Hypertension in Children – 18 Board-Style Cases with Answers

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What this deck covers

Hypertension in Children in 18 board-style clinical cases with worked explanations. Each case gives you a clinical vignette, four options, the correct answer, and an explanation of why each of the other three is wrong, with the guideline or textbook it follows named on the answer.

Board-style teaching questions for paediatricians and trainees preparing for board, MRCPCH and Prometric examinations. Written from published guidelines and standard paediatric textbooks, with the source named on every answer.

The 18 cases, in order

  1. The number the nurse wrote down
  2. Three readings, all a little high
  3. Sweaty feeder with a back murmur
  4. Big, snoring, and it runs in the family
  5. What to send off first
  6. Thin child with a belly bruit
  7. Both hormones are low
  8. Fitting at one ninety over one twenty five
  9. Cola, takeaways and no sport
  10. The right drug, the wrong moment
  11. Attacks, then perfectly normal
  12. The rugby player with bad acne
  13. High here, normal at home
  14. A thicker heart on the annual scan
  15. A lump found in the bath
  16. Five weeks old and climbing
  17. Good enough, but not for her
  18. Choosing around the asthma

Diagnoses and management options tested

Across the 18 cases you are asked to choose between options such as: Repeat the reading with a correctly sized cuff, Elevated blood pressure, Renal artery stenosis from fibromuscular dysplasia, Chronic kidney disease, Plasma metanephrines and a nuclear medicine scan, Primary hyperaldosteronism, Renovascular hypertension, Sublingual nifedipine repeated until it normalises, Lifestyle change, with review in three to six months, That the drug also lowers her cholesterol, An echocardiogram, Cushing syndrome, Arrange 24-hour ambulatory blood pressure monitoring, Nothing, because she has no symptoms.

Clinical pearls from this deck

  • Check the cuff before you check the kidneys.
  • Paediatric thresholds are centiles, not numbers, until thirteen years old.
  • Feel the femoral pulses in every hypertensive child; it is five seconds that changes the diagnosis.
  • Young and severe means secondary; older and mild means primary.
  • An echocardiogram belongs in the first pass; left ventricular hypertrophy is the target organ damage that changes management.
  • Severe hypertension with a low potassium is renin or aldosterone until you have measured both.

Work through the deck once for recognition, then again a week later to test yourself — each question gives the answer and explains why every other option fails.

More from this system: all nephrology case decks · pediatric reference values.

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