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{{WBRQuestion
{{WBRQuestion
|QuestionAuthor={{Rim}}
|QuestionAuthor={{Rim}}, {{AJL}} {{Alison}}
|ExamType=USMLE Step 1
|ExamType=USMLE Step 1
|MainCategory=Behavioral Science/Psychiatry
|MainCategory=Behavioral Science/Psychiatry
Line 20: Line 20:
|MainCategory=Behavioral Science/Psychiatry
|MainCategory=Behavioral Science/Psychiatry
|SubCategory=Pulmonology
|SubCategory=Pulmonology
|Prompt=A 43 year old male patient is diagnosed with hypertension.  His physician recommends he undergoes polysomnography to rule out secondary hypertension caused by obstructive sleep apnea.  While analyzing the polysomnogram, the physician notes the beginning of a sleep stage characterized by sleep spindles and K complexes.  Which of the following findings is most likely to be present in the patient during this stage of sleep?
|Prompt=A 43-year-old male, diagnosed with hypertension, is recommended to undergo polysomnography in order to rule out secondary hypertension caused by obstructive sleep apnea.  While analyzing the polysomnogram, you note the beginning of a sleep stage characterized by sleep spindles and K complexes.  Which of the following findings is most likely to be present in the patient during this stage of sleep?
|Explanation=[[Sleep]] [[bruxism]] is reported in approximately 8% of the adult population.  It is the clenching of teeth that occurs during sleep due to rhythmic masticatory muscle movement (RMMA) with repetitive jaw muscle contractions.   Bruxism may be a destructive process that causes tooth destruction, jaw pain, limited movement of the mandible, and headaches.  Although bruxism can occur in all stages of sleep, it is most frequently seen in stages 1 and 2 than in slow-wave sleep or in [[rapid eye movement]] ([[REM]]) sleep.  
|Explanation=[[Sleep bruxism]], reported in approximately 8% of the adult population, is the clenching of teeth due to rhythmic masticatory muscle movement (RMMA) with repetitive jaw muscle contractions. [[Bruxism]] may cause tooth destruction, jaw pain, limited movement of the mandible, and headaches.  Although [[bruxism]] can occur in all stages of sleep, it is most frequently occurs during stages 1 and 2 of sleep.  
[[Sleep spindles]] and [[K complexes]] are characteristic findings of stage 2 of sleep on [[polysomnography]].  
[[Sleep spindles]] and [[K complexes]] are characteristic findings of stage 2 of sleep on [[polysomnography]].  


Educational Objective:
|EducationalObjectives= [[Sleep bruxism]], or teeth clenching, usually occurs during stage 2 of sleep, which is characterized by sleep spindles and K complexes on polysomnography.
Sleep bruxism, or teeth clenching during sleep, usually occurs during stage 2 of sleep.  This stage is characterized by sleep spindles and K complexes on polysomnography.
|References= Lavigne GJ, Kato T, Kolta A, et al. Neurobiological mechanisms involved in sleep bruxism. Critical Reviews in Oral Biology and Medicine. 2003;14(1):30-46
Macaluso GM, Guerra P, Di Giovanni G, et al. Sleep bruxism in a disorder related to periodic arousals during sleep. Journal of Dental Research. 1998;77(4):565-573


References:
Lavigne GJ, Kato T, Kolta A, et al. Neurobiological mechanisms involved in sleep bruxism. Critical Reviews in Oral Biology and Medicine. 2003;14(1):30-46
Macaluso GM, Guerra P, Di Giovanni G, et al. Sleep bruxism in a disorder related to periodic arousals during sleep. Journal of Dental Research. 1998;77(4):565-573
|AnswerA=Rapid eye movement
|AnswerA=Rapid eye movement
|AnswerAExp=Dreaming, erections, and loss of motor tonicity are usually present during REM sleep.
|AnswerAExp=Rapid eye movement, dreaming, erections, and loss of motor tonicity frequently manifest during REM sleep.
|AnswerB=Bruxism
|AnswerB=Bruxism
|AnswerBExp=Bruxism is usually seen in stage 2 of sleep, characterized by sleep spindles and K complexes.
|AnswerBExp=Bruxism frequently manifests in stage 2 of sleep, characterized by sleep spindles and K complexes upon polysomnography.
|AnswerC=Bedwetting
|AnswerC=Bedwetting
|AnswerCExp=Bedwetting, night terrors, and sleep walking are usually present during stage 3 of sleep.
|AnswerCExp=Bedwetting, night terrors, and sleep walking frequently manifest during stage 3 of sleep.
|AnswerD=Night terrors
|AnswerD=Night terrors
|AnswerDExp=Night terrors are usually present during stage 3 of sleep.
|AnswerDExp=Night terrors are usually present during stage 3 of sleep.
|AnswerE=Penile erection
|AnswerE=Penile erection
|AnswerEExp=Penile erections are usually present during REM sleep.
|AnswerEExp=Penile erections, dreaming, erections, and loss of motor tonicity frequently manifest during REM sleep.
|RightAnswer=B
|RightAnswer=B
|WBRKeyword=Bruxism, polysomnography, stage, sleep, K, complex, spindle
|WBRKeyword=Bruxism, polysomnography, sleep, K complex, sleep spindles, REM, sleep stages,
|Approved=No
|Approved=Yes
}}
}}

Revision as of 14:57, 21 July 2014
Author [[PageAuthor::Rim Halaby, M.D. [1], Alison Leibowitz [2] (Reviewed by Alison Leibowitz)]]
Exam Type ExamType::USMLE Step 1
Main Category MainCategory::Behavioral Science/Psychiatry
Sub Category SubCategory::Pulmonology
Prompt [[Prompt::A 43-year-old male, diagnosed with hypertension, is recommended to undergo polysomnography in order to rule out secondary hypertension caused by obstructive sleep apnea. While analyzing the polysomnogram, you note the beginning of a sleep stage characterized by sleep spindles and K complexes. Which of the following findings is most likely to be present in the patient during this stage of sleep?]]
Answer A AnswerA::Rapid eye movement
Answer A Explanation AnswerAExp::Rapid eye movement, dreaming, erections, and loss of motor tonicity frequently manifest during REM sleep.
Answer B AnswerB::Bruxism
Answer B Explanation AnswerBExp::Bruxism frequently manifests in stage 2 of sleep, characterized by sleep spindles and K complexes upon polysomnography.
Answer C AnswerC::Bedwetting
Answer C Explanation AnswerCExp::Bedwetting, night terrors, and sleep walking frequently manifest during stage 3 of sleep.
Answer D AnswerD::Night terrors
Answer D Explanation AnswerDExp::Night terrors are usually present during stage 3 of sleep.
Answer E AnswerE::Penile erection
Answer E Explanation AnswerEExp::Penile erections, dreaming, erections, and loss of motor tonicity frequently manifest during REM sleep.
Right Answer RightAnswer::B
Explanation [[Explanation::Sleep bruxism, reported in approximately 8% of the adult population, is the clenching of teeth due to rhythmic masticatory muscle movement (RMMA) with repetitive jaw muscle contractions. Bruxism may cause tooth destruction, jaw pain, limited movement of the mandible, and headaches. Although bruxism can occur in all stages of sleep, it is most frequently occurs during stages 1 and 2 of sleep.

Sleep spindles and K complexes are characteristic findings of stage 2 of sleep on polysomnography.
Educational Objective: Sleep bruxism, or teeth clenching, usually occurs during stage 2 of sleep, which is characterized by sleep spindles and K complexes on polysomnography.
References: Lavigne GJ, Kato T, Kolta A, et al. Neurobiological mechanisms involved in sleep bruxism. Critical Reviews in Oral Biology and Medicine. 2003;14(1):30-46 Macaluso GM, Guerra P, Di Giovanni G, et al. Sleep bruxism in a disorder related to periodic arousals during sleep. Journal of Dental Research. 1998;77(4):565-573]]

Approved Approved::Yes
Keyword WBRKeyword::Bruxism, WBRKeyword::polysomnography, WBRKeyword::sleep, WBRKeyword::K complex, WBRKeyword::sleep spindles, WBRKeyword::REM, WBRKeyword::sleep stages
Linked Question Linked::
Order in Linked Questions LinkedOrder::
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