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Medical Lectures > Sleep apnea, DVT > Flashcards

Sleep apnea, DVT Flashcards

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USMLE® Step 1 flashcards
1
Q

What is sleep apnea?

A

period collapse of upper airway during sleep

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2
Q

When does sleep apnea occur?

A

loss of normal pharygneal muscle tone allows pharynx to collapse during inspiration

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3
Q

Patients with sleep apnea have an increased risk of whast?

A 
diurnal and plumonary HTN
noctural dysrhythmias
right and left ventricular failure
MI/atrial fibrillations
stroke
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4
Q

Risk factors with sleep apnea:

A

narrowed upper airway
hypothyroidism
smoking
cardiovascular related disease

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5
Q

Factors that aggravate sleep apnea:

A

alcohol or sedatives

nasal obstruction

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6
Q

What is OSA an independent risk factor for developing?

A

stroke
CAD
congestive cardiac failure
hypertension (cardiovascular disease)

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7
Q

Hallmark findings of OSA:

A

obese, middle aged men

systemic HTN

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8
Q

Patient complaints with OSA:

A 
daytime fatigue
morning sluggishness and HA
cognitive impairment
recent weight gain
impotence
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9
Q

What do bed partners report with OSA?

A 
loud snoring
breath cessation
witnessed apneas
restlessness
thrashing during sleep
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10
Q

Non-MSK differential diagnosis:

A 
asthma
central sleep apnea syndrome
COPD
depression
GERD
hypothyrodism
narcolepsy
periodic limb movement disorer
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11
Q

MSK differential diagnosis:

A

arthritis
fibroyalgia
chronic back pain

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12
Q

STOP-Bang questionnaire:

A 
snoring
tiredness
observed apnea
high BP
BMI
age
gender male
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13
Q

Gold standard for OSA:

A

polysomnography

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14
Q

Berline questionnaire:

A

self reported
BMI greater than 30
high risk 2 or more categories with positive score

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15
Q

American Academy of Sleep Medicine Diagnostic Criteria5

A
  1. Excessive daytime sleepiness that is not better explained by other factors.
  2. Two or more of the following that are not better explained by other factors:

a. Choking or gasping during sleep
b. Recurrent awakenings from sleep
c. Unrefreshing sleep
d. Daytime fatigue
e. Impaired concentration

  1. Overnight monitoring demonstrates five or more obstructed breathing

events per hour of sleep

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16
Q

PT interventions:

A 
weight management
jaw pain relief
soft tissue mobs
postural exercises
patient ed
17
Q

OSA causes acute physiological changes including:

A

alveolar hypoventilation

pulmonary artery vasoconstriction

18
Q

Calf muscle pump:

A

When flexed, the muscles force blood up towards the heart, and when
relaxed, the veins refill from the superficial circulation comprising two
veins

19
Q

Hallmark findings of DVT

A 
Unilateral tenderness or leg/calf pain
Unilateral swelling
Warmth
Discoloration
Pain with placement of BP cuff around calf & inflated to 160 - 180 mmHg
Pain intensified with standing or walking
Pain relieved by rest and elevation
Possible pallor
Possible loss of dorsalis pedis pulse
20
Q

Calf measurement:

A

10cm below tibial tuberosity

swelling 3cm of more

21
Q

DVT differential diagnosis:

A 
positive Homan
Ruputered Baker's cyst
cellulitis
post-thrombotic syndrome
venous insufficiency
22
Q

Where do 70-80% of DVT occurs:

A

popliteal vein and superficial femoral vein

23
Q

When are DVT symptoms present?

A

present 24-48 hours postoperatively

24
Q

How long does the risk of developing a DVT last

A

3 months

25
Q

DVT red flags:

A

Calf pain, edema, tenderness, warmth
Calf pain that is intensified with standing or walking and relieved by rest and elevation
Recent surgery, malignancy, pregnancy, trauma, leg immobilization

26
Q

High probablity of DVT

A

3 or more

27
Q

Moderate probability of DVT

A

1 or 2

28
Q

Low probability of DVT

A

0

29
Q

Wells criteria questions worth 1 point:

A

active cancer (6 months)
paralysis, paresis or recent immobilization
Bedridden for 3 or more days with past 12 weeks
localized tenderness along distribution of deep venous system
entire leg swelling
previous DVT
pitting edema
Swelling larger than 3 cm
collateral superficial veins

30
Q

Wells criteria -2 points:

A

alternative diagnosis at least as likely as DVT

Medical Lectures (11 decks)

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