loss of concious Flashcards by Ahmed Mohamed

What is one of the cerebral causes of coma mentioned in the text?

Head injury

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Cerebral thrombosis is a type of cerebrovascular accident (CVA) listed under cerebral causes of coma, not a separate cause

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Describe the characteristics of syncope.

Characteristics of syncope:

Transient loss of consciousness

Rapid onset and short duration

Loss of postural tone

Spontaneous complete recovery

Often preceded by symptoms like lightheadedness, nausea, or visual disturbances

Commonly known as fainting or blackout

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Explain the physiological changes that occur during vasovagal syncope.

During vasovagal syncope, the following physiological changes occur:

Activation of the vagus nerve

Heart rate slows down

Blood pressure drops

Blood vessels in the legs dilate

Blood pools in the lower body, reducing flow to the brain

These changes can lead to weakness, nausea, and fainting.

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Which response category has the highest possible score in the GCS?

Motor response (maximum score of 6)

Verbal response (maximum score of 5)
Eye opening response (maximum score of 4)

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What are some non-cardiac causes of syncope?

Non-cardiac causes of syncope include:

Orthostatic hypotension
Vasovagal syncope
Prolonged standing
Sudden position changes
Hot or crowded environments
Sight of blood or intense emotions
Straining during heavy lifting or bowel movements

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Discuss the importance of the Glasgow Coma Scale in assessing patients.

The Glasgow Coma Scale (GCS) is crucial for assessing consciousness levels in head injury patients. It classifies brain injury severity:

Severe: GCS 8 or less

Moderate: GCS 9-12

Mild: GCS 13-15

GCS helps determine treatment needs, like mechanical ventilation for low scores.

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vasovagal syncope

A sudden drop in heart rate leading to fainting

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What is orthostatic hypotension?

A drop in blood pressure upon standing

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Describe the differences between hypoglycemic coma and diabetic ketoacidosis.

Hypoglycemic Coma:

Caused by low blood sugar
Often due to insulin overdose or missed meals
Brain lacks glucose, leading to unconsciousness

Diabetic Ketoacidosis (DKA):

Caused by insulin deficiency
Body uses fat for energy, producing ketones
High blood sugar and ketone levels, can lead to coma if untreated

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What are the key steps in the management of diabetic ketoacidosis?

Key steps in managing diabetic ketoacidosis:

Administer intravenous fluids to correct dehydration

Start insulin therapy to lower blood sugar and ketone levels

Monitor electrolytes, especially potassium

Assess and treat underlying causes (e.g., infections)

Regularly check blood glucose and ketone levels

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What condition occurs when blood sugar levels drop critically low?

Hypoglycemic coma

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Diabetic ketoacidosis

Diabetic ketoacidosis results from high blood sugar and lack of insulin, not critically low blood sugar.

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How can severe pain trigger a vasovagal response?

Severe pain can trigger a vasovagal response by stimulating the vagus nerve. This leads to increased acetylcholine, slowing the heart rate and dilating blood vessels. As a result, blood pools in the legs, reducing blood flow to the brain, which can cause fainting or feeling weak.

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What triggers vasovagal syncope?

Prolonged standing and intense emotions

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How can physical or emotional trauma trigger diabetic ketoacidosis?

Physical or emotional trauma can trigger diabetic ketoacidosis by increasing stress hormones like adrenaline and cortisol, which counteract insulin’s effects.

What factors can lead to orthostatic hypotension?

Factors leading to orthostatic hypotension include:

-Neurally mediated causes:

Peripheral neuropathy (e.g., diabetes)

Parkinsonism

-Non-neurally mediated causes:

Decreased blood volume (blood loss, dehydration)

Medications (antihypertensives, vasodilators)

What triggers diabetic ketoacidosis (DKA)?

Missed insulin doses

What is a common symptom of diabetic ketoacidosis?

Excessive thirst

How does insulin therapy help in the treatment of diabetic ketoacidosis?

Insulin therapy helps treat diabetic ketoacidosis by:

Lowering blood glucose levels

Reducing ketone production

Allowing glucose to enter cells for energy

Correcting metabolic acidosis

This therapy is crucial for reversing the dangerous effects of DKA and restoring normal metabolic function.

What are the potential risks associated with fainting?

Potential risks associated with fainting include:

Injuries from falls

Confusion or disorientation upon waking

Underlying health issues (e.g., heart problems)

Increased risk of future
fainting episodes

Potential for accidents if fainting occurs while
driving or operating machinery

What role do baroreceptors play in maintaining blood pressure upon standing?

Baroreceptors help maintain blood pressure when standing by detecting changes in blood flow. They trigger a reflex that increases sympathetic activity

What can cause a person to faint when standing up quickly?

Vasovagal syncope is the most common cause of fainting. A sudden change in position, like standing quickly,

What are the potential complications of untreated diabetic ketoacidosis?

Potential complications of untreated diabetic ketoacidosis include:

Diabetic coma

Severe dehydration

Electrolyte imbalances

Kidney failure

Brain swelling (cerebral edema)

Heart problems

Increased risk of infections

These complications can be life-threatening and require immediate medical attention.

How can emotional distress contribute to episodes of syncope?

Emotional distress can trigger vasovagal syncope by stimulating the vagus nerve,

Vasovagal syncope is the most common cause of fainting. It's triggered by a stressor activating the vagus nerve, slowing heart rate, dropping blood pressure, and causing blood to pool in the legs, reducing blood flow to the brain

Describe the process by which ketone bodies accumulate in the bloodstream during DKA.

In diabetic ketoacidosis (DKA), low insulin levels prevent glucose from entering cells, causing the body to break down fat for energy. This process produces ketone bodies

How might medications contribute to syncope or orthostatic hypotension?

Medications can contribute to syncope or orthostatic hypotension by: Causing blood pressure drops (e.g., antihypertensives, vasodilators) Reducing blood volume (e.g., diuretics) Affecting heart rate or rhythm These effects can lead to decreased blood flow to the brain, resulting in fainting or dizziness.

What factors can lead to an inadequate insulin therapy that may trigger DKA?

Factors leading to inadequate insulin therapy that may trigger DKA include: Missed insulin doses Inadequate insulin dosage Illness or infection (e.g., pneumonia, UTIs) Physical or emotional trauma Certain medications (e.g., corticosteroids) Alcohol or drug abuse (e.g., cocaine)

What preventive measures can be taken to avoid hypoglycemic episodes in diabetic patients?

To prevent hypoglycemic episodes in diabetic patients: Monitor blood sugar regularly Take medications as prescribed Eat regular meals and snacks Avoid vigorous exercise without food Educate friends/family on hypoglycemia signs Carry fast-acting glucose sources (like candy) for emergencies

Parkinsonism

الشلل الرعاشي

paroxysmal attacks

.Epilepsy *Syncope *Hysteriai هو عباره عن عدم من عماليات الاغماء التي تحدث للمريض

Causes of coma

1) Cerebral causes: * Head injury (trauma). * Cerebro-vascular accidents: as in cerebral thrombosis, embolism,or hemorrhage. * Meningitis and encephalitis (التهاب الدماغ). 2) Metabolic causes: * Diabetic coma. * Uremia (uremic coma) = renal coma. * Hepatic coma. * Hyperthermia as in heat stroke. * Hypothermia as in myxoedema coma. 3) Toxic causes: * Alcohol. * Narcotics.

Symptoms of ketoacidosis

* Excessive thirst * Frequent urination * Nausea and vomiting * Abdominal pain * Weakness or fatigue * Shortness of breath * Fruity-scented breath * Confusion More-specific signs of diabetic ketoacidosis — which can be detected through home blood and urine testing kits — include: * High blood sugar level (hyperglycemia) * High ketone levels in your urine

Non-ketotic hyperosmolar syndrome (NKHS)

*Diabetic hyperosmolar syndrome. This is a condition in which the blood sugar is as high as 600 mg/d * There are no ketones in the urine but the blood is thicker due to the high blood sugar levels.

What diagnostic tests are typically performed to confirm diabetic ketoacidosis?

To confirm diabetic ketoacidosis, the following diagnostic tests are typically performed: Blood sugar level (high) Urine ketones (ketonuria) Blood gas analysis (acidosis) Electrolyte levels (especially potassium) These tests help assess the severity and presence of ketoacidosis.

What treatment is recommended for hypoglycemic coma?

Intravenous concentrated glucose

Which hormone is primarily responsible for counteracting low blood sugar levels?

Glucagon

antihypertensive

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