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History taking > Common cerebral histories - Fit/syncope > Flashcards

Common cerebral histories - Fit/syncope Flashcards

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1
Q

What would you want to know when asking about a fit/fall/syncope?

A
  • Before
  • During
  • After
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2
Q

What would you ask about seizure/LOC - during the event?

A
  • Duration
  • Movements - floppy/stiff/jerking
  • Incontinence/tongue biting
  • Complexion
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3
Q

What would you ask about seizure/LOC - after the event?

A
  • Amnesia
  • Muscle pain
  • Confusion/sleepiness
  • Injuries
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4
Q

What questions would you want to ask in relation to LOC/seizure on systems enquiry?

A
  • General - fever
  • CVS - Palpiations, chest pain, SOB, wheeze, leg swelling
  • Neuro - Headache, dizziness, vision, hearing, memory loss, neck stiffness, weakness/wasting, incontinence, numbness
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5
Q

What features associated with Fit/faints/fall may suggest postural hypottension?

A
  • Dizziness +/- LOC on standing from sitting/lying
  • Rcent medication change
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6
Q

What features associated with fit/faint/fall would suggest arrythmia as a cause?

A
  • Fall after palpitations/felt strange
  • CArdiac history
  • Family history
  • Occured during exercise or when supine
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7
Q

What features associated with LOC/fits/falls would suggest aortic stenosis?

A
  • Collapse on exertion
  • SOB worse on exercise
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8
Q

What features associated with fit/faint/fall would suggest a simple partial seizure?

A
  • Focal motor seizure
  • No LOC
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9
Q

What features associated with fit/faint/fall would suggest a complex partial seizure?

A

Strange actions with impaired awareness

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10
Q

What features associated with fit/faint/fall would suggest a generalised tonic clonic seizure?

A
  • Sudden LOC
  • Limbs stiff then jerk
  • May become incontinent
  • Bite tongue
  • Feel awful with myalgia and confusion afterwards
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11
Q

What features associated with fit/faint/fall would suggest a generalised abscence seizure?

A

Unresponsive stare into space for > 5 seconds

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12
Q

What features associated with fit/faint/fall would suggest a generalised atonic seizure?

A

All muscles relax and drop to the floor

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13
Q

What features associated with fit/faint/fall would suggest a generalised myoclonic seizure?

A

Involuntary flexion

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14
Q

What features associated with fit/faint/fall would suggest a generalised tonic seizure?

A

All muscles become rigid

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15
Q

What features associated with fit/faint/fall would suggest a parkinsons disease?

A

TETRAD

  • Tremor
  • Bradykinesia
  • Postural instability
  • Rigidity
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16
Q

What features associated with fit/faint/fall would suggest a TIA/stroke?

A

LOC/syncope very uncommon - Focal Neuro symptoms

17
Q

What features associated with fit/faint/fall would suggest a vasovagal?

A
  • Occurs in response to stimuli - emotion, pain, feat, prolonged standing
  • Preceding nausea, pallor, sweat, closing visual fields
  • LOC for approx 2 minutes
18
Q

What are cardiorespiratory causes of a fit/faint/fall?

A
  • Postural hypotension
  • Arrythmia
  • Aortic stenosis
  • HOCM
  • Situational syncope
  • Carotid sinus hypersensitivity
  • Vertebrobasilar insufficiency
  • PE
19
Q

What are neurological causes of fits/faint/falls?

A
  • Seizure
  • Parkinson’s disease
  • TIa/stroke
  • Vasovagal
  • Neuropathy
  • Intracranial haemorrhage
  • Drop attack
20
Q

What are abdominal cause of fits/faints/seizures?

A
  • Ectopic pregnancy
  • Ruptured AAA
21
Q

What non-cardiovascular/neurological/abdominal causes of fits/faints/falls would you also consider as part of a differential?

A
  • Drugs - alcohol, opiates, other
  • Anaemia
  • Hypoglycaemia
  • Vertigo
  • Eyesight problems
  • Mechanical/arthritis

History taking (53 decks)

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