Exam 4 Syncope Flashcards Preview

Q4 Clin Med III (GI) > Exam 4 Syncope > Flashcards

Flashcards in Exam 4 Syncope Deck (23)
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1
Q

Syncope is?

a/w?

Result of?

A

Sudden, transient LOC w/ spontaneous recovery

Postural tone loss

↓ cerebral blood flow

2
Q

Syncope etiology? (4)

A

Reflex (vasovagal, situational)
Cardiac (obstruction, arrhy)
Ortho/autonomic
Psych (anxiety, panic somatization)

3
Q

Meds that cause Syncope? (8)

A
Anti-HTN
Anti-depress
Anti-anginal
Anti-arrhy
Anti-ED
Analgesics
EtOH
Drugs
4
Q

Syncope prodrome signs? (10)

A
Lightheaded
Facial pallor
Diaphoresis
Nausea
Uneasy
Visual blur
Chest pain
SOB
HA
Focal neuro
5
Q

Syncope exam should include? (4)

A

Orth BP both arms: drop > 20 SBP or > 10 DBP

Cardiac: rr, murmur, displ PMI, carotid bruits

Resp: hypervent

Neuro: LOC, CN, motor, cerebellar

6
Q

Syncope tests? (7)

A
ECG
Echo if card dz
Electrophys test (conduction system)
Stress test if a/w exertion
Carotid US
MRI
EEG (r/o seizure)
7
Q

Syncope labs?

A

CBC
e-
Glucose

8
Q

Tilt Table when?

A

Recurrent, unexplained syncope

No hx of cardiac dz

9
Q

Carotid Sinus Massage when?

A

Recurrent syncope w/ neg w/u

Hx of carotid sinus syncope

10
Q

Cardiac causes of Syncope?

A

Bradyarrhy:
SN dysf
AV block

Tachy

Outflow obstruction:
Aortic stenosis/dissection

11
Q

Syncope DDX?

A

Hypertrophic obstructive cardiomyopathy
PE
Cardiac tamponade
Cardia sinus syncope

12
Q

Vasovagal Syncope is?

A

Loss of sump tone or increase in parasym tone ->

vasodilation and brady -> hypoTN -> syncope

13
Q

Vasovagal Syncope a/w?

A

Stress

Pain/Shock

14
Q

Vasovagal Syncope prodrome? (4)

A

Lightheaded
Facial pallor
Diaphoresis
Nausea

15
Q

Micturition Syncope is?

A

Sync afte emptying distended bladder from excess fluids/etoh

2° to vagal stim or orthostasis

16
Q

Tussive Syncope is?

U seen in who?

A

Severe cough -> ↑intrathoracic pressure and CO

Barrel-chest/COPD, asthmatic kids

17
Q

Orthostatic HypoTN/Vasomotor syncope seen in who?

a/w?

A

U elderly

AntiHTN meds or TCAs
Dehydration

18
Q

Autonomic Syncope a/w?

A

DM neuropathy
Parkinson’s
Debilitation: malnutrition, anemia, adrenal insuff

19
Q

Subclavian Steal Synd is?

A

Subclavian artery stenosis near origin ->
flow reversal in ipsilat vertebral artery ->
↓ cerebral perfusion

20
Q

Subclavian Steal Synd presentation? (3)

A

Diplopia, vertigo, dysarthria
Sxs w/ arm exertion
Unequal pulses in UE

21
Q

Syncope tx?

Hospitalize when? (5)

A

tx cause

> 70yo
Heart dz
Neuro sxs
Freq or exertional syncope
Mod/severe ortho hypoTN
22
Q

Syncope vs Seizure:

Posture related?

Aura/prodrome?

Convulsion?

Skin color?

Cardio signs?

A

Posture related:
Sync = common
Seiz = no

Aura/prodrome:
Sync = long
Seiz = brief

Convulsion:
Sync = rare
Seiz = common

Skin color:
Sync = pallor
Seiz = cyanotic

Cardio signs:
Sync = common
Seiz = no

23
Q

Syncope vs Seizure:

Injury?

Urinary incont?

Postictal confusion?

Postictal HA?

Focal neuro?

Abn EEG?

A

Injury?:
Sync = rare
Seiz = common

Urinary incont:
Sync = rare
Seiz = common

Postictal confusion:
Sync = rare
Seiz = common

Postictal HA:
Sync = no
Seiz = common

Focal neuro:
Sync = no
Seiz = occasional

Abn EEG:
Sync = rare
Seiz = common