Hypertension in Children Flashcards
1
Q
Secondary hypertension is the most common cause in children. What is the most common cause of secondary hypertension in children?
A
Renal parenchymal disease (80%)
2
Q
What are some causes of hypertension in children?
A
- Renal parenchymal disease
- Renal vascular disease
- Coarctation of the aorta
- Phaeochromocytoma
- Congenital adrenal hyperplasia
- Essential or primary hypertension (becomes more common as children become older)
3
Q
What is the correct cuff size in children?
A
2/3 the length of the upper arm
4
Q
What are some symptoms of aortic coarctation?
A
- Lower limb claudication
- Cardiomegaly
- Headache
- Radiofemoral delay
5
Q
If a blood pressure reading is high, what should you offer?
A
A 24 hr BP monitor.
6
Q
What tests should be done in a child with hypertension?
A
-
Urine - blood and ACR.
- Blood is more serious than protein. (Blood is a bigger molecule than protein)
- Renal USS - looking for renal artery stenosis, scarring, renal parenchymal disease (Can also look at the adrenals for CAH and phaeochromocytoma)
- Bloods - U&Es, early morning renin-aldosterone (Conn’s), early morning cortisol (Cushing’s)
- ECG - QT interval > 460ms=abnormal.
- Cardiac Screening - HOCM.
7
Q
The younger the child…..
A
The great the chance that the cause of the hypertension will be from the kidneys.
8
Q
How do you treat it?
A
As per NICE guidelines in adults.
But as a GP you will refer to the paediatrician for investigations & treatment.
