Monday, September 2, 2013

9/2/2013

9/2/2013

Answers:
Risk factors for adult OSA include all of the following except.
A) African American 
B) Native American 
C) Male Gender 
D) Obesity

African Americans and Caucasian adults have similar risks for OSA however, African American children appear to have higher rates of sleep disordered breathing than their caucasian counterparts. Native American ancestry, male gender and obesity are all risk factors for adult OSA.

Describe the pathway by which OSA causes nocturia/enuresis?

OSA causes increased negative inspiratory pressures. These pressures are transferred to the right atrium transmurally which stretches the atrial walls and causes release of ANP thus causing nocturia/enuresis.

MC Question:
All of the following are used to create an Obstructive Sleep Apnea Syndrome Score except?
A) Tonsil Size 
B) BMI 
C) Palate Position 
D) Tongue Size

Free Response Question:
1st line treatment for OSA in adults is---?

Quick Facts:
Powell-Riley Protocol
-thorough PE, upper airway endoscopy w/ Muller maneuver, cephalometric studies w/ PSG.
Phase 1 Surgery:
-Type 1 (oropharyngeal obstruction) = UPPP
-Type II (oro/hypopharyngeal obstruction) = UPPP and genioglossus advancement w/ possible hyoid myotomy.
-Type III (hypopharyngeal obstruction = genioglossus advancement w/o palatal surgery. Phase 2 Surgery: Maxillomandibular advancement

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