Question 1

Which tests are indicated as part of the initial evaluation for women of childbearing age who report syncope? (Select all that apply.)&#10;A) 12-lead electrocardiogram&#10;B) Cardiac enzyme levels&#10;C) Complete blood count&#10;D) Electroencephalogram&#10;E) Serum glucose testing

Accepted Answer

A 12-lead electrocardiogram is indicated as syncope may be a symptom of cardiac arrhythmias.

A complete blood count can help rule out anemia and infection.

Serum glucose testing is important as hypoglycemia can cause syncope.

Cardiac enzyme levels and electroencephalogram are not typically indicated in the initial evaluation of syncope in women of childbearing age.

Question 2

An elderly patient reports experiencing syncope each morning when getting out of bed. Which assessment will the health care provider perform first to evaluate this patient's symptoms?&#10;A) Cardiac enzyme levels&#10;B) Electroencephalogram&#10;C) Fasting blood glucose&#10;D) Orthostatic blood pressures

Accepted Answer

The most likely cause of syncope when getting out of bed in the morning is orthostatic hypotension, which can be evaluated by checking orthostatic blood pressures (BP). This involves measuring BP while the patient is lying down, sitting up, and standing up. If there is a significant drop in BP with standing, it could cause the patient to faint. The other options are less likely to be the cause of syncope in this situation. Cardiac enzyme levels may be checked if the patient has chest pain or other signs of a heart attack. An electroencephalogram (EEG) is used to evaluate brain function and would not be the first test to evaluate syncope. Fasting blood glucose levels may be checked if there is concern for diabetes or hypoglycemia, but it would not be the first test to evaluate syncope in this situation.

Question 3

A healthy 20-year-old patient reports having had 1 or 2 episodes of syncope without loss of consciousness. Which is the most likely type of syncope in this patient?&#10;A) Cardiac&#10;B) Neurogenic&#10;C) Orthostatic hypotensive&#10;D) Reflex syncope

Accepted Answer

Reflex syncope is the most likely type of syncope in a healthy 20-year-old patient who reports 1 or 2 episodes of syncope without loss of consciousness. This type of syncope is usually triggered by a sudden, strong emotional or physical stimulus, leading to a drop in blood pressure and a transient loss of consciousness. Cardiac syncope, neurogenic syncope, and orthostatic hypotensive syncope are less likely in this patient population.

Deck 33: Syncope