Chapter 33, Module 5; Syncope

Question 1

Shortness of breath, chest pain, palpitations, exercise-associated syncope

Answer 1

Organic heart disease

Question 2

May have bradycardia or tachycardia, cyanosis

Answer 2

Organic heart disease

Question 3

Diagnostics for Organic heart disease?

Answer 3

Refer

Question 4

Palpitations; absence of other symptoms

Answer 4

Arrhythmias

Question 5

Loud S2, S3; murmur, lift

Answer 5

Arrhythmias

Question 6

Diagnostics for Arrhythmias

Answer 6

Electrocardiogram, Holter monitor, echocardiogram Doppler studies, cardiac stress testing

Question 7

Emotional event, standing for long periods, crowded room, warm environment

Answer 7

Vasovagal

Question 8

Physical Findings for Vasovagal?

Answer 8

None

Question 9

Diagnostics for Vasovagal?

Answer 9

Tilt-table testing, CSM

Question 10

Occurs with cough, micturition, defecation, swallowing

Answer 10

Situational

Question 11

Physical Findings for Situational?

Answer 11

None

Question 12

Diagnostics for Situational?

Answer 12

None

Question 13

Children 6 mo to 5 yr; associated with anger, pain, brief cry; breath-holding LOC; may have twitching

Answer 13

Breath holding

Question 14

Cyanosis or pallor

Answer 14

Breath holding

Question 15

Diagnostics for Breath holding?

Answer 15

None

Question 16

Anxiety- or fear-induced event, shortness of breath

Answer 16

Hyperventilation

Question 17

Physical Findings for Hyperventilation?

Answer 17

None

Question 18

Diagnostics for Hyperventilation?

Answer 18

None

Question 19

History of asthma; coughing paroxysm awakens child from sleep, becomes flaccid with clonic muscle spasm, LOC

Answer 19

Cough syncope

Question 20

Physical Findings for Cough syncope?

Answer 20

Wheezes

Question 21

Diagnostics for Cough syncope?

Answer 21

none

Question 22

Position change from lying/sitting to standing, pregnancy, prolonged bed rest

Answer 22

Orthostatic hypotension

Question 23

Hypotension on testing orthostatic blood pressure

Answer 23

Orthostatic hypotension

Question 24

Diagnostics for Orthostatic hypotension?

Answer 24

20-mm Hg drop insystolic pressureon standing

Question 25

History of antidepressants, antiarrhythmic agents, (B-blockers, or diuretics

Answer 25

Prescribed medications

Question 26

Depends on underlying condition

Answer 26

Prescribed medications

Question 27

Diagnostics for Prescribed medications?

Answer 27

none

Question 28

History of use of illicit drugs

Answer 28

Drug-induced causes

Question 29

Arrhythmia may be present

Answer 29

Drug-induced causes

Question 30

Diagnostics for Drug-induced causes?

Answer 30

Toxicology screen

Question 31

Headache, vomiting, photophobia, positive family history

Answer 31

Migraine

Question 32

Usually none; nystagmus, photophobia

Answer 32

Migraine

Question 33

Diagnostics for Migraine?

Answer 33

none

Question 34

Convulsions, incontinence, postictal phase

Answer 34

Seizures

Question 35

Usually none; nystagmus

Answer 35

Seizures

Question 36

Diagnostics for Seizures?

Answer 36

Electroencephalogram

Question 37

Symptoms consistent with depression, anxiety, panic

Answer 37

Mental disorder

Question 38

Physical findings Mental disorder?

Answer 38

None

Question 39

Diagnostics for Mental disorder?

Answer 39

Psychiatric evaluation

Question 40

Adolescent, event occurs with audience present; gentle fall, memory of incident exact

Answer 40

Hysterical reaction

Question 41

Physical findings hysterical reaction?

Answer 41

none

Question 42

Diagnostics for Hysterical reaction?

Answer 42

none

Question 43

No diagnostic characteristics

Answer 43

Unknown Causes

Question 44

Physical findings of unknown causes?

Answer 44

none

Question 45

Diagnostics for Unknown Causes?

Answer 45

Workup normal results