0521779407-19 CUNY1086/Karliner 0 521 77940 7 June 6, 2007 17:50
1394 Syncope Syphilis■ECG & Holter monitoring may indicate disturbance of cardiac
rhythm
■Lab studies may reveal systemic cause (eg, anemia or cardiac,
metabolic, toxic or endocrine disorder; hypovolemia)
■In pts w/ neurologic abnormalities on examination, CT scan or MRI
may reveal structural cause in CNS; NCS may reveal abnormalities
in PNS
differential diagnosis
■Cause of syncope may be revealed by testing as above; in many cases,
no specific cause found
■Prodromal symptoms, loss of muscle tone, precipitating circum-
stances, rapid recovery w/ recumbency distinguish syncope from
seizuresmanagement
■During syncopal episode, ensure pt becomes recumbent
■Syncope may be averted by placing pt recumbent during precipitat-
ing circumstances or presyncopal events
specific therapy
■Treat underlying causefollow-up
■As needed, depending on causecomplications and prognosis
■Depend on underlying cause
■Usually good prognosis in typical vasovagal syncopeSYPHILIS
SARAH STAEDKE, MD
history & physical
History
■Syphilis is a complex systemic illness caused by the spirochete Tre-
ponema pallidum; natural course of disease is divided into three
stages
■Modes of transmission: sexual contact, blood transfusion, direct
inoculation, vertically to fetus