Welcome to your Neurophysiology Name Email 1. [What is the best interpretation of the hypnogram shown below? (fig)] Poor sleep efficiency REM rebound after continuous positive airway pressure (CPAP) therapy Narcolepsy REM sleep behavior disorder (RBD) None Comment . 2. [Prolongation of central conduction time (CCT; ie, N22–P37 interpeak latency [IPL]) after tibial nerve stimulation can be seen in all of the following conditions except] Barbiturate-induced anesthesia Brainstem multiple sclerosis Neuromyelitis optica Adrenomyeloneuropathy None . 3. [Repetitive nerve stimulation was performed in a man with proximal limb weakness asshown below. Which of the following statements is correct? (fig)] This is slow repetitive stimulation which reveals significant decrement This is fast repetitive stimulation which reveals significant decrement This is slow repetitive stimulation which reveals significant increment This is fast repetitive stimulation which reveals significant increment None Comment . 4. [Which of the following studies provides information regarding cardiovagal function?] Phase IV part of the Valsalva waveform Phase II Late part of the Valsalva waveform Sudomotor testing Heart rate deep breathing range None . 5. [All of the following statements about common mode signals are true except] Common mode signals are dissimilar potentials at different electrode sites that should be ideally rejected Amplifiers are designed to preferentially block common mode signals and to pass the differential-mode signals Unequal impedances between electrodes can affect common mode signals It is recommended that the common mode signals be rejected at a ratio of 80 dB None . 6. [Which sleep state is least likely to show epileptiform abnormalities?] N1 N2 N3 REM None . 7. [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 . 8. [Wave I of a brainstem auditory evoked potential (BAEP)] Arises in the cochlear nucleus Is recorded as a near-field, positive potential around the stimulated ear Is recorded as a far-field, positive potential at the vertex May persist after sectioning of the 8th nerve during surgery for acoustic neuroma None . 9. [The commonly performed late response nerve conduction studies, F-wave and H-reflex, have certain unique differences. Which of the following statements is correct regarding these 2 late responses?] Both have fixed morphology with repeated stimulations Both have shorter latencies with proximal stimulation Both require supramaximal stimulation Same nerve fibers carry afferent responses for both studies None . 10. [A 15-year-old boy presents to his neurologist with slowly worsening gait and weaknessthat he has had for many years. He underwent a peroneal motor study, as shown below. The findings suggest which of the following conditions? (fig)] Charcot–Marie–Tooth (CMT) type 2A CMT type 1 Spinal muscular atrophy Distal myopathy None Comment . 11. [A polysomnogram (PSG) is being scored. The technologist labeled an epoch as Stage N2 when he noticed a K-complex. During the next 2-minute period, there are no spindles or K-complexes, but the EEG background consists of low-voltage mixed-frequencies. At the end of the 2 minutes, there is an arousal; after the arousal, the background continues to show low-voltage mixed-frequencies.] 2 3 4 5 None . 12. [An 11-year-old boy with learning disability had a single nocturnal seizure associated with subtle facial twitching and hypersalivation. What abnormality would you expect to see?] Centrotemporal spikes Frontal spikes Parietal spikes Occipital spikes None . 13. [In a patient with weakness, a muscle biopsy was completed. Muscle tissue was stained with adenosine triphosphatase at different pH values. On these stains, the patient was noted to have fiber-type grouping and loss of the usual checkerboard pattern of type 1 and type 2 fibers. Among the following, which type of EMG finding best correlates with fiber-type grouping on muscle biopsy?] Positive sharp waves and normal motor unit potentials Motor unit potentials with large amplitude and long duration Motor unit potentials with small amplitude and short duration Fasciculation potential None . 14. [Intermittent rhythmic delta activity (IRDA) is] Usually diffuse but predominant in the frontal region in children Activated by hyperventilation (HV) Activated by sleep Not reactive to eye opening None . 15. [Which thalamic nucleus helps in synchronization of EEG?] Reticular nucleus Anterior nucleus Pulvinar nucleus Medial geniculate nucleus None . 16. [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 . 17. [Intraoperative monitoring (IOM) of somatosensory evoked potentials (SSEPs) can reliably detect neural pathway compromise in all of the following surgical procedures except] Total hip arthroplasty Carotid endarterectomy Resection of parietal glioma Reduction of pelvic fracture None . 18. [Low-voltage EEG records are characterized by all the following except] They are common in children They are seen in 5% of adolescents They are seen in 12% of adults They are dominated by beta range activity None . 19. [A 45-year-old man had extensive surgery in the right lower abdominal/groin area forretroperitoneal sarcoma. After surgery, he noticed significant weakness and sensory loss in the right lower limb. Because his symptoms did not improve after 8 weeks, bilateral nerve conduction studies were performed as shown below. What is the most likely localization? (fig)] Sciatic nerve Lower lumbosacral plexus Femoral nerve Lateral femoral cutaneous nerve of thigh None Comment . 20. [Around 32–34 weeks of conceptional age, the background during active sleep (AS) and quiet sleep (QS) tends to be] Tracé discontinu in both states A more continuous pattern in AS and tracé discontinu in QS Tracé discontinu in AS and a more continuous pattern in QS More continuous patterns in both states None . 21. [Ctenoids are] Rhythmic sinusoidal waveforms Surface positive waveforms Frontal in distribution with shifting predominance Seen in 58% of healthy adults None . 22. [Motor unit potentials noted on needle EMG of the right tibialis anterior muscle areshown below. This type of motor unit morphology may be seen in which of the following conditions? (fig )] Toxic myopathies Chronic polyradiculopathy Chronic neuromuscular junction diseases such as myasthenia gravis Acute inflammatory demyelinating polyradiculoneuropathy (AIDP) None Comment . 23. [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 . 24. [A 25-year-old male had an EEG (filter: 1–70 Hz; sensitivity: 5 μV/mm; the solid verticallines are 1 second apart) as part of the workup for syncope. During the recording asshown below, the technologist noted focal rhythmic activity in the left central region,which went away when the patient wiped his nose with his right hand. Which of thefollowing statements is true regarding this activity? (fig)] Its frequency is in the theta range Nose wiping with the right hand has no relation to the activity It represents the resting rhythm of the Rolandic cortex It represents a brief ictal discharge that may have originated in the temporal region None Comment . 25. [A 54-year-old man is being evaluated for loud snoring. A 30-second epoch of his overnight polysomnogram (PSG) is shown below. Which of the following statements best describes the findings on this epoch? (fig)] Sleep stage is N3 There is a hypopnea There is an apnea There is elevated chin EMG suggestive of REM behavior disorder None Comment .
