syncope

Question 1

extreme lightheadedness, visual sensations, variable degrees of altered consciousness W/O complete LOC.

Answer 1

near syncope

Question 2

transient, complete LOC, inability to maintain postural tone with rapid and complete recovery.

Answer 2

syncope

Question 3

most common etiology of syncope is of what type?

Answer 3

reflex

Question 4

d/t a mutation in cardiac sodium channel gene (sodium channelopathy) esp in Asian descent

Answer 4

brugada syndrom

Question 5

Abnormal ECG (sometimes) + 1+ of
* VF or polymorphic VT
* fam hx of sudden cardiac death under 45
* coved type ECG in fam members
* syncope

Answer 5

brugada syndrome

Question 6

these are predictors of what type of syncope

• palpitations before syncope
• quick event, minimal or no sx, amnestic
• known heart dz, abnormal ECG
• syncope while lying down or during effort

Answer 6

cardiac syncope

Question 7

syndrome that Predisposes to malignant ventricular arrhythmias (eg. torsades)

Answer 7

long QT syndrome

Question 8

4 causes of long QT syndrome

Answer 8

1. meds
2. genetics
3. myocardial dz
4. low Ca, K, MG

Question 9

which monitor?

continuous recording; for pt w/ daily symptoms & correlate w/ event diary

Answer 9

holter monitor 24-48hrs

Question 10

which monitor?

patient activated or automatically activated; for pt w/ sx few times/month

Answer 10

event monitor: up to 30 days

Question 11

which monitor?

continuous recording with patient-trigger capabilities; 1-2 wks

Answer 11

ZIO patch

Question 12

which monitor?

continuous monitoring; trans-telephonic trasmission; patient activation w/ automatic detection of sig. arrhythmias; 2-3 years

Answer 12

loop recorder

Question 13

you can use tilt table testing for which two types of syncope?

Answer 13

reflex & orthostatic hypotension

Question 14

these are causes of

idiopathic degenerative fibrosis
ischemia
cardiomyopathies
infiltrative dz
congenital abnormalities

Answer 14

5 intrinsic causes of sinus sick syndrome

Question 15

• drugs
• autonomic dysfunction
• hypothyroidism
• hyperkalemia

Answer 15

4 extrinsic causes of sick sinus syndrome

Question 16

SSS involves which node? how is it treated?

Answer 16

loss of SA node function
tx depends on underlying cause

Question 17

you should suspect ____ if

• hear crescendo-decrendo murmur SEM (@ RUSB)
• fatigue, dyspnea, exertional angina, LE edema, near syncope, syncope

Answer 17

aortic stenosis

Question 18

2 most common causes of aortic stenosis in western world

Answer 18

senile aortic valve calcification
bicuspid aortic valve

Question 19

leading cause of AS & MS in developing nations

Answer 19

rheumatic heart dz

Question 20

2 tx options for aortic stenosis

Answer 20

valvuloplasty or replacement

Question 21

these are ____ conditions where you’d do an ECG for diagnosing

• Inheritable CV conditions predisposing to arrhythmias
• Sinus brady < 40 or pauses > 3 sec
• Mobitz II
• Sustained SVT or VT
• Pacemaker ICD malfunction w/ cardiac pauses

Answer 21

cardiac-arrhythmic conditions