American Board of Internal Medicine (ABIM) Certification Practice Exam

Which validated tool should all surgical patients be screened for OSA?

1. STOP-BANG

2. Epworth Sleepiness Scale

3. Pittsburgh Sleep Quality Index

4. Berlin Questionnaire

The correct answer is: STOP-BANG

The STOP-BANG questionnaire is a validated screening tool specifically designed to assess the risk of obstructive sleep apnea (OSA) in patients, particularly in surgical contexts. This tool is favored because it is straightforward, easy to administer, and consists of eight simple questions that evaluate key risk factors associated with OSA, including snoring, tiredness, observed episodes of stopped breathing during sleep, high blood pressure, body mass index, age, neck circumference, and gender. In surgical patients, identifying OSA is crucial because it can significantly increase perioperative risks, including postoperative complications such as hypoxia and cardiovascular issues. Utilizing the STOP-BANG tool provides a rapid risk assessment which can help healthcare providers make informed decisions about necessary interventions or further evaluations prior to surgery, ensuring better patient outcomes. While the other options also relate to sleep disorders, they do not specifically target the screening for OSA in the surgical population as effectively as STOP-BANG. The Epworth Sleepiness Scale, for instance, is more focused on daytime sleepiness rather than risk factors for OSA. The Pittsburgh Sleep Quality Index assesses overall sleep quality rather than specifically identifying OSA risks, and the Berlin Questionnaire, while useful, is less widely adopted in surgical settings compared to STOP-BANG.