Neurology - Collapse : What is the Cause ? Flashcards
differential diagnoses for collapse
epilepsy
syncope
psychogenic attacks
TIA
migraine
hypoglycaemia
infection
what is important to consider when taking a collapse history
witnesses
before, during , after event
examinations for collapse
cardiovascular
hr and bp
precordium
neuro
investigation for blackouts
ecg
carotid sinus massage
tilt table
echo
mri head
eeg
what does inverted t wave indicate
a.atrial fibrillation
b.bundle branch block
c.ventricular tachycardia
d.ventricular hypertrophy
b.bundle branch block
what egg changes indicate a trifascicular block
pr prolongation
axis deviation
slurred S wave
what parts of the heart are blocked in trifascicular block
a.right bundle branch, left anterior /posterior fascicular block and av block (prolonged pr)
b.left bundle branch, left anterior/posterior fascicular block and av block (prolonged pr)
a.right bundle branch, left anterior /posterior fascicular block and av block (prolonged pr)
what ecg changes occur in right bundle branch block
qrs more than 120 ms
broad S wave in v5/v6
large r wave in v1/v2
ecg criteria for left anterior fascicular block
left axis deviation (L1> L3)
which type of syncope shows trifascicular block
a.cardiac
b.vasovagal
c.carotid sinus
d.orthostatic hypotension
e.psychogenic attacks
a.cardiac
patient fainting , experiences nausea preceeding and a gradual build up, witness says they looked pale and did not jerk, they have no incontinence and it lasted 20 seconds the patient felt tired for a few hrs after what is more likely
a.vasovagal
b.cardiac
a.vasovagal
patient had fainted suddenly, witness said they looked and had no jerks / incontinence, patient said they bit their tongue a bit and it lasted a few mins, afterwards they experienced no confusion or fatigue
which is more likely
a.vasovagal
b.cardiac
b.cardiac
a period of inability to perform voluntary movements at sleep onset or upon wakening during the night or the morning with associated hallucination , sensed presence , pressure of chest and out of body experience
sleep paralysis
excess sleepiness typically associated with sleep paralysis and cataplexy
narcolepsy
which type of narcolepsy is caused by hypocretin deficiency and is almost always associated with cataplexy
a.type 2
b. type 1
c.idiopathic
b. type 1
which type of narcolepsy has 2 or more sleep onset REM periods in multiple sleep latency test
a.type 2
b. type 1
c.idiopathic hypersonic
a.type 2
which type of narcolepsy has less than 2 sleep onset REM periods in multiple sleep latency test
a.type 2
b. type 1
c.idiopathic hypersomnia
c.idiopathic hypersomnia
in which age group is knlein levin syndrome most common
a.elderly
b.children
c.teenagers
c.teenagers
what condition is characterised by persistent episodic hypersomnia , mood changes, hyperphagia (excessive eating) and hyper sexuality . it has recurrent episodes for more than 10 yrs with episodes lasting up to 4 wks . onset of this condition usually follows a viral infection
a.type 1 narcolepsy
b.type 2 narcolepsy
c.vasovagal syncope
d.klein levin syndrome
e. eaton Lambert syndrome
f.idopathic hypersomnia
d.kllein levin syndrome
60 yr old obese male patient has excessive day time drowsiness, wakes up with a dry throat , poor memory and concentration, headaches in the morning, nocturna
pmh : hypertension , stroke
what is most likely diagnosis
a.type 1 narcolepsy
b.type 2 narcolepsy
c.vasovagal syncope
d.klein levin syndrome
e. eaton Lambert syndrome
f.idopathic hypersomnia
g.obstructive sleep apnoea
g.obstructive sleep apnoea
patient experiencing seizures especially following periods of stress
they are gradual onset, and accompanied by head shaking side to side and back arching , and tongue biting , her limbs also move out of sync , her eyes are closed and she experiences incontinence
what is most likely cause of seizure
a.psychogenic non epileptic
b.epileptic
c.frontal lobe
a.psychogenic non epileptic
patient experiencing seizures with tongue biting , cyanosis ,
ictal grasping , noisy breathing and incontinence lasting less than 2 mins and eyes open during onset
what is most likely cause of seizure
a.psychogenic non epileptic
b.epileptic
c.frontal lobe
c.frontal lobe
frontal lobe epilepsy mimics what
a.psychogenic seizure
b.narcolepsy
c.idiopathic hypersomnia
d.klein levine syndrome
e.obstructive sleep apnoea
a.psychogenic seizure
patient has seizures, eyelids not fully closed, ictal grasping , pelvic thrusting and vocalisation common , happens when they arise from sleep involve quick tonic posturing
which most likely
a.psychogenic non epileptic
b.epileptic
c.frontal lobe
c.frontal lobe
what is the gold standard for differentiating seizures
a.mri
b.eeg
c. fmri
d.ecg
b.eeg
