EUNACOM Sección Práctica Practice Questions - Chile EUNACOM Sección Práctica - Examen Clínico Objetivo Estructurado (ECOE) Exam

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During a clinical simulation station on syncope, a 22-year-old female presents after a brief loss of consciousness while having blood drawn while standing. She describes a clear prodrome of warmth, lightheadedness, nausea, tunneling of vision, and pallor before slumping to the ground, with immediate spontaneous return of full consciousness within 15 seconds of assuming a recumbent position. Physical exam, orthostatic vitals, and 12-lead ECG are completely normal. What is the diagnosis and appropriate management?

Vasovagal (neurocardiogenic / reflex) syncope; reassure the patient, educate on recognizing prodromal symptoms, advise counter-pressure maneuvers (leg crossing, hand gripping), and avoid triggers without hospital admission Ventricular tachycardia syncope; admit to ICU for immediate automated implantable cardioverter-defibrillator (ICD) implantation Subclavian steal syndrome; perform emergency bilateral carotid endarterectomy Complex partial seizure; initiate lifelong oral carbamazepine

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