USMLE Forum Archives - USMLE Step 3 - I keep falling asleep doc :(
I keep falling asleep doc :(
harry206 - 05-05-09 03:23
A 35-year-old Caucasian male presents to your office and complains of excessive daytime sleepiness for the last several months. He elaborates by saying, "I keep falling asleep during the inappropriate times of the day." He denies any episodes of weakness, inability to move, or hallucinations. He does not have any problems falling or staying asleep during the night. His past medical history is insignificant. He smokes 1 ½ packs of cigarettes daily and drinks alcohol occasionally. The physical examination is within normal limits. Which of the following is the best next step in the management of this patient?
harry206 - 05-05-09 03:23
A 35-year-old Caucasian male presents to your office and complains of excessive daytime sleepiness for the last several months. He elaborates by saying, "I keep falling asleep during the inappropriate times of the day." He denies any episodes of weakness, inability to move, or hallucinations. He does not have any problems falling or staying asleep during the night. His past medical history is insignificant. He smokes 1 ½ packs of cigarettes daily and drinks alcohol occasionally. The physical examination is within normal limits. Which of the following is the best next step in the management of this patient?
The correct answer and explanation will be available after you answer.
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#2
Re: I keep falling asleep doc :( usmlefever3 - 05-05-09 04:17 My answer is: a.
obstructive sleep apnea
#3
Re: I keep falling asleep doc :( bingousmle - 05-05-09 10:02 My answer is: a.
daytime sleepiness can be either due to narcolepsy or obstructive sleep apnea. but since he does not have a disturbed nocturnal sleep pattern and experiences no weakness inability to move or hallucinations, its more of obstructive sleep apnea.
#4
Re: I keep falling asleep doc :( sarabrodke1 - 05-05-09 11:25 seems to be Narcolepsy.. Give Ritalin ...if Iam right...so d is my answer
#5
Re: I keep falling asleep doc :( InSitu - 05-05-09 11:35 My answer is: d.
The diagnosis was made in th case...its Narcolepsy and Mehylphenidate (Ritalin) is the answer.
#6
Re: I keep falling asleep doc :( InSitu - 05-05-09 11:35 This is not obstructive sleep apnea. This guy sleeps well at night.
#9
Re: I keep falling asleep doc :(
harry206 - 05-06-09 03:25 ANSWWER :A
EXPLANATION:
The causes of excessive daytime sleepiness include narcolepsy, sleep apnea syndrome, periodic limb movements of sleep, insufficient sleep, or the effects of sedating medications.
Arriving at a specific diagnosis may be difficult if no associated clue (e.g., history of snoring or cataplexy) is present.
Overnight polysomnography (PSG) seems to be the best approach in managing patients with an impartial history.
#10
Re: I keep falling asleep doc :( rocksfrow - 05-06-09 10:16 
posted by harry206 on 05-06-09 03:25
ANSWWER :A
EXPLANATION:
The causes of excessive daytime sleepiness include narcolepsy, sleep apnea syndrome, periodic limb movements of sleep, insufficient sleep, or the effects of sedating medications.
Arriving at a specific diagnosis may be difficult if no associated clue (e.g., history of snoring or cataplexy) is present.
Overnight polysomnography (PSG) seems to be the best approach in managing patients with an impartial history.
ANSWWER :A
EXPLANATION:
The causes of excessive daytime sleepiness include narcolepsy, sleep apnea syndrome, periodic limb movements of sleep, insufficient sleep, or the effects of sedating medications.
Arriving at a specific diagnosis may be difficult if no associated clue (e.g., history of snoring or cataplexy) is present.
Overnight polysomnography (PSG) seems to be the best approach in managing patients with an impartial history.
Can you please fill this explanation into the form when you create the thread for new questions? Below the multiple choice options while creating the question there is a text box for you to fill the explanation, if you fill this out the explanation will also show with the correct answer after the 24 hour wait period. This keeps everything much more organized and does not require you to come back and post the answer/explanation!
Thanks.
#11
Re: I keep falling asleep doc :( harry206 - 05-06-09 10:25 Hi Rocksfrow,
I m not giving explanation in box, because like this i get revision twice.
But i will 100% post my explanation after answer is available.
GL
#12
Re: I keep falling asleep doc :( rocksfrow - 05-06-09 10:31 posted by harry206 on 05-06-09 10:25
Hi Rocksfrow,
I m not giving explanation in box, because like this i get revision twice.
But i will 100% post my explanation after answer is available.
GL
Hi Rocksfrow,
I m not giving explanation in box, because like this i get revision twice.
But i will 100% post my explanation after answer is available.
GL
What do you mean you get revision twice?
#13
Re: I keep falling asleep doc :( harry206 - 05-06-09 10:34 I am doing Q & posting Q simultaneously,
after 24 hr i revise them again while posting their explanation
Will follow this only
Will post explanation after 24 hr only, when answer is available.
GL
#14
Re: I keep falling asleep doc :( rocksfrow - 05-06-09 10:37 posted by harry206 on 05-06-09 10:34
I am doing Q & posting Q simultaneously,
after 24 hr i revise them again while posting their explanation
Will follow this only
Will post explanation after 24 hr only, when answer is available.
GL
I am doing Q & posting Q simultaneously,
after 24 hr i revise them again while posting their explanation
Will follow this only
Will post explanation after 24 hr only, when answer is available.
GL
IF you must do it this way, that's fine. We appreciate your input regardless. We will be updating the point system shortly. It is simply unfair to receive an additional 6 points on every question you post the explanation to when it's intended to be posted originally (what you're earning the initial points for).
Thanks harry206.
#15
Re: I keep falling asleep doc :( harry206 - 05-06-09 10:39 Ok frnd,
I m here to learn basically.
I hv step 3 in July, so i don think i will earn much :)
GL
#16
Re: I keep falling asleep doc :( rocksfrow - 05-06-09 10:41 Good luck on your Step 3!
Again we appreciate all of your input, perhaps I misunderstood your intentions! All is good here at doctok!
#18
Re: I keep falling asleep doc :( harry206 - 05-06-09 10:49 Hi rocksfrow,
Hi have one suggestion:
U should add this feature: where Poster should be able to add explanation on Top anytime.
Like this we don't have to post again.
So feature for Editing must be there
I hope this is possible
GL
#44
Re: I keep falling asleep doc :( babbu5508 - 07-28-10 05:36 My answer is: d.
Narcolepsy is a chronic sleep disorder, or dyssomnia, characterized by excessive daytime sleepiness (EDS) in which a person experiences extreme fatigue and possibly falls asleep at inappropriate times
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