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NBME 24 Answers

nbme24/Block 2/Question#2

A 45-year-old man comes to the physician because of ...

Oxygen saturation

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Classic sleep apnea in the patient. Cessation of breathing causes nocturnal hypoxia and systemic hypertension/arrhythmic/sudden death can persist. PaO2 is normal during day and decreased during episodes and at night. Classically seen in Obese patients such as the patient in the question stem.

tinydoc  Caused a cessation of breathing rather than a ↓ in lung volume although a patient could develop an obesity related restrictive lung disease thats not whats happening with this question. +  
sunshinesweetheart  p 665 FA 2019 +  

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submitted by krewfoo99(40),

Lung volume will decrease in obesity hypoventilation syndrome. Even though this patient is obese, he has all the clinical features of sleep apnea

How does OSA lead to peripheral edema and loud S2?

futuredoc  Hypoxia leads to pulmonary vasoconstriction and therefore pulmonary HTN. This can lead to the peripheral edema. Furthermore pulmonary HTN can present with a loud S2. +4