IBHRE Syncope and Autonomic Disorders 2

Question 1

In the VASIS (Vasovagal Syncope International Study) classification, Type 2B vasovagal syncope is characterized by:

Accepted Answer

Cardioinhibitory response with asystole ≥3 seconds

Answer

Cardioinhibitory response without asystole

Answer

Pure vasodepressor response

Answer

Mixed equal bradycardia and hypotension

Question 2

The standard tilt table test is typically performed at what upright angle?

Accepted Answer

70 degrees

Answer

45 degrees

Answer

60 degrees

Answer

90 degrees

Question 3

Fludrocortisone reduces syncope primarily by:

Accepted Answer

Increasing blood volume via renal sodium and water retention

Answer

Increasing heart rate through sympathetic stimulation

Answer

Decreasing peripheral vascular resistance

Answer

Blocking vagal efferent signals to the heart

Question 4

Syncope occurring during exercise in a young patient should raise concern for which underlying condition?

Accepted Answer

Hypertrophic cardiomyopathy

Answer

Vasovagal syncope

Answer

Orthostatic hypotension

Answer

Carotid sinus hypersensitivity

Question 5

The autonomic response in vasovagal syncope involves activation of which reflex?

Accepted Answer

Bezold-Jarisch reflex

Answer

Hering-Breuer reflex

Answer

Bainbridge reflex

Answer

Cushing reflex

Question 6

On an implantable loop recorder (ILR) in a patient with recurrent syncope, which finding best supports a neurally mediated (vasovagal) mechanism?

Accepted Answer

Gradual progressive bradycardia leading to asystole coinciding with syncope

Answer

Sustained monomorphic ventricular tachycardia

Answer

Sudden onset complete AV block without preceding slowing

Answer

Rapid ventricular response during atrial fibrillation

Question 7

POTS is most commonly seen in which demographic group?

Accepted Answer

Young women between ages 15 and 50

Answer

Elderly men over age 65

Answer

Middle-aged men between ages 40 and 60

Answer

Pre-pubertal children under age 10