Syncope

Question 1

Defined as sudden, transcient, and complete conscience & postural loss

Answer 1

Syncope

Question 2

SXS include extreme lightheadedness, tunnel vision, “graying out”, alterned mentation, general weakness, palpitaions

Answer 2

pre-syncope

Question 3

what type of syncope is associated with cough, micturition, defication, deglutination, Cardiac sinus syndrome?

Answer 3

Situational syncope

Question 4

what type of syncope is associated with Drug- induced, ANS failure, adv diabetes, >20/10 BP drop with positional changes

Answer 4

orthostatic

Question 5

what type of syncope is associated with bradycardia, tachycardia, prolonged QT?

Answer 5

cardiac arrhythmia syncope

Question 6

what type of syncope is associated with AMI, Aortic stenosis, HCM, Pulm HTN, Aortic dissection

Answer 6

Structural Cardion Pulm syncope

Question 7

What is a major Ddx of Syncope

Answer 7

Pots (postural orthostatic tachycardia syndrome)

Question 8

A thorough Hx for syncope includes

Answer 8

Angina, Positional change, exertion, Hx of Syncope, cardiac problems, Diabetes, Fx: CAD, SCD, syncope seizures, Arrythmias

Question 9

SXS including Lightheadedness, facial pallor, diaphoresis, and nausea are associated with?

Answer 9

Prodrome stage of VV syncope

Question 10

Which syncope is associated with a supine to standing change in BP greater than 20/10?

Answer 10

orthostatic

Question 11

What diagnostic test can you perform to diagnose someone with VVS

Answer 11

Tilt table test

Question 12

What is the most common form of syncope, and who does if affect most?

Answer 12

VVS, young and female patients

Question 13

Heat exposure, prolonged standing, and physical exertion are triggers for what syncope

Answer 13

VVS

Question 14

The Classic Prodromal Sxs of _____ syncope are Lightheadedness, diaphoresis, palpitations, nausea, GI discomfort, blurred vission, pallor

Answer 14

VVS

Question 15

How do you treat VVS?

Answer 15

Avoid triggers, education, and increase Na and water intake

Question 16

What is Carotid sinus syndrome

Answer 16

Carotid sinus stimulation leads to syncope, like shaving, a tight necktie, or prior surgery (>50mmHg drop)

Question 17

How can you diagnose Carotid sinus syncope

Answer 17

Carotid massage, Contraindicated if patient has bruit or prior TIA, MI, Stroke within 3 months.

Question 18

This type of syncope is due to hypolovemia, medications, or autonomic dysfunction (MS, Parkinson’s, DM, Alcohol, Amyloids)

Answer 18

Orthostatic

Question 19

which syncope is a diag of exclusion?

Answer 19

orthostatic

Question 20

How can you treat orthostatic Syncope?

Answer 20

Midodrine, fludrocortisone, fluids, tilt training, and water salt consumption

Question 21

What is the number 1 cause of Cardiovascular syncope?

Answer 21

Aortic stenosis

Question 22

Which syncope is associated with valvular diseases, HCM, Tamponade, ischemia, PE, Pulm HTN?

Answer 22

Structural cardiovascular syncope

Question 23

Which syncope is associated with A-fib, SVT, V-tach, AV block, and Brugada (genetic mutation, predisposed to arrhythmias)

Answer 23

Arrhythmia cardiovascular syncope

Question 24

What syncope yields the lowest survival rates

Answer 24

Cardiovascular syncope

Question 25

What is sinus node syndrome

Answer 25

a pattern of tachy-brady-pause and repeat

Question 26

Which AV blocks are associated with Arrhythmia Cardiovacular syncope

Answer 26

Mobitz 2 and 3 degree

Question 27

Which Tachycarcias are associated with Arrhythmia Cardiovacular syncope

Answer 27

SVT, WPW, A-fib with RVR, V-tach, V-fib, Torsades de pointes

Question 28

What drugs induce prolonged QT intervals

Answer 28

Quinolones, Azoles, Macrolides

Question 29

Aortic stenosis is most common as obstructive cardio syncope, what other aortic disease can occur?

Answer 29

Aortic dissection

Question 30

What syncope is associated with HCM, PE, and tamponade?

Answer 30

Obstructive cardiovascular syncope

Question 31

How can you treat Cardiovascular syncope?

Answer 31

Pacemaker, Anti-arrythmic drugs, Fluid to increase preload

Question 32

What is a fake syncope called? and how can you test for it?

Answer 32

Conversion Disorder or Psychogenic. Do the drop arm test

Question 33

How can you treat syncope in general?

Answer 33

Assess pt's pulse, elevate legs, call for help

Question 34

What is the San Francisco syncope rule?

Answer 34

CHESS | CHF, Hemocrite <30%, EKG abnormality, SOB, SBP< 90mmHg

Question 35

What are the red flags for VVS?

Answer 35

Fhx of SCD, EKG abnormalities, or Syncope working out

Question 36

associations: 1. Supine to sitting 2. changing position 3. prolonged standing 4. No prodrome 5. prodrome 6. Micturition 7. Stress induced 8. exertion

Answer 36

1. cardiogenic 2. orthostatic 3. VVS 4. arrhythmias 5. VVS 6. VVS 7. VVS 8. Cardiogenic

Question 37

What should you rule out if a patient passes out?

Answer 37

Seizures

Question 38

Syncope from hemodynamic instability is called

Answer 38

Syncope from PE

Question 39

Syncope from an ectopic pregnancy, ruptured aneurism, trauma, GI bleed is called

Answer 39

Hemorrhagic syncope

Question 40

Syncope and headache may be due to

Answer 40

Subarachnoid hemorrhage