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#Phase 2.2: Elderly & Chronic Care > Syncope > Flashcards

Syncope Flashcards

1
Q

What is syncope?

A

Temporarily losing consciousness bc disruption of blood flow to brain

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2
Q

What is a vasovagal episode?

A

Problem with Autonomic Nervous System regulating blood flow to the brain

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3
Q

What are the 7 steps of a Vasovagal episode?

A
  1. Stimulus: emotional event / painful sensation / change in temp
  2. Parasympathetic Nervous System stimulated
  3. PNS counteracts SNS (which vasoconstricts blood vessels to brain)
  4. Blood vessels to brain relax
  5. Cerebral Circulation BP drops
  6. Hypoperfusion of brain tissue
  7. Patient loses consciousness
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4
Q

What is the feeling patients feel before a syncope episode called?

A

Prodrome

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5
Q

What do patients feel in the Prodrome period before a syncope episode? (6 things)

A
  1. Hot / clammy
  2. Sweaty
  3. Heavy
  4. Dizzy
  5. Blurry vision / dark
  6. Headache
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6
Q

What may a collateral history from a person who witnessed a syncope event show? (3 things)

A
  1. Sudden loss of consciousness + fall to ground
  2. Unconscious on ground for few seconds to minute as blood returns to brain
  3. Twitching / shaking / convulsion (could confuse for seizure)
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7
Q

What is similar between syncope events and seizures? (3 things)

A
  1. Twitching / shaking / convulsion
  2. Groggy after
  3. Incontinence
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8
Q

How would you differentiate a syncope event from a seizure? (4 things)

A

Seizure = groggy after but called postictal period:
1. Prolonged period of confusion
2. Drowsinesss
3. Irritability
4. Disorientation

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9
Q

Is Prolonged upright position before the event associated with Syncope or Seizures?

A

Syncope

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10
Q

Is Epilepsy aura (smells, tastes or deja vu) before the event associated with Syncope or Seizures?

A

Seizures

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11
Q

Is Lightheaded before the event associated with Syncope or Seizures?

A

Syncope

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12
Q

Is Head turning or abnormal limb positions associated with Syncope or Seizures?

A

Seizures

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13
Q

Is Sweating before the event associated with Syncope or Seizures?

A

Syncope

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14
Q

Is Tonic clonic activity associated with Syncope or Seizures?

A

Seizures

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15
Q

Is Blurring or clouding of vision before the event associated with Syncope or Seizures?

A

Syncope

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16
Q

Is Tongue biting associated with Syncope or Seizures?

A

Seizures

17
Q

Is Reduced tone during the episode associated with Syncope or Seizures?

A

Syncope

18
Q

Is Cyanosis associated with Syncope or Seizures?

A

Seizures

19
Q

Is Return of consciousness shortly after falling associated with Syncope or Seizures?

A

Syncope

20
Q

Is Lasts more than 5 minutes associated with Syncope or Seizures?

A

Seizures

21
Q

Is No prolonged post-ictal period associated with Syncope or Seizures?

A

Syncope

22
Q

Is Prolonged post-ictal period associated with Syncope or Seizures?

A

Seizures

23
Q

What are the primary causes of syncope? (4 things)

A
  1. Dehydration
  2. Missed meals
  3. Standing for long time in warm environment (e.g 11 November minute silence)
  4. Vasovagal (emotional event / pain / seeing blood)
24
Q

What are the secondary causes of syncope? (6 things)

A
  1. Hypoglycaemia
  2. Anaemia
  3. Arrhythmias
  4. Valvular heart disease
  5. Infection
  6. Anaphylaxis
25
Q

What should you do when examining a Syncope patient? (5 things)

A
  1. Any physical injuries bc fall (e.g head injury)
  2. Any concurrent illness (e.g infection)
  3. Neuro exam
  4. CVS exam (esp Pulses, HR, Rhythm, Murmurs)
  5. BP (lying + standing)
26
Q

What investigations should do for a Syncope patient? (4 things)

A
  1. ECG (esp check arrhythmia / long QT syndrome)
  2. 24 hr ECG (if sus paroxysmal arrhythmia)
  3. Echo (if sus structural heart disease)
  4. Bloods
27
Q

What are you looking for in a bloods of a Syncope patient? (3 things)

A
  1. FBC (anaemia)
  2. Electrolytes (arrhythmias / seizures)
  3. Blood glucose (diabetes)
28
Q

What is the management for recurrent Syncope episodes?

A

Ntn, usually resolves by adulthood

29
Q

What is the most important aspect of managing a Syncope patient?

A

Confident diagnosis and excluding other pathology

30
Q

What advice should you give a simple vasovagal episode patient? (4 things)

A
  1. Avoid dehydration
  2. Avoid missing meals
  3. Avoid standing still for long periods
  4. If experiencing prodrome: sit / lie down / have water / eat

#Phase 2.2: Elderly & Chronic Care (8 decks)

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