Medical Emergencies · patient case with 1 question
Patient with obstructive sleep apnea
Scenario: A patient with OSA (obstructive sleep apnea) presenting with fever and swelling.
Question 1
What does this patient have?
Show answer and explanation
Correct answer: B. Swollen (enlarged) lymphoid tissue / lymph nodes
- A. Angular cheilitis reflects candidal/staphylococcal infection at the commissures, often with reduced vertical dimension or nutritional deficiency.
- B. Correct per the source key. Enlarged lymphoid tissue — tonsils, adenoids and cervical nodes — narrows the upper airway and is a recognised contributor to obstructive sleep apnea, especially in children, where adenotonsillar hypertrophy is the leading cause.
- C. Amyloid macroglossia is associated with MULTIPLE MYELOMA and systemic amyloidosis.
- D. A bald or atrophic tongue points to nutritional deficiency (iron, folate, B12) or to atrophic candidiasis, not to sleep apnea.
Note: Classic OSA risk factors worth knowing: obesity (BMI over 30), large neck circumference, retrognathia, macroglossia, enlarged tonsils/adenoids, male sex and increasing age. Diagnosis is by OVERNIGHT POLYSOMNOGRAPHY.