Admission Diagnosis Syncopal Question & Answer Guide (With Explanation)
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Original Question
ADMISSION DIAGNOSIS: Syncopal episodes, rule out seizure disorder. DISCHARGE DIAGNOSIS: Same SUMMARY: The patient is a 1 7 – year – old female in good health who on 0 9 / 1 5 while doing some canning at home suddenly collapsed onto the floor apparently losing consciousness. There was no seizure activity noted, and there was no postictal period. She was seen in the Emergency Room, evaluated and sent home. She had a similar episode on 0 9 / 1 6 and again on the day of admission. The episode on the day of admission occurred while she was walking with a friend, and she suddenly collapsed and fell backward. Her friend took her home, put her to bed, but then she had another episode and was brought to the Emergency Room. There was no documented seizure activity with any of the episodes. Past Medical History contained in the admission history and physical. Physical exam on admission – blood pressure 1 3 8 / 8 8 , pulse 8 8 , respirations 2 0 . Head Ears Eyes Nose Throat exam was normal. The pupils equal and reactive to light; extraocular movements intact. Sclera and conjunctiva clear. There was no nystagmus. Neck was supple with no thyromegaly. Lungs were clear. Heart had a regular rhythm with no murmur. Abdomen was soft, nontender, no masses or organomegaly. Breasts normal. Laboratory: A complete blood count on admission – the white count was 8 , 7 0 0 with 5 5 segmented cells, 3 4 lymphocytes, 1 0 monocytes and 1 eosinophil. Hemoglobin was 1 3 .
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