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Paediatric

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CVS

Question
61 out of 63
 

2 year old child presented with sudden onset of altered sesorium on examination BP was 200/100 -(AIIMS Nov 2012)



A Renal artery stenosis
B Coarctation of Aorta

C Glomerulonephritis
D Essential hypertension

E Phaeochromocytoma

Ans. C

Glomerulonephritis

This child is suffering from hypertensive crisis.

Hynertensive crisis

a. In hypertensive crisis, BP is rapidly rising or a high BP level is associated with neurological manifestations,

b. heart failure or pulmonary edema.

c. Hypertensive crisis may be divided : -

i. Hypertensive emergencies -, Situations in which immediate reduction of BP is needed (within minutes), usually with parentral therapy.

ii. Hypertensive urgencies - Situations in which reduction of BP is needed within hours, usually with oral agents.

iii. Acclerated malignant hypertension -+ Situations in which papilledema, hemorrhage, and exudate are associated with markedly elevated BP. The diastolic pressure is usually greater than I 40 mm Hg.

iv. Hypertensive encephalopathy --> Siaations in which markedly elevated BP is associated with severe headache and various alteration in consciousness.

d. So, the child in question having hypertensive encephalopathy markedly elevated BP with impaired sensoriuin.

e. Hypertensive enceprhalopathy may develop in any cause of secondary hypertension if BP is markedly elevated.

Most common cause of secondary hypertension in a child is chronic glomerulonephritis.

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