100+ Free ABPN CAP Practice Questions

Anxiety, OCD & Trauma

Pediatric GAD/separation anxiety/social anxiety, selective mutism, OCD (sertraline ≥6 yo, fluoxetine ≥7, fluvoxamine ≥8; ERP first-line), PANDAS/PANS (post-streptococcal abrupt onset, immunotherapy in PANDAS), pediatric PTSD (DSM-5-TR 6-and-under subtype; TF-CBT gold standard; prazosin for nightmares; NO FDA-approved SSRI in peds PTSD), acute stress disorder, adjustment, traumatic grief.

ADHD

DSM-5-TR (onset <12 yo, 2+ settings, ≥6 symptoms), AAP 2019 guideline (behavioral first <6 yo; stimulants + behavioral 6-12; stimulants + behavioral + school interventions 12-18). Stimulants — methylphenidate (Ritalin/Concerta) and amphetamine (Adderall/Vyvanse); diversion risk, appetite/sleep/tic/growth/CV effects, baseline CV screening. Non-stimulants — atomoxetine FDA ≥6, guanfacine ER 6-17, clonidine ER. Monitor height/weight q6mo, BP/HR. IEP vs 504.

Autism Spectrum & Neurodevelopmental

DSM-5-TR (social communication + RRB + early onset, severity levels 1-3 by support needs). Screening — M-CHAT-R/F at 18 and 24 months (AAP 2020). Gold-standard evaluation ADOS-2, parent ADI-R. Etiologic workup — chromosomal microarray first-tier (10-20% yield), fragile X FMR1 CGG >200, MECP2 girls with regression (Rett), PTEN if macrocephaly. FDA-approved risperidone and aripiprazole for irritability. EIBI/ABA, DIR Floortime, AAC, school IDEA Part B/C.

Mood Disorders

Pediatric MDD — fluoxetine FDA ≥8 yo; escitalopram ≥12; black-box suicidality <25; PHQ-A screening. DMDD (DSM-5 new diagnosis for chronic severe irritability — intended to curb pediatric bipolar overdiagnosis). Pediatric bipolar — manic criteria must be discrete episode; lithium FDA ≥12 for mania; risperidone/aripiprazole ≥10; quetiapine ≥10; olanzapine ≥13. Suicide risk (C-SSRS), means restriction (firearm locks, poison-control pill counts).

Development, Attachment & Temperament

Erikson psychosocial stages, Piaget cognitive stages (sensorimotor <2, preoperational 2-7, concrete 7-11, formal operations 12+), Bowlby/Ainsworth Strange Situation — secure, ambivalent/resistant, avoidant, disorganized. Thomas-Chess temperament (easy, difficult, slow-to-warm-up). Milestones — gross/fine motor, language (single words ~12 mo, 2-word combinations ~24 mo), social-emotional, red flags.

Disruptive, Conduct & Tic Disorders

ODD — parent management training (PCIT, Triple P, Incredible Years) first-line. Conduct disorder — multisystemic therapy (MST), functional family therapy. Tourette and tic disorders (DSM-5-TR motor + vocal tics >1 yr, onset <18) — CBIT first-line, alpha-agonists (clonidine, guanfacine), aripiprazole FDA, avoid haloperidol/pimozide due to TD risk. Comorbid ADHD and OCD in ~50%.

Eating & Elimination Disorders

Anorexia (restrictive, atypical; bradycardia, hypokalemia, refeeding syndrome — monitor phosphate and magnesium; olanzapine off-label; FBT-Maudsley family-based therapy first-line in adolescents; NO FDA-approved medication). Bulimia — fluoxetine 60 mg FDA. BED — lisdexamfetamine FDA. ARFID. Enuresis (DDAVP, bell-and-pad alarm first-line ≥7 yo). Encopresis (PEG osmotic laxative + scheduled toilet sitting).

Early-Onset Psychosis & Adolescent SUD

Early-onset schizophrenia (<18 yo) vs very early-onset (<13). First-episode psychosis — coordinated specialty care (CSC). Metabolic monitoring (BMI, waist circumference, HbA1c, lipids, BP) at baseline, 3 months, then annually. Clozapine in refractory illness — agranulocytosis, myocarditis, seizures. Adolescent SUD — CRAFFT ≥2 positive; MAT — buprenorphine FDA ≥16, naltrexone; vaping and cannabis use.

Abuse, Neglect & Forensic

Sentinel injuries (bruising in non-ambulatory infants, intraoral injuries), abusive head trauma. Mandated reporting — CAPTA federal framework plus state statutes; clinicians report reasonable suspicion with good-faith immunity and are NOT investigators. Child advocacy centers, NICHD forensic interviewing protocol (open-ended), CPS vs law enforcement roles, foster care and adoption mental health, ACEs (Adverse Childhood Experiences).

Suicide, Self-Harm & Emergencies

Adolescent suicide is the 2nd leading cause of death ages 10-24 per CDC. NSSI (nonsuicidal self-injury — DSM-5 condition for further study) differs from suicidal behavior. C-SSRS risk assessment, safety planning (NOT no-suicide contracts), means restriction counseling (firearms in locked safe with ammunition separate, medication locks). Agitation — verbal de-escalation first; IM olanzapine or ziprasidone; lorazepam; avoid restraints when possible.

Ethics, Legal & Systems of Care

Informed consent and assent — mature minor doctrine; state-variable minor consent for STI, contraception, SUD, and mental-health services. Confidentiality with adolescents (disclosed to parents EXCEPT SI/HI/abuse disclosures). Tarasoff duty to protect identifiable third parties. Mandated reporting. Custody evaluations. Gender-affirming care. School-based MH, pediatric collaborative care, transition to adult services, cultural humility, equity.

Assessment & Psychopharmacology Pearls

MSE in children, CBCL Child Behavior Checklist (parent/teacher/youth), K-SADS semistructured interview, Vanderbilt and Conners for ADHD, CGI. Clinical interviewing with parents AND child. FDA approvals peds vs off-label, CYP metabolism variability, weight-based dosing, metabolic monitoring of second-generation antipsychotics, QTc prolongation, growth effects of stimulants.