ADHD

Question 1

What is ADHD?

Answer 1

Attention deficit and hyperactivity disorder, neurodevelopmental condition
characterized by symptoms of inattention, hyperactivity, and impulsivity.
Direct negative impact on academic, social or occupational functioning
Outside expected for age and intellect

Question 2

What neurotransmitters are altered levels in the pathophysiology of ADHD?

Answer 2

Dopamine and noradrenaline

Reduced neurotransmission - secretion, binding to receptors or inc reuptake

These neurotransmitters are crucial for attention and impulse control.

Question 3

Which brain regions are involved in ADHD?

Answer 3

• Prefrontal cortex
• Basal ganglia - short circuit
• Corpus callosum
• Cerebellum
  *Limbic system
  May be structural or communication between these areas

Changes in these areas affect cognitive functions and behavior.

Question 4

What are the classifications of ADHD?

Answer 4

• Predominantly inattentive
• Predominantly hyperactive-impulsive
• Combined

Based on predminant symptoms over the last 6 months

Question 5

What is the heritability percentage for ADHD?

Answer 5

70-80%

This indicates a strong genetic component in the disorder.

Question 6

What are some environmental risk factors for ADHD?

Answer 6

• Prenatal tobacco, alcohol, or drug exposure
• Premature birth and low birth weight
• Early childhood exposure to toxins

Question 7

In terms of epidemiology, how much more common is ADHD in boys compared to girls?

Answer 7

3:1

Question 8

What percentage of UK adults are estimated to have ADHD?

Answer 8

4%

This statistic reflects the adult prevalence of the disorder.

Question 9

What socioeconomic factors are associated with ADHD?

Answer 9

• Poverty
• Lower family income
• Social class
• family environment encourages behaviour

Question 10

At what age do symptoms of ADHD typically appear?

Answer 10

Between age 3 and 7 years
Diagnosis often occurs after age 7

.

Question 11

What are the classic signs of hyperactivity in ADHD?

Answer 11

• Constant motion
• Fidgeting
• Excessive talking or moving

Question 12

What is a common symptom of impulsive behavior in ADHD?

Answer 12

Interrupting conversations
Risk taking behaviour
Social difficulties
Classroom disruption

Question 13

What symptoms characterize inattentiveness in ADHD?

Answer 13

• Lack of attention during tasks
• Not listening when spoken to directly
• Losing items
• Trouble organizing activities
• Avoiding tasks requiring mental effort (homework and school work)

Question 14

How does ADHD change during adolescence?

Answer 14

Hyperactivity decreases; attention and impulse worsen - leading to risk taking behaviour

.

Question 15

What challenges do adults with ADHD typically face?

Answer 15

• Time management
• Goal setting
• Employment
• Relationships

These challenges can significantly impact daily life.

Question 16

For how long must ADHD symptoms be present to consider a diagnosis?

Answer 16

At least 6 months in two different environments

Question 17

What does a comprehensive assessment for ADHD include?

Answer 17

• Developmental history
• School performance
• Behavior in different settings
• Exclusion of differentials

A thorough evaluation is essential for accurate diagnosis.

Question 18

What is a non-pharmacological treatment for ADHD in children under 6 years?

Answer 18

Parent-training programmes
School based intervention - education or behavioural.

Question 19

What is the first-line medication for ADHD?

Answer 19

Methylphenidate (Ritalin)

Question 20

What are common side effects of Methylphenidate?

Answer 20

• Aggression
• Alopecia
• Anxiety
• Appetite depression
• Arrhythmias
• Arthralgia

Monitoring for side effects is important during treatment.

Question 21

What are the second-line medications for ADHD?

Answer 21

• Dexamfetamine
• Atomoxetine

These may be used if first-line medications are ineffective.

Question 22

What is the first-line medication for adults with ADHD?

Answer 22

• Lisdexamfetamine
• Atomoxetine

These medications can help manage symptoms in adults.

Question 23

What co-morbidities are commonly associated with ADHD?

Answer 23

• Learning disabilities
• Anxiety
• Forensic history
• Depression
• Substance abuse

Question 24

How does methylphenidate work to treat ADHD?

Answer 24

• CNS stimulant medication
• Inhibition of reuptake of dopamine and norepinephrine
• increase dopamine and norephineprhine in synpatic cleft – inc activity at synapse ->
• prefrontal cortex (attention and executive function)

Question 25

What biological factors can be risk factors for ADHD?

Answer 25

Epilepsy Acquired brain injury Lead exposure Iron deficiency Child health conditions (head injuries)

Question 26

What is the typical process in the diagnosis of ADHD?

Answer 26

Must be over 5yrs Intial 10w watch and wait ADHD focused parent training or educational programme NDA following DSM-5 scale Neurodevelopmental panel for clinical formulation and diagnosis.

Question 27

What are the common side effects of ADHD medication?

Answer 27

Headaches Increase in HR and BP Irritability Trouble sleeping Loss of appetite Nausea Dizziness Suicidal thoughts (atomoxetine) Liver damage (atomoxetine)

Question 28

What therapy may be used to treat ADHD?

Answer 28

Psychotherapy Behavioural therapy - management stratergies for behaviour Social skills training - role plays scenarios to help learn skills CBT - talking therapies help patients manage problems by changing approach Diet - healthy and balanced, may suggest omega3/6