Child and Adolescent Psychiatry
1. A 14-year old boy appears in psychiatry OPD by his parents. The parents say that the boy is very aggressive to them and fights with others. He often lies, steals and stays out of at night without their permission. He does not do study and spends time with bad boys. They are struggling with the boy since his early childhood and the boy is now totally out of their control. Recently, he has been was suspended from the school for the charge of theft. The boy was fidgeting and inattentive.
a) Mention the areas of assessment with reasons. 5
b) Outline the management plan. 5
2. A 10-year old boy starts refusing to go school after summer vacation and only agree to go if his mother sits beside him in classroom. On forceful effort, the child resists entering school, cries and at time vomits. This happens in every subsequent failure effort.
a) What else are required to diagnose the case? 4
b) Outline the management plan. 6
3. A 9-year old boy becomes fearful and senseless after exposure to thunder 5 days back. Worried parents consult with a neurologist who refers the boy to psychiatry OPD. Parents say that similar event first happens 9 month back in face of thunder. Gradually the child fears of storm, cloud, loud sound, and noises and avoids such situations. Parents close doors and windows particularly during storm and thunder and give earplug to block the noise with the aim of reducing his fear. However, these efforts do not work and child is increasingly fearful and unwilling to go school though he is studious boy.
a) Explain the psychopathology of this case. 6
b) Outline the treatment plan. 4
4. A 14-year old girl has been brought by his parents to you with repeated wrist cutting and tempered behaviour.
a) Write down the basic steps to interview this girl. 5
b) Prepare a checklist of the assessment areas 5
5. A 12-year old boy attends in the psychiatry OPD with his parents. Parents say that the boy is very restless and inattentive in study. Teacher complains that he disturbs in class, does silly mistake and never finishes his task. The boy is fidgeting most of the time.
a) What will be most likely diagnosis? 4
b) List the information you need to be gathered. 6
6. A 34-year old boy who is a case of severe intellectual disability recently shows repetitive violent and asultative behaviour that the family members are terrified about possible harm to them.
a) What are the areas you need to assess? 5
b) Outline the management plan. 5
7. A 3-year old child is not talking and said to appear not to understand what his parents say.
a) Give outline of differential diagnosis you will consider 5
b) List the required examinations and investigations necessary to clarify the diagnosis. 5
8. A 10-year old boy refuses to go to school due to breathing difficulties and chest pain. His parents consult with several physicians including cardiologist but the problems remain. The child is clingy to his mother, increasingly fearful and feels better staying at home.
a) What information you will gather keeping in mind differential diagnoses? 4
b) What could be the psychopathology of her condition? 3
c) Outline the treatment plan. 3
9. A 14-year old girl presented by her mother who recently becomes unruly, irritable, impulsive, outgoing, inappropriate sexual behaviour. Mother reports that she is very quiet, polite and obedient girl but these changes happen last 3 months.
a) Outline the assessment plan for this case mentioning the assessment areas. 6
b) How will you manage this case? 4
10. A 15-year old girl appears to be marked irritable, lack of self-care, shows little interest in work. She also has menstrual dysregulation since 3 months. Recently, she stops going school and most of time lies in bed and doing nothing. Her mother has similar problems and is under treatment.
a) What could be best possible diagnosis? 4
b) Outline a comprehensive treatment plan. 6
11. A 12-year old girl appeared in psychiatry OPD with intense headache followed by repetitive fit 3 days back. Nothing abnormality was found in neurological assessment and investigations.
a) Make a checklist of assessment areas keeping in mind possible diagnosis. 6
b) Outline the treatment plan. 4