted palpebral fissure • Low nasal bridge • Flat nasal bridge • Small mouth & ears • Single palmer cease • Short & wide palms • Muscle hypotonia

  7. Down’s cause Q. Most are caused by?

  8. Down’s cause Ans. Trisomy 21.

  9. Angelman syndrome Q. Characteristics of Angelman’s syndrome?

  10. Angelman’s syndrome Ans. 1] severe mental retardation 2] can’t speak but periodic laughter 3] ataxia, motor clumsiness 4] have a large mouth

  11. Angelman syndrome - genetics Q. What genetic abnormality is associated with Angelman syndrome?

  12. Angelman’s syndrome - genetics Ans. If you say “chromosome 15,” that should be sufficient. More specifically, deletion of the section 15q11-q13 of the maternal chromosome.

  13. Prader-Willi syndrome Q. Features of Prader-Willi?

  14. Prader-Willi syndrome Ans. • Mild to moderately retarded. • Small hands and feet • Muscles are hypotonic • Poor feeders as infants and later are vociferous eaters of about anything which leads to obesity.

  15. Prader-Willi syndrome - genetics Q. Genetics of Prader-Willi syndrome?

  16. Prader-Willi syndrome - genetics Ans. Chromosome 15 abnormality, deletions, unlike Angelman syndrome, originate from the father.

  17. Fragile X Q. Characteristics of fragile X?

  18. Fragile X Ans. 1] usually moderate mental retardation 2] oblong face 3] prominent ears and jaw 4] macroorchidism

  19. Fetal alcohol syndrome Q. Features of fetal alcohol syndrome?

  20. Fetal alcohol syndrome Ans. While variable, examiners are likely to expect: • Mild to moderate mental retardation • Growth retardation • Facial dysmorphic features [“fetal alcohol effects” = 2 of these 3.]

  21. Reading disorder Q. Basic criteria of Reading Disorder?

  22. Reading disorder Ans. Reading ability is substantially below what would be expected given pt’s age, schooling, intelligence, and need.* *”Need” gets to the issue that it has to be problematic in some way.

  23. Mathematical disorder Q. Criteria for mathematical disorder?

  24. Mathematics disorder Ans. Mathematical ability is substantially below what would be expected given the pt’s age, schooling, intelligence, and need.

  25. Written expression Q. Criteria for Disorder of Written Expression?

  26. Written expression Ans. Written expression is substantially below what is expected of the pt given the age, schooling, intelligence, and need.

  27. Motor Skills Disorder Q. ‘Criteria for motor skills disorder?

  28. Motor skills disorder Ans. The pt’s motor skills are substantially below what would be expected of someone of that age, intelligence, training, physical health, and need.

  29. Expressive language Q. Criteria for expressive language disorder?

  30. Expressive language Ans. Pt’s expressive language [vocabulary, grammar] are substantially below what would be expected given the age, intelligence, schooling, and need.

  31. Phonological disorder Q. What is criteria for phonological disorder?

  32. Phonological disorder Ans. Pt’s ability to make correct speech sounds is substantially below what is expected given the person’s age, intelligence, schooling, and need [e.g., “t” sound for “k” sound].

  33. stuttering • Q. Basic criteria for stuttering?

  34. Stuttering Ans. Pt has disturbance in fluency and time pattering of speech that is inappropriate for someone of his/her age and need – and beyond any neurological deficits.

  35. Stuttering - treatment Q. General treatment for stuttering?

  36. Stuttering - treatment Ans. Speech therapist, who often attempt to modify speech’s rhythm and speed, and as a temporary manner, encourage prolongation of the speech.

  37. Autism Q. The three major areas of psychopathology of autism are?

  38. Autism Ans. 1] Impaired social interaction 2] Impaired communication 3] Stereotyped patterns of behavior.

  39. Autism – social function Q. DSM expects at least 2 of 4 signs of impaired social functioning. List the 4.

  40. Autism – social functioning Ans. 1] impaired social behaviors such as eye-to-eye contact 2] failure to develop peer relationships appropriate to age level 3] lack of seeking social interactions 4] lack of social interaction reciprocity

  41. Autism - communications Q. DSM expects at least one of four communications deficits. Name the four.

  42. Autism -- communications Ans. • Delay in development of spoken language • If can use spoken language, marked impairment in ability to sustain a conversation • Repetitive or idiosyncratic language • Lack of varied, make-believe play or social imitative play.

  43. Autism – stereotyped behaviors Q. DSM expects at least one of four stereotyped behaviors. Name the four.

  44. Autism – stereotyped behavior Ans. 1] abnormal intensity or focus of interests. 2] inflexible adherence to rituals 3] repetitive motor mannerisms 4] overly persistent preoccupation with parts of objects.

  45. Rett’s Q. Rett’s has 8 requirements, 3 of which are “normal.” List the 8.

  46. Rett’s – ans. - 1 Ans. • Normal prenatal and perinatal development. • Normal psychomotor for first 5 months. • Normal head circumference at birth. • Deceleration of head growth between 5 months and 48 months. • See next slide

  47. Rett’s – ans. - 2 5] loss of previous hand skills, replaced with stereotyped hand movements between 5 and 30 months. 6] loss of social engagement 7] poorly coordinated gait 8] impaired expressive and receptive language.

  48. Rett’s - gender Q. Gender breakdown with Rett’s?

  49. Rett’s - gender Ans. Only females.

  50. Childhood Disintegrative Disorder Q. List the four general requirements of childhood disintegrative disorder.

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