ABDSM Final Exam Test Comprehensive
Questions And Verified Detailed Answers
[Most Tested Questions] Certified Study Guide
Resources Graded A+
What are some diurnal symptoms of OSA? - ANSWER -- Daytime sleepiness
- Memory and concentration dysfunction
- GERD
- Irritability, depression
- Traffic accidents
- Waking with a dry mouth, irritated throat
What are some nocturnal symptoms of OSA? - ANSWER -- Heavy, persistent
snoring
- Apnea with limb movement
- Nocturia
- Nocturnal sweating
- Sudden awakening with noisy breathing
- Accidents related to sleepiness
- Insomnia
What does AHI consist of? - ANSWER -Apneas + Hypopneas
What is the difference in AHI and RDI? - ANSWER -RERAs are included for
RDI
CMS views AHI = RDI because they don't recognize RERA's
What is considered mild OSA? - ANSWER -5-15 RDI per hour
CMS will cover OSA therapy if comorbidity like:
- HTN
,- Stroke
- Sleepiness
- Ischemic heart disease
- Insomnia
- Mood disorders
What is considered moderate OSA? - ANSWER -15-30 RDI per hr
What is considered severe OSA? - ANSWER -30+ RDI per hr
What is ODI? - ANSWER -Oxygen desaturation index
# of 3% desaturations per hr
What does a CPAP do? - ANSWER -- Splints airway open
- + pressure decreases fluid leakage into alveoli
- + pressure decreases work of breathing and O2 requirements
- Improves cardiac function and output by decreasing preload and afterload
- Increases lung volume
Does CPAP prevent CV disease in patients with CVD + OSA? - ANSWER -No -
not compared to usual care alone
What is the compliance rate for CPAP? - ANSWER -30-70%
Is nasal patency a major contributor to OSA? - ANSWER -NO - using nasal
dilators doesn't significantly improve nasal flow or apnea index
What are the 3 patterns of tissue deformation during mandibular advancement? -
ANSWER -- Whole tongue moves forward en bloc
- Whole tongue elongates
- Inferior tongue moves forward
**POSTERIOR TONGUE DOESN'T MOVE
, What are the cardiovascular benefits of oral appliance therapy? - ANSWER --
Reduced BP (34-75%)
- Endotheilal and left ventricular function improves
Does bariatric surgery/weight loss cure OSA? - ANSWER -No - most patients will
still have moderate residual OSA - still needs treatment
Does reduce AHI though
How are apneas scored? What are the requirements? - ANSWER -Decreased flow
signal >90% for >10 seconds
BOTH must be met
What is the difference between obstructive and central apnea? - ANSWER -
Obstructive has continued effort, central has no effort
Mixed = absence of effort initially followed by resumption of effort
What are the requirements for a hypopnea? - ANSWER -- Decreased flow >30%
of baseline for >10 seconds
- A 3% oxygen desaturation from baseline OR an arousal
**CMS requires 4%
When is a hypopnea considered obstructive? - ANSWER -If any of the following
occur:
- Snoring
- Inspiratory flattening
- Thoracoabdominal paradox
What is a RERA? - ANSWER -Breathes >10 seconds by increasing rate or
flattening, leading to an arousal when it doesn't meet criteria for apnea or hypopnea
, When MUST you do a PSG over HST? - ANSWER -- Cardiorespiratory disease
- Neuromuscular weakness
- Hypoventilation
- Opiate use
- Hx of stroke
- Severe insomnia
What are the 3 primary signals tested with hST? - ANSWER -- Airflow
- Respiratory effort
- Oximetry
Do HST's over or underestimate OSA severity? - ANSWER -Overestimate
What do HST's not measure? - ANSWER -Total sleep time, RERA's
How is sleep monitored with HST? - ANSWER -SCOPER
- Sleep
- Cardiac measure
- Oximetry
- Position
- Effort
- Respiration
How does OSA treat SDB? - ANSWER -- Maintains mandible closed
- Increases anterior and lateral dimensions of oropharynx
- Increases anterior and lateral dimensions of velopharynx
- Increases base of tongue muscle tone
What are some observed changes with OAT? - ANSWER -- Increased lower face
height
- Lateral displacement of parapharyngeal fat pads
- Anterior positioning of base of tongue
- Increase in total airway volume
Questions And Verified Detailed Answers
[Most Tested Questions] Certified Study Guide
Resources Graded A+
What are some diurnal symptoms of OSA? - ANSWER -- Daytime sleepiness
- Memory and concentration dysfunction
- GERD
- Irritability, depression
- Traffic accidents
- Waking with a dry mouth, irritated throat
What are some nocturnal symptoms of OSA? - ANSWER -- Heavy, persistent
snoring
- Apnea with limb movement
- Nocturia
- Nocturnal sweating
- Sudden awakening with noisy breathing
- Accidents related to sleepiness
- Insomnia
What does AHI consist of? - ANSWER -Apneas + Hypopneas
What is the difference in AHI and RDI? - ANSWER -RERAs are included for
RDI
CMS views AHI = RDI because they don't recognize RERA's
What is considered mild OSA? - ANSWER -5-15 RDI per hour
CMS will cover OSA therapy if comorbidity like:
- HTN
,- Stroke
- Sleepiness
- Ischemic heart disease
- Insomnia
- Mood disorders
What is considered moderate OSA? - ANSWER -15-30 RDI per hr
What is considered severe OSA? - ANSWER -30+ RDI per hr
What is ODI? - ANSWER -Oxygen desaturation index
# of 3% desaturations per hr
What does a CPAP do? - ANSWER -- Splints airway open
- + pressure decreases fluid leakage into alveoli
- + pressure decreases work of breathing and O2 requirements
- Improves cardiac function and output by decreasing preload and afterload
- Increases lung volume
Does CPAP prevent CV disease in patients with CVD + OSA? - ANSWER -No -
not compared to usual care alone
What is the compliance rate for CPAP? - ANSWER -30-70%
Is nasal patency a major contributor to OSA? - ANSWER -NO - using nasal
dilators doesn't significantly improve nasal flow or apnea index
What are the 3 patterns of tissue deformation during mandibular advancement? -
ANSWER -- Whole tongue moves forward en bloc
- Whole tongue elongates
- Inferior tongue moves forward
**POSTERIOR TONGUE DOESN'T MOVE
, What are the cardiovascular benefits of oral appliance therapy? - ANSWER --
Reduced BP (34-75%)
- Endotheilal and left ventricular function improves
Does bariatric surgery/weight loss cure OSA? - ANSWER -No - most patients will
still have moderate residual OSA - still needs treatment
Does reduce AHI though
How are apneas scored? What are the requirements? - ANSWER -Decreased flow
signal >90% for >10 seconds
BOTH must be met
What is the difference between obstructive and central apnea? - ANSWER -
Obstructive has continued effort, central has no effort
Mixed = absence of effort initially followed by resumption of effort
What are the requirements for a hypopnea? - ANSWER -- Decreased flow >30%
of baseline for >10 seconds
- A 3% oxygen desaturation from baseline OR an arousal
**CMS requires 4%
When is a hypopnea considered obstructive? - ANSWER -If any of the following
occur:
- Snoring
- Inspiratory flattening
- Thoracoabdominal paradox
What is a RERA? - ANSWER -Breathes >10 seconds by increasing rate or
flattening, leading to an arousal when it doesn't meet criteria for apnea or hypopnea
, When MUST you do a PSG over HST? - ANSWER -- Cardiorespiratory disease
- Neuromuscular weakness
- Hypoventilation
- Opiate use
- Hx of stroke
- Severe insomnia
What are the 3 primary signals tested with hST? - ANSWER -- Airflow
- Respiratory effort
- Oximetry
Do HST's over or underestimate OSA severity? - ANSWER -Overestimate
What do HST's not measure? - ANSWER -Total sleep time, RERA's
How is sleep monitored with HST? - ANSWER -SCOPER
- Sleep
- Cardiac measure
- Oximetry
- Position
- Effort
- Respiration
How does OSA treat SDB? - ANSWER -- Maintains mandible closed
- Increases anterior and lateral dimensions of oropharynx
- Increases anterior and lateral dimensions of velopharynx
- Increases base of tongue muscle tone
What are some observed changes with OAT? - ANSWER -- Increased lower face
height
- Lateral displacement of parapharyngeal fat pads
- Anterior positioning of base of tongue
- Increase in total airway volume
