Deck 15: Physiology of Sleep Disordered Breathing
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Deck 15: Physiology of Sleep Disordered Breathing
1
Which phase is characterized by the presence of K-complexes?
A) Stage 1 NREM
B) REM
C) Stage 2 NREM
D) Awake
A) Stage 1 NREM
B) REM
C) Stage 2 NREM
D) Awake
Stage 2 NREM
2
Which of the following is the most common dyssomnia in the United States?
A) Hypersomnolence
B) MSA
C) CSA
D) OSA
A) Hypersomnolence
B) MSA
C) CSA
D) OSA
OSA
3
Which of the following are consequences of uncorrected OSA?
I.Decreased libido
II.Decreased mental performance
III.Hypertension
IV.Exacerbation of coronary artery disease
A) I, II, IV
B) II, III
C) I, II, III, IV
D) II, III, IV
I.Decreased libido
II.Decreased mental performance
III.Hypertension
IV.Exacerbation of coronary artery disease
A) I, II, IV
B) II, III
C) I, II, III, IV
D) II, III, IV
I, II, III, IV
4
What neck circumference is highly correlated with the incidence of OSA in men?
A) Greater than 15 inches
B) Greater than 16 inches
C) Greater than 17 inches
D) Greater than 18 inches
A) Greater than 15 inches
B) Greater than 16 inches
C) Greater than 17 inches
D) Greater than 18 inches
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5
Which of the following anatomical abnormalities are considered contributing factors to OSA?
I.Macroglossia
II.Micrognathia
III.Retrognathia
IV.Deviated nasal septum
A) I, II, IV
B) I, IV
C) I, II, III, IV
D) II, III, IV
I.Macroglossia
II.Micrognathia
III.Retrognathia
IV.Deviated nasal septum
A) I, II, IV
B) I, IV
C) I, II, III, IV
D) II, III, IV
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6
Which of the following anatomical structures are visualized to determine the Mallampati Score?
I.Tongue
II.Hard and soft palate
III.Epiglottis
IV.Uvula
A) I, II, IV
B) I, IV
C) I, II, III, IV
D) II, III
I.Tongue
II.Hard and soft palate
III.Epiglottis
IV.Uvula
A) I, II, IV
B) I, IV
C) I, II, III, IV
D) II, III
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7
EEG tracings during REM typically reflect the level of brain activity seen in which state?
A) Stage 1 NREM
B) REM
C) Stage 2 NREM
D) Awake
A) Stage 1 NREM
B) REM
C) Stage 2 NREM
D) Awake
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8
Which of the following environmental cues plays an important role in the regulation of sleep?
A) Touch
B) Light
C) Food
D) Wind
A) Touch
B) Light
C) Food
D) Wind
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9
How long does the typical individual stay in NREM before transitioning to REM?
A) 5 to 30 minutes
B) 10 to 15 minutes
C) 60 to 90 minutes
D) 1 to 5 minutes
A) 5 to 30 minutes
B) 10 to 15 minutes
C) 60 to 90 minutes
D) 1 to 5 minutes
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10
What is a common complaint of individuals with nasal septum abnormalities?
A) Hypoxemia
B) Headache
C) Poor quality of sleep
D) Snoring
A) Hypoxemia
B) Headache
C) Poor quality of sleep
D) Snoring
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11
Which of the following risk factors are associated with worsening of OSA?
I.BMI
25
II.Alcohol ingestion before bedtime
III.Smoking
IV.Diabetes
A) I, II, IV
B) I, II, III
C) I, II, III, IV
D) II, III, IV
I.BMI

II.Alcohol ingestion before bedtime
III.Smoking
IV.Diabetes
A) I, II, IV
B) I, II, III
C) I, II, III, IV
D) II, III, IV
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12
What reduction of the tidal volume is considered as defining hypopnea?
A) 10%
B) 20%
C) 30%
D) 50%
A) 10%
B) 20%
C) 30%
D) 50%
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13
Which of the following are neurotransmitters that mediate arousal?
I.Histamine
II.Serotonin
III.Norepinephrine
IV.Acetylcholine
A) I, II, III
B) I, IV
C) I, II, III, IV
D) II, III
I.Histamine
II.Serotonin
III.Norepinephrine
IV.Acetylcholine
A) I, II, III
B) I, IV
C) I, II, III, IV
D) II, III
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14
Which phase is characterized by the presence of delta waves?
A) Stage 1 NREM
B) REM
C) Stage 2 NREM
D) Stage 3 NREM
A) Stage 1 NREM
B) REM
C) Stage 2 NREM
D) Stage 3 NREM
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15
In which stage do adults spend most of the total sleep period?
A) Stage 1 NREM
B) REM
C) Stage 2 NREM
D) Awake
A) Stage 1 NREM
B) REM
C) Stage 2 NREM
D) Awake
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16
Which of the following is the most common SBD?
A) Dyssomnias
B) Parassomnias
C) Sleep sickness
D) Snoring
A) Dyssomnias
B) Parassomnias
C) Sleep sickness
D) Snoring
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17
Which of the following SBDs is more common in children and infants than in adults?
A) Hypersomnolence
B) MSA
C) CSA
D) OSA
A) Hypersomnolence
B) MSA
C) CSA
D) OSA
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18
Which phase is characterized by the presence of alpha waves?
A) Stage 1 NREM
B) REM
C) Stage 2 NREM
D) Awake
A) Stage 1 NREM
B) REM
C) Stage 2 NREM
D) Awake
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19
Which of the following is the most vulnerable position for the patient with OSA?
A) Prone
B) Supine
C) Side
D) Fowler's
A) Prone
B) Supine
C) Side
D) Fowler's
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20
Apnea is defined as absence of ventilation lasting more than how many seconds?
A) 10
B) 15
C) 20
D) 30
A) 10
B) 15
C) 20
D) 30
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21
Which of the following therapies are considered options for treating SDB?
I.PAP therapy
II.Oral appliances
III.Positional solutions
IV.Tongue enlargement procedures
A) I, II, III
B) II, III
C) I, II, III, IV
D) II, III, IV
I.PAP therapy
II.Oral appliances
III.Positional solutions
IV.Tongue enlargement procedures
A) I, II, III
B) II, III
C) I, II, III, IV
D) II, III, IV
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22
The absence of thoracic and abdominal efforts with loss of airflow in a patient who has been successfully treated for OSA with CPAP is consistent with the presence of which of the following disorders?
A) OSA
B) Cheyne-Stokes respirations
C) MSA
D) Hypopnea
A) OSA
B) Cheyne-Stokes respirations
C) MSA
D) Hypopnea
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23
An AHI of 50 in a sleep study should be interpreted as what?
A) Mild sleep apnea
B) Moderate sleep apnea
C) Severe sleep apnea
D) Mixed sleep apnea
A) Mild sleep apnea
B) Moderate sleep apnea
C) Severe sleep apnea
D) Mixed sleep apnea
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24
What is the gold standard test to determine the presence of a sleep disorder?
A) PSG
B) ABG
C) CT of the upper airway
D) V/Q scan
A) PSG
B) ABG
C) CT of the upper airway
D) V/Q scan
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25
What is the goal of titrating PAP for individuals with sleep disorders?
A) Using PAP pressure to reduce AHI to 10 or less per hour while the patient is in the prone position
B) Using PAP pressure to reduce AHI to 5 or less per hour while the patient is in the supine position
C) Using PAP pressure to reduce AHI to 10 or less per hour while the patient is in the supine position
D) Using PAP pressure to reduce AHI to 15 or less per hour while the patient is in the semi-Fowler's position
A) Using PAP pressure to reduce AHI to 10 or less per hour while the patient is in the prone position
B) Using PAP pressure to reduce AHI to 5 or less per hour while the patient is in the supine position
C) Using PAP pressure to reduce AHI to 10 or less per hour while the patient is in the supine position
D) Using PAP pressure to reduce AHI to 15 or less per hour while the patient is in the semi-Fowler's position
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26
What is the most common sign of CSA?
A) Snoring
B) Difficulty swallowing
C) Dysphonia
D) Cheyne-Stokes respirations
A) Snoring
B) Difficulty swallowing
C) Dysphonia
D) Cheyne-Stokes respirations
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27
Long-standing SDB has been associated with the presence of which of the following diseases?
A) Cardiovascular disease
B) Renal failure
C) Cerebral disease
D) Lung disease
A) Cardiovascular disease
B) Renal failure
C) Cerebral disease
D) Lung disease
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