Welcome to your Neurophysiology Name Email 1. [A 70-year-old nursing home resident developed acute altered mental status. An MRI of the brain showed no acute changes. Based on the following EEG (filter 1–70 Hz), what is the most likely etiology? (f 84)] Stroke Herpes simplex encephalitis (HSE) Focal status epilepticus Toxic-metabolic encephalopathy None . 2. [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 . 3. [While performing a blink reflex study with right trigeminal stimulation, ipsilateral R1, ipsilateral R2, and contralateral R2 responses were absent. A focal lesion in which of the following locations could lead to these findings?] Right facial nerve or nucleus Right trigeminal nerve or nucleus Right oculomotor nerve or nucleus Right abducens nerve or nucleus None . 4. [What is the relative current needed to depolarize the sciatic nerve with respect to that needed to stimulate the posterior tibial nerve?] Less More Same Cannot be determined None . 5. [Magnetoencephalography (MEG) is a measure of] Magnetic fields caused by tangential current dipoles Magnetic fields caused by radial current dipoles Cortical current dipoles on the convexity of gyri Summated volume currents None . 6. [On needle EMG of certain muscles, it is theoretically possible to injure the adjacent nerves. Among the options below, performing EMG of which muscle is not likely to injure the paired nerve?] Flexor pollicis longus and superficial radial nerve Pronator teres and median nerve First dorsal interosseous and ulnar nerve Gluteus maximus and sciatic nerve None . 7. [All of the following are true of a term infant’s EEG 1 month after birth except] In wakefulness, the EEG background develops into centrally predominant, nonreactive, rhythmical theta activity The background is relatively symmetrical and synchronous Quiet sleep (QS) develops into slow wave sleep Tracé alternant remains prominent with asynchronous bursts None . 8. [Which of the following statements best describes the evolution of vertex waves and K-complexes?] Both appear simultaneously by age 3 months Vertex waves appear much later than K-complexes Vertex waves may have frontal predominance during infancy Both have smaller amplitudes in children than adults None . 9. [When performing a 3-point ulnar nerve stimulation (at the wrist, below elbow, and above elbow), it is important to perform the study with the elbow flexed. Otherwise, it will result in] Artifactual increase in conduction velocity across the elbow Artifactual decrease in conduction velocity across the elbow Artifactual increase in ulnar compound muscle action potential (CMAP) amplitude Artifactual decrease in ulnar CMAP amplitude None . 10. [Which of the following differences between Landau–Kleffner syndrome (LKS) and continuous spike waves of sleep (CSWS) is true?] The discharges in LKS are more bitemporal and/or biparietal vs more diffuse in CSWS There is language regression in CSWS vs a global behavioral regression in LKS Epileptiform activity in LKS gets activated in REM sleep vs in NREM sleep in CSWS Carbamazepine may help in CSWS vs steroids in LKS None . 11. [Hyperventilation (HV) could be potentially helpful in all of the following clinical scenarios except] An 8-year-old boy who frequently daydreams in school A 58-year-old male with a history of right-sided hemiplegia A 27-year-old female with a history of significant psychosocial stressors and nonstereotyped intractable seizures A 30-year-old female with seizures characterized by déjà vu and lip smacking None . 12. [Which of the following is true regarding somatosensory evoked potential (SSEP) changes during intraoperative operative monitoring (IOM)?] Transient or persistent changes in central conduction time (CCT) compared to baseline occur in a small number of patients Transient intraoperative SSEP changes can be associated with adverse postoperative clinical outcome in 25% of patients Transient intraoperative SSEP changes do not predict postoperative SSEP deterioration Persistence of SSEP changes at the end of surgery increases the risk of adverse postoperative clinical outcome None . 13. [All of the following statements regarding periodic leg movement sequences are true except] They have amplitude of at least 25% above the resting EMG They consist of at least 4 consecutive leg movements The interval between leg movements should be 5–60 seconds Leg movements between 2 legs separated by 5 seconds or less are counted as a single movement None . 14. [Which of the following promotes sleep?] Ingesting an adenosine antagonist A lesion in the ventrolateral preoptic nucleus of the hypothalamus Low levels of orexin All of the above None . 15. [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 . 16. [To ensure patient safety] The ground electrode should always be placed on the patient’s feet if possible The ground electrode should be connected to the earth ground The recording device plugged into the wall jack should have a second, direct earth ground connection The patient should not be connected to multiple recording devices simultaneously because of the risk of forming ground loops None . 17. [A 27” computer screen has a resolution of 1920 (horizontal) by 1080 (vertical) pixels with vertical borders of 250 pixels each. An EEG sampled at 1000 Hz is displayed at 15 seconds per page. How many pixels per inch (PPI) are present on the computer screen?] 40 63.1 71.1 81.6 None . 18. [A 41-year-old female with ataxia is being evaluated for suspected multiple sclerosis. Median somatosensory evoked potential (SSEP) shows intact potentials with the only abnormality being prolonged P14–N20 interpeak latency (IPL). The differential diagnosis includes all of the following except] Neuromyelitis optica Friedreich’s ataxia Midbrain tumor Demyelination in the thalamocortical radiation None . 19. [What should be the duration of an EEG in order to qualify for an electrocerebral inactivity (ECI) recording according to the American Clinical Neurophysiology Society (ACNS) guidelines?] At least 15 minutes At least 30 minutes At least 60 minutes At least 24 hours None . 20. [Which of the following features of the motor unit action potential is most suggestive of proximity of the needle electrode to the motor unit?] Duration Rise time Amplitude Number of phases None . 21. [Which of the following features is highly suggestive of an acquired demyelinating polyneuropathy?] Prolonged distal latency Severely reduced conduction velocity Abnormal temporal dispersion Severely reduced motor or sensory amplitude None . 22. [Myogenic motor evoked potentials (MEPs) recorded with transcranial electrical stimulation (TES) are characterized by all of the following except] Produced by summated D-waves Best recorded using trains of high-intensity stimuli with an interstimulus interval of 2–3 ms Highly variable across multiple trials Highly likely to be suppressed by a combination of propofol and opioid total intravenous anesthesia None . 23. [Ciganek rhythm is characterized by all of the following except] Presence in the bitemporal region Presence during both wakefulness and drowsiness Activation by mental task Notched morphology None . 24. [Which of the following drugs can cause a combination of toxic neuropathy and myopathy?] Metronidazole Hydroxychloroquine Isoniazid Phenytoin None . 25. [Amplitude of EEG activity] Does not exceed 50 μV on the scalp Does not exceed 500 μV on electrocorticograms Is typically measured from peak to peak Needs to be accurately reported at least for the posterior dominant rhythm (PDR) None .
