Flashcards in 3. Blackout Deck (20)
What are the 4 syncopal causes of a transient loss of consciousness (LOC)?
What is the main reflex causes of LOC?
What is the main cardiac cause of LOC?
What is the main orthostatic cause of LOC?
Drugs: antihypertensives, anti sympathetics
What are the main causes of LOC in the following:
55: vasovagal + arrythmia
85: orthostatic hypotension due to medication
How do you split up your questions in a LOC history?
Before, during + after
What 3 questions should you ask about before the LOC?
? Precipitating factors: exercise, straining, fear
? Head trauma: subdural haemorrhage
? Warning signs: dizziness, palpitations, aura
What 3 questions should you ask about regarding what happened during a LOC?
Tongue biting/ limb movements/ incontinence
What questions should you ask about after a LOC?
Did they recover spontaneously?
How long did it take to recover?
Were they confused after?
What drugs are you looking out for in someone who has had a LOC?
Insulin/ Oral hypoglycaemics
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
What are the first line investigations in someone with a LOC?
Blood glucose: hypoglycaemia, DM
U+Es: Dehydration, electrolyte imbalance
List 4 causes of non-syncopal LOC
Intoxication e.g. alcohol
Epileptic/ psychogenic seizure
What is syncope?
LOC due to brain hypo perfusion
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
What do you ask in PMH of LOC?
Previous occurrence/ frequency?
What 7 signs do you look for on examination in a patient who has LOC?
Heart murmurs/ pulse
Focal neurological signs
For a suspected structural cardiac abnormality causing LOC, what investigation would you perform?
For a suspected carotid sinus sensitivity causing LOC, what investigation would you perform?
Carotid sinus massage