Question

CASE STUDY 46 ATTENTION DEFICIT/HYPERACTIVITY DISORDER For the Di S CD-ROM mary for this study PATIENT CASE Mother's Chief Complaints "Tm at the end of my rope and I don't know what to do anymore. My son won't behave orlis ten at school and he most certainly will not listen to me at home He always seems to be in motion and can't sit still for even 5 minutes. He likes watching cartoons on TV but gets bored with them in a matter of minutes. His first grade teacher tells me that he can't sit still at school that he is constantly squirming in his seal and that sometimes he will get up during the middle of a class and roam around the room looking at different thing. She has also told me that he is problematic when he has to wait for things that he wants like in the lunch line and he is always grabbing things away from other children. She is always reminding him not to interrupt when others are speaking and to wait until she finishes asking a ques rion before he begins his awe I have to do that too, at home HPI HISTORY OF THE PE NEN SP is a 6-year-old boy who presents to the pediatrie clinic with his mother, Ms. A.T. She states that her son has shown hyperactive and inattentive behaviors now for almost one year but everything seems to be getting wong Teachers complain that he does not listen to them, does not follow instructions like the other children, is easily bored during activities and has difficulty both waiting his turn and engaging in playground games for any signifi cant length of time. The boy's behavior has been so disruptive that no daycare centers will accept him. This is a major concern, because Ms. AT is a single parent and must work to support her child and herself PMH PAST MEDICAL HISTORY • Mother had taken her son to a pediatrician about 4 months ago and complained of simi- lar problems, but the pediatrician had dismissed her complaints by telling her that she needed to set mare boundaries for her child both at home and at school Pregnancy and delivery with SP were normal Vaccinations are current • No prior surgeries, serious medical problems, or established psychiatric illnesses 218

Answer 1

The patient vital signs Temperature ,pulse,respiratory,blood pressure are apparently normal.

The most important contributory risk factor in this child to develop ADHD is family history of maternal uncle diagnosed with hyperactivity syndrome during childhood.

In this child the Thyroid profile is normal. Thyroid stimulating hormone is 3.8 microgram and T4 values ranging from 6.8 micrograms.

The Complete blood count hemoglobin,hematocrit,platelet and WBC are with in normal limits.

Blood urea nitrogen and creatinine are considered as waste products excreted from kidneys. The normal BUN 7-20 mg/dl. In this scenario the BUN and creatinine are within normal limits.