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Flashcards in Peds - Acquired Cardiovascular Deck (17):
1

Hypertension -
how is diagnosis established?

At least 3 measurements
>95th percentile per published tables for height and weight

2

Typical causes of HTN in children? (2)

HTN secondary to another disease
aldosterone problem
renovascular disease

3

HTN workup (8)

X-ray
cortisol level (first thing in AM)
aldosterone level
UA
BMP
CBC
cholesterol and triglycerides
ECG

4

What condition is being ruled in or out with cortisol level in HTN workup?

Cushing's syndrome

5

HTN signs and symptoms (6)

headache
dizziness
nosebleed
visual problems
respiratory distress
irritability

6

NP management of HTN in children

Manage initial work up
Refer to cardiology
JNC-7 / 8

7

Rheumatic fever

cause?
age?
affects which body systems? (3)

post-infection with group A strep

most common in ages 6 - 15
heart
joints
CNS

8

Which valve is most commonly affected by Rheumatic fever?

Mitral valve

permanent damage

9

What criteria are used to diagnose Rheumatic fever?

Jones' criteria -
2 major
OR
1 major + 2 minor

10

Jones criteria - MAJOR manifestations (4)

carditis
polyarthritis
chorea
erythema marginatum - confluent, circular
subcutaneous nodules

11

Jones' criteria - MINOR manifestations (4)

PROLONGED PR INTERVAL on ECG #

arthralgia sans objective inflammation
fever >39 C (102.2 F)
elevated ESR and CRP

12

Management of Rheumatic fever

manage workup/diagnostics
aggressive management of strep infection
refer to pediatric cardiologist

13

Kawasaki

acute febrile syndrome causing vasculitis

14

Typical age for Kawasaki

under 2 years

15

Kawasaki symptoms

"Firey CRASH"

Fever

Conjunctivitis - bilateral
Rash - polymorphous, pruritic
Adenopathy - cervical
Strawberry tongue (can also have peeling lips)
Hands - desquamation

16

Kawasaki ECG changes

prolonged PR or QT interval

17

NP management of Kawasaki

Immediate referral to pediatric cardiologist
High dose ASA therapy