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Obstructive sleep apnoea — MCCQE Part 1 MCQ

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EasySleepObstructive sleep apnoeaMCCQE Part 1

52-year-old man presents with daytime sleepiness and loud snoring. His partner reports witnessed apnoeas and BMI is 36. Which of the following is the most appropriate next step?

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Correct answer: D — Order sleep study and advise driving precautions if excessively sleepy

Order sleep study and advise driving precautions if excessively sleepy is best because classic symptoms and obesity suggest OSA requiring objective testing. Discharge with reassurance and routine follow-up only is suboptimal because it underestimates acute or progressive risk; Treat symptomatically and defer definitive assessment is suboptimal because symptom control alone does not address the likely underlying diagnosis; Arrange non-urgent outpatient imaging in several months is suboptimal because delayed imaging is unsafe when the presentation has red flags; Start long-term corticosteroids without confirming the diagnosis is suboptimal because empiric steroids can obscure infection, malignancy or other diagnoses. Untreated OSA increases cardiovascular and driving risk.

Reference: Canadian Thoracic Society sleep apnoea guidance