2 year old child presented with sudden onset of altered sesorium on examination BP was 200/100 ?
Ans. is 'c' i.e., Glomerulonephritis This child is suffering from hypeensive crisis. Hypeensive crisis o In hypeensive crisis, BP is rapidly rising or a high BP level is associated with neurological manifestations, hea failure or pulmonary edema. o Hypeensive crisis may be divided : Hypeensive emergencies --> Situations in which immediate reduction of BP is needed (within minutes), usually with parentral therapy. Hypeensive urgencies --> Situations in which reduction of BP is needed within hours, usually with oral agents. iii) Accelerated malignant hypeension --> Situations in which papilledema, hemorrhage, and exudate are associated with markedly elevated BP. The diastolic pressure is usually greater than 140 mm Hg. iv) Hypeensive encephalopathy --> Situations in which markedly elevated BP is associated with severe headache and various alteration in consciousness. So, the child in question having hypeensive encephalopathy i.e., markedly elevated BP with impaired sensorium. o Hypeensive encephalopathy may develop in any cause of secondary hypeension if BP is markedly elevated. Most common cause of secondary hypeension in a child is chronic glomerulonephritis.
Renal aery stenosis
Coarctation of Aoa
Glomerulonephritis
Essential hypeension