Term
| testing oculocephalic reflex and results |
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Definition
| pt keeps eyes open, rotates head quickly back and forth laterally. Brainstem intact=pt lookes away from deviation. Brainstem injured=eyes follow direction of mov't. |
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Term
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Sudden transient (10-20 sec) loss of consciousness & postural tone with spontaneous recovery.
1. term
2. benign cause
3. lethal cause
4. pathology
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Definition
1. syncope
2. vaso-vagal event benign
3. v-fib is lethal
4. decr nutrient delivery to brainstem reticular activating system. |
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Term
Dysrhythmias as cause of syncope:
1. cardiac arrest & sinut pauce greater than ______
2. a type of V-tachycardia associated with prolonged QT interval.
3. syndrome of preexcitation of the ventricles due to accessaory pathway named Bundle of Kent (an atrioventricular reentrant tachycardia.
4. bradycardia less than ______bpm
5. dysfunction of Na, Ca, or K channels - name 2 syndromes |
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Definition
1. cardiac arrest & sinut pauce greater than 2-3 seconds
2.Tourades de pointe: a type of V-tachycardia associated with prolonged QT interval.
3. Wolff-Parkinson-White Syndrome (WPW): syndrome of preexcitation of the ventricles due to accessaory pathway named Bundle of Kent (an atrioventricular reentrant tachycardia.
4. bradycardia less than 35 bpm
5. Long QT Syndrone & Brugada syndrome: dysfunction of Na, Ca, or K channels |
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Term
Cardiac Structural Abnormalities responsbile for syncope:
1. LV outflow obstruction (4)
2. RV outflow obstruction (2)
3. Inflow Obstruction (3) |
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Definition
1. LV outflow obstruction
Syncope on exertion: AS, MS, MVP, HCM
2. RV outflow obstruction
PE, pulm HTN
3. Inflow Obstruction
atrial myxoma, pneumothorax, cardiac taponade |
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Term
| Which pharmas have risk of syncope? (3) |
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Definition
1. anti HTN (alpha blockers have 1st dose syncope, used for BPH as well)
2. nitrates - tell pt to sit
3. antidepressants |
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Term
vertigo & syncope with arm movement. BP arm difference 45 mmHG. finger ulcer & gangrene
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Definition
| Subclavian Steal Syndrome - stenosis of subcl a. |
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Term
Causes of syncope
1. neuralgia of what 2 CNs?
2. a specifc brain bleed
3. 3 psychiatric causes
4. goal of finding the cause of syncope |
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Definition
Causes of syncope
1. neuralgia of what 2 CNs? trigem, glossopharngeal
2. a specifc brain bleed SAH
3. 3 psychiatric causes panic, anxiety, hyperventilation
4. goal of finding the cause of syncope
differentiate btwn cardiac or neuro cause (cardiac has higher mortality) |
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Term
| What do you ask about in family history for syncope? |
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Definition
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Term
| Always order this Lab in evaluating syncope. |
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Definition
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Term
Consider admission for syncope if...
1. age
2. lab results
3. PMH
4. Signs and sx related to what 2 systems?
5. HPI
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Definition
Consider admission for syncope if...
1. age >45 y/o
2. lab results abnml ECG
3. PMH dysrhythmias, CAD, HF
4. Signs and sx related to what 2 systems?
Neuro or Cardiac
5. HPI frequent episodes |
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Term
most common etiology of syncope
1. age
2. pathophys
3. precipitating factors |
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Definition
Neurocardiogenic/vasovagal
1. young individuals
2. Venous pooling, low preload, sympathetic response
3. Prolonged standing, hot weather, fear, injury, abdominal pain, medical procedure, anxiety |
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Term
| pre-vent warmth, lightheaded, nausea, roaring tinnitus, vision dimming, diaphoresis |
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Definition
neurocardiogenic/vasovagal syncope,
Prodrome-Warning signs |
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Term
| common type of syncope in eldery. sx of blurred vision and dizziness. |
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Definition
Orthostatic Hypotension
Drop in SBP >20 mmHg or DBP >10 mmHg or to <90 mmHg upon change to upright posture. Tilt= pulse 30 beats per minute
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Term
÷Addision’s Disease
÷Parkinson’s Disease
÷Shy-Drager syndrome
...all can exibit what type of syncope?
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Definition
Orthostatic Hypotension
*Shy-Drager syndrome: A mysterious progressive disorder of the central and sympathetic nervous systems, also called multiple system atrophy with postural hypotension.
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Term
| Chest Pain, syncope (exercise-induced), dyspnea, typical systolic murmur gets worse w sitting to standing |
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Definition
| Hypertrophic cardiomyopathy - get ECG and echo |
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