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A Short Note On Diabetes And Adolescent Adolescents

Good Essays
Hypertension in Adolescents
I. Case Presentation
A 16 year old African American male arrives at his pediatrician’s office for a preparticipation physical evaluation. His history includes asthma as a toddler, tonsillectomy in 2010. His mother, grandmother, and uncle all have hypertension. His grandmother has diabetes as well. He has an older brother and younger sister, both are healthy. His father is a paraplegic due to a MVA, otherwise his father has no health issues.
The patient vital signs are normal except for his blood pressure which is 146/89. The medical assistant informs the patient that his blood pressure is high and questions about his day and diet. The patient did have a full day of school before rushing to the office.
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The most common ones are obesity and a family history of hypertension. Assessment involves a detailed history and physical examination, laboratory tests, and possibly specialized studies. Nonpharmacologic management of hypertension include weight reduction, exercise, and dietary modifications. Recommendations for pharmacologic treatment are based on several factors. They include symptomatic hypertension, evidence of end organ damage, stage 2 hypertension, stage 1 hypertension not affected by lifestyle modifications, and hypertension with diabetes mellitus (JNC 7 report).

Questions:
3. How many readings need to be considered high or abnormal before a patient is diagnosed with HTN?
4. Name some referrals that a PCP would order for an adolescent diagnosed with HTN?

III. Additional case presentation
One week later the 16 year old arrives back to the office with the results. Every day the results were abnormal. The pediatrician decides to refer the patient to a pediatric nephrologist.
The initial visit with the pediatric nephrologist included lab work (CBC, CMP, Lipid Panel, U/A) and a comprehensive history. Although all the lab work came back normal, the nephrologist decided to order an echocardiogram and renal ultrasound, as well as an ambulatory blood pressure monitor for 24 hours.
After all test results normal, the patient was diagnosed with essential hypertension. The physician decides to start the patient on Lisinopril 10mg daily
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