Differential Diagnosis for Loss of Consciousness:
Loss of Consciousness (LOC) is one of the important conditions that is tested on USMLE step 2 CS, since it is very common especially in the elderly. Are you Having trouble differentiating between all the important causes of Loss of Consciousness (LOC)? If so, then try this Loss of Consciousness Mnemonic for your USMLE Step 2 CS.
Key history for Loss of Consciousness:
Presence or absence of preceding symptoms:
— Nausea, diaphoresis, palpitation, pallor or light-headedness.
— Exertional, postural, traumatic, stressful; painful or claustrophobic experience; dehydration.
— Tongue biting or incontinence, tonic-Clonic movements, prolonged confusion after LOC or dyspnea.
— History of heart disease, Arrhythmia, hypertension, diabetes, alcohol or drug use.
- Vital signs including orthostatic vital signs
- Complete neurologic exam including: DTR’s, CN2-12, motor, sensory, gait
- Carotid and cardiovascular exam
- Pulmonary exam
- Exam of the lower extremities
- Glucose level to rule out hypoglycemia
- Urine toxicology,
- Electrocardiogram (ECG) to rule out arrhythmias or ischemia
- 24 hour holter monitoring to monitor for arrhythmias
- CT of the head,
- MRI of the brain,
- Lumbar puncture for CSF analysis,
- Electroencephalogram (EEG) to rule out seizure
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