The most appropriate immediate management of prolonged Scoline apnea is
AReversal with neostigmine
BEstimation of plasma cholinesterase
CExchange transfusion
DContinuation of artificial ventilation
A 56-year-old woman with diabetes, hypertension, and hyperlipidemia is found to have an A1C of 11 despite her best attempts at diet and faithfully taking her metformin and glyburide. She reports severe fatigue and sleepiness in the daytime, which has limited her ability to exercise. On examination, she is obese, has a full appearing posterior pharynx, clear lungs, a normal heart examination, and trace bilateral edema. Her TSH is 2.0 m/L (normal). Before adding another oral agent or switching to insulin, what is the best next step?
AArrange for a sleep study to check the patient for obstructive sleep apnea.
BConsider prescribing a sleep aid to help her sleep better and increase her energy to exercise during the day.
CAssess for possible depression as a contributor to her fatigue.
DEducate the patient on sleep hygiene as a supportive measure to improve her overall well-being.
A 40-year-old man presents with daytime sleepiness and impaired concentration and memory. On examination his BMI is 41 kg/m2, BP is 160/100 mm Hg. His awake ABG analysis is given: PaO2=66 mm Hg, PaCO2=50 mm Hg, HCO3=28 mEq/L. What is the most likely diagnosis?
AObstructive sleep apnea
BNarcolepsy
CObesity hypoventilation syndrome
DCentral sleep apnea
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