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Postpartum pulmonary embolism — SCE Respiratory MCQ

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HardPulmonary Vascular DiseasePostpartum pulmonary embolismSCE Respiratory

After adequate nocturnal polysomnography and correction of insufficient sleep and medication effects, a patient with daily irresistible sleepiness undergoes MSLT. Mean sleep latency is 6.5 minutes with two sleep-onset REM periods. Cataplexy is absent. Which classification is supported?

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Correct answer: A — Narcolepsy type 2 if the clinical duration and exclusion criteria are also fulfilled

Explanation lettering: D = shown as A · C = shown as B · A = shown as C · E = shown as D · B = shown as E

D is correct. An MSLT mean sleep latency of 8 minutes or less plus at least two sleep-onset REM periods supports narcolepsy; a SOREMP on the preceding PSG can count as one. In the absence of cataplexy or documented low CSF orexin, the phenotype is type 2 once persistent sleepiness and alternative causes are excluded. Idiopathic hypersomnia has zero or one SOREMP, type 1 needs cataplexy or orexin deficiency, and valid interpretation requires adequate preceding sleep and attention to REM-suppressing medicines and shift work.

Reference: https://pmc.ncbi.nlm.nih.gov/articles/PMC9159677/