Cardiology - Syncope

Question 1

if a patient with known aortic stenosis faints what should be done

a.beta blocker given
b.ace inhibitor
c.cpr
d.hospital admission

Answer 1

d.hospital admission

Question 2

if a patient reports chest pain, sob, syncope on exertion or supine what should be done

Answer 2

hopsital admission

Question 3

patient reports an episode of fainting they describe it as being precipitated by pain, fea, and standing up they report a distinct prodrome phase involving sweat g and nausea what is the most likely diagnosis

a.vasovagal syncope
b.situational reflex syncope
c.cardiac syncope
d.orthostatic hypotension

Answer 3

a.vasovagal syncope

Question 4

patient reports fainting during/immediately after specific triggers with no warning

a.vasovagal syncope
b.situational reflex syncope
c.cardiac syncope
d.orthostatic hypotension

Answer 4

b.situational reflex syncope

Question 5

patient passes out while playing football , very sudden onset palpations immediately followed by syncope what is the most likely diagnosis

a.vasovagal syncope
b.situational reflex syncope
c.cardiac syncope
d.orthostatic hypotension

Answer 5

c.cardiac syncope

ECG could show- bradycardia, bundle branch block, heart block , Qt changes

Question 6

patient passes out while standing

a.vasovagal syncope
b.situational reflex syncope
c.cardiac syncope
d.orthostatic hypotension

Answer 6

d.orthostatic hypotension

discontinue anti hypertensives if possible

Question 7

what investigations should be done for suspected cardiac syncipe after ecg

a.eeg
b.excercise test then external loop recorder
c.bloods

Answer 7

b.excercise test then external loop recorder

Question 8

a patient has persistent heart failure despite 3-6. months of medication with ejection fraction remaining below <35%

a.pacemaker
b.cath ablation
c.implatable cardioverter

Answer 8

c.implatable cardioverter

Question 9

if unknown cause of syncope

Answer 9

carotid sinus massage - pause >3s and fall in bp >50

orthostatic challenge standing systolic falls >20 from baseline

if unknown still use an external loop recorder