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38 Cards in this Set
- Front
- Back
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To what hormone imbalance is CSA linked? |
1. Testosterone |
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What is the MCC of excessive daytime drowsiness? |
1. OSA |
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What are the ssx of OSA? |
1. Morning headaches 2. Excessive daytime drowsiness 3. HTN |
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What are the sequelae to OSA? |
1. HTN 2. Heart disease |
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How do you dx OSA? |
1. Polysomnography 2. Apnea/hypopnea >15/hr. of sleep 3. Apnea >10s is significant |
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How do you tx OSA? |
1. CPAP 2. Weight loss 3. Uvulopalatopharyngoplasty |
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What is narcolepsy type I? II? |
1. I- narcolepsy with cataplexy 2. II--narcolepsy w/o cataplexy |
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What are the ssx of narcolepsy type I? |
1. Sleep attacks 2. Cataplexy 3. Sleep paralysis 4. Hypnagogic hallucinations |
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What is lost in narcolepsy? |
1. Orexin |
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How do you dx narcolepsy? |
1. Multiple sleep latency test 2. Hypocretin test 3. Polysomnogram 4. 2 week sleep diary |
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How do you tx narcolepsy? |
1. Sodium oxybate (Xyrem)--- stabilizes sleep cycles 2. Modafinil |
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What are the ssx of jet lag syndrome? |
1. Insomnia 2. Excessive sleepiness 3. Decreased daytime performance 4. Fatigue 5. Must cross two time zones |
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How long does it take to recover from jet lag syndrome? |
1. 1 day per time zone crossed |
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What are the ssx of shift work sleep disorder? |
1. Excessive sleepiness due to circadian rhythm misalignment 2. Accidents 3. HA |
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How do you tx SWSD? |
1. Change work shifts |
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What are the ssx of parasomnias in NREM and REM? |
1. NREM-- sleep walking, night terrors 2. REM-- nightmares |
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When do sleep disorders and nightmares occur? |
1. Sleep disorders early 2. Nightmares late |
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What are the ssx of a night terror? |
1. Intense fear 2. Autonomical arousal 3. Relative unresponsiveness to others to comfort 4. Significant distress |
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How do you dx nightmare disorder? |
1. Awakening with recall of intensely disturbing mentation 2. Full alertness on awakening without significant confusion
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When do night terrors occur? |
1. 1st third of night 2. NREM |
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When does nightmare disorder occur? |
1. 2nd half of sleep 2. REM |
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What are the ssx of sleepwalking? |
1. Difficult to awaken 2. Amnestic of event 3. Can hurt themselves 4. Most grow out of it |
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What are the triggers for sleepwalking? |
1. Sleep deprivation 2. Chaotic sleep schedules 3. Fever 4. Stress 5. Mg deficiency 6. Alcohol intoxication |
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What drugs can cause sleepwalking? |
1. Sedatives/hypnotics 2. Neuroleptics 3. Minor tranquilizers 4. Stimulants 5. Antihistamines |
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How do you tx sleepwalking? |
1. Keep environment safe 2. Sleep hygiene |
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What are the ssx of RSBD? |
1. Shouting and violent motor activity in any REM cycle 2. May remember a dream fragment 3. Patients frequently injure themselves |
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How do you dx RSBD? |
1. REM sleep w/o atonic on polysomnography |
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How do you tx RSBD? |
1. Clonazepam 2. L-dopa |
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What are primary and secondarily RLS? |
1. 1o-- not related to any other disorder 2. 2o-- most commonly associated with Fe deficiency and end-stage renal disease |
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What are the diagnostic criteria for RLS? |
1. Urge to move legs with dysesthesia 2. Onset or exacerbation with rest 3. Relief with movement 4. Circadian pattern--- worse at night or in the evening |
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What are the ssx of RLS? |
1. Dysesthesias in one or both lower extremities during rest |
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How do you dx RLS? |
1. Polysomnography |
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How do you tx RLS? |
1. Avoid triggers 2. Sleep hygiene 3. Schedule sedentary activities in the morning 4. Schedule exercise or housework later in the day |
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What are the ssx of PLMD? |
1. Rhythmic motions consisting of dorsiflexion of great toe and ankle with flexion of knee and hip 2. Uni- or bilateral |
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How do you dx PLMD? |
1. Polysomnography 2. Normal= <5/hr |
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What should you test for in PLMD? |
1. Serum ferritin |
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How do you dx PLMD? |
1. Polysomnography 2. Fe/ferritin 3. Mg 4. B12/folate |
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How do you tx RLS/PLMD? |
1. Dopamine agonist DOC=requip (ropinirole) or mirapex (pramipexole) |
