Skip to content

Syncope

Context and Definition

Pathophysiology

Causes of Syncope

Clinical Assessment

History – Question

Physical Examination – Overview

Cardiovascular Examination

Neurological and Other Examinations

Differential Diagnosis

Risk stratification

Risk stratification – Question

Risk Stratification Tools

Investigation Strategy – Question

Syncope

Syncope
Syncope

Now that you have completed the learning session, record your knowledge of the subject.

Time limit: 0

Exam Summary

0 of 10 Questions completed

Questions:

Information

You have already completed the exam before. Hence you can not start it again.

Exam is loading…

You must sign in or sign up to start the exam.

You must first complete the following:

Results

Exam complete. Results are being recorded.

Results

Time has elapsed

You have reached 0 of 0 point(s), (0)

Earned Point(s): 0 of 0, (0)
0 Essay(s) Pending (Possible Point(s): 0)

Average score
Your score

Categories

Not categorized 0%

You will need to meet or exceed the 80% pass mark to obtain a certificate. Save the module to log it in your CPD Diary.

Enter your course reflection:

Enter your course outcomes:
Congratulations, you have passed the test and obtained a certificate. Save the module to log it in your CPD Diary.

Enter your course reflection:

Enter your course outcomes:

Review
Answered
Correct
Incorrect

Question 1 of 10

1. Question
1 point(s)

Which one of the following statements is the most accurate definition of syncope?

Transient loss of consciousness regardless of pathology
Correct Incorrect Correct answer

Reduced cerebral perfusion with either loss of consciousness or reduced conscious level
Correct Incorrect Correct answer

Loss of consciousness from either global or focal reduction in cerebral perfusion
Correct Incorrect Correct answer

Loss of consciousness from global cerebral hypoperfusion regardless of duration
Correct Incorrect Correct answer

Transient loss of consciousness from cerebral hypoperfusion with full recovery without the need for medical intervention
Correct Incorrect Correct answer
Question 2 of 10

2. Question
1 point(s)

In patients presenting to the emergency department with transient loss of consciousness, which one of the following is the commonest final diagnosis?

Cardiac abnormality
Correct Incorrect Correct answer

Epileptic seizure
Correct Incorrect Correct answer

Orthostatic hypotension
Correct Incorrect Correct answer

Vasovagal syncope
Correct Incorrect Correct answer

Transient ischaemic attack
Correct Incorrect Correct answer
Question 3 of 10

3. Question
1 point(s)

Which one of the following statements is true concerning clinical examination following syncope?

Clinical examination rarely picks up any abnormalities and is of little use in syncope
Correct Incorrect Correct answer

Clinical examination will usually provide a definitive diagnosis in syncope
Correct Incorrect Correct answer

Clinical examination will often fail to provide a definitive diagnosis but will usually differentiate between vasovagal and other causes of syncope
Correct Incorrect Correct answer

Clinical examination often does not provide a definitive diagnosis but is useful in risk stratification
Correct Incorrect Correct answer

Normal clinical examination effectively excludes serious causes for loss of consciousness
Correct Incorrect Correct answer
Question 4 of 10

4. Question
1 point(s)

After a solitary vasovagal episode, in a patient who has a normal ECG and normal examination, which of the following is true

There is no need to inform the DVLA if the incident happened when the patient was standing and “felt faint” before the collapse
Correct Incorrect Correct answer

They may not drive and must inform the DVLA
Correct Incorrect Correct answer

If the patient was sitting at the time of the vasovagal episode, there is no need to inform the DVLA
Correct Incorrect Correct answer

The same DVLA rules apply to bus and lorry drivers as to car drivers
Correct Incorrect Correct answer
Question 5 of 10

5. Question
1 point(s)

Which one of the following statements is true regarding loss of consciousness suspected to be due to epilepsy?

Epilepsy is unlikely in the absence of tongue biting
Correct Incorrect Correct answer

History is more important than examination or laboratory tests for epilepsy
Correct Incorrect Correct answer

Serum prolactin measurements should be made if epilepsy is suspected
Correct Incorrect Correct answer

In an observed loss of consciousness, absence of typical tonic/clonic movements excludes epilepsy as a diagnosis
Correct Incorrect Correct answer

Electroencephalograpy (EEG) should be performed urgently
Correct Incorrect Correct answer
Question 6 of 10

6. Question
1 point(s)

Which is not part of the San Francisco Rule for syncope

Haematocrit < 30%
Correct Incorrect Correct answer

Congestive heart failure history
Correct Incorrect Correct answer

Abnormal ECG
Correct Incorrect Correct answer

Shortness of breath
Correct Incorrect Correct answer

HR > 120
Correct Incorrect Correct answer
Question 7 of 10

7. Question
1 point(s)

Which one of the following is the most useful routine investigation in a patient with a history of transient loss of consciousness?

Urea and electrolytes
Correct Incorrect Correct answer

Electrocardiogram (ECG)
Correct Incorrect Correct answer

Echocardiogram
Correct Incorrect Correct answer

CT scan of the head
Correct Incorrect Correct answer

Tilt table testing
Correct Incorrect Correct answer
Question 8 of 10

8. Question
1 point(s)

A 74-year-old lady with known ischaemic heart disease and cardiac failure presents to the ED with a history of syncope. Which one of the following is true of syncope in the presence of cardiac failure?

The majority of cases of syncope in patients with a history of cardiac failure are benign
Correct Incorrect Correct answer

Drugs used in the treatment of cardiac failure may cause syncope
Correct Incorrect Correct answer

The absence of third and fourth heart sounds makes cardiac failure unlikely
Correct Incorrect Correct answer

The absence of an elevated jugular venous pressure makes biventricular cardiac failure unlikely
Correct Incorrect Correct answer

Cardiac failure rarely causes syncope in the absence of arrythmia
Correct Incorrect Correct answer
Question 9 of 10

9. Question
1 point(s)

Which one of the following is true of the Emergency Department management of syncope?

Most patients with transient loss of consciousness require immediate admission to hospital
Correct Incorrect Correct answer

History and clinical examination are more important than use of investigations
Correct Incorrect Correct answer

It is rare not to have a definitive diagnosis for a cause for transient loss of consciousness
Correct Incorrect Correct answer

No patient should be discharged without routine investigations including urea and electrolytes; ECG; chest x-ray; urinalysis and full blood count
Correct Incorrect Correct answer

Follow up within 2 weeks should be arranged for patients not admitted
Correct Incorrect Correct answer
Question 10 of 10

10. Question
1 point(s)

An 80-year-old man presents to the ED with a histroy of transient loss of consciousness. You use the San Francisco Rule to risk stratify him; specifically regarding the San Francisco Syncope Rule, which one of the following findings is considered as a risk factor indicating the need for admission?

Age >65 years
Correct Incorrect Correct answer

Haematocrit <30%
Correct Incorrect Correct answer

Syncope without prodrome
Correct Incorrect Correct answer

Presence of focal neurological deficit
Correct Incorrect Correct answer

History of back pain preceding syncope
Correct Incorrect Correct answer

24 Comments

Nabarun Das February 11, 2018 at 6:55 pm

good short but detailed write up regarding syncope, very useful.

Log in to Reply

hurryr5717 June 14, 2018 at 2:18 pm

really useful module on syncope. many thanks

Log in to Reply

hurryr5717 June 14, 2018 at 2:18 pm

excellent

Log in to Reply

Alasdair Fatkin May 7, 2019 at 7:48 am

good summary. Thanks

Log in to Reply

Martha Ann Dimech May 20, 2019 at 4:21 pm

Great summary of causes and differential diagnoses

Log in to Reply

Stephen Mckenzie (Group Leader) May 28, 2019 at 11:42 am

great summary session including red flags and NICE guidelines

Log in to Reply

Dr Fadl Ali Al-Tairy June 14, 2021 at 4:06 pm

Good review

Log in to Reply

Dr Elizabeth Kaye Griffiths January 4, 2022 at 11:58 am

Very good

Log in to Reply

Dr. Emma Louise Jenkinson February 6, 2022 at 6:37 pm

Well presented, good level of detail, thank you

Log in to Reply

Amit Gupta February 7, 2022 at 11:45 pm

Useful Module.

Log in to Reply

Dr. Fahad Fahim Khan February 10, 2022 at 1:13 pm

Good one

Log in to Reply

Dr. Sachin Kumar Sekhsaria February 11, 2022 at 3:56 pm

useful and very relevant to practice in ED

Log in to Reply

Dr Akhil Kavanakuzhiyil Janardhanan April 20, 2022 at 7:38 am

great

Log in to Reply

Dr Aymen Babiker Abdelrahman Yasin April 30, 2022 at 1:45 am

useful with relevant information

Log in to Reply

Dr Syed Shahbaz Ahmer August 3, 2022 at 10:48 am

Excellent learning session

Log in to Reply

Jan February 3, 2025 at 12:38 pm

An important reading for A&E practitioners!
Thank you!

Log in to Reply

Dr Ramesh Kumar April 26, 2025 at 9:10 pm

Great Revision

Log in to Reply

Dr Diana Virlan November 18, 2025 at 10:27 am

Great learning session !

Log in to Reply

Dr Mohammad Aqil February 14, 2026 at 3:22 pm

Good revision

Log in to Reply

Dr Lucky Osakue Idemudia February 21, 2026 at 7:28 pm

Nice revision

Log in to Reply

Miss Lindsey Newey March 1, 2026 at 11:52 am

Good

Log in to Reply

Mr Abdelrafi Yousif Badway Ali March 3, 2026 at 5:42 pm

Excellent

Log in to Reply

[email protected] April 20, 2026 at 11:43 am

nice

Log in to Reply

Dr Alexander Philip Ruddy April 21, 2026 at 12:21 pm

Very useful resource

Log in to Reply

Leave a Comment Cancel reply

You must be logged in to post a comment.

We use cookies to store information to make your visit to this site richer and to personalize information according to your interests. See our privacy policy for more information on what cookies are, how we use them and how to change your preferences.

By continuing to use this site you are consenting to our use of cookies.Accept Privacy Policy Reject

Privacy Policy

Privacy Overview

This website uses cookies to improve your experience while you navigate through the website. Out of these cookies, the cookies that are categorized as necessary are stored on your browser as they are as essential for the working of basic functionalities of the website. We also use third-party cookies that help us analyze and understand how you use this website. These cookies will be stored in your browser only with your consent. You also have the option to opt-out of these cookies. But opting out of some of these cookies may have an effect on your browsing experience.

Necessary

Necessary

Always Enabled

Necessary cookies are absolutely essential for the website to function properly. This category only includes cookies that ensures basic functionalities and security features of the website. These cookies do not store any personal information.

SAVE & ACCEPT