WOEMA CME Webinar Series: Obstructive Sleep Apnea - 06/16/2011

It will only take a few minutes to complete the questionnaire and by doing so, you are eligible to receive CME credit (WOEMA members only.) We greatly appreciate your time and input.

CREDIT: WOEMA is accredited by the Institute of Medical Quality/California Medical Association to provide continuing medical education for physicians. WOEMA takes responsibility fo the content, quality, and scientific integrity of this CME activity.
WOEMA designates this educational activity when combined with completion and submission of the on-line questionnaire, for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Certificates will be issued and e-mailed to participants who successfully participate and complete the webinar.

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1. 55 year old, male, long haul truck driver presents for renewal of his commercial driver's license (CDL). He snored a long time ago but reports being "cured" as his wife makes him sleep on his side. He denies any accidents or daytime sleepiness. He takes Hydrocholorthiazide for hypertension but reports being otherwise healthy.
Blood pressure is 134/86, Height= 71 in., Weight=235 lbs. >>> BMI= 33. Benign exam for neck circumference of 18 inches but his upper airway appears normal.

Indicate how you would manage this case:

a. Clear for 1 year due to hypertension with advice to exercise and lose weight.

b. Give temporary clearance long enough to obtain a sleep study.

c. Disqualify until sleep apnea is ruled out.

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2. Same patient returns 1 month later with a sleep study which demonstrates an Apnea Hypopnea Index (AHI) of 18.

Indicate how you would manage this case:

a. Tell the patient that he doesn't have sleep apnea and clear for 1 year.

b. Advise the patient that he does have sleep apnea but doesn't require treatment except for diet and exercise.

c. Advise the patient that he does have sleep apnea, doesn't require treatment in order to drive, but should wear CPAP to avoid the health complications.

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3. Same patient returns 1 year later. His weight is now 260 lbs. and blood pressure is successfully treated (128/86) on Atenol, Hydrocholorthiazide, and Lisinopril. He denies snoring, daytime sleepiness, or motor vehicle accidents.

Indicate how you would manage this case:

a. Strongly advise diet and exercise and extend clearance for 1 year.

b. Repeat sleep study.

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4. 32 year old, male school bus driver presents for re-certification of his CDL. Three months ago he underwent a sleep study and had an AHI of 38. He was adamant about not wearing CPAP and was evaluated by a head and neck surgeon who performed a Uvulopalatopharyngoplasty (UPPP). The patient report he feels much better now and needs his license to return to work. He has a repeat sleep study with an AHI of 15.

Indicate how you would manage this case:

a. Clear for 2 years.

b. Clear for 1 year.

c. Patient is not medically qualified.

d. Refer to a sleep specialist.

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5. 58 year old, female firefighter presents for re-certification of her CDL. Essentially normal exam except for BMI of 35 with a Mallampati class of 3. No significant change in weight since prior evaluation. Sleep study is discussed and the patient reports that she had the test last year and she now wears a dental device at night which has cured her. Review of her records confirms that her AHI was 24 and decreased to 18 while using the device.

Indicate how you would manage this case:

a. Clear for 2 years.

b. Clear for 1 year.

c. Not medically qualified.

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6. How well did the speaker meet the educational objectives for this presentation?

a. Excellent

b. Very good

c. Good/Average

d. Below average

e. Not at all

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2. Same patient returns 1 month later with a sleep study which demonstrates an Apnea Hypopnea Index (AHI) of 18. Indicate how you would manage this case:

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3. Same patient returns 1 year later. His weight is now 260 lbs. and blood pressure is successfully treated (128/86) on Atenol, Hydrocholorthiazide, and Lisinopril. He denies snoring, daytime sleepiness, or motor vehicle accidents. Indicate how you would manage this case:

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6. How well did the speaker meet the educational objectives for this presentation?

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7. Additional Comments:

2. Same patient returns 1 month later with a sleep study which demonstrates an Apnea Hypopnea Index (AHI) of 18.

Indicate how you would manage this case:

3. Same patient returns 1 year later. His weight is now 260 lbs. and blood pressure is successfully treated (128/86) on Atenol, Hydrocholorthiazide, and Lisinopril. He denies snoring, daytime sleepiness, or motor vehicle accidents.

Indicate how you would manage this case: