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Flashcards in 3. Blackout Deck (20)
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1

What are the 4 syncopal causes of a transient loss of consciousness (LOC)?

Reflex
Cardiac
Orthostatic
Cerebrovascular

2

What is the main reflex causes of LOC?

Vasovagal syncope

3

What is the main cardiac cause of LOC?

Arrythmia

4

What is the main orthostatic cause of LOC?

Drugs: antihypertensives, anti sympathetics

5

What are the main causes of LOC in the following:
25 yo
55 yo
85 yo

25: vasovagal
55: vasovagal + arrythmia
85: orthostatic hypotension due to medication

6

How do you split up your questions in a LOC history?

Before, during + after

7

What 3 questions should you ask about before the LOC?

? Precipitating factors: exercise, straining, fear
? Head trauma: subdural haemorrhage
? Warning signs: dizziness, palpitations, aura

8

What 3 questions should you ask about regarding what happened during a LOC?

Tongue biting/ limb movements/ incontinence
Length
Any witnesses

9

What questions should you ask about after a LOC?

Did they recover spontaneously?
How long did it take to recover?
Were they confused after?

10

What drugs are you looking out for in someone who has had a LOC?

Insulin/ Oral hypoglycaemics
Antihypertensives
Vasodilators
Antiarrythmics
Antidepressants
Warfarin/ anticoagulants

11

What things in the Shx and Fhx should you look out for in someone with a LOC?

Shx: Alcohol intake + stimulant recreational drugs

Fhx: sudden death in any relations < 65

12

What are the first line investigations in someone with a LOC?

Blood glucose: hypoglycaemia, DM
FBC: Anaemia
U+Es: Dehydration, electrolyte imbalance
ECG

13

List 4 causes of non-syncopal LOC

Intoxication e.g. alcohol
Head trauma
Metabolic (hypoglycaemia)
Epileptic/ psychogenic seizure

14

What is syncope?

LOC due to brain hypo perfusion

15

How do diuretics + ACEi, B-blockers, A-Blockers + CCBs contribute to orthostatic hypotension?

D+A: Decreased blood volume + vasodilation
BB: Inability to increase HR
AB:Inability to vasoconstrict capacitance veins
CCB: Inability to vasoconstrict + some negative ionotropy/ chronotropy

16

What do you ask in PMH of LOC?

Previous occurrence/ frequency?
Diabetes?
Cardiac illness?
PVD?
Epilepsy?
Anaemia?
Psychiatric illness?

17

What 7 signs do you look for on examination in a patient who has LOC?

Bitten tongue
Dehydration
Head trauma
Heart murmurs/ pulse
Carotid bruits
BP
Focal neurological signs

18

For a suspected structural cardiac abnormality causing LOC, what investigation would you perform?

Echocardiogram

19

For a suspected carotid sinus sensitivity causing LOC, what investigation would you perform?

Carotid sinus massage

20

For a suspected epilepsy causing LOC, what investigation would you perform?

Brain scan (CT/ MRI)