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.
Which of the following statements regarding prolactin levels is true?
AHyperthyroidism - Increased prolactin
BSleep - Increased prolactin
COrganic seizure - normal prolactin
DPsychogenic seizure - Normal prolactin
During polysomnography, which stage of sleep is represented by the marked areas when observing the following wave patterns? EOG (Electrooculography) EEG (Electroencephalography) EMG (Electromyography)
AREM sleep
BNREM I sleep
CNREM II sleep
DNREM III sleep
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