Hypertensive emergency – labetalol — RACP Paediatrics MCQ

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ModerateNephrologyHypertensive emergency – labetalolRACP Paediatrics

A 5-year-old with APSGN presents with severe hypertension (BP 190/120 mmHg), headache, visual disturbance, and vomiting. Fundoscopy shows papilloedema and flame-shaped haemorrhages. What is the most appropriate immediate antihypertensive?

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Correct answer: C — IV labetalol infusion

Hypertensive emergency (severe hypertension with end-organ damage: encephalopathy, visual changes, papilloedema) requires immediate controlled BP reduction with IV antihypertensives. IV labetalol (combined alpha/beta-blocker) is the most commonly used first-line agent in paediatric hypertensive emergencies. BP should be reduced by no more than 25% in the first 8 hours to avoid cerebral hypoperfusion.

Reference: RCH Melbourne – 2024 – Hypertension CPG; RACP Paediatric Curriculum – Nephrology/Emergency