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Obstructive sleep apnea — USMLE Step 2 CK MCQ

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EasyInternal MedicineObstructive sleep apneaUSMLE Step 2 CK

A 57-year-old Asian American woman comes to the clinic because of neurologic symptoms. History and focused examination are notable for loud snoring, witnessed apneas, morning headaches, and daytime sleepiness. Temperature is 98.6°F (37.0°C), blood pressure is 126/78 mmHg, pulse is 84/min, respirations are 16/min, and oxygen saturation is 98% on room air. Physical examination confirms the key finding and shows no unrelated abnormality that would better explain the presentation. Focused laboratory studies and initial testing support the clinical pattern described in the stem. Which of the following is the most appropriate initial diagnostic study?

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Correct answer: E — Overnight polysomnography

The vignette describes Obstructive sleep apnea, supported by loud snoring, witnessed apneas, morning headaches, and daytime sleepiness. Overnight polysomnography is the single best answer because it matches the diagnostic or management priority in this clinical setting. The other choices are plausible alternatives in related presentations, but they do not best fit the timing, findings, and guideline-directed approach described here.

Reference: American Academy of Sleep Medicine 2021 Guideline