Attention and Hyperactivity Disorder

# 165

*! Baby, nine years old. Born on time, weighing 4500 gr. after stimulation, the first words appeared at three years old, phrasal speech at 4.5 years old. In 3,5 years there was a convulsive attack. In kindergarten he could not memorize poetry, for a long time did not distinguish colors, confused the count of fingers, was subjected to ridicule. I went to school from the age of seven, for a long time I could not master the score within 20, counted on the fingers, wrote letters crookedly. Remained in the second year. At the age of eight he read the primer, counted to one hundred, carried out simple arithmetic operations, and was "mechanically" transferred to the second class. At the time of examination - dysplastic, ears low set, large. Speech-language, concrete thinking, is difficult to generalize objects, does not understand the meaning of proverbs. Your diagnosis:

Oligophrenia in the degree of debility

# 166

*! The child is 12 years old. From the age of two, he was diagnosed with Childhood Autism. F 84.0 ”According to the mother’s words, the child has recently stopped playing his usual games, disturbed sleep, appetite, constipation. Previous activities that the child did with pleasure ceased to bring him joy.

Which group of drugs is most indicated in this case?

Antipsychotics (haloperidol), antidepressants

# 167

*! A 17-year-old student is saddened by the fact that his nose seems to him to be crooked, although others consider the nose to be normal. Dysmorphophobia syndrome does not occur in adolescents suffering

Oligophrenia

# 168

*! A boy, 14 years old, does not learn the school curriculum, especially in mathematics. Phrasal speech at four years old, in kindergarten was difficult to behave, breaking toys. She hardly reads in syllables, cannot solve simple problems, does not reveal the meaning of simple proverbs and sayings, graduated from only two classes of a comprehensive school, is slow. A history of birth injury. Your conclusion and your medical tactics:

Oligophrenia, Nootropil

# 169

*! A child of 5 years old twists his fingers, grimaces. In mental status - negativism, a pathological version of attachment to the mother. Weak need for communication, the presence of a number of motor stereotypes. Excited. It is aggressive towards the youngest child in the family. In the anamnesis - from the period of infancy, lack of reaction to discomfort, decreased instinctive activity, perversion of game activity, lack of a direct look and ignoring those present. Hygienic skills are not vaccinated.

Which group of drugs is most indicated in this case?

Diagnosis - early childhood schizophrenia (100%), treatment - antipsychotics, antipsychotics, correctors

# 170

*! The child is 13 years old. From early childhood, she was diagnosed with Childhood Autism. F 84.0 "According to the mother, the child has recently changed. He began to behave noisily, he could not sit still in one place, he began to do one thing, but without finishing it, he took up another thing. He began to sleep and eat little, lost 2 kg. When viewed: speech is accelerated, vocabulary is scarce, movements are accelerated.

Which group of drugs is most indicated in this case?

Nootropics

# 171

*! Girl 12 years old. The first year of life, psychomotor development corresponded to age. Closer to one and a half years, acquired speech, motor and subject-role skills began to disappear. The movements became stereotyped, monotonous and inhibited, lost their purposeful character. She began to wring her hands, squeezes her fingers, rubs her hands. I began to plunge into myself often. Unnatural laughter quickly gives way to a wild squeal. It cannot move independently. There is scoliosis. In the last six months, generalized convulsions with loss of consciousness have been noted.

Which group of drugs is MOST shown in this case?

Diagnosis - Rett syndrome (100%), treatment - m. anticonvulsants

# 172

*! Boy, 3 years. From the anamnesis it is known: pregnancy and childbirth in the mother proceeded without features. By two months, a “revitalization complex” appeared: he watched his parents, began to actively move his arms and legs, walk, smile. Crawled for a long time, began to walk in one year. Further development without features. It is known that the father of the child began to talk late. At 3 years old, the child began to attend kindergarten. After some time, the psychologist advised the parents to see a doctor, in connection with a delay in the development of speech. The child understood the speech addressed to him, carried out all the instructions, but could not say what he wanted to take, he pointed with his finger at the desired subject, the vocabulary was low, he did not always choose the right words, and he maintained contact with his eyes.

What is the primary prevention of this disorder?

Nootropics?

# 173

*! Girl, 2 years. From the anamnesis it is known: pregnancy and childbirth in the mother proceeded without features. Early development took place according to age. The patient’s uncle is registered with a neurologist about a convulsive syndrome. The doctor was contacted due to the fact that the child cannot point to familiar household items when they are called, does not understand simple instructions. He plays with peers, can engage in role-playing games and use gesture speech to a limited extent. Strangers think that the girl does not hear, but she adequately responds to auditory stimuli, except speech.

What non-drug treatment can be with this disorder?

Children's psychiatrist, psychologist, neurologist, speech therapist

# 174

*! Boy, 3 years old. The mother of the child complains that the child does not have a formed speech, often there are outbreaks of aggression, as well as auto-aggression. From the anamnesis it is known: the pregnancy in the mother proceeded against the background of severe toxicosis, there was a threat of termination of pregnancy, the mother was in the last weeks of pregnancy. The child was born on time, full-term, there was a single entanglement of the umbilical cord. In early development, a lag in psychophysical development was noted. On examination, it is noted: the lack of eye contact does not respond to the addressed speech, grabs the mother by the hand and directs her to the desired object, swings the torso. According to the mother, it is known that she does not communicate with other children, she can play with objects that are not intended for games in debt.

Which group of drugs is MOST shown in this case?

Sedatives, antipsychotics?

# 175

*! Boy, 3 years old. The mother of the child complains that the child does not have a formed speech, often there are outbreaks of aggression, as well as auto-aggression. From the anamnesis it is known: the pregnancy in the mother proceeded against the background of severe toxicosis, there was a threat of abortion, the mother was in the last weeks of pregnancy. The child was born on time, full-term, there was a single entanglement of the umbilical cord. In early development, a lag in psychophysical development was noted. On examination, it is noted: the lack of eye contact does not respond to the addressed speech, grabs the mother by the hand and directs her to the desired object, swings the torso. According to the mother, it is known that she does not communicate with other children, she can play with objects that are not intended for games in debt.

What is the tertiary prevention of this disorder?

Consultation of a psychiatrist, psychologist?

# 176

*! Patient, eleven years old. Father drank, abandoned the family. In the family - stepfather and sister five years from the second marriage. Studying in the third grade at "4" and "5". Grew up difficult, stubborn and capricious, prone to lies. From the age of seven, she began to lie more, leave home, met teenagers older than herself, carried away small things, and then money. At school, she furtively took pens and pencils from others, and once she was caught stealing money from a teacher’s bag. Conflicted with her grandmother, she was jealous of her sister to her mother, hostile to her stepfather. Once she stated that she had been raped by teenagers, that her uncle was in love with her. I cut my sister’s new things to pieces, took them from home and spent 5000 rubles. At the time of inspection - it looks infantile. Cries, denies everything. At repeated examinations gives conflicting answers. Which specialist should the child be referred to?

Diagnosis - pathological personality development (100%), psychiatrist?

# 177

*! Boy, 9 years old. From the anamnesis it is known: pregnancy and childbirth in the mother proceeded without features. Early development took place according to age. He attended kindergarten. I went to school from the age of 7. First grade graduated excellent. By nature, sociable, kind. The condition has changed 6 months ago. The patient began to experience difficulties in speech: he did not understand the speech addressed to him, and also could not say what he needed. In this connection, he stopped attending school. At home, he communicates with gestures with relatives. Also, for 6 months, the patient had two generalized epileptic seizures. Behavioral disorders appeared: increased motor activity, decreased concentration, aggressiveness and fits of rage. On the EEG, continuous bilateral epileptic discharges in the temporal regions are detected, there are no other neurological disorders. Hearing without abnormalities.

What group of drugs is indicated for the treatment of this disorder?

Antiepileptic therapy

# 178

*! Mom with a child 3 years old, went to a general practitioner. According to the mother, the child has a poor appetite, sits poorly, walks poorly, doesn’t ask for a pot, there is practically no play activity, he lags behind peers in physical development When interacting with parents and older children in the family, he does not show positive emotions. What disorder is MOST characteristic of this symptom?