CBE Clinical Assessment Methods 5 — Questions and Answers
Question 1: An apnea-hypopnea index (AHI) of 34 events per hour on polysomnography indicates what OSA severity?
- Mild
- Moderate
- Normal
- Severe (Correct answer)
Correct answer: Severe
AHI ≥30 events per hour is classified as severe obstructive sleep apnea; 15-29 is moderate and 5-14 is mild.
Question 2: Which questionnaire is commonly used to screen for binge eating severity in bariatric candidates?
- Epworth Sleepiness Scale
- Binge Eating Scale (BES) (Correct answer)
- Beck Anxiety Inventory
- CAGE questionnaire
Correct answer: Binge Eating Scale (BES)
The 16-item Binge Eating Scale is widely used in bariatric programs to screen for binge eating behaviors.
Question 3: Why is BMI alone a limited assessment tool for an individual patient?
- It cannot be calculated without laboratory data
- It overestimates obesity in all women
- It does not distinguish fat mass from lean mass or show fat distribution (Correct answer)
- It requires DXA validation
Correct answer: It does not distinguish fat mass from lean mass or show fat distribution
BMI uses only height and weight, so it misclassifies muscular individuals and ignores visceral fat distribution.
Question 4: Which simple anthropometric measure is associated with OSA risk and is included in the STOP-BANG questionnaire?
- Neck circumference greater than 40 cm (about 16 inches) (Correct answer)
- Wrist circumference greater than 7 inches
- Mid-arm circumference greater than 30 cm
- Hip circumference greater than 40 inches
Correct answer: Neck circumference greater than 40 cm (about 16 inches)
STOP-BANG scores a point for neck circumference >40 cm, reflecting upper airway fat deposition.
Question 5: In the transtheoretical model, a patient who says they plan to start changing their eating habits within the next 30 days and has taken small steps is in which stage?
- Precontemplation
- Contemplation
- Action
- Preparation (Correct answer)
Correct answer: Preparation
Preparation describes intent to act within about 30 days with some initial steps taken, preceding the action stage.
Question 6: Which serum marker has a short half-life of about 2-3 days and has historically been used to monitor acute changes in protein status, though it is affected by inflammation?
- Albumin
- Prealbumin (transthyretin) (Correct answer)
- Total cholesterol
- Hemoglobin A1c
Correct answer: Prealbumin (transthyretin)
Prealbumin has a half-life of about 2-3 days versus about 20 days for albumin, but both are negative acute-phase reactants.
Question 7: Which Epworth Sleepiness Scale score suggests excessive daytime sleepiness warranting further evaluation?
- Greater than 10 (Correct answer)
- Greater than 3
- Greater than 20
- Exactly 5
Correct answer: Greater than 10
An ESS score above 10 (out of 24) indicates excessive daytime sleepiness.
CBE Clinical Assessment Methods 5
An apnea-hypopnea index (AHI) of 34 events per hour on polysomnography indicates what OSA severity?