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Flashcards in OSA Deck (26)
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1
Q

What are the 4 history clues for OSA?

A

Impaired daytime attention for no reason
Snoring
Witnessed Apnea
Mood alterations

2
Q

What patient population should always be screened for OSA?

A

Obese patients with depression

3
Q

What are 6 characteristics of the typical OSA patient?

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

2 main goals we have for managing OSA patients?

A

Improve daytime sleepiness and prevent long term complications

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

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

7
Q

What are the two effects CPAP has on the patient?

A

Increased intraluminal airway pressure and FRC

8
Q

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

A

Mandibular assist device and UPPP

9
Q

How does the mandibular assist device work?

A

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

10
Q

What is going on during a UPPP procedure?

A

They respect part of the oropharynx so the airway is larger

11
Q

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

A

Respiratory, which includes the airway, CNS, and CV

12
Q

What is the problem with the CNS?

A

Decreased central respiratory drive

13
Q

What is going on with the airway?

A

OSA

14
Q

What two things are going on with the heart?

A

CAD and CHF

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

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?

A

OSA

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?

A

Obesity

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
Q

What are the two cornerstones of therapy for OSA?

A

Lifestyle changes and CPAP

26
Q

What can we put patients on if CPAP is not comfortable for them?

A

BIPAP