Pre-test Questions

Q1. Your patient, a 54-year-old male with no significant past medical history, presents to you with insomnia characterized by trouble falling asleep. Once asleep, he is fine. After optimizing sleep hygiene, you decide to prescribe medication. Which of the following FDA-approved medications for insomnia is ideal for this patient?
  a. Eszopiclone 1 mg HS
  b. Temazepam 30 mg HS
  c. Zolpidem CR 6.25 mg HS
  d. Doxepin 3 mg HS
  e. Zaleplon 5 mg HS
 
Q2. The STOP-BANG questionnaire is used to help identify which patient is at high risk for obstructive sleep apnea (OSA). Which of the following patients are at high risk for OSA and should be considered for sleep testing?
  a. 60-year-old male with obesity, HTN, and snoring
  b. 30-year-old tired woman with obesity, neck size 16.5", HTN, and observed stop breathing
c. 55-year-old normal weight, tired man, neck size 17", wife says he snores
d. 70-year-old normal weight, tired woman, husband says she snores loudly and chokes in her sleep, and has HTN
  e. All of the above
 
Q3. A 49-year-old white female presents to you with insomnia and daytime tiredness. She reports having discomfort in her legs every night, worsens as the night progresses, worsens with inactivity, and improves with leg movement. The discomfort interferes with her ability to get to sleep. You diagnose her with restless legs syndrome (RLS). Work up is negative for secondary causes. You decide to prescribe medication. Which of the following is not an ideal first choice of medication for this patient?
  a. Ropinirole 0.25 mg at bedtime
  b. Pramipexole 0.125 mg at bedtime
  c. Gabapentin 300 mg at bedtime
  d. Pregabalin 25 mg at bedtime
  e. Carbidopa/levodopa 10/100 mg at bedtime
 
Q4. Patients with drowsiness may be screened for narcolepsy most effectively using which of the following?
  a. Swiss Narcolepsy Scale (SNS)
  b. Epworth Sleepiness Scale (ESS)
c. Multiple Sleep Latency Test (MSLT)
d. Maintenance of Wakefulness Test (MWT)
 
Q5. Which of the following medications approved for the excessive daytime sleepiness of narcolepsy is not a DEA scheduled medication?
  a. Methylphenidate
  b. Modafinil
c. Pitolisant
d. Solriamfetol
e. Armodafinil
       
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