Welcome to your Neurophysiology Name Email 1. [Acceptable methods for measuring the peak waveform amplitude of the somatosensory evoked potentials (SSEPs) during intraoperative monitoring (IOM) include all of the following except] With respect to the following peak of opposite polarity With respect to the preceding peak of opposite polarity With respect to the baseline level of the waveform preceding the peak With respect to the baseline level of the waveform following the peak None . 2. [Which of the following EEG patterns is least likely to be associated with status epilepticus (SE)?] Recurrent 5–7 Hz rhythmic temporal activity Generalized periodic discharges occurring at a frequency of 2–3 Hz Normal scalp EEG Intermittent polymorphic delta activity None . 3. [Which of the following potentials is considered a standing wave?] The motor response seen when stimulating the peroneal nerve above the knee with the patient standing The sensory response in standard bipolar digit sensory nerve conduction The P37 potential seen when stimulating the posterior tibial nerve The P9 potential seen when stimulating the median nerve None . 4. [A 35-year-old man noticed weakness in his right hand for the last few months and thenrecently developed painless left leg weakness. He denies any pain in his limbs or sensory loss. His median motor study is shown below. Based on this nerve conduction study finding, what is the most likely diagnosis? (fig)] Carpal tunnel syndrome (CTS) Multifocal motor neuropathy Lower trunk brachial plexopathy Hirayama’s monomelic amyotrophy None Comment . 5. [In a term infant, how does the predominant sleep pattern change during the first 6 weeks of life?] At term, active sleep (AS) predominates while at 46 weeks, quiet sleep (QS) predominates At term, QS predominates while at 46 weeks, AS predominates AS predominates at term and during the first 6 weeks QS predominates at term and during the first 6 weeks None . 6. [A 26-year-old female presented with new-onset seizures characterized by “dizziness,light-headedness, spacing out prior to falling to the floor.” What is most likely finding inthe occipital region on her EEG (filter: 1–70 Hz) shown below? (fig)] Positive occipital sharp transients of sleep (POSTS) Occipital seizure Normal activation response Slow alpha variant None Comment . 7. [Stimulation of the median nerve at the wrist with recording from the scalp to obtain somatosensory evoked potential causes activation in all of the following structures except] Medial and lateral cords of brachial plexus Nucleus cuneatus Lateral lemniscus Ventral posterolateral nucleus of thalamus None . 8. [Which of the following EMG findings is most likely in a patient with polymyositis?] Long-duration motor unit potentials with reduced recruitment patterns Short-duration motor unit potentials with reduced recruitment patterns Positive sharp waves/fibrillation potentials and short-duration motor unit potentials Fasciculation potentials and short-duration motor unit potentials None . 9. [All of the following statements regarding focal slow activity are true except] Continuous focal arrhythmic polymorphic delta activity can be seen in a brain tumor Continuous focal arrhythmic polymorphic delta activity can be seen during a migraine attack Continuous focal rhythmic monomorphic theta activity suggests an underlying white matter lesion Intermittent focal rhythmic monomorphic delta activity can be seen in epilepsy None . 10. [Subdermal needle electrodes differ from scalp electrodes in all of the following ways except] They have a smaller contact area They have lower input impedances They are more susceptible to noise They are less likely to cause skin breakdown None . 11. [All of the following are features of a normal EEG in a 1-year-old child except] 6 Hz posterior dominant rhythm (PDR) Hypnagogic hypersynchrony Sleep spindles with vertex predominance Discernible photic driving response None . 12. [An 8-year-old has right eye blindness since birth. He fainted after playing outside in the summer. All of the following abnormalities can be expected on an EEG except] Left occipital spikes Slowing of the right posterior dominant rhythm (PDR) Loss of photic driving Loss of lambda waves None . 13. [Safety factor at the neuromuscular refers to the] Separation of acetylcholine into primary, secondary, and tertiary presynaptic quanta Amplitude of end-plate potential above the threshold value needed to generate muscle fiber action potential Amplitude of end-plate potential below the threshold value needed to generate muscle fiber action potential Minimum nerve action potential needed to open presynaptic calcium channels None . 14. [Alpha rhythm is] Seen in visual, somatosensory, and temporal cortices Neither facilitatory nor inhibitory during attentional processes Generated in the thalamus Generated by the pyramidal neurons in layer VI of the visual cortex None . 15. [The activity seen at Point 2 was noted to have an amplitude asymmetry with the amplitude being 80–110 μV on the left side and 100–130 μV on the right. Which of the following statements is true about the amplitude of the depicted activity? (fig)] It is always asymmetric, being higher on the left side Amplitude asymmetry of more than 25% between the 2 sides is considered abnormal It tends to diminish with age It can be increased by doing simple math None Comment . 16. [With sciatic nerve compression, which of the following findings is relatively common on electrodiagnostic testing?] Absent tibial response but normal peroneal and sural responses Significantly decreased peroneal amplitude compared to tibial amplitude Absent tibial and peroneal responses with preserved sural response Normal tibial H-reflex None . 17. [Bilateral absence of lumbar potentials (LPs) with normal P37 latencies after tibial nerve stimulation is seen in which of the following conditions?] Severe peripheral neuropathy Bilateral cauda equina syndrome Guillain–Barré syndrome Technical problem with stimulation or recording None . 18. [A 40-year-old man recently had a knee injury and noticed weakness in his right leg. Thefindings on peroneal motor study are shown below. What does this suggest? (fig)] Peroneal mononeuropathy at the fibular head Peroneal mononeuropathy at the ankle Normal variant Peroneal mononeuropathy above the popliteal fossa None Comment . 19. [An EEG (filter: 1–70 Hz) from a 32-year-old woman with a long history of intractableepilepsy is shown below. Which of the following statements is true regarding the finding shown in the figure? (fig)] The patient has nystagmus The patient is in REM sleep The patient is reading a book The patient is having a focal seizure involving the bioccipital region None Comment . 20. [Which of the following statements regarding chloride is false?] Its concentration is more than 10 times greater in the extracellular space than in the intracellular space The resting membrane potential is closest to the Nernst potential for chloride It requires active transport across the cell membrane Chloride does not contribute as much as potassium in neuronal repolarization None . 21. [Which of the following is true regarding wicket spikes?] They usually occur in adults above 30 years of age They have a strong association with seizures when seen in adolescents They are common patterns seen in up to 25% of EEG records They are seen in wakefulness and REM sleep but absent during drowsiness None . 22. [Which of the following is false regarding the action of sodium channels during an action potential?] They open in response to changes in membrane potential They operate in a feed-forward manner They close due to changes in calcium conductance They close due to intrinsic channel properties independent of membrane potential None . 23. [EEG reactivity to auditory or tactile stimulation in a term infant is characterized by all of the following except] Diffuse flattening Burst of generalized theta activity Burst of generalized delta activity Occipital delta activity None . 24. [A 40-year-old, obese male is being evaluated for snoring, witnessed apneas, and excessive daytime sleepiness. Which of the following statements is true about the 30-second epoch of his polysomnogram (PSG) shown below? (fig)] It shows Stage N1 There is a periodic limb movement of sleep (PLMS) There are generalized epileptiform discharges Nasal pressure channel (marked PNAS) is uninterpretable because of artifact None Comment . 25. [A neonate of 36 weeks conceptional age (CA) was found to have respiratory arrestshortly after birth. Shortly thereafter, the patient was extubated and clinically stable.An EEG was done for suspected seizures as shown below (filter: 1–70 Hz; sensitivity: 15μV/mm; the solid vertical lines are 1 second apart). The patient was noted to be restingquietly at time of recording. What is the best interpretation of the findings seen?(fig)] Epileptiform activity Artifact Encephalopathy Normal finding None Comment .
