Amir Sam - Collapse

Question 1

What do you ask about if someone collapses?

Answer 1

What happened before, during or after?

Question 2

What suggests epileptic seizure?

Answer 2

Warning signs
Tongue biting
Confusion after collapse

Question 3

Differentials for collapse

Answer 3

Hypoglycaemia (DO NOT EVER FORGET GLYCAEMIA)

Vasovagal
Arrhythmia
Outflow obstruction (aortic stenosis, pulmonary embolism)
Postural hypotension
Seizure 

VAOPS

Question 4

What arrhythmias would cause collapse?

Answer 4

Tachycardia

Bradycardia

Question 5

What predisposes to tachycardia?

Answer 5

Long QT predisposes to Tachycardia

Question 6

Causes of left and right sided outflow obstruction causing collapse?

Answer 6

Left: Aortic stenosis, ?
Right: pulmonary

Question 7

Signs of aortic stenosis?

Answer 7

Low volume
Slow rising (like a thrill)
Ejection systolic murmur

Question 8

What investigations would you do if you’re suspecting a PE?

Answer 8

D-dimer

CTPA

Question 9

Where is the QT normally?

Answer 9

The QT has finished before the half way point between two R waves

Question 10

Causes of long QT syndrome

Answer 10

Congenital mutations in potassium channels

Acquired - drugs that lower potassium or magnesium