Pulm. OSA and OHS + mehlham (09-29) (2) Flashcards
OSA. pathophysiology? 2
Relaxation of pharyngeal muscles leads to closure of airway
Loud snoring with periods of apnea
OSA. sequelae?
Systemic hypertension
Pumonary hypertnesion and right heart failure
OSA. symptoms? 4
daytime somnolence
Non-restorative sleep with frequent awakenings
Morning headaches
Affective and cognitive symptoms
OSA. physical examination? 3
Obesity. BMI>35
Increased neck girth
Systemic HTN
OSA. what reproductive finding?
Erectile dysfunction
OSA. what findings resolves during daytime?
hypoxia and hypercapnia resolve during day unless couples with OHS.
OSA. what blood finding?
Hypoxemia –> incr. EPO –> incr. RBC and hematocrit
OSA. what method to diagnose?
nocturnal polysomnography.
OSA. nocturnal polysomnography. what diagnostic findings?
5 or more obstructive respiratory events (apnea or hypopneas) per hour is
diagnostic.
OSA. what is apnea?
Apnea: cessation of breathing for 10 or more seconds.
OSA. what is hypopnea?
Hypopnea: reduced airflow causing saturation to decrease by 4% or more.
OSA. treatment. Mild to moderate?
Mild to moderate: weight reduction, avoidance of sedatives and alcohol,
and avoidance of supine posture during sleep.
OSA. treatment. other than conservative?
Others: uvulopalatopharyngoplasty and nasal CPAP.
STOP-Bang survey for OSA. 1 point for each.
Snoring
excessive daytime Tiredness
Observed apneas or choking/gasping
high blood Pressure
BMI > 35
Age > 50
Neck size: men >17, women >16 inches
male Gender
STOP-Bang survey for OSA. points for risk?
0-2 = low risk
3-4 = intermitent risk
>= 5 –> high risk
OHS. 3 diagnostic criteria?
Obesity with BMI >=30
Awake daytime hypercapnia (PaCO2 > 45)
No alternate cause of hypoventilation
OHS. workup. ABG?
ABG on room air (hypercapnia, normal A-a gradient)
OHS. workup. x ray finding?
No intrinsic pulmonary disease on xray