A 26-year-old librarian presents with chronic daytime somnolence, which has frequently caused him to fall asleep at work. He does not smoke but drinks 1 to 2 glasses of wine daily. He says he frequently awakens at night but denies any visual or auditory hallucinations on falling asleep. His height is 186 cm (73 in), and his weight is 60% greater than expected. Chest examination reveals no specific findings other than distant breath sounds. Arterial blood gas analysis during normal ventilation shows: Pa02 82 mm Hg PaC02 55mmHg After the patient voluntarily hyperventilates for 1 minute, blood gas analysis returns within normal limits.Which of the following will have the greatest benefit on this patients symptoms? (A) Benzodiazepines at bedtime (B) Daily acetazolamide (C) Morning administration of dextroamphetamine (D) Supplemental oxygen at night (E) Weight loss https://facebook/groups/medclick/
Posted on: Wed, 02 Jul 2014 02:06:10 +0000
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