#may2020mccqe1
A 60-year-old man with a history of congestive heart failure presents to his physician. He has a 5-year history of excessive daytime sleepiness and snoring. He also admits to three drinks of alcohol per day. His temperature is 36.6°C (98.0°F), pulse is 85/min, blood pressure is 138/82 mm Hg, respiratory rate is 14/min, and oxygen saturation is 99% on room air. His body mass index is 31 kg/m2. Physical examination is significant for macroglossia and a short neck. Polysomnography is performed and is significant for multiple nocturnal episodes of airflow cessation at the nose and mouth, despite evidence of continuing respiratory effort. Which of the following is the most effective management for this patient?
(A) Avoidance of alcohol
(B) Avoidance of supine posture
(C) Nasal continuous positive airway pressure
(D) Uvulopalatopharyngoplasty
(E) Weight reduction
A 60-year-old man with a history of congestive heart failure presents to his physician. He has a 5-year history of excessive daytime sleepiness and snoring. He also admits to three drinks of alcohol per day. His temperature is 36.6°C (98.0°F), pulse is 85/min, blood pressure is 138/82 mm Hg, respiratory rate is 14/min, and oxygen saturation is 99% on room air. His body mass index is 31 kg/m2. Physical examination is significant for macroglossia and a short neck. Polysomnography is performed and is significant for multiple nocturnal episodes of airflow cessation at the nose and mouth, despite evidence of continuing respiratory effort. Which of the following is the most effective management for this patient?
(A) Avoidance of alcohol
(B) Avoidance of supine posture
(C) Nasal continuous positive airway pressure
(D) Uvulopalatopharyngoplasty
(E) Weight reduction
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