Pediatric Hypertension Flashcards¶
Definitions & Classification¶
Q: What defines elevated blood pressure in children (2017 AAP)? A: SBP or DBP ≥90th but <95th percentile (or 120/80 in adolescents) Tags: hypertension, definition, high-yield
Q: What defines Stage 1 hypertension in children? A: SBP or DBP ≥95th to <95th + 12 mmHg (or 130/80-139/89 in adolescents) Tags: hypertension, staging, high-yield
Q: What defines Stage 2 hypertension in children? A: SBP or DBP ≥95th + 12 mmHg (or ≥140/90 in adolescents) Tags: hypertension, staging, high-yield
Q: At what age do adult BP cutoffs apply? A: Age ≥13 years Tags: hypertension, definition
Q: What is the screening recommendation for BP in children? A: Annual BP screening starting at age 3 years (or earlier if risk factors) Tags: hypertension, screening
Etiology¶
Q: What is the most common cause of secondary hypertension in children? A: Renal parenchymal disease Tags: hypertension, etiology, high-yield
Q: What percentage of hypertension in children is primary (essential)? A: Increasing - now majority in adolescents; less common in younger children Tags: hypertension, etiology
Q: What vascular cause of hypertension should be considered with upper/lower extremity BP discrepancy? A: Coarctation of the aorta Tags: hypertension, coarctation, high-yield
Q: What endocrine causes should be considered in pediatric hypertension? A: Pheochromocytoma, hyperthyroidism, Cushing syndrome, primary aldosteronism Tags: hypertension, etiology, endocrine
Q: What medications can cause hypertension in children? A: Stimulants (ADHD meds), steroids, NSAIDs, oral contraceptives, decongestants Tags: hypertension, medications
Evaluation¶
Q: What is the first-line confirmatory test for hypertension? A: Ambulatory Blood Pressure Monitoring (ABPM) Tags: hypertension, abpm, high-yield
Q: What ABPM finding confirms hypertension? A: Mean SBP or DBP ≥95th percentile Tags: hypertension, abpm
Q: What is "masked hypertension" on ABPM? A: Normal office BP but elevated ambulatory BP Tags: hypertension, abpm
Q: What is "white coat hypertension" on ABPM? A: Elevated office BP but normal ambulatory BP (no treatment needed, monitor) Tags: hypertension, abpm
Q: What initial workup is indicated for confirmed hypertension? A: BMP (renal function), UA, lipid panel, fasting glucose, echo (if Stage 2) Tags: hypertension, workup
Q: When is renal artery imaging indicated? A: Stage 2 HTN, young child with HTN, poor response to treatment Tags: hypertension, workup, renovascular
Treatment¶
Q: What is first-line treatment for Stage 1 hypertension without target organ damage? A: Lifestyle modifications (DASH diet, weight loss, exercise, reduce sodium) Tags: hypertension, treatment
Q: What BP target is recommended for treatment in children? A: <90th percentile (or <130/80 in adolescents) Tags: hypertension, treatment, target
Q: What is first-line antihypertensive for children with CKD or proteinuria? A: ACE inhibitor or ARB Tags: hypertension, treatment, high-yield
Q: What antihypertensive class is first-line for children with diabetes? A: ACE inhibitor or ARB Tags: hypertension, treatment, diabetes
Q: What antihypertensive is useful for children with migraine comorbidity? A: Beta-blocker (propranolol) or calcium channel blocker Tags: hypertension, treatment
Q: What defines hypertensive urgency vs emergency? A: Emergency = severe HTN with target organ damage; Urgency = severe HTN without TOD Tags: hypertension, emergency