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22 Cards in this Set
- Front
- Back
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define apnea
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no breathing for at least 10 seconds
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define hypopnea
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decrease of airflow (50%) with a desaturation of O2 of 4%
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what is the biggest problem in obstructive sleep apnea?
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tongue drops back and occludes the airway
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what is the difference between obstructive and central sleep apnea
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obstructive: you will see the chest move in an attempt to breathe
central: chest wont move, signal is not sending down to breathe |
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wife says they need to kick or punch husband to get them to breathe during sleep
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this is the normal way it comes to you in the clinic
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what are 4 clinical risk factors for sleep apnea?
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Neck Size > 17 in1
Epworth Sleep Score > 102 Mallampati score 3+3 History of apnea, heavy snoring/gasping |
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an Epworth score greater than what is likely to have sleep disordered breathing?
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10
questions include: do you fall asleep when doing different shit |
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pulmonary HTN, arrhythmias, and HTN are all co-morbid conditions with what?
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sleep apnea
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how do you diagnose sleep apnea?
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Polysomnogram (PSG)
Overnight observation of sleep with EEG, pulse ox, EKG, flow sensors on chest |
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what is apnea hypopnea index (AHI)
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number of apnea/hypopnea events per hour
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what is the nonsurgical treatment of sleep apnea? 2
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non surgical....masks
CPAP: one pressure throughout entire cycle BiPAP: pressure change allows for gas exchange component |
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what is the amphetamine related drug that is good adjunct therapy for sleep apnea?
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Modafinil
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what is the newer version of Modafinil?
What is this used for? MOA? |
Nuvigil
Apnea unknown |
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what is the gold standard last resort treatment of apnea?
problem with this? |
tracheostomy
problem: Lose humidification of nasopharynx Direct access to lower respiratory tract (easier to get sick) |
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what is Uvulopalatopharyngeoplasty
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Surgical approach to reduce redundant tissue at one of the obstructive sites
Does not cover the lower pharynx occlusion which is more common Used when patients cannot tolerate or wear CPAP (craniofacial abnormalities) |
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CPAP vs BiPAP?
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CPAP: fixed amount running the whole time over your face
BiPAP: when you inspire you get a certain pressure. When expiration occurs, the pressure is dropped, the change in pressure allows for GAS EXCHANGE** |
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27 year old, low diffusion capacity level, no symptoms of pneumonia, no asthma or COPD. What can be the cause of this problem
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if diffusion capacity is diminished but lungs are normal you have to look at blood flow problems
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55 year old Caucasian male, smoker, with new gradual onset dyspnea on exertion
Recent clean cardiac catheterization (no cardiac problem). What should you order? |
Spirometry
looking for COPD |
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30 year old African American female, nonsmoker, with cough, rhinitis and dyspnea. spirometry shows a reversible component and a restrictive component. What do you order due to the restrictive component?
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Chest Xray
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if you see cobble-stoning on the mucosal surface what should you think
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Sarcoid!
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37 year old white female, smoker with dyspnea and wheeze and abnormal CXR showing basilar predominate bullous emphysema..what is going on?
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Alpha 1 deficiency
genetic testing shows she is a PIZZ |
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40 year old obese Caucasian white male presents to office with sudden onset dyspnea after returning from business trip to New York
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sudden onset with immobilization should ring bells for
PE |
