Attention-deficit hyperactivity disorder — viva

Stem

Examiner-led viva on paediatric ADHD. [1]

Examiner: How do you open this “medication today” visit? [1]

Strong answer: I greet the child first, set a joint agenda, and reframe the request as a full multi-setting assessment: developmental history, function, mimics, comorbidity, school information and shared decision-making — not a same-day label from one complaint. [1]

Examiner: What age-of-onset number do you use? [1]

Strong answer: Onset of symptoms before age 12 in DSM-5-TR style criteria — not the old DSM-IV before-7 rule. [1]

Examiner: Sleep is 8 hours with screens. Why does that matter? [20]

Strong answer: School-age children often need roughly 9–12 hours’ sleep opportunity per AASM consensus. Short sleep is a reversible driver of ADHD-like behaviour and must be addressed before or alongside diagnostic labelling. [20]

Examiner: Diagnosis is confirmed moderate-severe combined ADHD. First-line plan? [1]

Strong answer: Psychoeducation, parent behavioural strategies and classroom supports plus carefully monitored stimulant medication for moderate-severe impairment, with growth, BP, HR, appetite, sleep, mood/tics and diversion review. [1] [3] [15]

Examiner: What did MTA show at 14 months? [4]

Strong answer: Carefully managed medication management and combined medication-plus-behavioural treatment were superior to behavioural treatment alone and community care for core ADHD symptoms. [4]

Examiner: Parent fears stimulants cause later drug abuse. Your reply? [17]

Strong answer: Meta-analytic evidence does not support stimulant therapy causing later substance abuse; untreated ADHD raises substance-use risk, and diversion is managed with long-acting formulations and monitoring. [17]

Examiner: Why might you choose atomoxetine? [13]

Strong answer: Stimulant intolerance, contraindication, high diversion risk, or preference for non-controlled continuous coverage; counsel that benefit builds over weeks toward roughly 1.2 mg/kg/day frameworks. [13]

Examiner: Adolescent driving risk? [27]

Strong answer: Untreated ADHD associates with higher relative traffic accident risk; counsel distraction, impulsivity, sleep, substances and medication timing, and document advice. [27]