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fundamentals > Sleep > Flashcards

Sleep Flashcards

1
Q

The ___ examines how long it takes a patient to fall asleep on avg during several naps throughout a day.

A

Multiple Sleep Latency Test (MSLT)

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2
Q

A MSLT <8mins and rapid onset of REM sleep on PSG are characteristic of ___ diagnosis.

A

Narcolepsy

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3
Q

Polysomnogram demonstrates the presence of REM without atonia.

Diagnosis?

A

REM sleep behavior disorder (associated w/neurodegen conditions like Parkinsons, DLB, multisystem atrophy)

normally there is atonia during REM sleep

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4
Q

The overall Friedman stage incorporates the patients
1. _____
2. tonsillar grade (1+ through 4+)
3. tongue position (1 through 4)

A

The overall Friedman stage incorporates the patients
1. BMI (</>40)
2. tonsillar grade (1+ through 4+)
3. tongue position (1 through 4)

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5
Q

The overall Friedman stage incorporates the patients
1. BMI (</>40)
2. _____
3. tongue position (1 through 4)

A

The overall Friedman stage incorporates the patients
1. BMI (</>40)
2. tonsillar grade (1+ through 4+)
3. tongue position (1 through 4)

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6
Q

The overall Friedman stage incorporates the patients
1. BMI (</>40)
2. tonsillar grade (1+ through 4+)
3. ___

A

The overall Friedman stage incorporates the patients
1. BMI (</>40)
2. tonsillar grade (1+ through 4+)
3. tongue position (1 through 4)

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7
Q

Patients w/Friedman stage __ disease have an excellent chance of successfull surgery w/UPPP, and patients have an 80% chance of a cure.

A

Patients w/Friedman stage I disease have an excellent chance of successfull surgery w/UPPP, and patients have an 80% chance of a cure.

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8
Q

14M w/recurrent episodes of hypersomnia lasting up to 10d, sleeping continuously throughout the day and night, waking up only to eat and go to the bathroom. During these episodes he is in a bad mood.

Diagnosis?

A

Kleine-Levine syndrome

a type of recurrent hypersomnia, episodes lasting days to weeks, sleeping18-20hrs waking only to eat/void

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9
Q

Major sleep episode is delayed, resulting in sx of sleep-onset insomnia and difficulty awakening.

Diagnosis?

A

Delayed sleep phase syndrome.

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10
Q

Stage 1 sleep is characterized by ___ waves and ___ eye movements.

A

Stage 1 sleep is characterized by vertex sharp waves and slow eye movements.

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11
Q

Stage 2 sleep is characterized by the presence of ___ and ___.

A

Stage 2 sleep is characterized by the presence of K complexes and sleep spindles.

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12
Q

Stage 3 sleep is characterized by ___ waves.

A

Stage 3 sleep is characterized by delta waves.

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13
Q

REM is characterized by ___ EMG tone and ___ eye movement.

A

REM is characterized by low EMG tone and rapid eye movement

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14
Q

___, ___ and ___ are 1st stage procedures of the Stanford Protocol.

A

UPPP, genioglossus advancement and hyoid suspension are 1st stage procedures of the Stanford Protocol.

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15
Q

___ is a second stage procedure of the Stanford Protocol.

A

Maxillomandibular advancement (MMA) is a second stage procedure of the Stanford Protocol.

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16
Q

A level III PSG is a portable study that records ___ variables, and are typically unattended.

A

A level III PSG is a portable study that records 4 variables:
* ventilation
* HR
* ECG
* O2 sat

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17
Q

A level I PSG is a portable study that records ___ variables

A

A level III PSG is a portable study that records 7 variables:
* EEG
* EOG
* chin or leg EMG
* ventilation
* respiratory effort
* O2 sat

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18
Q

A level II PSG measures all 7 variables of level I, and is performed in what setting __location__.

A

A level II PSG measures all 7 variables of level I, and is performed with a portable setup at the patients home.

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19
Q

Narcolepsy is associated w/___ CSF hypocretin levels.

A

Narcolepsy is associated w/low CSF hypocretin levels.

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20
Q

A PSG for narcolepsy shows ___ stage 1 sleep.

A

A PSG for narcolepsy shows increased stage 1 sleep.

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21
Q

Patient worries about being unable to sleep and focuses on insomnia, which causes frustration and inability to fall asleep.

Diagnaosis?

A

Psychophysiologic insomnia

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22
Q

An individuals major sleep episode is advanced in relation to the desired clock time, resulting in excessive evening sleepiness, early sleep onset, and awakening earlier than desired.

Diagnosis?

A

Advanced sleep phase syndrome

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23
Q

45F works btwn 11-7AM 3d/wk, and btwn 7-3PM 2d/wk. During vacations, she tends to sleep well.

Diagnosis?

A

Shift work sleep disorder

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24
Q

If ___ is present, it is pathognomonic for narcolepsy, and thus does not require a MSLT for diagnosis.

A

If cataplexy is present, it is pathognomonic for narcolepsy, and thus does not require a MSLT for diagnosis.

25
Q

The Mueller maneuver is performed w/the patient ___ in either the ___ or ___ position.

A

The Mueller maneuver is performed w/the patient awake in either the sitting or supine position.

patient performs reverse valsalva while a FFL assesses degree of retropalatal or retroligual collapse

26
Q

RERAs are measured by an EEG finding of gradually increasing ___ followed by an arousal.

A

RERAs are measured by an EEG finding of gradually increasing upper airway resistance followed by an arousal.

27
Q

RERAs are best detected by what test?

A

Esophageal manometry
(esophageal tone and luminal pressure are elevated before RERAs)

28
Q

The RDI measures the frequency of ___, ___, and ___ per hour of sleep.

A

The RDI measures the frequency of apneas (central, obstructive, or mixed), hypopneas, and RERAs per hour of sleep.

AHI + RERA index

29
Q

The RDI is used by many to monitor ___ in patients with SDB.

A

The RDI is used by many to monitor clinical response to therapy in patients with SDB.

30
Q

Post-op PSG after MMA is comparable to PSG w/CPAP.

T/F?

A

Post-op PSG after MMA is comparable to PSG w/CPAP.

True

31
Q

Apnea is defined by a cessation of air movement of ___secs.

A

Apnea is defined by a cessation of air movement of 10secs.

32
Q

Hypopnea is a decrease of air movment by >/=___% for >__secs, and is associated w/a >/=__% O2 desat.

A

Hypopnea is a decrease of air movment by >/=30% for >10secs, and is associated w/a >/=4% O2 desat.

33
Q

Sleep-related hypoventilation is a >/=__ mmHg increase in PaCO2 compared to awake values, and up to a level of >50 for at least 10mins.

A

Sleep-related hypoventilation is a >/=10 mmHg increase in PaCO2 compared to awake values, and up to a level of >50 for at least 10mins.

34
Q

___ should be considered in patients w/OSA who demonstrate tongue base obstruction.

A

Tongue suspension (can be done in conjunction w/tongue base resection)

35
Q

“patients wake up screaming or crying, w/prominent associated autonomic and behavioral manifestations of intense fear, and confusion on awakening”

Diagnosis?

A

Sleep terrors

36
Q

Nightmares occur during ___ sleep.

A

REM sleep

37
Q

12M wakes up in the middle of the night w/frightening dream of a big clown eating his parents. On awaking, he recalls the dream well, and does not look confused.

Diagnosis?

A

Nightmare

38
Q

The mean sleep latency of a patient w/OSA is <__mins.

A

The mean sleep latency of a patient w/OSA is <5mins.

39
Q

The mean sleep latency of a healthy patient is ___mins.

A

The mean sleep latency of a healthy patient is 10-15mins.

40
Q

The most common cardiac arrhythmia associated w/OSA is ___.

A

sinus bradycardia

41
Q

The most prominent pharyngeal dilator muscles are the ___ and ___muscles.

A

The most prominent pharyngeal dilator muscles are the genioglossus and tensor palatini muscles.

42
Q

___ inflammatory marker is associated w/OSA and cardiovascular disease.

A

C-reactive protein

43
Q

Prolactin levels ___ with sleep.

A

Prolactin levels increase with sleep.

44
Q

Cortisol and TSH are circadian modulated and ___ and ___, respectively, with sleep.

A

Cortisol and TSH are circadian modulated and rise and fall, respectively, with sleep.

45
Q

Growth hormone is __ initially during sleep, and is associated with slow wave sleep, but not REM.

A

Growth hormone is increased initially during sleep, and is associated with slow wave sleep, but not REM.

46
Q

Growth hormone levels ___ throughtout the night.

A

Growth hormone levels decrease throughtout the night.

47
Q

Glucose and insulin levels ___ during sleep.

A

Glucose and insulin levels increase during sleep.

48
Q

OSAHS scores of 8 or more have a __% chance of having at least moderate OSA.

A

OSAHS scores of 8 or more have a 90% chance of having at least moderate OSA.

49
Q

What % of patients have improvement to an AHI <15 w/oral appliance after failing initial CPAP therapy?

A

50%

50
Q

___, a system that automatically adjusts the pressure level delivered via mask, may help avoid excessively elevated continuous pressures associated w/CPAP use.

A

Auto-PAP, a system that automatically adjusts the pressure level delivered via mask, may help avoid excessively elevated continuous pressures associated w/CPAP use.

51
Q

Recurrent episodes during which there is absent airflow along w/cessation of ventilatory effort during sleep.

Diagnosis?

A

Central sleep apnea syndrome

52
Q

The difference between peripheral and central OSA is that there is a transient central cessation of respiratory drive, and ___ does not occur.

A

The difference between peripheral and central OSA is that there is a transient central cessation of respiratory drive, and airway obstruction does not occur.

53
Q

The difference between peripheral and central OSA is that there is a transient ___, and airway obstruction does not occur.

A

The difference between peripheral and central OSA is that there is a transient central cessation of respiratory drive, and airway obstruction does not occur.

54
Q

At what time of day is the core body temperature the coolest?

A

between 4-5 AM

55
Q

Hypopnea events are defined as a ___% reduction in airflow for >10s w/a concominant >4% desat.

A

Hypopnea events are defined as a >30% reduction in airflow for >10s w/a concominant >4% desat.

56
Q

Hypopnea events are defined as a >30% reduction in airflow for >__sec w/a concominant >4% desat.

A

Hypopnea events are defined as a >30% reduction in airflow for >10sec w/a concominant >4% desat.

57
Q

Hypopnea events are defined as a >30% reduction in airflow for >10s w/a concominant >__% desat.

A

Hypopnea events are defined as a >30% reduction in airflow for >10s w/a concominant >4% desat.

58
Q

Melatonin is produced in the ___ gland.

A

Melatonin is produced in the pineal gland.

fundamentals (3 decks)

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