SudaMediCa, The Sudanese Medical Community

. A 12-yr-old presents with headaches and a blood pressure of
210/110 mm Hg. There is no history of recent infection. Results of urinalysis
are unremarkable. The most appropriate next step in evaluation is to:
A.Measure serum complement
B.Perform a renal ultrasound examination
C.Perform a voiding cystourethrogram
D.Measure streptococcal titers
E.Perform a renal arteriogram

Option. C. Looks reasnble to me

sever hypertension in this age with normal urine analysis points towards renal segmental hypoplasia
so I will go with option B

The Keyword is next, to me the best option is B.as bed side non invasive investigation preferably duplex U/S, exclude reversible causes, such as obstruction,which causes pain & diagnose fibromuscular dysplasia as this is suspected too.

B=U/S

For the next step I'll go with doing renal ultrasound scan.

most important next step is performing renal US