Peds HTN, Dislipidemia, and obesity

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Author:
choward04
ID:
205419
Filename:
Peds HTN, Dislipidemia, and obesity
Updated:
2013-03-06 15:17:27
Tags:
Peds
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Description:
Pediatrics
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  1. What are 3 environmental causes of Increased Cardio risk?
    • 1. Sedentary
    • 2. sodium
    • 3. stress
  2. What are 3 comorbidities that increase cardio risk?
    • 1. Obesity
    • 2. DM
    • 3. Sleep apnea
  3. When should routine BP be started?
    3yo
  4. What is the proper cuff proportions?
    40:80
  5. What is the difference in HTN definition for peds versus adults?
    • -Based on gender/weight/height & is a reflection of normal population
    • -Adults--> reflect CV event morbidity and mortality
  6. Normal BP is?
    <90th percentile
  7. What are the 2 parameters for Pre-HTN?
    • 1. >90th but < 95th OR
    • 2. Systolic >120mmHg and <90th
    •     Diastolic >80mmHg and <90th
  8. What are the 2 parameters for Stage 1 HTN in kids?
    • 1. >95th and
    • 2. Systolic -5mmHg >99th
    •     Diastolic -5mmHg >99th
  9. What are the Stage II HTN parameters for kids?
    -Between >99th plus 5mmHg (both systolic/diastolic)
  10. T or F.  Childhood HTN is most often secondary to other conditions.
    True
  11. What are 4 primary causes of HTN?
    • 1. postpubertal
    • 2. mild
    • 3. Family hx
    • 4. obesity/overweight
  12. What are 4 secondary causes of Childhood HTN?
    • 1. Renal
    • 2. Endocrine
    • 3. Renovascular
    • 4. Pre-pubertal??
  13. T or F. Pediatric BP PREDICTS adult BP.
    True
  14. An initial HTN assessment includes a BP in both arms and 1 leg, why?
    R/o coarctation
  15. KNOW: Define BEARS
    • B- Bedtime problems
    • E- Excessive daytime sleepiness
    • A- Awakenings during the night
    • R- Regularity and duration of sleep
    • S- Snoring
  16. What are 4 labs for HTN diagnostics?
    • 1. CBC
    • 2. Fasting Chem 21
    • 3. UA
    • 4. Fasting Lipid Panel
  17. If a kid has a Pre-HTN BP, when should a recheck be performed?
    6mo
  18. When a Kid is diagnosed with Stage 1 HTN, when should an eval or referral be down?
    Within 1 month
  19. What is the goal of HTN treatment?
    • Treat to get Primary HTN < 95th%
    • -Secondary HTN should be treated to <90th%
  20. T or F.  Pharmocological HTN txt--> should titrate to highest recommended dose prior to adding 2nd agent.
    True, if goal not met by 2 agents--> refer
  21. T or F.  A pharm dose should never exceed adult does despite weight.
    True
  22. KNOW figure 8.1 & 8.2
  23. Which HTN meds can be given in kids < 6yo?
    Diuretics & B-blockers
  24. T or F.  In kids < 15yo or prepubertal, HTN is secondary until proven otherwise.
    True
  25. What TG level is considered high and what level is considered urgent?
    • TG- >150mg/dl
    • TG- > 500mg/dl
  26. What is the normative level for Cholesterol, LDL, HDL?
    • Cholesterol- <170
    • LDL- <110
    • HDL- >60
  27. If a kid <1yo has dyslipidemia, what should your DD be?
    1. Obstructive liver disease
  28. With younger kids with dyslipidemia, what DD should you consider?
    • 1. Endocrine
    • 2. Medications
  29. With adolescents who have dyslipidemou consideria, what etiology should you consider?
    1. Lifestyle
  30. What 4 labs should be performed for dyslipidemia?
    • 1. LFT/FLP
    • 2. Renal function
    • 3. UA
    • 4. TSH
  31. KNOW: When is a "selective" screening performed?
    • High risk children initial screening between 2-8yo
    • -Parents w/ TC >240
    • -Unknown family hx
    • -Personl risk factors
    • -High risk parents/grandparents <55
  32. KNOW: When is a universal screening given?
    • -All children b/w 9-11 & 17-21yo
    • -Lipid panel (fasting or non-)
    • -If non-fasting (chol-HDL) = 145 or HDL <40, the must get fasting lipid panel
  33. KNOW table 9-1 for lipids, txt based on risk factors
  34. At what age should kids with dyslipidemia be referred for treatment?
    10yo
  35. What lipid levels in kids should be evaluated by a specialist?
    • -LDL >250mg/dl
    • -TG >500mg/dl
    • -refractory or complicated
  36. What is generally the only dyslipidemia med that can be used in kids?
    • statins
    • (bile acids as adjunctive only)
  37. What percentile are kids considered "overweight"?
    85-95th percentile
  38. What percentile are kids considered "obese"?
    >95th percentile

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