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Flashcards in Pediatrics: HTN Deck (58)
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1

When do you begin BP screening?

At 3 (when you stop measuring head size, start doing BP)

2

What is normal BP determined by?

Age and gender as compared to the nomogram determined by the national heart, lung, and blood institute (last updated in 1996)

3

What is blood pressure?

CO * PVR

4

What normal BP for peds?

Systolic and diastolic uner 90% for age, height, and gender

5

What is pre-HTN for peds?

Average systolic and/or average diastolic BP between 90-95 percentiles for age, height, and gender

6

What is HTN in peds?

Average systolic and/or diastolic BP greater than or equal to the 95th % for age, height, and gender with measurements on at least 3 separate occasions

7

What 4 things are required for HTN Dx?

1. Exclude errors of measurement
2. Ensure proper interpretation
3. In the same location
4. Consistent method

8

What is stage 1 HTN?

95-99% for age, hieght, and gender

9

What is stage 2 HTN?

Greater than 99% + 5mmHg for age, height, and gender

10

What are 4 errors of measurement?

1. Use of inappropriate cuff sizes
2. Poor auscultation technique
3. Use of unvalidated/uncalibrated monitorying device
4. Improper use of nomogram (harriet-Lane Handbook)

11

What are 4 errors in ensuring proper BP interpretation

1. Improper use of nomogram
2. Use of improper nomogram
3. Lack of use of nomogram
(Nomograms available in the Harriet Lane Handbook

12

What is the prevalence of pediatric HTN in the US?

Under 1%

13

What % of HTN children require medication?

Under 0.1%

14

What % of HTN children are symptomatic?

Less than 0.1%

15

In the US, what ethnic groups does pediatric HTN affect most?

1. Mexican American
2. Non-hispanic black children

16

What are 4 RF for pediatric HTN?

1. Ethnicity
2. Gender
3. Family history
4. BMI

17

What is the classification based on for peds HTN?

ETIOLOGY
1. Primary/essential
2. Seconday

18

What % of peds HTN is primary?

10%
(Primary is no identifiable cause...Dx of exclusion)

19

Is primary peds HTN familial?

YES

20

What is the most common cause of HTN in adolescence?

Primary

21

What % of peds HTN is secondary?

90%

22

What are the 2 most common reasons for secondary HTN (remember, secondary HTN has an identifiable cause)?

1. 70-80% renal
2. 10% cardiac and endocrine
-Meds

23

What are the possible etiologies for neonate HTN?

-Coarctation of the Aorta
-Renal Artery Thromboembolism
-Renal Artery Stenosis
-Congenital Renal Abnormalities
-Hyperthyroidism
-Neoplasia
-Iatrogenic
-CNS causes
-Bronchopulmonary Dysplasia

24

What are the possible etiologies for HTN in infants to 6 years?

-Renal Parenchymal Disease
-Coarctation of the Aorta
-Renal Artery Stenosis
-Neoplasia
-Iatrogenic

25

What are the possible etiologies for HTN in 6-10 years?

-Renal Parenchymal Disease
-Renal Artery Stenosis
-Endocrinopathy
-Obesity
-Neoplasia

26

What are the possible etiologies for HTN in adolescence?

1. Renal parenchymal disease
2. Endocrinopathy
3. Obesity
4. Meds/drugs

27

What is the number 1 cause of secondary HTN in children?

Renal- Generally reflux nephropathy secondary to undiagnosed vesicoureteral reflux

28

What history is important to get for pediatric HTN?

1. Family history of HTN
2. Family history of endocrinologic disorders
3. Trauma
4. Medication use

29

What medications might contribute to pediatric HTN?

-Corticosteroids
-OCPs
-Alcohol
-Nicotine
-NSAIDS
-Lead/toxins
-Illicit drug use

30

What are special consideration in ROS for ped HTN?

-Epistaxis
-Headache
-Blurry vision
-Weight gain or loss
-Flushing
-Chest pain
-History of urinary tract infections
-Neonatal history