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Step 2 CS - Minicases > Insomnia > Flashcards

Flashcards in Insomnia Deck (5)
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1
Q

Key history in insomnia

A

Duration
Description (trouble falling asleep, staying asleep, multiple awakenings, early-morning rises)
Daytime sleepiness
Other medical problems (arthritis, diabetes)
Loud snoring, nightmares, depression
Caffeine, alcohol, medication, drug use
Jet lag, shift work
Stressors, sleep hygiene
Psychiatric symptoms (irritability, grandiose delusions)

2
Q

Key physical exam in insomnia

A

Vital signs, MMSE, thyroid exam

3
Q

25 yo F with 3-week Hx of difficulty falling asleep but sleeps 7 hours without snoring or nightmares
+ recently began college
+ trouble with boyfriend
+ drinks 3-4 cups of coffee per day

A

Stress-induced insomnia
Caffeine-induced insomnia
Insomnia related to circadian rhythm sleep disorder

Polysomnography
MMSE
Urine toxicology
CBC
TSH
4
Q

55 yo obese M with several months of poor sleep, daytime fatigue, morning headaches
+ snores loudly

A

Obstructive sleep apnea
Daytime fatigue in primary hypersomnia
Insomnia with circadian rhythm sleep disorder

CBC, TSH, polysomnography, ECG

5
Q

33 yo F with three weeks of fatigue and trouble sleeping
+ falls asleep easily but wakes up in early morning and cannot fall asleep again
+ 8 pound weight loss
+ ahedonia

A

Insomnia related to major depressive disorder
Primary hypersomnia
Insomnia with circadian rhythm sleep disorder

MMSE, TSH, CBC, polysomnography