Blackout

Question 1

differentials for blackout

Answer 1

reflex syncope
arrhythmia 
outflow obstruction
postural hypotension
orthostatic
cerebrovascular

Question 2

key features of a history

Answer 2

any warning?
any precipitating factors?
head trauma?
how long?
bite they tongue?
incontinence?
recovery after blackout?

Question 3

epileptic

Answer 3

before: may have aura or no warning
during: minutes, stereotypes, tongue biting
after: slow recovery and confusion

Question 4

vasovagal

Answer 4

before: sweating, pallor, nausea
during: seconds, twitch or incontinence
after: rapid recovery

Question 5

arrhythmia

Answer 5

before: no warning
during: seconds, twitch or incontinence
after: rapid spontaneous recovery

Question 6

examination

Answer 6

tongue - bitten
dehydration
headtrauma
heart
carotid bruits
blood pressure
focal neurological signs

Question 7

investigations

Answer 7

bloods - capillary glucose, FBC, U+Es
ECG
echocardiogram
carotid sinus massage
brain scan

Question 8

status epilepticus

Answer 8

seizures lasting for more than 30 minutes or multiple seizures without intervening regained consciousness

Question 9

management of status epilepticus

Answer 9

PR benzodiazepines e.g. lorazepam

ECG and BP monitoring

Question 10

causes of status epilepticus

Answer 10

poor compliance with anti convulsants
metabolic
alcohol
infection
cerebral tumour
head injury or abscess 
hypoxia
hypertensive encephalopathy

Question 11

Strokes-Adams

Answer 11

sudden transient loss of consciousness induced by a slow/absent pulse and then loss of CO

Question 12

causes of strokes-adams

Answer 12

complete heart block - 3rd degree

Sino-atrial disease

Question 13

what is strokes-adams treated with?

Answer 13

defibrillator implantation

Question 14

epilepsy

Answer 14

a tendency to recurrent, unprovoked seizures

Question 15

seizure

Answer 15

transient excessive eléctrica activity with motor, sensory or cognitive manifestations

Question 16

tonic clonic

Answer 16

patients are initially rigid and then convulsive with rhythmical muscular contractions

Question 17

absence

Answer 17

loses consciousness and appears vacant and unresponsive to observers

Question 18

atonic

Answer 18

brief loss of muscle tone, causing patient to fall to the ground

Question 19

tonic

Answer 19

rigidity

Question 20

clonic

Answer 20

rhythmical muscular contractions

Question 21

myoclonic

Answer 21

extremely brief muscular contractions seen as jerky movements

Question 22

partial complex

Answer 22

impaired consciousness

Question 23

partial simple

Answer 23

unimpaired consciousness

Question 24

rare cardiac causes of collapse

Answer 24

hypertrophic obstructive cardiomyopathy
long QT syndrome
brugada syndrome
arrhythmogenic right ventricular dysplasia