Cardiovascular risk screening in childhood — formative SAQs

SAQ 1 (10 marks)

An asymptomatic 9-year-old has office BP 124/78 using an unknown cuff size. BMI is elevated. Father had MI at 44. ^{[1] [3]}

1. Outline your immediate BP assessment steps. (3) ^[1]
2. What cardiovascular history and examination details matter most? (3) ^{[1] [3]}
3. How will you approach lipids given guideline controversy? (4) ^{[2] [3]}

Model answer

Re-measure after rest with correct cuff size; repeat abnormal readings; stage with paediatric guidance rather than adult cut-offs; plot BMI. ^[1]

History: premature ASCVD/FH family history, kidney/heart disease, drugs, sleep, diet, activity, smoke/vape. Exam: pulses/femorals, heart, thyroid, acanthosis, oedema. ^{[1] [3]}

Name USPSTF insufficient evidence for routine asymptomatic screening while recognising premature parental CVD as a strong selective indication; confirm abnormal lipids; consider FH pathway. ^{[2] [3] [6]}