Cardiology: vasovagal syncope: practice question

A General Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Medicine · Cardiology: vasovagal syncope

Sample item

A 20-year-old faints after standing for a long time in a hot crowded room, with prior nausea and sweating, and recovers quickly. ECG and examination are normal. What is the best initial advice?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Reassurance, avoiding triggers, adequate fluids and salt, and counterpressure manoeuvres

Typical triggers and prodromal symptoms with normal examination and ECG indicate reflex (vasovagal) syncope, which has a benign prognosis. Management is education, hydration, recognising the prodrome and physical counterpressure manoeuvres such as leg crossing. Devices are reserved for selected cases with documented asystole.

Option by option

  • A. Implantable cardioverter-defibrillator

    An ICD is for ventricular arrhythmia risk, which is not suggested.

  • B. Electrophysiological study

    An EP study is not required for a classic vasovagal faint.

  • C. Reassurance, avoiding triggers, adequate fluids and salt, and counterpressure manoeuvres (correct)

    Correct. Reassurance and trigger avoidance are first-line.

  • D. Permanent pacemaker implantation

    Pacemaker therapy is for documented cardioinhibitory syncope refractory to other measures.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is C, Reassurance, avoiding triggers, adequate fluids and salt, and counterpressure manoeuvres. Typical triggers and prodromal symptoms with normal examination and ECG indicate reflex (vasovagal) syncope, which has a benign prognosis.

Why is "Implantable cardioverter-defibrillator" not the answer?

An ICD is for ventricular arrhythmia risk, which is not suggested.

Why is "Electrophysiological study" not the answer?

An EP study is not required for a classic vasovagal faint.

Why is "Permanent pacemaker implantation" not the answer?

Pacemaker therapy is for documented cardioinhibitory syncope refractory to other measures.

What concept does this question test?

It tests Cardiology: vasovagal syncope in General Medicine. Management is education, hydration, recognising the prodrome and physical counterpressure manoeuvres such as leg crossing. Devices are reserved for selected cases with documented asystole.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Cardiology: vasovagal syncope?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.