i human 6 Billy Johnson
CASE STUDY
PSY MISC i-human 6
Billy Johnson
, Billy Johnson
13 yo
“I hate school”
With his mother
Observations
● Fidgeting
● Warm, dry skin
Last Visit
One year ago, billy was seen for his well check. He was noted to be a little
hyperactive at times; his parents had recently divorced and he was a little
irritable and frustrated with having to go between his mother’s and father’s
house. Had difficulty following his coach’s directions. Father has a history of
cocaine abuse.
Differential Diagnosis
1. ADHD - Lead
2. Hyperthyroidism - MnM
a. TSH
3. Generalized anxiety disorder
4. Substance use disorder - MnM
a. Drug toxicology, urine
5. Depressive disorder - MnM
Plan
● Discuss medication as first line treatment
● Consider pretreatment ECG if there is a personal history of heart
disease, or a FH of unexplained syncope or sudden cardiac death
● Utilize Conners ratings scales, child behaviour checklist (CBCL), and
Vanderbilt ADHD scales at baseline for longitudinal monitoring of
treatment response at school.
● Monitor weight, blood pressure, and pulse over time
CASE STUDY
PSY MISC i-human 6
Billy Johnson
, Billy Johnson
13 yo
“I hate school”
With his mother
Observations
● Fidgeting
● Warm, dry skin
Last Visit
One year ago, billy was seen for his well check. He was noted to be a little
hyperactive at times; his parents had recently divorced and he was a little
irritable and frustrated with having to go between his mother’s and father’s
house. Had difficulty following his coach’s directions. Father has a history of
cocaine abuse.
Differential Diagnosis
1. ADHD - Lead
2. Hyperthyroidism - MnM
a. TSH
3. Generalized anxiety disorder
4. Substance use disorder - MnM
a. Drug toxicology, urine
5. Depressive disorder - MnM
Plan
● Discuss medication as first line treatment
● Consider pretreatment ECG if there is a personal history of heart
disease, or a FH of unexplained syncope or sudden cardiac death
● Utilize Conners ratings scales, child behaviour checklist (CBCL), and
Vanderbilt ADHD scales at baseline for longitudinal monitoring of
treatment response at school.
● Monitor weight, blood pressure, and pulse over time
