Summary of Treatment Guidelines   for ADHD       AAP Treatment Recommendations Nov 2019         First-line    Second line    Preschool children (4-5 years)    Behaviour therapy    Methylphenidate        Methylphenidate, if no significant improvement and moderate-to- severe functional impairment    Elementary school (6–11 years)    Behaviour therapy or medication, preferably both .     Evidence      stimulants > atomoxetine > guanfacine ER > Clonidine ER    Summary, NICE Treatment Recommendations 2018        First-line    Second line    Children under 5 years    Discussion    Group parent-training program    (ADHD-Focused)    Medication     (Only a specialist can start)    Start medications only after seeking advice from ADHD specialist services    Children over 5 years    Discussion and ADHD-focused Support     Medication    Support     Offer a minimum of 1 or 2 sessions of support, can be    group-based        education on the causes and impact of ADHD    advice on parenting

Which childhood onset disorder is characterized by gaze avoidance?

Delirium Tremens Delirium Tremens is an emergent situation, that we may regard as the most severe form of alcohol withdrawal syndrome. In most cases, it occurs after long-term heavy use. It may also occur in patients who stop benzodiazepines.  In most cases, it occurs after long-term heavy use of alcohol.  Presentation Psychological and behavioural manifestations Rapidly changing picture Clouding of Consciousness Disorientation Disorganised mental activity Short term memory disturbance Perceptual abnormalities Hallucinations Visual misinterpretations Illusions Cocaine bugs (formication) Behavioural manifestations Agitation Shouting Restlessness Fear Sleeplessness  Physical Manifestations General Physical Dehydration Electrolyte disturbances Autonomic Manifestations Autonomic manifestations of delirium tremens differentiate it from delirium (acute confusional state) that occurs because of organic causes other than substance use and alcohol withdrawal.  Sweating  Fever tachycardia Raised

Mnemonic: Clinical Signs of Anorexia Nervosa BE WICKED Bradycardia  Emaciation  Weak proximal muscles Cold hands and feet Erosion of teeth Dry hand, dependent oedema Swelling of the parotid and submandibular glands, Skin discolouration