Clin Med Pediatric MH and Sleep Disorders

A child with suspected ADHD is undergoing initial evaluation. Which assessment strategy would be MOST effective in differentiating ADHD from a primary language disorder or learning disability?

Which of the following accurately describes the FIRST-LINE pharmacological treatment for ADHD, and its primary mechanism of action?

What is the MOST important element of behavioral management for a child diagnosed with ADHD?

When initiating stimulant medication for a child with ADHD, what is the PRIMARY mechanism of action that leads to improved attention and decreased hyperactivity?

Why is it important to recognize ADHD as a chronic condition?

Which of the following statements BEST reflects the clinical application of clonidine and guanfacine in treating ADHD?

A 6-year-old child is newly diagnosed with ADHD. According to the guidelines, what is the MOST appropriate initial treatment approach?

Which statement BEST encapsulates the interconnectedness of professionals in managing pediatric ADHD?

Which of the following BEST describes how anxiety may manifest in children, beyond just fear or worry?

A child excessively worries about separating from their parents. The anxiety is beyond what is normally expected at the child’s age, and it interferes with the child's daily activities. What is MOST likely the specific anxiety disorder?

A 14-year-old consistently avoids social situations due to intense fear of being negatively evaluated by others. This avoidance significantly impairs their ability to form friendships and participate in school activities. Which condition BEST aligns with this presentation?

Prior to diagnosing a patient with an anxiety disorder, it is essential to rule out other medical conditions. Which of the following could potentially mimic anxiety symptoms in children and adolescents?

A child presents with repeated episodes of sudden, unexpected, intense fear accompanied by symptoms such as heart pounding, difficulty breathing, dizziness, and sweating. After several such episodes, they begin to fear having these attacks in public. Which anxiety disorder is MOST consistent with these symptoms?

Which of the following biological factors is least likely to be directly implicated in the etiology of ADHD?

A child presenting with severe, persistent irritability and frequent temper outbursts that occur, on average, three or more times per week would most likely be evaluated for which condition?

When initiating SSRI treatment for a child with an anxiety disorder, what is the most critical consideration to discuss with the family regarding potential adverse effects?

A 16-year-old presents with symptoms of low mood, anhedonia, and changes in sleep and appetite for the past three weeks. Initial screening indicates possible depression. What is the most important next step in their assessment?

A 7-year-old child is brought in for evaluation due to frequent episodes of loss of consciousness, often preceded by crying, that resolve spontaneously within one minute. There are no postictal symptoms. How can a breath-holding spell be differentiated from a seizure?

Which factor most strongly suggests the need to evaluate for bipolar disorder rather than unipolar depression in an adolescent presenting with depressive symptoms?

What is the most appropriate initial step in managing a child diagnosed with Obsessive-Compulsive Disorder (OCD)?

A 3-year-old child exhibits deficits in social communication and interaction, along with restricted, repetitive patterns of behavior; however, the symptoms are only recognized recently due to increased social expectations at preschool. How does this impact the diagnostic process for Autism Spectrum Disorder (ASD)?

A 16-year-old presents with a first-time manic episode. Considering the guidelines for initial therapy, which medication would be the MOST appropriate FIRST choice?

When initiating treatment with a second-generation antipsychotic for a child, which of the following monitoring parameters is MOST critical to assess and follow up on due to increased risk?

A child with Bipolar Disorder is stable on medication, but continues to have difficulty with medication adherence and persistent depressive symptoms. Which of the following non-pharmacological interventions would be MOST beneficial?

A 7-year-old is brought in by his parents due to repetitive hand-washing rituals that interfere with schoolwork and daily activities. Which neurotransmitter system is MOST implicated in the pathophysiology of this child's likely condition?

Which of the following neurological findings is most closely associated with the pathophysiology of Obsessive-Compulsive Disorder (OCD)?

A 9-year-old patient presents with excessive hand washing, ordering rituals, and recurrent intrusive thoughts about contamination. These behaviors are significantly impacting their daily life and causing distress. According to the information provided which is the most likely risk factor?

A prescriber is considering lithium for a 14-year-old with Bipolar Disorder. Besides baseline kidney and thyroid function tests, what other screening measure is essential before initiating treatment?

Which of the following clinical features would best differentiate Obsessive-Compulsive Disorder (OCD) from Obsessive-Compulsive Personality Disorder (OCPD)?

A 10-year-old patient displays signs and symptoms indicative of OCD. Based on the content provided what would be the best first-line approach to management?

A clinician is evaluating a child with suspected OCD. The child presents with intrusive thoughts and compulsive behaviors. According to the provided text, what is the typical age of diagnosis for OCD?

Which of the following physical exam findings would be most consistent with a diagnosis of OCD in a pediatric patient?

You are asked to assess a 16-year-old male referred for suspected OCD. He describes intrusive thoughts but denies any repetitive behaviors. What is the most important next step in your assessment to differentiate OCD from other conditions?

What is the strongest piece of evidence indicating a genetic component to OCD?

A 15-year-old patient presents with moderate to severe depression. Initial treatment approaches should prioritize which of the following?

According to guidelines for antidepressant use in children and adolescents, what is the recommended minimum duration of treatment following remission of symptoms?

Which of the following side effects of SSRIs requires vigilant monitoring, particularly in the initial 1-4 weeks of treatment for a child?

A child on an SSRI develops disinhibition, impulsivity, and marked irritability soon after starting the medication. Which of the following is the MOST appropriate initial step?

To align with DSM-5 updates regarding bipolar disorders, which presentation would most accurately fit a diagnosis of Bipolar I disorder?

Which factor presents the greatest increase in risk for a child developing bipolar disorder?

Which of the following strategies is MOST important in the long-term management of bipolar disorder in adolescents?

What is the primary goal of maintenance therapy in managing bipolar disorder?

Why is lithium commonly favored in the acute treatment of manic episodes and as maintenance therapy in children and adolescents with bipolar disorder?

When would valproate be considered in children and adolescents with bipolar disorder?

Which of the following are symptoms of ADHD? (Select all that apply)

What is the time criteria for diagnosing ADHD?

Which of the following are considered first-line agents for the treatment of ADHD?

What are the most common side effects of Methylphenidate and Amphetamine used for the management of ADHD? (Select all that apply)

What alternative medications are better for inattention in ADHD? (Select all that apply)

Selective mutism is defined as?

Agoraphobia is defined as?

Which of the following are key symptoms of depression in pediatrics? (Select all that apply)

Major Depressive Disorder must include which of the following symptoms?

What is a classic symptom in children with Bipolar I disorder?

What is PANDAS?

Autism Spectrum Disorder has lifelong impairments in?

At what age does the American Academy of Pediatrics (AAP) recommend screening for Autism?

Disruptive, Impulse-Control, and Conduct disorders are defined as which of the following?

Oppositional defiant disorder is defined as?

What is a key difference between Oppositional Defiant Disorder and Conduct Disorder?

Breath holding spells have an overlap with which of the following conditions?

A researcher is studying the effects of aging on sleep architecture. Which of the following changes in sleep cycles is MOST characteristic of older adults compared to younger adults?

A patient reports vivid dreams and muscle paralysis during sleep. Which of the following physiological changes is MOST characteristic of the sleep stage associated with these phenomena?

A patient is being evaluated for excessive daytime sleepiness. Polysomnography reveals a short REM sleep latency (less than 15 minutes) and cataplexy. These findings MOST strongly suggest which diagnosis?

A patient with a history of alcohol dependence reports persistent insomnia despite achieving sobriety. Which of the following mechanisms BEST explains the relationship between chronic alcohol use and sleep disturbance?

Which scenario is MOST indicative of needing a referral to a sleep specialist?

A patient reports consistent difficulty falling asleep, often spending over 30 minutes trying to do so, and frequently wakes up during the night, with these issues occurring at least three times a week for the past four months. They deny any daytime impairment or distress related to their sleep. According to DSM-V criteria, what is the MOST appropriate diagnosis?

A patient with chronic insomnia has tried sleep hygiene techniques without success. Considering pharmacological options, which factor is MOST important when choosing between a benzodiazepine like lorazepam and a nonbenzodiazepine hypnotic sedative like zolpidem?

A patient consistently feels excessively sleepy during the day despite adequate nighttime sleep. Initial evaluation reveals no evidence of sleep apnea, narcolepsy, or medication-induced drowsiness. What is the MOST crucial next step in evaluating this patient's hypersomnia?

A patient reports excessive daytime sleepiness. The patient denies any feelings of depression or other psychiatric conditions. He has a BMI of 40, snores loudly at night, and often wakes up gasping for air. Which of the following should be prioritized?

A patient reports taking diphenhydramine (Benadryl) nightly for chronic insomnia. What is the MOST important consideration when counseling the patient on the long-term use of this medication?

A 10-year-old child is brought to the clinic with complaints of frequent, vivid, and disturbing dreams that cause significant distress. The child is fully alert upon awakening and remembers the dreams in detail. The episodes occur mainly in the later part of the night. Which of the following is the MOST likely diagnosis?

A 6-year-old child is referred for evaluation of suspected sleep terrors. The parents report episodes of screaming and apparent fear during sleep, but the child is unresponsive during these events and has no memory of them the next morning. The episodes occur in first third of the night. Which of the following management strategies should be initially recommended?

An adolescent is suspected of having excessive daytime sleepiness. The provider orders a polysomnography followed by a multiple sleep latency test. What is the PRIMARY purpose of the multiple sleep latency test?

A 14-year-old patient has been taking a sedative-hypnotic medication almost daily for the past 45 days to manage chronic insomnia. What is the MOST appropriate next step in managing this patient's sleep issues?

A 50-year-old patient presents with a history notable for excessive daytime sleepiness and cataplexy. After a polysomnogram and MSLT study, the patient is diagnosed with Narcolepsy. What would be the next step in management?

A 17-year-old male reports excessive daytime sleepiness, and is suspected of having narcolepsy. Which of the following historical details would MOST strongly suggest a diagnosis of narcolepsy TYPE 1?

You are evaluating a 22-year-old patient for possible narcolepsy. After obtaining a thorough history, which diagnostic test would be MOST helpful in differentiating between narcolepsy type 1 and type 2?

A 10-year-old child is experiencing sleep terrors. How would you counsel the parents on differentiating them from nightmares?

When evaluating a 13-year-old patient for excessive daytime sleepiness, what aspect of their medical history would most warrant further investigation to rule out secondary causes of hypersomnia?

What is the most appropriate initial recommendation to parents of a 7-year-old child experiencing frequent episodes of sleepwalking?

A college student with narcolepsy is concerned about the potential for tolerance and dependence with stimulant medications. What is an appropriate recommendation?

A 25-year-old patient with a history of PTSD presents with frequent nightmares. What pharmacological intervention is MOST specifically indicated for nightmare reduction related to PTSD?

Which aspect of sleep is most likely to be disrupted in a patient with a history of chronic alcohol abuse?

The intricate orchestration of sleep transitions relies on the communication between various brain regions. If the brainstem's capacity to modulate arousal and sleep cycles were selectively impaired, while the suprachiasmatic nucleus (SCN) remained fully functional, which of the following clinical manifestations would MOST likely emerge?

During polysomnography, a patient exhibits physiological characteristics including decreased heart rate and blood pressure, slowed respiration, and reduced muscle tone. EEG analysis reveals delta wave predominance. Which stage of sleep is the patient MOST likely experiencing, and what is its primary physiological significance?

A researcher is investigating the role of different sleep stages in cognitive function. To isolate the impact of REM sleep on memory consolidation, which experimental paradigm would be the MOST appropriate, considering the unique neurophysiological properties of REM sleep?

An 80-year-old individual reports increased daytime sleepiness despite maintaining a consistent bedtime. Considering the age-related changes in sleep architecture, which alteration in their sleep cycle is the MOST probable contributing factor to this complaint?

During a sleep history assessment for a patient presenting with chronic insomnia, which aspect of social history would be MOST critical to explore to identify potentially modifiable contributing factors?

The Epworth Sleepiness Scale (ESS) is administered to a patient who scores a 15. While this score indicates excessive daytime sleepiness, what is the MOST significant limitation of relying solely on the ESS for diagnosing a sleep-wake disorder?

A patient reports persistent difficulty initiating and maintaining sleep, causing significant daytime impairment. In contrast, another patient describes excessive daytime sleepiness despite prolonged nighttime sleep. How do these presentations DISTINCTIVELY align with DSM-5 classifications of sleep-wake disorders?

Night terrors, sleepwalking, and confusional arousals are classified under which broad category of sleep-wake disorders in the DSM-5, and what is the key distinguishing feature of these disorders?

A patient with a known history of bipolar disorder presents with worsening insomnia during a depressive episode. How should a clinician MOST appropriately interpret and manage this patient's sleep disturbance in the context of their psychiatric comorbidity?

Gamma-aminobutyric acid (GABA) is a critical neurotransmitter in sleep regulation. Considering its role, which pharmacological strategy would be MOST consistent with the neurochemical mechanisms promoting sleep onset and maintenance?

REM sleep is important for which of the following?

Parasomnia is defined as?

Which of the following medications are melatonin receptor agonists?

Hypersomnia is defined as?

Narcolepsy is defined as?

Cataplexy is defined as:

Low levels of which neurotransmitter indicate narcolepsy?

What is the main difference between Type 1 and Type 2 Narcolepsy?

Which of the following medications are commonly used for the treatment of narcolepsy? (Select all that apply)

Which of the following are considered non-REM parasomnias? (Select all that apply)

What are nightmares defined as?

Nightmare disorder occurs during what part of the sleep cycle?

ADHD as a Chronic Condition

Behavioral Management in ADHD

Optimal Educational Settings for ADHD

How Stimulant Meds Work (ADHD)

Speed of Stimulants

Clonidine/Guanfacine for ADHD

Non-Pharmacologic ADHD Treatment

Pediatric Anxiety

Separation Anxiety

Selective Mutism

Panic Disorder

Social Anxiety

Generalized Anxiety

Aripiprazole, Quetiapine, Risperidone, Lurasidone

Lithium Toxicity - Monitoring

2nd Gen Antipsychotics - Side Effects

Valproate - Monitoring

Obsessions (OCD)

Pediatric Depression

Depression Symptoms

Screening Tools (Anxiety)

Anxiety Medication

Complicated Anxiety Treatment

Refractory Anxiety

Depressive Disorders (DSM-5)

Depression - Diagnosis

Mild Depression Treatment

Moderate-Severe Depression Treatment

Pharmacologic Treatment - Depression

Duration of Treatment - Depression

SSRI Side Effects

Bipolar I Disorder

Bipolar II Disorder

Cyclothymic Disorder

Bipolar Disorder - medications

Goals of Bipolar Disorder Treatment

OCD Obsessions

OCD Compulsions

OCD Comorbidities

OCD Risk Factors

OCD Onset

OCD Physical Exam Findings

OCD vs. Psychotic Disorders

OCD vs. OCPD

Insomnia Definition

Hypersomnia Definition

Narcolepsy Definition

Parasomnias Definition

Sleep Laboratory Function

Insomnia

Insomnia Treatment

Hypersomnia

Hypersomnia Management

Insomnia Medications

Hypothalamus Role in Sleep

Suprachiasmatic Nucleus (SCN)

Brainstem & Sleep

GABA and Sleep

NREM Sleep

REM Sleep

Sleep Log

Epworth Sleepiness Scale

Nightmare Disorder

Management of Sleepwalking/Terrrors

REM Sleep Behavior Disorder Treatment

When to Refer to Sleep Medicine

Polysomnography

Cataplexy

Sleep Paralysis

Hypnagogic/Hypnopompic Hallucinations

Hypocretin (Orexin) Deficiency

Narcolepsy: Non-Pharm Management

Parasomnias: Overview

NREM Sleep Arousal Disorders