12. MTB Step 3 - Syncope Evaluation Flashcards

Cards Complete:

1
Q

SYNCOPE EVALUATION

What are the (3) Criteria that the Management of Syncope is based on?

A
  1. Loss of Consciousness:
    • ​​Sudden vs. Gradual
  2. Regaining Consciousness:
    • ​​Sudden vs. Gradual
  3. Cardiovascular Exam:
    • ​​Normal vs. Abnormal

*SEE PICTURE FOR FLOWCHART*

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2
Q

SYNCOPE EVALUATION

What are (6) Exams that should be performed on Syncope Evaluation?

A
  1. Cardiovascular and Neurological exams
  2. ECG
  3. Cardiac Enzymes (Troponins, CK-MB)
  4. Chemistries (glucose)
  5. Oximeter
  6. CBC
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3
Q

SYNCOPE EVALUATION

How should you Manage the Special Circumstance of Syncope + MURMUR?

A

Echocardiogram

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4
Q

SYNCOPE EVALUATION

How should you Manage the Special Circumstances of Syncope + FOCAL NEUROLOGIC FINDINGS?

A

CT Scan Head

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5
Q

SYNCOPE EVALUATION

How should you Manage the Special Circumstances of Syncope + HEAD TRAUMA DUE TO SYNCOPE?

A

CT Scan Head

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6
Q

SYNCOPE EVALUATION

How should you Manage the Special Circumstances of Syncope + HEADACHE?

A

CT Scan Head

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7
Q

SYNCOPE EVALUATION

How should you Manage the Special Circumstances of Syncope + SEIZURE (described or suspected)?

A

CT Scan Head

and

EEG

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8
Q

SYNCOPE EVALUATION

What is the Mechanism of Syncope caused by a Brainstem Stroke only?

A
  • The brainstem controls sleep and wake in the brain.
  • Only stroke or TIA of the posterior circulation can cause syncope.
  • Vertebral/basilar circulation is synonymous with the posterior or brainstem circulation.
  • There is no place in the circulation of the middle cerebral artery that can cause syncope.
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9
Q

SYNCOPE EVALUATION

If the Diagnosis is NOT clear after moving the clock forward to obtain the initial results, what are (6) Tests that should be done on Further Management?

A
  1. Holter Monitor (outpatients)
  2. Telemetry (inpatients)
  3. Repeat CK-MB & Troponins 4 hours after initial
  4. Urine & Blood Toxicology screens
  5. TILT TABLE Testing to diagnose Neurocardiogenic (Vasovagal) Syncope
  6. ELECTROPHYSIOLOGIC Testing
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10
Q

SYNCOPE EVALUATION

What Percentage of Mortality from Syncope is from Cardiac causes?

A

> 80%

The most important thing to do in Syncope is to EXCLUDE a Cardiac cause (i.e., Arrhythmia)

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11
Q

SYNCOPE EVALUATION

TREATMENT

What is the Treatment if a Ventricular Dysrhythmia is diagnosed as the cause of Syncope?

A

Implantable Cardioverter/Defibrillator

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12
Q

SYNCOPE EVALUATION

DIAGNOSIS

Which (4) Diagnostic Test should you order for Syncope?

A
  1. ECG
  2. Troponin, CK-MB
  3. Echocardiogram
  4. Head CT
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