Welcome to your Neurophysiology Name Email 1. [Fibrillation potentials on the needle EMG are secondary to] Irregular firing of single motor units Irregular firing of single muscle fibers Regular firing of single muscle fibers Regular firing of adjacent muscle fibers None . 2. [Which of the following EEG abnormalities is associated with a risk for seizures?] Frontal phantom spike-wave discharges Occipital phantom spike-wave discharges Rudimentary spike-wave discharges (pseudo petit mal discharges) Needlelike occipital spikes None . 3. [The main contributor for the extracellular potential measured in EEG is] Calcium action potential Depolarizing afterpotential Hyperpolarizing afterpotential Postsynaptic potential None . 4. [Which of the following EEG patterns is highly specific for an underlying seizure disorder?] Triphasic waves Temporal intermittent rhythmic delta activity (TIRDA) Frontal intermittent rhythmic delta activity (FIRDA) Generalized periodic epileptiform discharges (GPEDs) None . 5. [The N13 component of the median somatosensory evoked potential (SSEP) is characterized by all of the following except] It is generated by stimulation of large myelinated fibers in the dorsal horn It is best seen as a negative potential over the C5–C7 spinous processes It is preserved in brain death It is abolished in cervicomedullary lesions None . 6. [Which of the following statements is true of photoparoxysmal response (PPR)?] It is never seen in focal seizures Its presence is always considered as abnormal It is most likely to be elicited by a flash frequency of 15–18 Hz in photosensitive epilepsy It is more likely to occur upon eye opening None . 7. [An absent P100 waveform after monocular stimulation can be associated with all of the following conditions except] Cataract Optic neuritis Technical problem with the hardware Cortical blindness None . 8. [All of the following statements are true regarding the effect of age on visual evoked potential (VEP) except] P100 latencies reach adult values by age 1 year for larger check sizes P100 latencies reach adult values by age 1 year for smaller check sizes P100 latency may decrease during adolescence P100 latency increases after age 60 years None . 9. [A large posterior thalamic hemorrhage can be associated with all of the following except] Intact P14 Absent N18 Absent N20 Absent P22 None . 10. [All of the following physiological changes occur in NREM sleep except] Secretion of thyroid stimulating hormone (TSH) Decreased blood pressure Decreased cardiac output Decreased heart rate None . 11. [Normal arousal from sleep can be associated with all of the following except] Diffuse 4–6 Hz activity with intermixed slower frequencies in children Frontal rhythmic sharp and spiky activity in adolescents Shorter duration, diffuse theta activity in older children Rapid transition to waking rhythm in adolescents None . 12. [A 44-year-old man presented with increasing shortness of breath and orthopnea. Chestx-ray revealed elevated right hemi-diaphragm. EMG tracing from right hemi-diaphragmbelow reveals (fig)] Active denervation and myopathic motor units with early recruitment Normal changes with respiration Myokymia Neurogenic process with decreased recruitment None Comment . 13. [While performing a sensory nerve conduction study, the neurology resident in the electrodiagnostic laboratory notices a stimulus artifact before the sensory response. All of the following techniques can help reduce the stimulus artifact except] Increase the stimulus intensity Increase the distance between the stimulator and recording electrode Place the ground between the stimulator and the recording electrode Rotate the anode of the stimulator None . 14. [The phantom spike-and-waves are generally considered to be a normal EEG variant. Which of the following statements best describes them?] They are typically asymmetric and asynchronous in distribution They tend to be of lower amplitude in the frontal region They are felt to be associated with seizures only when found in the occipital region They may show gender differences in their distribution None . 15. [A 30-second epoch of a polysomnogram (PSG) from a 30-year-old woman with insomnia is shown below. This is most consistent with (fig)] Normal wake epoch Normal N2 epoch Hypopnea Periodic limb movement disorder (PLMD) None Comment . 16. [All of the following statements regarding the Modified Combinatorial Nomenclature(MCN) of EEG electrode placement are true except] Extra electrodes are added using the 10% division Extra letter codes are introduced to allow naming of intermediate electrode sites T3 and T4 are renamed as T7 and T8, respectively TP7 and TP8 are renamed as P7 and P8, respectively None . 17. [All of the following characteristics are true about 14- and 6-Hz positive bursts except] They are most common in young adults They can be seen concurrently with 6-Hz spike-wave discharges The bursts last less than 2 seconds They tend to be maximal in the posterior–temporal regions None . 18. [A 7-year-old boy, who had normal development, started to have difficulty with language. An EEG showed state-related continuous spike-wave discharges. Which of the following is false regarding this disorder?] It is known as Landau–Kleffner syndrome (LKS) The spike-wave discharges tend to activate in sleep The amount of language regression is related to the duration of the abnormal activity EEG can assist in diagnosis but not in monitoring treatment of the disorder None . 19. [All of the following conditions are correctly matched with EEG findings except] West syndrome: High-amplitude, disorganized slow activity with multifocal spikes and generalized electrodecrements that can be associated with spasms Infantile ceroid lipofuscinosis: Occipital spikes in the setting of photic stimulation Eyelid myoclonia with absences: Eyelid myoclonia immediately after eye opening in the dark and brief bilateral spike-wave discharges Lennox–Gastaut syndrome (LGS): Slow spike wave with fast activity in sleep None . 20. [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 . 21. [The following figure shows serial brainstem auditory evoked potentials (BAEPs) from apatient undergoing microvascular decompression of the trigeminal nerve. The bottomtrace is the earliest (11:51 a.m.) and the top trace is the latest (13:30 p.m.). All of the following statements are true based on the observed changes in BAEPs except (fig)] Wave I is absent after 12:21 p.m. Changes at 13:30 p.m. are consistent with cochlear infarction Changes after 12:23 p.m. are consistent with increase in sevoflurane dose Changes in Wave V until 12:05 p.m. are consistent with cerebellar traction None Comment . 22. [A 70-year-old man developed complete right sciatic nerve injury after hip replacement surgery. On sensory examination, which part of the lower extremity is expected to be normal?] Dorsum of the foot Lateral part of the calf First web space between the great toe and second toe Medial aspect of the leg (over the tibial bone) None . 23. [A 24-year-old administrator with hypothyroidism has noticed numbness in her hands. She frequently wakes up at night with tingling in her fingers and hands. Her primary care physician diagnosed her with carpal tunnel syndrome (CTS) and referred her for electrodiagnostic studies. Her median and ulnar motor studies were normal. Her median and ulnar antidromic sensory studies with recording from 2nd and 5th digits were normal. Which of the following is the best step to find evidence of CTS in this patient?] Perform median and ulnar mixed palmar studies Measure median and ulnar digit 4 sensory latencies Median nerve study with inching across the wrist Any of the above None . 24. [The EEG waveforms that occur after scanning a complex pattern in a brightly lit room are characterized by all of the following except] They occur in the occipital and frontal regions near-simultaneously with a fixed latency They are biphasic or triphasic with the most prominent phase being positive They are time-locked to the saccadic eye movement They cannot be triggered by mental imagination of a complex picture None . 25. [Which of the following neuromuscular manifestations may be seen in amiodarone toxicity?] Severe peripheral neuropathy only Proximal myopathy only Both peripheral neuropathy and myopathy Neuromuscular junction dysfunction None .
