Sleeping on the job session 2

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Sleeping on the job session 2 by Mind Map: Sleeping on the job session 2

1. Step 6

1.1. Review session 1

1.1.1. Summary of step 5

1.2. Report new knowledge

1.2.1. sleep apnea disorders obesity? other disorders that might cause these symptoms relative antomy

1.2.2. sleep physiology

1.2.3. hypoxia and confusion

1.3. 30 minutes

2. Step 8

2.1. Diagnostic decision

2.1.1. obstructive sleep apnea with complication excerbated by upper airay infection

2.2. Mechanism

2.2.1. airway narrowing and hypoxia causing systemic complications,

2.3. Presentation

2.3.1. had episodes of apnea, obese, hypopnea, confustion, hypoxia, dyspnea and bilateral edema

2.4. Supporting data

2.4.1. cxr, lft, abg, elevated bp, high bmi,

2.5. 10 minutes

3. Step 7

3.1. Inquiry plan and info gathering

3.1.1. History of presenting complain couple of times incidence of apnea dry mouth sudden sleep during day more than 10 seconds stoped driving because of difficulties confusion started 48 hours ago dyspnea fatigue during daytime wife left the room due to his snoring leg movment during sleep cyanosis happened in the last couple of days loud snoring recent memory diffculty yellowish sputum morning headaches apnea episodes leg edema for couple of months renal disease lateley

3.1.2. Previous medical / surgical history dyspnea for several years stopped tennis inguinal hernial repair require o2 endotracheal intubation difficulties bp mildly elevated

3.1.3. Drug history / allergy tenazipam

3.1.4. Family history father snored died of mi hypothyrodism in mother unckle died of stroke son is snorer

3.1.5. Social / occupational history drinks 4 glass of beer smokes 20 cig per day (20-26)

3.1.6. Systemic review

3.1.7. Physical examination rr 20 pulse 90 165/95 bp 37.2 temp obese 105 kg 170cm bmi 36 thick neck crowded upper airway no cyanosis edema soft heart souns no murmur disoriented in place and time (personal ok)

3.1.8. tests results

3.2. 40 minutes