Child Abuse
Who are the most common perpetrators for sexual abuse?
Sexual abuse=male and close access to child
Name the only non stimulant medication used as second line in the treatment of ADHD.
Atomoxetine (Strattera)
What is the minimum duration depression symptoms must be present to meet the diagnostic criteria for major depressive disorder?
2 weeks
This disorder is characterized by re-experiencing a traumatic event
Post traumatic stress disorder
An episode that is characterized by impending doom in the absence of danger.
Panic attack
Who are the most common perpetrators in physical abuse?
Physical abuse=mother
Father or boyfriend more violent
This disorder is characterized by uneasiness, excessive rumination(fixation and thinking) and apprehension about the future
Anxiety disorder
What is the most common method of suicide in pediatric population?
Firearms
Name the disorder in which patients have a valid or irrational concern about a parent and wish to maintain close proximity with the caregiver.
Separation Anxiety Disorder
Diagnosis requires at least 1 month of persistent worrying about having another panic attack and the presence of recurrent, unexpected panic attacks.
Panic disorder
What genitourinary symptoms might support sexual abuse?
Unexplained vaginal or penile injury, STI, pregnancy
This disorder is characterized by a persistent pattern with defiance and violation of the rights of others.
Conduct disorder
What symptoms must a patient have to be diagnosed with major depressive disorder?
Either depressed mood or/and lost on interest or pleasure in nearly all activities
What is the timeframe that separates acute stress disorder from PTSD?
Acute stress disorder is present immediately after trauma up to 1 month.
PTSD after 1 month, symptoms usually begin within 3 months of the trauma
Term used for avoidance due to anxiety/fear of situations where escape is difficult or would draw unwanted attention to the person.
Agoraphobia
What physical exam findings would be seen in a child who has been sexually abused?
Most will have normal GU exams. 72 hour window
3yo raised in multiple foster homes, minimally smiles, does not seek comfort, has hard time with emotions people are showing to them.
A.) reactive attachment disorder
B.) social anxiety disorder
C.) generalized anxiety disorder
D.) no pathological diagnosis
A.) What is reactive attachment disorder
Reactive attachment disorder is a consistent pattern of inhibited, emotionally withdrawn behavior towards adult caregivers, manifested by both of the following, child rarely or minimally seeks comfort when distressed, child rarely or minimally responds to comfort when distressed
Conduct disorder has a high incidence of developing what type of personality disorder in adulthood?
Anti-social personality disorder
Patient will present with angry or irritable mood, argumentative behavior and vindictiveness for at least 6 months, but no legal issues.
Oppositional Defiant Disorder
Generalized anxiety disorder is characterized by out of proportion worry and anxiety which must be present for how long?
6 months
In patients who present with suspicious injuries of physical abuse what additional radiographic testing is recommended?
Skeletal survey
What specific SSRI has been shown to reduce binge-purge cycle?
Fluoxetine (prozac)
What 4 main areas are present in a patient suspected of conduct disorder?
Serious violations of law, aggressive/cruel to animals, deceitfulness, destruction of property.
This disorder is characterized by an identifiable stressor(loss of relationship, job, etc.) and is the most common depressive disorder in children and adolescents.
Adjustment Disorder
List two FDA approved SSRIs used for the treatment of anxiety disorders
Fluoxetine (prozac) Sertraline (Zoloft) fluvoxamine (Luvox)