Welcome to your Neurophysiology Name Email 1. [Which of the following statements is true regarding the effect of recording parameters on the latencies of brainstem auditory evoked potentials (BAEPs)?] Click rates greater than 10 Hz decrease interpeak latencies (IPLs) Higher click intensity decreases IPLs Condensation clicks decrease Wave V latency Rarefaction clicks decrease Wave I latency None . 2. [A 20-year-old male was diagnosed with Guillain–Barré syndrome (GBS) in the emergency department based on acute onset of weakness 4 days ago, areflexia, and elevated cerebrospinal fluid protein. Nerve conduction study and EMG were performed on the day of admission. EMG is most likely to reveal the following in the weak muscles ( fig )] None Comment . 3. [Which of the following is true regarding electrode impedance when performing an EEG?] It should be more than 5 kΩ for scalp electrodes It is not critical because the electrode–electrolyte interface does not resemble a resistor– capacitor (RC) circuit Large electrode impedances can lead to large artifacts It is increased by removing the scalp oil None . 4. [Which of the following studies can help differentiate a cervical root avulsion from brachial plexopathy?] Motor nerve conduction studies in upper limb F-wave reflex testing in upper limb Somatosensory evoked potential (SSEP) testing from the upper limb Sensory nerve conduction study None . 5. [In the sural antidromic sensory study shown below, what is the sweep speed likely to be? (fig 1)] 0.1 ms/division 0.5 ms/division 1 ms/division 2 ms/division None Comment . 6. [A 20-year-old college student presents with difficulty walking for 5 years but recently developed an increased tendency to trip and fall along with mild weakness in her hands. She also reports mild numbness in her feet. She denies any pain. Her birth and initial development were normal, but as a child she did not perform well in sports. On examination, cranial nerves are normal. Proximal limb strength is normal. She has distal weakness with bilateral foot drop and moderate finger extension and abduction weakness. She also has high-arched feet and atrophy of foot intrinsic muscles. Deep tendon reflexes are absent and there is lengthdependent sensory loss. What is the next most appropriate test to perform in the above patient?] Peripheral myelin protein (PMP) deletion/duplication genetic test Mitofusin (MFN) mutation test Spinal fluid analysis and sural nerve biopsy Muscle biopsy None . 7. [Studies on monitoring brainstem auditory evoked potentials (BAEPs) during intraoperative monitoring (IOM) suggest] No role for BAEP monitoring as it does not improve postoperative neurologic outcome Adverse neurologic outcome even after a transient loss of all BAEP waves Potential for hearing impairment only when Wave V latency is delayed by greater than 2 ms Preservation of functional hearing after acoustic neuroma resection if BAEP and electrocochleogram waves are present at the end of surgery None . 8. [A 30-second epoch of a polysomnogram (PSG) is shown below. What sleep stage is it?(fig)] Wake N1 N2 REM None Comment . 9. [A 35-year-old man had extensive injuries in a motor vehicle accident. A few weeks after discharge from the intensive care unit, while underlying rehabilitative therapy, he was noted to have significant weakness in the right upper limb. Findings on needle EMG are shown in the table below. What is the best localization based on these findings? (fig )] Lateral cord Medial cord Posterior cord Lower trunk None Comment . 10. [In a resistor–capacitor (RC) circuit, a larger resistor will cause the time constant to be] Longer Shorter Unchanged More dependent on the capacitor size None . 11. [All of the following are true of a term infant’s EEG 1 month after birth except] In wakefulness, the EEG background develops into centrally predominant, nonreactive, rhythmical theta activity The background is relatively symmetrical and synchronous Quiet sleep (QS) develops into slow wave sleep Tracé alternant remains prominent with asynchronous bursts None . 12. [A 56-year-old female presented with difficulty walking. On examination, she was found to have spastic paraplegia with a mid-thoracic sensory level. The cranial nerve and upper extremity exams were normal. Which of the following sets of somatosensory evoked potential (SSEP) patterns could be expected in this patient?] Normal N22 latency, normal N22–P37 latency, normal N9–N20 latency Normal N22 latency, abnormal N22–P37 latency, abnormal N9–N20 latency Abnormal N22 latency, normal N22–P37 latency, abnormal N9–N20 latency Abnormal N22 latency, abnormal N22–P37 latency, normal N9–N20 latency None . 13. [A 10-year-old, developmentally normal boy has a 4-year history of seizures. Which ofthe following is true based on the EEG (filter 1–70 Hz)? (fig)] The epilepsy syndrome is typically associated with myoclonic jerks There is a high chance of the epilepsy syndrome going into remission The seizure associated with the above EEG pattern does not present with automatisms This is a normal hyperventilation (HV) response not associated with epilepsy None Comment . 14. [At 29 weeks of conceptional age, the majority of delta brushes is observed during] Wakefulness Active sleep (AS) Quiet sleep (QS) Fairly equally between the 3 states None . 15. [A 50-year-old male has an EMG for weakness in the upper limb. Below is the tracing from needle EMG. What is the amplitude and firing frequency of the largest motor unit shown? (Gain: 1 mV and sweep speed 10 ms) (fig)] 7.5 mV and 5 Hz 2 mV and 10 Hz 7.5 mV and 10 Hz 5 mV and 20 Hz None Comment . 16. [A 60-year-old man with weakness undergoes an ulnar motor study at baseline and after 15 seconds of exercise as shown below. What does it show? (fig)] Low compound muscle action potential (CMAP) amplitude at baseline and significant increment Low CMAP at amplitude at baseline and nonsignificant increment Normal CMAP at amplitude at baseline and significant increment Normal CMAP at amplitude at baseline and nonsignificant increment None Comment . 17. [All of the following statements about Rolandic spikes are true except] They can be seen in healthy siblings of patients with benign Rolandic epilepsy (BRE) They typically resolve by age 16 years They exhibit horizontal dipole with central negativity and temporal positivity They can occur in trains during sleep None . 18. [While performing the tibial H reflex, the H wave amplitude decreases with increasing stimulus intensity because] At higher stimulus intensity, Ia afferent fibers are not activated At higher stimulus intensity, there is increased collision between antidromic motor stimulus and orthodromic H reflex potentials At higher stimulus intensity, the M response suppresses H waves D. At higher stimulus intensity, there is synergy between antidromic motor stimulus and orthodromic H reflex potentials None . 19. [The interface between the EEG electrode and the electrolyte paste can be considered as] An electrical double layer that presents capacitance impeding current flow Potentially unstable with new electrodes causing “pop” artifacts A source of half-cell potential that remains stable despite movement of the electrode Highly polarized when a silver–silver chloride interface is used None . 20. [Alexander disease is likely to be associated with which of the following EEG findings?] Bifrontal slowing Generalized periodic discharges (GPDs) Temporal spikes Burst suppression None . 21. [A 55-year-old man noticed right leg weakness for a few weeks. On examination, he hasweakness of his right toe extension and sensory loss on the dorsum of the foot. A peroneal motor study with recording from tibialis anterior is shown below. Which of the following is most likely to be the underlying etiology? (fig)] Recent significant weight loss Traumatic ankle fracture Recent lumbosacral spine injury Recent fracture of tibia None Comment . 22. [All of the following EEG patterns are felt to be independent predictors of poor outcome (modified Rankin Scale greater than 4) for patients with subarachnoid hemorrhage (SAH) except] Presence of sleep spindles Periodic (epileptiform) discharges Nonreactive EEG background Nonconvulsive status epilepticus None . 23. [Which of the following criteria is required for scoring an arousal?] Presence of stable sleep for at least 30 seconds before the arousal Elevation of chin EMG signal for at least 3 seconds if arousal is scored during REM sleep Presence of leg EMG signal changes for at least 3 seconds A sudden shift in EEG frequencies lasting at least 3 seconds None . 24. [A 27” computer screen has a resolution of 1920 (horizontal) by 1080 (vertical) pixels with vertical borders of 250 pixels each. An EEG sampled at 1000 Hz is displayed at 15 seconds per page. How many pixels per inch (PPI) are present on the computer screen?] 40 63.1 71.1 81.6 None . 25. [Abductor pollicis brevis is innervated by the median nerve. The motor fibers for this innervation come from which of the following cervical roots?] C6, C7, C8 C7, C8 C5, C6, C7 C8, T1 None .
