Signs + Symptoms Flashcards
What pre-syncopal symptoms can occur?
- Dizziness
- Light-headed
- Visual blurring
- Auditory changes
- Sweating/feeling cold
- Abnormal taste/smell
- Did they know where they were
What history can be taken from a witness?
- Warning symptoms
- What happened
- Colour change
- Movement in limbs (stiffness, jerking) + how long for
- After movement stopped were they unresponsive/came around immediately
- Have they had episodes in past
What are the 3 P’s to distinguish cardiogenic and vasovagal syncope?
- Precision - should be when upright
- Provocation - pain, dehydration, emotional shock
- Prodromal - lightheaded, visual blurring, ringing in ears
What are the signs of cardiogenic syncope?
- Patient slumps
- Eyes roll back
- Some movement in arms and legs
- Very low BP - hypoperfusion of brain
What are the signs of a generalised tonic/colonic seizure?
- Cry out, fall, stiff, blue
- Tonic/clonic jerks, generalised shaking
- Unconscious - until few mins after
- As seizure goes on jerks become slower but bigger before stopping
What is a typical absence seizure?
- Childhood absence epilepsy 4-7yrs
- Juvenile absence epilepsy 13yrs
- 30 secs where patient blacks out, seems confused
What are the signs of Guillain-Barré syndrome?
- Occurs few weeks after infection (food poisoning)
- Severe Acute neuropathy - ascending weakness and numbness affecting all 4 limbs (including facial muscles)
What are the signs of a complex partial seizure?
- Loss of awareness, not loss of consciousness
- Chewing of mouth
- Can’t put into words the feeling before
What is status epilepticus?
Recurrent generalised tonic clonic seizures - fails to regain full consciousness.
What is a vasovagal syncope?
- Occurs due to reflex bradycardia +/-peripheral vasodilation provoked by emotion, pain or standing too long
- Onset is over secs and is often preceded by pre-syncopal symptoms e.g. nausea, pallor, sweating and narrowing of visual fields
- Brief clonic jerking may occur
- No urinary incontinence or tongue biting
- Unconscious ~2mins + recovery is rapid
What is situation syncope?
- Symptoms as for vasovagal but with a precipitant
- Cough syncope
- Effort syncope: brought on by exercise, usually cardiac cause e.g. AS, HCM
- Micturition syncope: happens during or after micturition (usually men, at night)
What is carotid sinus syncope?
Hypersensitive baroreceptors cause excessive reflex bradycardia +/- vasodilation on minimal stimulation e.g. head turning, shaving.
What are signs of epilepsy?
- Attacks when sleeping or lying down
- Aura
- Identifiable triggers e.g. TV
- Altered breathing
- Cyanosis
- Typical tonic clonic movements
- Incontinence of urine
- Tongue biting
- Prolonged post-ictal drowsiness
- Confusion
- Amnesia
- Transient focal paralysis (Todd’s palsy)
What are stokes-adams attacks?
- Transient Arrhythmias e.g. bradycardia due to complete heart block, cause decreased CO + LOC
- No warning (+/-palpitations) patient collapses
- Pale + slow/absent pulse
- Recovery in secs, patient flushes, pulse speeds up and consciousness regained
- Anoxic clonic jerks may occur in prolonged LOC
- Attacks may happen several times a day/any posture
What are symptoms of hypoglycaemia?
- Tremor
- Hunger + perspiration
- Light-headedness or LOC
