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Flashcards in syncope Deck (22)
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1

Define syncope (this was short answer on quiz)

Abrupt, transient, complete loss of consciousness that occurs due to a period of insufficient cerebral perfusion. LOC followed by complete, rapid, spontaneous recovery

2

What factors are required for a person to be "conscious"?

1) Organized cortical activity
2) Glucose
3) Oxygen

3

What are the 3 broad categories of syncope?

1) Neurally Mediated
2) Cerebrovascular
3) Cardiopulmonary

4

What are the 5 subcategories of Neurally mediated syncope?

1) vasovagal
2) situational
3) autonomic insufficiency
4) carotid sinus hypersensitivity
5) psych

5

What is the most common type of syncope? Give an example.

Vasovagal: faint at the sight of blood

6

Syncope following a coughing spell or bowel movement

situational

7

Orthostatic hypotension is responsible for what type of syncope?

Autonomic failure

8

Give some examples of who might have autonomic failure:

1) DM
2) EtOH
3) Elderly
4) Meds

9

What is carotid sinus sensitivity?

Atherosclerotic patients commonly have carotid artery occlusion and are likely to have syncope if carotids are compressed/massaged

10

Your patient has a "thunderclap headache". What do you suspect? And what classification of syncope is this?

SAH, cerebrovascular disease

11

This cerebrovascular dz is caused by ischemia that reduces the perfusion in the back of the neck. Ischemic vessels cause retrograde blood flow which results in vertigo, syncope, nystagmus, and arm symptoms which include coolness, paresthesias, and pulse discrepancies

Subclavian steal syndrome

12

How can you dx SSS?

Check distal pulses, US, MRA

13

What are the cerebrovascular syncopes?

SAH and SSS

14

What are the 5 major cardiopulmonary diseases?

1) ischemia/infarct
2) arrhythmia
3) PE
4) Structural
5) Cardiac tamponade

15

What structural abnormality can be detected by performing the Valsalva?

HOCM

16

what does HOCM stand for?

hypertrophic cardiomyopathy

17

Would seizures, head trauma, or metabolic factors be termed syncope? If so, what category do they fall under? If not, why not?

Nonsyncopal, b/c the cause of LOC is not insufficient cerebral perfusion, also recovery is often slow rather than spontaneous

18

How do you treat neurally mediated syncope?

Reassurance, avoid triggers

19

Who is the biggest risk group of syncope patients? (for sudden death)

CHF'ers

20

SAH is in the cerebrovascular syncope category. You could also say it is a neurologic syncopy. What else falls into this category?

TIA

21

If you have a young, healthy patient with normal PE and basic dx tests who's been having multiple syncopal episodes, what is high on your DDx?

Psychiatric syncope

22

What factors can help you determine if you patient had a syncopal episode or a seizure?

1) was there a prodrome?
2) was there tonic/clonic activity or posturing?
3) has the lateral tongue been bitten?
4) b/b incontinence?
5) postictal phase?
(some require witness, obviously)