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YR3: MM FC Ed. > 3. Blackout > Flashcards

3. Blackout Flashcards

1
Q

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

A

Reflex
Cardiac
Orthostatic
Cerebrovascular

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2
Q

What is the main reflex causes of LOC?

A

Vasovagal syncope

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3
Q

What is the main cardiac cause of LOC?

A

Arrythmia

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4
Q

What is the main orthostatic cause of LOC?

A

Drugs: antihypertensives, anti sympathetics

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5
Q

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

A

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

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6
Q

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

A

Before, during + after

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7
Q

What 3 questions should you ask about before the LOC?

A

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

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8
Q

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

A

Tongue biting/ limb movements/ incontinence
Length
Any witnesses

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9
Q

What questions should you ask about after a LOC?

A

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

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10
Q

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

A 
Insulin/ Oral hypoglycaemics
Antihypertensives
Vasodilators
Antiarrythmics
Antidepressants
Warfarin/ anticoagulants
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11
Q

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

A

Shx: Alcohol intake + stimulant recreational drugs

Fhx: sudden death in any relations < 65

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12
Q

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

A

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

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13
Q

List 4 causes of non-syncopal LOC

A

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

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14
Q

What is syncope?

A

LOC due to brain hypo perfusion

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15
Q

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

A

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

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16
Q

What do you ask in PMH of LOC?

A 
Previous occurrence/ frequency?
Diabetes?
Cardiac illness?
PVD?
Epilepsy?
Anaemia?
Psychiatric illness?
17
Q

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

A 
Bitten tongue
Dehydration 
Head trauma
Heart murmurs/ pulse
Carotid bruits
BP
Focal neurological signs
18
Q

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

A

Echocardiogram

19
Q

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

A

Carotid sinus massage

20
Q

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

A

Brain scan (CT/ MRI)

YR3: MM FC Ed. (46 decks)

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