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MS4 - Neurology > Blackouts > Flashcards

Blackouts Flashcards

1
Q

Acronym for causes of blackouts

A

CRASH

Cardiac
Reflexes
Arterial
Systemic
Head

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2
Q

Cardiac causes of blackouts

A

Stokes-Adams Attacks
Brady - heart block, sick sinus, long-QT
Tachy - SVT, VT
Structural - weak heart (LVF, tamponade), block (AS, HCM, PE)

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3
Q

Reflex causes of blackouts

A

1) Vasovagal syncope
2) Sympathetic underactivity = postural hypotension

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4
Q

Acronym for sympathetic underactivity causes of blackouts

A

STANDUP

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5
Q

Sympathetic underactivity causes of blackouts

A

Salt deficiency
Toxins
Autonomic Neuropathy
Dialysis
Unwell
Pooling

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6
Q

Salt deficiency causes of blackout

A

Addisons

Hypovolaemia

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7
Q

Toxin causes of blackout

A

ACEi

Diuretics

TCAs

Benzos

L-Dopa

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8
Q

Autonomic neuropathy causes of blackout

A

Parkinson’s

Lew body dementia

DM

Amyloidosis

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9
Q

Pooling causes of blackout

A

Venous

Varicose veins

Prolonged standing

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10
Q

Arterial causes of blackouts

A

Migraine

TIA

Stroke

Subclavian steal

HTN

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11
Q

Systemic causes of blackouts

A

Hypoglycaemia

Hypoxia

Anaemia

Hyperviscosity

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12
Q

Head causes of blackouts

A

Epilepsy
Drop attacks

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13
Q

Ix for blackouts

A
  1. lying and standing BP (>20/10 difference after 3 min → postural hypotension)
  2. ECG ± 24hr ECG
  3. U+E, FBC, Glucose
  4. Tilt table
  5. EEG, sleep EEG
  6. Echo, CT, MRI brain
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14
Q

Triggers for cardiogenic syncope

A

exertion, drugs, unknown

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15
Q

Sx before cardiogenic syncope

A

palpitations, chest pain, dyspnoea

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16
Q

Symptoms during cardiogenic syncope

A

pale, slow/absent pulse, clonic jerks may occur

17
Q

Symptoms after cardiogenic syncope

A

rapid recovery

18
Q

Ix for cardiogenic syncope

A
  • ECG
  • 24hr ECG
  • Echo
19
Q

Triggers for vasovagal syncope

A

prolonged standing
heat
fatigue
stress

20
Q

symptoms before vasovagal syncope or postural hypotension

A
  • Gradual onset: secs→mins
  • Nausea, pallor, sweating, tunnel vision, tinnitus
  • Cannot occur lying down
21
Q

symptoms during vasovagal syncope or postural hypotension

A
  • Pale, grey, clammy, brady
  • Clonic jerks and incontinence can occur, but no tongue biting
22
Q

symptoms after vasovagal syncope or postural hypotension

A

rapid recovery

23
Q

Ix for vasovagal syncope or postural hypotension

A

tilt-table testing

24
Q

Triggers for postural hypotension

A

standing up

25
Q

Triggers for arterial causes of blackout

A
  • arm elevation (subclavian steal)
  • migraine
26
Q

symptoms of arterial blackout

A

same as vasovagal
+ diplopia, nausea, dysarthria

27
Q

investigations for arterial blackout

A
  • MRA
  • duplex vertebrobasilar circulation
28
Q

symptoms of hypoglycaemic syncope

A

tremor, hunger, sweating, lightheadedness
→ LOC

29
Q

triggers for epileptic causes of blackout

A

flashing lights
fatigue
fasting

30
Q

symptoms before epileptic blackout

A

e.g. aura in complex partial seizures – feeling
strange, epigastric rising, deja/jamias vu, smells, lights,
automatisms

31
Q

symptoms during epileptic blackout

A

Tongue biting,
incontinence,
stiffness→jerking,
eyes open,
cyanosis,
↓SpO2

32
Q

symptoms after epileptic blackout

A

headache,
confusion,
sleeps,
Todd’s palsy

33
Q

Ix for epileptic blackout

A

EEG
↑ se prolactin at 10-20min

34
Q

Triggers for drop attacks

A

nil

35
Q

Sx before drop attacks

A

no warning

36
Q

Sx during drop attacks

A

sudden weakness of legs causes older woman
to fall to the ground.

37
Q

Sx after drop attacks

A

no post-ictal phase

MS4 - Neurology (11 decks)

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