Neurology\ Presyncope/Syncope

Question 1

What is syncope?

Answer 1

a transient boss of consciousness studies associated with loss of postural tone with a spontaneous immediate return to baseline, neurologic function.

Question 2

What term is used to describe the symptom of “nearly blacking out”, or “nearly fainting”?

Answer 2

Presyncope

Question 3

The evaluation of syncope presyncope is the same as evaluation of syncope copy. True or False?

Answer 3

True.

Question 4

What are the common causes of syncope?

Answer 4

• vasovagal syncope in 50%
• cardiac conditions 23%
• neurological psychiatric conditions 1% Or
• unknown cause 18%

Question 5

what are life threatening causes of syncope?

Answer 5

• cardiac conditions
• bleeding
• pulmonary embolism
• subarachnoid hemorrhage

Question 6

What cardiac conditions can cause syncope?

Answer 6

• arrhythmias, eg.
  
  • Bradycardia
  • AV nodal block
  • sustained ventricular tachycardia supraventricular tachycardia
• valvular disease.
• Structural disease. e.g.
  
  • hypertrophic cardiomyopathy
• tamponade
• pacemaker malfunction.

Question 7

What is another name for neurocardiogenic syncope?

Answer 7

• vasovagal scope

Question 8

What is a pathophysiology of vasovagal syncope?

Answer 8

• Increased vagal tone leads to bradycardia and/or vasodilation.

Question 9

Most patients with facial vagal syncope have prodrome of lightheadedness, a sensation of warmth, pallor, diaphoresis and nausea. True or False?

Answer 9

• True. These symptoms result from increased vagal tone.

Question 10

What are some common triggers for vasovagal syncope?

Answer 10

• maturation, deification, deglutition
• painful stimuli
• fear or anxiety provoking situations e.g. having blood drawn
• extreme emotions
• prolonged standing
• heat exposure.

Question 11

What variant of vasovagal syncope results from pressure at the carotid sinus eg turning of the head, shaving, wearing a shirt with a tight collar?

Answer 11

• carotid sinus hypersensitivity.

Question 12

What is the definition of orthostatic hypotension?

Answer 12

• A symptomatic drop in blood pressure, that occurs with change in position.

Question 13

How do you test for orthostatic hypotension?

Answer 13

• The posture test will demonstrate the systolic BP decrease of more than 20 mm Hg, or a diastolic BP decrease of more than 10 mm Hg, within three minutes of standing upright or sitting from a supine position.
• An increase in heart rate of 20 beats per minute is also commonly seen.

Question 14

What conditions can cause orthostatic hypotension?

Answer 14

• hypovolemia
• anemia
• autonomic nervous system dysfunction (from Parkinson, or diabetes mellitus)
• medications (such as antidepressants or antihypertensives)

Question 15

Is stroke a common cause of syncope?

Answer 15

• no stroke and transient ischemic attacks typically cause neurologic deficits that are not rapidly reversible.