Welcome to your Neurophysiology Name Email 1. [The accepted nomenclature of EEG electrodes includes all of the following except] Even numbers over the right hemisphere Odd numbers over the left hemisphere The letter “z” refers to midline electrode M1 and M2 refer to the earlobe electrodes None . 2. [All of the following statements regarding the development of REM sleep during the first year of life are true except] Low-voltage irregular (LVI) pattern changes into the asynchronous low-amplitude mixed frequencies of the adult REM sleep The percent of time spent in REM decreases by the first year of life REM sleep tends to be more prominent in the first half of the night for infants It is common for a 6-month-old infant to transition from wakefulness into REM sleep None . 3. [Latency and conduction velocity measured on nerve conduction studies reflect which of the following fibers within the specific nerve?] All the nerve fibers Only the fastest nerve fibers Only the slowest nerve fibers Only the unmyelinated fibers None . 4. [Which of the following statements is true regarding sleep-related events that affect cardiac function?] Respiratory obstruction can cause tachycardia Arousals can lead to bradycardia REM sleep can be associated with autonomic changes None of the above None . 5. [All of the following statements regarding the direct current (DC) shifts seen at seizure onset are true except] DC shifts can only be recorded using dedicated DC-coupled amplifiers DC shifts can be recorded using an amplifier with a long-time constant DC shifts are better seen by decreasing the low-frequency filter DC shifts at seizure onset are useful in localizing the seizure onset zone None . 6. [A 60-year-old man has noticed difficulty over the past 2 months getting up from a chair, climbing steps at work, and lifting objects above his head. His primary care physician also noticed a rash on sun-exposed areas of the man’s body. The patient was referred for electrodiagnostic testing. Needle EMG of proximal muscles in this patient would likely reveal] Decreased recruitment and large motor unit potentials Early recruitment and large motor unit potentials Early recruitment and small motor unit potentials Decreased recruitment and small motor unit potentials None . 7. [Myogenic motor evoked potentials (mMEPs; M-waves) obtained by transcranial electrical stimulation (TES) during intraoperative monitoring (IOM) are] Caused by compound muscle action potentials within the muscle Recorded only by needle electrodes Resistant to anesthetic effects Resistant to neuromuscular blockade None . 8. [Which of the following EEG findings is most consistent with a diagnosis of encephalopathy?] An 8.5 Hz posterior dominant rhythm (PDR) Temporal intermittent rhythmic delta activity (TIRDA) Frontal intermittent rhythmic delta activity (FIRDA) Subclinical rhythmic electrographic discharge of adults (SREDA) None . 9. [Routine nerve conduction and needle EMG studies are usually normal in which of the following conditions?] Lumbosacral radiculopathy Mild large-fiber neuropathy Small-fiber neuropathy Lambert–Eaton myasthenic syndrome (LEMS) None . 10. [What is the chance that the first routine EEG will be nondiagnostic for epilepsy?] 10% 20% 50% 90% None . 11. [All of the following statements regarding somatosensory evoked potentials (SSEPs) are true except] Up to 40% of patients with multiple sclerosis (MS) without sensory symptoms may have abnormal SSEPs The N20 waveform may be abolished by anesthesia Intravenous etomidate decreases the amplitude of cortical potentials Amplitude of cortical potentials may be increased in progressive myoclonus epilepsy syndromes None . 12. [A 42-year-old female with a 3-month history of seizures presents with symptoms ofalcohol withdrawal. The patient describes her events as “loss of consciousness with aterrible, helpless feeling that lasts 30–40 seconds.” She has a history of alcoholic abuse.What is the best interpretation of her EEG shown below (filter: 1–70 Hz; sensitivity:7 μV/mm; vertical lines are 1 second apart)? (fig)] Seizure discharge Breach rhythm over the right occipital region Left hemispheric dysfunction Normal variant None Comment . 13. [All of the following statements describe the EEG features during 37–40 weeks conceptional age except] Delta brushes are only seen in quiet sleep (QS), if they are present at all Encoches frontales and monorhythmic frontal delta are prominent, particularly during transition between active sleep (AS) and QS Sporadic multifocal sharps are still normal but rare High-voltage slow (HVS) waves during QS are considered abnormal None . 14. [All of the following statements about the amplifier are true except] Its gain is given by the ratio Vout/Vin of the signal Its gain is commonly expressed in decibels Its dynamic range is the voltage range over which it behaves linearly Its gain is directly proportional to sensitivity None . 15. [Which of the following statement is true regarding single-fiber needle EMG?] Normal patients have a jitter value of 100 Abnormal jitter is only seen with neuromuscular junction (NMJ) disorders Blocking is always present in myasthenia gravis Blocking may be seen in weak muscles in NMJ disorders None . 16. [All of the following statements regarding EEG changes observed after carotid crossclamping during carotid endarterectomy are true except] EEG changes usually occur within the first 20 seconds in the majority of patients Decrease of anterior alpha and beta activity on the clamped side suggests ischemia Increase of delta amplitude on the clamped side suggests progression of ischemia Bilateral EEG changes always suggest change in anesthesia or blood pressure None . 17. [Which of the following syndromes is considered to have a more favorable prognosis?] Epilepsy with generalized tonic-clonic seizures (GTCs) on awakening Neonatal myoclonic encephalopathy West syndrome Atypical benign partial epilepsy of childhood None . 18. [Which of the following statements best describes the utility of somatosensory evoked potentials (SSEPs) in the evaluation of peripheral nervous system disorders?] Intact N9 and absence of subsequent potentials suggest brachial plexus trunk lesion Absent popliteal fossa potential but intact lumbar potential (LP) is characteristically seen in Guillain–Barré syndrome SSEPs obtained by dermatomal stimulation are useful in the evaluation of radiculopathy SSEPs are always normal in Friedreich’s ataxia despite abnormal nerve conduction studies None . 19. [Delayed N9, P14, and N20 potentials with normal interpeak latencies (IPLs) in a median somatosensory evoked potential (SSEP) suggest] Carpal tunnel syndrome Pronator teres syndrome Brachial plexopathy Radiculopathy None . 20. [What is the anterior slow activity seen in the following EEG (filter 0.1–70 Hz)? (fig)] Lateral eye movements Sweat artifact 60 Hz artifact Frontal intermittent rhythmic delta activity (FIRDA) None Comment . 21. [Giant somatosensory evoked potentials (SSEPs) are characterized by all of the following except] Their peak-to-peak amplitude is usually more than 15 μV They have normal amplitude and latency of the N20 potential They reflect cortical hyperexcitability in area 3b They are always preceded by an abnormal cortical spike, which is best seen with jerklocked back-averaging of EEG None . 22. [Which of the following referential montages is least likely to be helpful to evaluate changes in the temporal region?] Cz Ipsilateral ear Contralateral ear Average None . 23. [Which of the following fibers have the slowest conduction velocity?] Aα Aβ Aδ C None . 24. [The waveforms shown below were acquired by repetitive nerve stimulation in the same patient at baseline (top) and immediately after exercise (bottom). The results are consistent with which of the following phenomena? (fig)] Facilitation but not repair Repair but not facilitation Both repair and facilitation Neither repair nor facilitation None Comment . 25. [An epileptiform spike is characterized by all of the following except] Steep upslope and steep downslope Duration less than 70 ms Wider field in Stage 2 sleep compared with REM sleep Horizontal dipole None .
