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cvr biweekly 1 > Taylor-Syncope > Flashcards

Taylor-Syncope Flashcards

1
Q

why I don’t passout when I stand up

A

my baroreceptor reflex acts instantly to make sure brain is still perfused; sympathetics fire

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2
Q

besides sympathetics, what other way can we ensure we don’t pass out when standing up

A

muscle compression that compresses veins and pushes venous return to heart

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3
Q

acute response to standing up maintains what

A

maintains arterial pressure

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4
Q

has transient corrections of BP (when there is a change in pressure or blood volume)

A

baroreceptor reflex

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5
Q

has sustained management of BP and blood volume

A

kidneys

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6
Q

4 main variables in the normal orthostatic response

A
  1. total blood volume
  2. drugs/alcohol
  3. temperature
  4. recent meal
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7
Q

ways that a patient can lose blood volume and make orthostatic response slow

A

dehydration
hemorrhage
laying down too long

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8
Q

drugs that can cause orthostatic response to be sluggish

A

diuretics, B blockers and vasodilators, SSRI’s

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9
Q

what makes orthostatic response sluggish in regards to temp.

A

heat–vasodilates blood vessels

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10
Q

main thing to check first if someone experiences syncope

A

make sure it is not cardiac related (order ecg and labs)

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11
Q

transient loss of consciousness (fainting) w/ spontaneous recovery (20 sec)

A

Syncope

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12
Q

most common cause of syncope

A

inadequate perfusion of brain

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13
Q

labs to order to see if syncope is due to a metabolic issue

A

glucose levels (hypoglycemia)
CBC (anemia)

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14
Q

blowing off too much CO2 and blood vessels constrict causing what

A

loss of consciousness

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15
Q

most important cause of syncope to recognize even though it is only 10% of all cases

A

cardiac

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16
Q

if you identified patient did not pass out due to cardiac pathology, then what do you check for

A

Dysautonomia

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17
Q

autonomic dysfunction due to essential failure or delay of sympathetic activation +/or response

A

Dysautonomia

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18
Q

2 main types of cardiac causes of syncope

A

Arrhythmia
Long QT syndrome

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19
Q

hypotension when standing; dizziness or fainting when standing

A

Orthostatic Intolerance

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20
Q

how to measure Orthostatic or Postural Hypotension

A

a decrease in systolic BP by 20 mmHg or a decrease in diastolic BP of 10 mmHg w/in 3 minutes of standing

21
Q

4 main types of Dysautonomia

A
  1. Vasovagal syncope
  2. Carotid sinus hypersensitivity
  3. pure autonomic failure
  4. PoTS
22
Q

common faint reflex (multiple triggers); 70-80% of syncope cases

A

Vasovagal syncope

23
Q

enhanced baroreflex in response to neck pressure

A

Carotid sinus hypersensitivity

24
Q

entire autonomic system and cardiovascular system damaged; due to brain neurodegenerative disease

A

Primary autonomic failure

25
Q

sustained rapid heart rate when standing

A

PoTS (postural tachycardia syndrome)

26
Q

characterized by rapid bradycardia and hypotension (withdrawal of sympathetic tone and increased vagal firing)

A

Vasovagal syncope

27
Q

specific degeneration of autonomic functions; inability to maintain bp when standing

A

Pure Autonomic Failure (PAF)

28
Q

increased HR within first 10 minutes of standing due to unstable BP and low cerebral perfusion

A

PoTS (postural tachycardia syndrome)

29
Q

seen recently after someone who has had COVID

A

PoTS

30
Q

how to assess for dysautonomia

A

Head Upright Tilt test (HUT)

31
Q

HUT test

A

check HR and BP of patient on tilted table w/out involvement of m. contraction

32
Q

after HUT test, both BP and HR fall

A

Vasovagal response

33
Q

after HUT test, only BP falls

A

Pure autonomic failure

34
Q

after HUT test, HR increases and remains elevated; BP unstable

A

PoTS

35
Q

top, middle, bottom represent what

A

top-normal
middle-PAF
bottom- PoTS

36
Q

to treat and manage syncope

A

ecg and labs and FH

37
Q

non-pharmacologic ways to treat syncope

A
  1. avoid triggers
  2. hydrate
  3. exercise (volume expansion)
38
Q

pharmacologic ways to treat syncope:

A

basically drugs that will increase sympathetics

39
Q

a1 receptor agonist used to treat syncope

A

Midodrine

40
Q

drug that increases Na+ and fluid retention (volume expansion) used to treat syncope

A

Fludrocortisone

41
Q

anticholinergic drugs that oppose parasympathetic effects and used to treat syncope

A

Atropine
Disopyramide

42
Q

drugs that act like accessory catecholamines to treat syncope

A

Ephedrine/Pseuodophedrine

43
Q

reduces serotonin reuptake drug used to treat syncope

A

SSRI’s

44
Q

drug that will keep NE and Epi in synapse longer; used to treat syncope

A

Ritalin

45
Q

a way to assess autonomic response and assess valve issues in heart

A

Valsalva maneuver

46
Q

triggered by immersing face in water (CN V)

A

dive reflex

47
Q

Involves parasympathetic mediated bradycardia; w/ sympathetic vasoconstriction in vasculature

A

dive reflex

48
Q

2 ways to quickly lower HR on your own

A

splash your face with water
rub one carotid

cvr biweekly 1 (19 decks)

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