IBHRE Syncope and Autonomic Disorders 3

Question 1

Which of the following is an example of situational reflex syncope?

Accepted Answer

Micturition syncope

Answer

Micturition syncope is a form of situational reflex syncope triggered by specific physiological acts such as urination, defecation, coughing, or swallowing.

Question 2

An implantable loop recorder (ILR) is most appropriately indicated for:

Accepted Answer

Patients with recurrent unexplained syncope after a complete initial evaluation

Answer

ILR is indicated for unexplained recurrent syncope where standard non-invasive tests have been inconclusive, allowing long-term ECG monitoring during spontaneous episodes.

Question 3

Neurogenic orthostatic hypotension is commonly associated with which of the following conditions?

Accepted Answer

Parkinson's disease

Answer

Parkinson's disease and related synucleinopathies (e.g., multiple system atrophy) cause central and peripheral autonomic neurodegeneration, leading to neurogenic orthostatic hypotension.

Question 4

The EGSYS (Evaluation of Guidelines in Syncope Study) score is primarily used to:

Accepted Answer

Predict the probability of a cardiac (arrhythmic) cause of syncope

Answer

The EGSYS score uses clinical variables (palpitations, ECG abnormalities, structural heart disease, absence of vagal triggers) to predict the likelihood of cardiac syncope and guide risk stratification.

Question 5

Physical counterpressure maneuvers (PCMs) such as leg crossing with muscle tensing and handgrip are recommended as first-line treatment for:

Accepted Answer

Prodromal vasovagal syncope with warning symptoms

Answer

PCMs increase venous return and cardiac output during the prodromal phase of vasovagal syncope, aborting or delaying the syncopal episode without pharmacologic side effects.

IBHRE - International Board of Heart Rhythm Examiners Practice Test

IBHRE - International Board of Heart Rhythm Examiners Practice Test

IBHRE Syncope and Autonomic Disorders 3