Syncope Flashcards

1
Q

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

A

Syncope

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2
Q

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

A

pre-syncope

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3
Q

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

A

Situational syncope

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4
Q

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

A

orthostatic

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5
Q

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

A

cardiac arrhythmia syncope

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6
Q

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

A

Structural Cardion Pulm syncope

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7
Q

What is a major Ddx of Syncope

A

Pots (postural orthostatic tachycardia syndrome)

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8
Q

A thorough Hx for syncope includes

A

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

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9
Q

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

A

Prodrome stage of VV syncope

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10
Q

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

A

orthostatic

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11
Q

What diagnostic test can you perform to diagnose someone with VVS

A

Tilt table test

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12
Q

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

A

VVS, young and female patients

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13
Q

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

A

VVS

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14
Q

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

A

VVS

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15
Q

How do you treat VVS?

A

Avoid triggers, education, and increase Na and water intake

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16
Q

What is Carotid sinus syndrome

A

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

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17
Q

How can you diagnose Carotid sinus syncope

A

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

18
Q

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

A

Orthostatic

19
Q

which syncope is a diag of exclusion?

A

orthostatic

20
Q

How can you treat orthostatic Syncope?

A

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

21
Q

What is the number 1 cause of Cardiovascular syncope?

A

Aortic stenosis

22
Q

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

A

Structural cardiovascular syncope

23
Q

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

A

Arrhythmia cardiovascular syncope

24
Q

What syncope yields the lowest survival rates

A

Cardiovascular syncope

25
Q

What is sinus node syndrome

A

a pattern of tachy-brady-pause and repeat

26
Q

Which AV blocks are associated with Arrhythmia Cardiovacular syncope

A

Mobitz 2 and 3 degree

27
Q

Which Tachycarcias are associated with Arrhythmia Cardiovacular syncope

A

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

28
Q

What drugs induce prolonged QT intervals

A

Quinolones, Azoles, Macrolides

29
Q

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

A

Aortic dissection

30
Q

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

A

Obstructive cardiovascular syncope

31
Q

How can you treat Cardiovascular syncope?

A

Pacemaker, Anti-arrythmic drugs, Fluid to increase preload

32
Q

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

A

Conversion Disorder or Psychogenic. Do the drop arm test

33
Q

How can you treat syncope in general?

A

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

34
Q

What is the San Francisco syncope rule?

A

CHESS

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

35
Q

What are the red flags for VVS?

A

Fhx of SCD, EKG abnormalities, or Syncope working out

36
Q

associations:

  1. Supine to sitting
  2. changing position
  3. prolonged standing
  4. No prodrome
  5. prodrome
  6. Micturition
  7. Stress induced
  8. exertion
A
  1. cardiogenic
  2. orthostatic
  3. VVS
  4. arrhythmias
  5. VVS
  6. VVS
  7. VVS
  8. Cardiogenic
37
Q

What should you rule out if a patient passes out?

A

Seizures

38
Q

Syncope from hemodynamic instability is called

A

Syncope from PE

39
Q

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

A

Hemorrhagic syncope

40
Q

Syncope and headache may be due to

A

Subarachnoid hemorrhage