Lillian is a 9-year-old who presents with her mother after a referral from the
pediatrician. Lillian is 54 inches tall and currently weighs 55 pounds (lbs). As a toddler,
Lillian ate most of the foods offered to her. When she was 6, she witnessed her
grandmother choke on a piece of meat and receive the Heimlich maneuver; her
grandmother survived, but since then, Lillian refused to eat meat. Over the past three
years, her eating has become more restricted; she will no longer eat anything that
requires chewing. Her mother has been offering soups, purees, and nutritional
supplements, but Lillian has failed to gain weight as she grows taller. Lillian endorses
that she is frequently bullied at school for her refusal to eat at lunch and during
classroom parties.
Does Lillian meet the diagnostic criteria for ARFID?
yes
no
unable to determine
Give this one a try later!
, Yes
Rationale: Lillian meets the diagnostic criteria for ARFID. She presents with
avoidance of eating food based on the sensory characteristics of the food
and failure to meet expected weight gain appropriate for age and height.
The behavior interferes with her psychosocial functioning and is not better
explained by cultural practice, lack of available food, or anorexia nervosa.
SOAR Online website
Give this one a try later!
training opportunities for professionals who care for clients who have
experienced trafficking
-equips professionals with skills to identify, treat, and respond
appropriately to human trafficking.
• Stop
• Observe
• Ask
• Respond
Consequences of prolonged grief:
Give this one a try later!
-increased substance use
-increased risk for cardiovascular disease
-increased risk of dropping out of school
DSM-5-TR trauma- and stressor-related diagnoses: Adjustment Disorder
,Give this one a try later!
-development of emotional or behavioral symptoms within 3 months of the
onset of a new stressor
-Symptoms cause significant impairment in social or occupational
functioning but do not persist past 6 months after the initial stressor has
resolved
-Persistent adjustment disorder may occur when stressors have no clear
resolution
• physical disability or living in a community with high crime rates
-classified using specifiers with:
• depressed mood
• anxiety
• mixed anxiety & depressed mood
• disturbance of conduct
• mixed disturbance of emotions & conduct
eating corn starch can cause _________
Give this one a try later!
iron deficiency anemia
-secondary to pica (eating corn starch)
SUD screening tools to use with adolescents 12-18 years
Give this one a try later!
-Screening to Brief Intervention (S2BI)
-Brief Screener for Tobacco, Alcohol, and other drugs (BSTAD)
, Tenzing is a 15-year-old who presents with restlessness, distractability, impulsive
behavior, and inattention at school. He sleeps very little most nights and is often
irritable. His parents describe him as "moody" and state that the smallest changes
cause his mood to shift. He has had these symptoms for a few years, but recently the
symptoms have gotten worse. The PMHNP diagnoses Tenzing with ADHD. Which of
the following is the most likely comorbid diagnosis for Tenzing?
bipolar disorder (BPD)
unipolar depression
generalized anxiety disorder
Give this one a try later!
bipolar disorder (BPD)
Rationale: After beginning medication for ADHD, Tenzing's remaining
symptoms are consistent with bipolar disorder. Although mood
dysregulation is common in clients with ADHD, mood changes are typically
situational. Bipolar disorder presents with more random and cyclical mood
changes. Both ADHD and BPD can present with irritability, sleep issues,
restlessness, and impulsive behavior.
Intermittent explosive disorder (IED)
Give this one a try later!
-low tolerance for frustration & adversity
-essential features: freq impulsive or angry outbursts, often include temper
tantrums, verbal assaults, or physical assaults towards others, animals, or
property
• unplanned
• rapid onset
• out of proportion to the trigger that elicited the response
• lasts no longer than 30 minutes
-Verbal outbursts: average of twice a week for three months
-behavioral outbursts or tantrums that involve the destruction of property
pediatrician. Lillian is 54 inches tall and currently weighs 55 pounds (lbs). As a toddler,
Lillian ate most of the foods offered to her. When she was 6, she witnessed her
grandmother choke on a piece of meat and receive the Heimlich maneuver; her
grandmother survived, but since then, Lillian refused to eat meat. Over the past three
years, her eating has become more restricted; she will no longer eat anything that
requires chewing. Her mother has been offering soups, purees, and nutritional
supplements, but Lillian has failed to gain weight as she grows taller. Lillian endorses
that she is frequently bullied at school for her refusal to eat at lunch and during
classroom parties.
Does Lillian meet the diagnostic criteria for ARFID?
yes
no
unable to determine
Give this one a try later!
, Yes
Rationale: Lillian meets the diagnostic criteria for ARFID. She presents with
avoidance of eating food based on the sensory characteristics of the food
and failure to meet expected weight gain appropriate for age and height.
The behavior interferes with her psychosocial functioning and is not better
explained by cultural practice, lack of available food, or anorexia nervosa.
SOAR Online website
Give this one a try later!
training opportunities for professionals who care for clients who have
experienced trafficking
-equips professionals with skills to identify, treat, and respond
appropriately to human trafficking.
• Stop
• Observe
• Ask
• Respond
Consequences of prolonged grief:
Give this one a try later!
-increased substance use
-increased risk for cardiovascular disease
-increased risk of dropping out of school
DSM-5-TR trauma- and stressor-related diagnoses: Adjustment Disorder
,Give this one a try later!
-development of emotional or behavioral symptoms within 3 months of the
onset of a new stressor
-Symptoms cause significant impairment in social or occupational
functioning but do not persist past 6 months after the initial stressor has
resolved
-Persistent adjustment disorder may occur when stressors have no clear
resolution
• physical disability or living in a community with high crime rates
-classified using specifiers with:
• depressed mood
• anxiety
• mixed anxiety & depressed mood
• disturbance of conduct
• mixed disturbance of emotions & conduct
eating corn starch can cause _________
Give this one a try later!
iron deficiency anemia
-secondary to pica (eating corn starch)
SUD screening tools to use with adolescents 12-18 years
Give this one a try later!
-Screening to Brief Intervention (S2BI)
-Brief Screener for Tobacco, Alcohol, and other drugs (BSTAD)
, Tenzing is a 15-year-old who presents with restlessness, distractability, impulsive
behavior, and inattention at school. He sleeps very little most nights and is often
irritable. His parents describe him as "moody" and state that the smallest changes
cause his mood to shift. He has had these symptoms for a few years, but recently the
symptoms have gotten worse. The PMHNP diagnoses Tenzing with ADHD. Which of
the following is the most likely comorbid diagnosis for Tenzing?
bipolar disorder (BPD)
unipolar depression
generalized anxiety disorder
Give this one a try later!
bipolar disorder (BPD)
Rationale: After beginning medication for ADHD, Tenzing's remaining
symptoms are consistent with bipolar disorder. Although mood
dysregulation is common in clients with ADHD, mood changes are typically
situational. Bipolar disorder presents with more random and cyclical mood
changes. Both ADHD and BPD can present with irritability, sleep issues,
restlessness, and impulsive behavior.
Intermittent explosive disorder (IED)
Give this one a try later!
-low tolerance for frustration & adversity
-essential features: freq impulsive or angry outbursts, often include temper
tantrums, verbal assaults, or physical assaults towards others, animals, or
property
• unplanned
• rapid onset
• out of proportion to the trigger that elicited the response
• lasts no longer than 30 minutes
-Verbal outbursts: average of twice a week for three months
-behavioral outbursts or tantrums that involve the destruction of property
