Welcome to your Neurophysiology Name Email 1. [The 2 waveforms below are from iliopsoas muscle during spontaneous activity recordings with different sweep speeds. What do these findings suggest? (fig)] Fasciculation potentials Fibrillation potentials Tremor Myokymia None Comment . 2. [Temporal resolution of the raw data is limited by which of the following?] Amplifier sampling frequency Bit rate of analog-to-digital (ADC) converter Input range of the amplifier Screen resolution None . 3. [Which of the following features is seen around 35–37 weeks of conceptional age?] Absence of reactivity of the EEG during wakefulness and active sleep (AS) Delta brushes are absent in quiet sleep (QS) Presence of tracé alternant instead of tracé discontinu pattern during AS Replacement of multifocal sharp transients by frontal sharp transients None . 4. [Tibial somatosensory evoked potential (SSEP) is preferred to common peroneal SSEP during intraoperative monitoring (IOM) because of all of the following except] It allows recording of peripheral compound nerve action potential It produces a larger cortical potential Its abnormalities correlate better with adverse postoperative outcome It causes less leg movement None . 5. [A 61-year-old man is undergoing continuous positive airway pressure (CPAP) titrationstudy for obstructive sleep apnea (OSA). A 30-second epoch of REM sleep during CPAPtitration is shown below. The stage of sleep shown in the epoch is associated with all ofthe following except (fig)] Rapid eye movements Ponto-geniculo-occipital (PGO) waves in animals Dream imagery Regular heart rate None Comment . 6. [Silver chloride electrodes are used for routine neurophysiological studies because] They develop the necessary amount of capacitance They behave like a built-in low-frequency filter They are not susceptible to “pops” The chloride ion common to the electrode and electrolyte prevents polarization None . 7. [Which of the following findings would most likely be seen in Rasmussen syndrome?] Burst suppression Generalized periodic discharges (GPDs) Electrographic status epilepticus Diffuse low voltage None . 8. [All of the following statements about neuronal postsynaptic potentials (PSPs) are true except] Intracellular potential of a neuron is about –60 mV Action potentials as opposed to postsynaptic potentials contribute to the generation of the extracellular field potentials There is net influx of cations into the neuron with an excitatory PSP There is net outflow of cations from the nerve cell with an inhibitory PSP None . 9. [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 . 10. [What is the most caudal point where the auditory information is represented bilaterally?] Cochlear nucleus Superior olivary nucleus Inferior colliculus Medial geniculate body None . 11. [Which of the following statements best characterizes the psychomotor variant?] It is abnormal in adults, being associated with temporal lobe seizures It is typically seen in slow wave sleep It tends to evolve into alpha or beta frequencies It is comprised of 5–7 Hz sharply contoured rhythmic bursts None . 12. [When requesting muscle biopsy in a patient with suspected myopathy, which of the following should be considered to increase the yield of the biopsy?] Biopsy a muscle with normal strength (5/5 on MRC scale) Biopsy a muscle with mild weakness (4/5 on MRC scale) Biopsy a muscle with severe weakness (2–3/5 on MRC scale) Obtain an MRI of the muscle before biopsy None . 13. [To score an epoch as REM, changes in which of the following are required?] EMG only EMG and EEG EMG or electrooculogram (EOG) EMG, EEG, and EOG None . 14. [Ion flow is determined by all of the following except] Ionic concentration gradients Channel conductance Electrical potential Transmembrane resistance None . 15. [During a routine 30-minute EEG, the technologist records video to show the occasional leg movements that the patient exhibited. The neurologist should code this as] A routine EEG A routine EEG plus modified video recording Video-EEG monitoring Video-EEG monitoring with a modifier for reduced service None . 16. [Hyperventilation (HV) during an EEG is contraindicated in all of the following situations except] In a patient with 2-day-old subdural hematoma In a patient with congestive heart failure and mild pulmonary edema In a patient with sickle cell anemia In a diabetic patient prone to hypoglycemic episodes None . 17. [A 60-year-old man developed Bell’s palsy. He was treated with oral corticosteroids andantiviral agents but continued to have facial weakness. He was seen by an ear–nose–throat physician for possible surgical intervention for the facial weakness, and facial electrodiagnostic studies were requested. EMG from the frontalis muscle during maximum activation is shown below. What does it reveal? (fig)] Early recruitment Severely reduced recruitment Normal recruitment for frontalis muscle Synkinesis None Comment . 18. [Which of the following is false regarding myelinated nerves?] Sodium channels and potassium channels are not evenly distributed in myelinated nerves Increased potassium conductance leads to repolarization in myelinated nerves Myelin reduces membrane capacitance and increases transmembrane resistance The junction of Schwann cells is called node of Ranvier None . 19. [What percentage of the input amplitude will pass at the cutoff frequency of a filter?] 0% 50% 70% 100% None . 20. [Continued insertional activity after moving a concentric EMG needle is considered normal if it lasts less than how many milliseconds?] 100 ms 200 ms 300 ms 400 ms None . 21. [A 72-year-old male with congestive heart failure and excessive daytime sleepiness is being evaluated for sleep apnea. A 30-second epoch of his polysomnogram (PSG) is shown below. All of the following findings are noted except (fig)] Snoring Apnea Hypopnea Hypoxemia None Comment . 22. [Which of the following is true regarding cathode?] It is the positively charged terminal of a galvanic cell It is the negatively charged terminal of a galvanic cell It repels electrons It represents the terminal into which the current flows None . 23. [What structure is the source of Wave I of the brainstem auditory evoked potential (BAEP)?] Organ of corti Hair cells Cochlear nerve Cochlear nucleus None . 24. [Current is by convention] Described as flow from the negative pole to positive pole Described as flow from the positive pole to the negative pole Defined as the rate of flow of electrons summated over a period of time Named for the movement of the negative charge None . 25. [On postoperative day 2 after a renal transplant, a 12-year-old boy became febrile anddeveloped altered mental status. He was placed on antibiotics and continuous video-EEG monitoring was obtained as shown below (filter 1–70 Hz; sensitivity 10 μV/mm;solid vertical bars are 1 second apart). Six hours into the monitoring session, a relativelyabrupt decrease in EEG amplitude was seen as shown below. What is the most likelycause of the change? (fig)] Cessation of a generalized seizure discharge Suctioning the patient Cerebral hypoperfusion Turning off propofol None Comment .
