Important

Question 1

Explain vasovagal syncope

Answer 1

In this condition in response to certain triggers such as overexerting in hot sunny weather can stimulate a nerve in the body that causes pooling of blood in legs –> decreased return of blood towards heart –> n thus blood supply towards the brain can be temporarily compromised which can lead to sudden faintness and collapse.

Question 2

DDx for Syncope

Answer 2

• Vasovagal syncope
• CVS:
  
  • ACS/ MI
  • AS
  • Arrhythmia - Long QT syndrome
  • HOCM
  • Pulmonary embolism
• Alcohol/ Drug overdose
• Hepatic encephalopathy
• Neuro -
  
  • Stroke/ TIA
  • Seizure/ Epilepsy
  • Head trauma
  • Brain tumor
  • Meningitis
  • SAH/ ICH
  • Migraine
• Electrolyte imbalance - Hyper/ Hypoglycemia
• Hyperthyroidism
• Panic attack/ Psychogenic seizures

Question 3

Causes for prolong QT?

Answer 3

• Genetic - cardiac ion channel mutation (Na+, K+)
• Drugs: Amiodarone, SSRI, Ondansetron, Droperidol, Many antibiotics
• Myocardial: MI, RF, 3rd degree HB, Cardiomyopathy
• Electrolytes: Low Ca2+, Low Mg2+

Question 4

How do you explain prolong QT syndrome to a patient?

Answer 4

Long QT syndrome is a heart rhythm disorder where the heart’s electrical system takes longer than usual to recharge between beats. This can lead to an increased risk of dangerous heart rhythms, which may cause fainting, dizziness, or, in severe cases, life-threatening arrhythmias.

Question 5

How to explain Psychogenic pseudoseizure to a patient?

Answer 5

Δ: Most likely you had a “Psychogenic Pseudoseizure”. Some of your symptoms are similar to a seizure but the episode just happened due to the stressful environment.

> Psychogenic pseudoseizure, also known as non-epileptic seizure or functional seizure, is a condition where a person experiences seizure-like episodes that are not caused by abnormal electrical activity in the brain. Instead, these episodes are triggered by emotional or psychological factors, and although they may look like seizures, they are not caused by epilepsy.

Question 6

PE risk factors?

Answer 6

• DVT risk factors: COST VMPF
  
  • C - Contraception
  • O - obesity : Do you consider your self to be overweight?
  • S - surgery : Any recent surgery?
  • T - Trauma: Any recent trauma?/ Any recent travel? - not that relevant
  • V - Varicose vein: Any dilated blood vessels in your arms
  • M - malignancy: LOW, LOA, L & B
  • P - Pregnancy
  • F - Family Hx of clots

Question 7

PR Bleeding DDx?

Answer 7

Rectal bleeding ddx:
▪ Haemorrhoid
▪ Anal Fissure
▪ Inflammatory bowel disease - Crohns
▪ Diverticulitis
▪ Mesenteric ischemia
▪ Colorectal cancer
▪ GE
▪ Blood thinners

Question 8

Explain COPD?

Answer 8

You have a condition called COPD, or chronic obstructive pulmonary disease, is a lung condition where the airways become inflamed and narrowed over time, making it difficult to breathe. It is usually caused by smoking or long-term exposure to irritants, and symptoms include coughing, shortness of breath, and reduced ability to perform physical activities.