OSA Flashcards

(26 cards)

1
Q

What are the 4 history clues for OSA?

A

Impaired daytime attention for no reason
Snoring
Witnessed Apnea
Mood alterations

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2
Q

What patient population should always be screened for OSA?

A

Obese patients with depression

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3
Q

What are 6 characteristics of the typical OSA patient?

A
Obese
Large neck
Nasal obstruction
Enlarged tonsils
Narrow oropharynx
Small jaw
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4
Q

2 main goals we have for managing OSA patients?

A

Improve daytime sleepiness and prevent long term complications

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5
Q

What are the 3 long term complications resulting from OSA?

A

More likely to die
More likely to develop cancer
More likely to have a CVA

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6
Q

What are 4 lifestyle modifications for OSA?

A

Lose weight
Avoid alcohol and sedatives a few hours before sleep
Lateral decubitus sleeping position
Intranasal decongestants can help

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7
Q

What are the two effects CPAP has on the patient?

A

Increased intraluminal airway pressure and FRC

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8
Q

What are two other tools we can use for the patient besides CPAP?

A

Mandibular assist device and UPPP

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9
Q

How does the mandibular assist device work?

A

It protrudes the jaw and pulls the tongue forward, opening the airway up

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10
Q

What is going on during a UPPP procedure?

A

They respect part of the oropharynx so the airway is larger

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11
Q

What are the 3 main systems being affected by Obesity Hypoventilation Syndrome?

A

Respiratory, which includes the airway, CNS, and CV

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12
Q

What is the problem with the CNS?

A

Decreased central respiratory drive

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13
Q

What is going on with the airway?

A

OSA

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14
Q

What two things are going on with the heart?

A

CAD and CHF

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15
Q

What is going on with the lungs? 4 things

A

Restrictive chest physiology
PHTN
Hypoxemia and Hypercapnia
Chronic respiratory acidosis with attempted compensation

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16
Q

What condition can OHS mimic, but what does the PFT look like?

A

Mimic COPD, but PFT is restrictive

17
Q

90% of OHS patients have what condition?

18
Q

OSA with marked hypoxemia can lead to secondary what?

A

Erythrocytosis

19
Q

What is the most common manifestation of OSA?

A

Excessive daytime sleepiness

20
Q

What are two tools we can use to screen for OSA?

A

Epworth sleepiness scale and stop bang questionnaire

21
Q

What is the most important risk factor for OSA?

22
Q

What kind of women are at risk for OSA?

A

Postmenopausal

23
Q

What study is needed to diagnose OSA and what is the confirming test result?

A

PSG.

Apnea-hypo apnea index greater than 5 confirms OSA.

24
Q

What are the two big time sequelae of untreated OSA?

A

Heart failure and stroke

25
What are the two cornerstones of therapy for OSA?
Lifestyle changes and CPAP
26
What can we put patients on if CPAP is not comfortable for them?
BIPAP