5 board-style questions on syncope in the PulseMD family medicine question bank, written against current guidelines with the reference cited on each question. Two free samples below; the full set with answers, explanations, and spaced review is free to start.
A 22-year-old otherwise healthy woman fainted while standing in line at a grocery store on a warm day. Bystanders report she was pale and diaphoretic before slowly slumping to the ground. She regained consciousness within 20 seconds, was oriented immediately, and had no tongue-biting, incontinence, or post-ictal confusion. In the emergency department, her vital signs are normal including orthostatic blood pressures. Physical exam and 12-lead ECG are unremarkable. What is the most likely diagnosis?
A 70-year-old man with a history of prior myocardial infarction and ejection fraction of 30% presents after a sudden loss of consciousness while sitting in a chair. His wife reports he had no warning symptoms before collapsing. He was unconscious for approximately 90 seconds and was briefly confused upon awakening. In the emergency department, ECG shows Q waves in leads II, III, and aVF, a QTc of 486 ms, and a 5-beat run of nonsustained ventricular tachycardia on telemetry. Neurological exam is normal. Which feature of this presentation most strongly suggests a cardiac etiology requiring urgent evaluation?
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