Syncope and weakness Flashcards
definisi syncope
transient LOC due to cerebral hypoperfusion
ciri-ciri syncope
- onset cepat
- durasi pendek dan spontan
- recovery COMPLETE
DD syncope (yg harus dipikirkan terlebih dulu)
- cardiac condition
- orthostatic hypotension
- Neurogenic
- Vasovagal
apa bedanya syncope akibat vasovagal dan orthostatic hypotension?
Vasovagal:
- akibat berdiri terlalu lama, atau micturition/defecation
- didahului gejala prodromal (mual, sweating, pandangan kabur)
Orthos hypo:
- akibat perubahan posisi mendadak
- tanpa gejala prodormal
what is cardiac condition cause syncope?
- dysarthimia (tachy/bradi)
- effort syncope: R/L outflow obstruction
- contractility: AMI, myocarditis
what is orthostatic condition cause syncope?
- fluid loss
- drugs
- autonomic neuropathy
what is neurogenic condition cause syncope?
- cerebral: stroke
- carotid sinus hypersensitivity syndrome
bagaimana mendiagnosis vasovagal syncope?
dengan meng-eksklusikan 3 kondisi sebelumnya (cardiac, orthostatic syncope, neurogenic)
apa saja kategori risk stratification syncope?
low-risk
intermediate-risk
high-risk
kategori low-risk syncope?
- gejala prodormal
- dipicu oleh batuk/defekasi/miksi
- perubahan posisi mendadak
- after unexpected unpleasant sigh/sound/pain/smell
- tidak ada riwayat penyakit jantung
- PF NORMAL
- EKG NORMAL
kategori high-risk syncope?
- nyeri dada, nyeri perut, sesak
- aktivitas fisik
- palpitasi riwayat penyakit jantung
- abnormal examination
- EKG ABNORMAL
diagnosa awal yg perlu dieksklusikan ketika pasien datang dengan kelemahan/lemas (weakness)
- hypoglicemia
- stroke
- hyper/hypokalaemia
bagaimana pendekatan pasien dengan keluhan lemas/kelemahan (weakness)
- assess ABC + cek GDS
- PF neurologis
- objective weakness (CNS) or subjective weakness (systemic)
DD/ objective weakness?
- Unilateral vs bilateral
- UMN vs LMN
DD/ LMN?
- NMJ: diffuse
- neuropathy: dominan distal
- myopathy: dominan proximal
DD/ subjective weakness
life-threatening: Sepsis. AMI, addisonian crisis
non-life-threatening: General malaise (dehydration, anemia, hypothyroidism)
