Welcome to your Neurophysiology Name Email 1. [The following EEG (filter 1–70 Hz; sensitivity 20 μV/mm; solid vertical lines are 1 secondapart) was obtained from a 19-month-old patient with Landau–Kleffner syndrome (LKS). This EEG is characterized by all of the following ways except (fig)] Association with auditory verbal agnosia Definite association with clinical seizures Clear activation with state change None of the above None Comment . 2. [What percentage of the input amplitude will pass at the cutoff frequency of a filter?] 0% 50% 70% 100% None . 3. [Which of the following electrodiagnostic findings in acute inflammatory demyelinating polyradiculoneuropathy (AIDP) is the most reliable predictor of poor prognosis?] Severely prolonged distal latency Severely reduced compound muscle action potential (CMAP) amplitude Severely reduced conduction velocity Positive sharp waves and fibrillation potentials None . 4. [All of the following statements regarding the stimulating parameters used for transcranial electrical stimulation (TES) are true except] Fz/Cz electrode pair stimulates corticospinal tracts to the legs C3/C4 electrode pair stimulates corticospinal tracts to the arms C1/C2 electrode pair stimulates corticospinal tracts to both arms and legs Laterally placed electrode pair selectively stimulates the corticospinal tracts to both arm and leg contralateral to the anode None . 5. [On slow repetitive stimulation at 2–3 Hz, significant decrement may be seen in all of the following except] Botulism Paramyotonia congenita Neomycin toxicity Becker muscular dystrophy None . 6. [A 47-year-old male with HIV presents with fever and new-onset seizure. What does hisEEG (filter 1–70 Hz) below show? (fig)] Periodic lateralized discharges (PLDs) Intermittent rhythmic delta activity (IRDA) Breach rhythm Seizure None Comment . 7. [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 . 8. [A 56-year-old, male is being evaluated for obstructive sleep apnea (OSA) with split-night polysomnogram (PSG). His hypnogram, including continuous positive airway pressure (CPAP) titration (labeled as “Airway Pressure”), is shown below. What would be the most appropriate CPAP pressure recommendation for this patient based on the information provided in the figure? (fig)] 8 cm water 10 cm water 12 cm water Inadequate trial, and the patient needs a full-night titration study None Comment . 9. [Changes in somatosensory evoked potential (SSEP) waveforms during intraoperative monitoring (IOM) suggestive of neural pathway compromise include all of the following except] Fifty percent or higher drop in waveform amplitude compared to baseline Ten percent or higher increase in waveform latency compared to baseline Sudden disappearance of both peripheral and central potentials Disappearance of P14 and N20 waveforms with persistence of peripheral waveform None . 10. [A 55-year-old man presents with severe fatigue and weakness for over 4 months and recent onset of dry mouth. He does not report any obvious diplopia. He is a chronic smoker. On examination, he has mild facial weakness, ptosis, mild to moderate weakness of neck flexion, and proximal limb weakness. Deep tendon reflexes are absent. Sensory examination is normal. Routine nerve conduction study and needle EMG study in the above patient is expected to reveal which of the following?] Absent sensory responses Decreased conduction velocity Decreased motor amplitudes Positive sharp waves and fibrillation potentials None . 11. [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 . 12. [The waveforms shown in the figure below may be found in all of the following conditions except (fig)] Steroid-induced myopathy Toxic myopathies Inflammatory myopathies Glycogen storage disorders None Comment . 13. [The following tibial somatosensory evoked potentials (SSEPs) were recorded duringintraoperative monitoring (IOM) from a patient undergoing resection of an intraduralextramedullary tumor in the lower thoracic region. The 2nd, 4th, and 6th traces represent the baseline potentials; the 1st, 3rd, and 5th traces represent traces obtained after decompression.Which of the following statements is most consistent with the findings shownin the figure? (fig)] The changes in latencies are due to the effect of decompression The changes in amplitude are due to the effect of decompression The changes in latencies are due to the effect of anesthesia None of the above None Comment . 14. [A 55-year-old woman presented with progressive weakness over 4 months. Initially, she noticed increasing difficulty with climbing steps and getting up from the floor. She recently noticed difficulty lifting her arms when reaching above her head or brushing her hair. She reports a mild dull ache in her muscles. She does not have any skin rash. On examination, she has moderate proximal weakness in the upper and lower limbs with preserved distal limb strength. Deep tendon reflexes and sensory examination were normal. Cranial nerve examination revealed mild facial weakness.The rest of the neurological examination is normal.Needle EMG of the deltoid muscle from the above patient is shown below (trace A is atrest and trace B is on active muscle contraction). What do they reveal? (fig)] Positive sharp waves only at rest and normal motor unit potentials on contraction Fibrillation potentials only at rest and normal motor unit potentials on contraction Positive sharp waves and fibrillation potentials during rest and short-duration motor unit potentials on contraction Positive sharp waves and fibrillation potentials at rest and long-duration motor unit potentials on contraction None Comment . 15. [Which of the following potentials on needle EMG has an irregular firing pattern?] Complex repetitive discharges Positive sharp waves Fibrillation potentials Fasciculation potentials None . 16. [Needle EMG in a patient with severe deltoid weakness revealed the following motor unit firing pattern on full activation. What does this finding suggest? (fig 3)] An underlying myopathy An underlying neuromuscular junction dysfunction An underlying neurogenic process This is a normal interference pattern None Comment . 17. [What is the typical morphology of end-plate spikes?] There is only a negative deflection There is only a positive deflection There is an initial negativity followed by a final positivity There is an initial positivity followed by negativity and ending with positive deflection None . 18. [A median motor study from a 40-year-old man with painless weakness is shown below.This is most consistent with which of the following conditions? (fig)] Amyotrophic lateral sclerosis Multifocal motor neuropathy Monomelic amyotrophy Spinobulbar muscular atrophy (SBMA) None Comment . 19. [Significant decrement may be seen on slow repetitive stimulation in which of the following conditions?] Lambert–Eaton myasthenic syndrome (LEMS) Myasthenia gravis Botulism All of the above None . 20. [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 . 21. [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 . 22. [Which of the following statements best describes EEG evaluation of suspected brain death?] The recommended term for “flat line EEG” is electrocerebral silence In all patients over 1 year of age, a minimum of 2 EEGs 24 hours apart should be obtained for confirmation Integrity of the recording system should be checked by touching each electrode with a cotton swab to produce an artifact potential EEG reactivity to noxious somatosensory stimuli need not be checked as long as there is no discernible electrical activity at 2 μV/mm sensitivity for 30 minutes None . 23. [Which of the following is true regarding the nomenclature of EEG activity?] Sigma rhythm refers to 15–20 Hz activity Rho waves refer to positive occipital sharp transients of sleep (POSTS) Phi rhythm refers to temporal rhythmic delta activity in children Ripples refers to 50–80 Hz activity None . 24. [What is the most caudal point where the auditory information is represented bilaterally?] Cochlear nucleus Superior olivary nucleus Inferior colliculus Medial geniculate body None . 25. [What types of signals are used in the calibration process for EEG?] Square wave inputs Sine wave inputs Cosine wave inputs Triangular wave inputs None .
