Welcome to your Neurophysiology Name Email 1. [By 3 months of age, what is the frequency of the posterior dominant rhythm (PDR)?] There is no clear PDR 2 Hz 3 Hz 5 Hz None . 2. [A 51-year-old male undergoes brainstem auditory evoked potential (BAEP) monitoring during resection of a right vestibular schwannoma. All of the following changes suggest an adverse postoperative outcome except] Loss of Waves I, III, and V suggests damage to the internal auditory artery Ninety percent attenuation of Wave I with intact Waves III and V during bone drilling suggests permanent damage to the cochlea Delay of Waves III and V but not Wave I suggests 8th nerve damage Loss of Waves III and V with preservation of Wave I suggests damage to the lower pons None . 3. [Which of the following is an absolute contraindication to proximal stimulation with nerve conduction studies?] Regular on-demand pacemaker External pacer wires Increased bleeding tendency Mechanically ventilated patient None . 4. [The following fast Fourier transform (FFT) spectrograms from a 50-year-old male show0–20 Hz activity from the left hemisphere (top panel) and right hemisphere (bottompanel); the color bar indicates the power, black being the lowest and white being thehighest. All of the following statements are correct interpretations at the time markerindicated by the vertical blue line except (fig)] There is a symmetric posterior dominant rhythm The left hemisphere has more power in the alpha and beta frequencies than the right hemisphere There is continuous high-amplitude delta slowing over the right hemisphere There is continuous delta and theta activity over the left hemisphere None Comment . 5. [Which of the following statements is true regarding F-wave and M-wave amplitudes?] F-wave amplitude is 50% of the M-wave amplitude F-wave amplitude is 30% of the M-wave amplitude F-wave amplitude is 3%–5% of the M-wave amplitude F-wave and M-wave amplitudes are the same None . 6. [The low-frequency filter setting should be set at 0.5 Hz while performing which of the following tests?] Slow repetitive stimulation at 3 Hz Fast repetitive stimulation at 50 Hz Sympathetic skin response Blink or facial studies None . 7. [A 42-year-old woman underwent right anterior temporal lobectomy 6 months ago, and has remained seizure free since the surgery on lamotrigine monotherapy. She wants to drive since she satisfies the local law of 6 months of seizure freedom to be able to drive. Her neurologic examination is normal. An EEG shows rare right temporal sharp waves. The most appropriate recommendation would be to] Continue the driving restriction and repeat another routine EEG in 6 months Remove the driving restriction if she continues to take lamotrigine as prescribed Obtain inpatient video-EEG monitoring for 3 days while on lamotrigine to see if seizures occur spontaneously Obtain inpatient video-EEG monitoring after stopping lamotrigine to see if seizures can be induced None . 8. [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 . 9. [Which of the following parameters from the motor nerve conduction study is not used in the calculation of the F estimate?] Compound muscle action potential (CMAP) amplitude CMAP distal latency Conduction velocity Distance between stimulator electrode to the spinal cord None . 10. [All of the following statements regarding the mu rhythm are true except] The frequency tends to be in the theta range It is best seen over the central head regions It is associated with the sensorimotor cortex It is generally asymmetrical and asynchronous in distribution None . 11. [All of the following statements about sensitivity are true except] It is typically expressed as microvolts/millimeter Increase in gain increases the sensitivity It alters the dynamic range of the amplifier It represents the size of the deflection seen on the paper or display None . 12. [A 23-year-old man presented to the neurology clinic with a history of multiple episodes of weakness. Each episode usually lasts a few hours. He originally noticed these episodes during his teenage years. Episodes are often preceded by prolonged activity or large meals. On examination, he did not have any clinical myotonia. Nerve conduction studies (NCS) and EMG were done. Which of the following is most likely on EMG?] None . 13. [All of the following statements about occipital intermittent rhythmic delta activity (OIRDA) are true except] It is best seen in children and adolescents aged 6–16 years It is activated by hyperventilation (HV) and photic stimulation It is attenuated by eye closure The slow waves may have a notched appearance None . 14. [Damage to which of the following structures can be expected to cause abnormalities in the somatosensory evoked potential?] Spinothalamic tract Tractus gracilis Superior olivary nucleus Lateral lemniscus None . 15. [What is the generator of physiological theta waves?] White matter Suprachiasmatic nucleus Hippocampus Thalamic pacemaker cells None . 16. [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. The above clinical presentation best localizes to] Peripheral nerve Skeletal muscle Neuromuscular junction Spinal cord None . 17. [All of the following statements regarding the development of REM sleep during the first year of life are true except] Low-voltage irregular (LVI) pattern changes into the asynchronous low-amplitude mixed frequencies of the adult REM sleep The percent of time spent in REM decreases by the first year of life REM sleep tends to be more prominent in the first half of the night for infants It is common for a 6-month-old infant to transition from wakefulness into REM sleep None . 18. [Which of the following statements is true regarding the homeostatic and circadian sleep drives?] The homeostatic drive decreases with sleep The circadian drive is controlled by the suprachiasmatic nucleus of the hypothalamus The ventrolateral preoptic nucleus of the hypothalamus promotes sleep All of the above None . 19. [All of the following are considered risk factors for developing acute quadriplegic myopathy in an ICU setting except] Liver transplant Hemodialysis for end-stage renal disease Prolonged high-dose corticosteroid therapy Sedation with opiates None . 20. [All of the following statements regarding the development of REM sleep are true except] REM sleep constitutes 30% of sleep at birth REM sleep is characterized by the presence of occipital sharp transients during infancy Brief apneic periods lasting 3–10 seconds can be seen in normal infants during REM sleep REM sleep shows increasing desynchronization by 6–12 years None . 21. [Vitamin B6 toxicity typically leads to which of the following electrodiagnostic findings?] Absent motor responses Absent motor responses and severe denervation in distal muscles Absent sensory responses Normal nerve conduction studies but denervation in proximal and distal muscles None . 22. [A 40-year-old man was admitted to the hospital with a 4-day history of progressive ascending weakness. All of the testing including spinal fluid analysis is suggestive of Guillain–Barré syndrome (GBS). A needle EMG performed within 5 days of onset of symptoms will likely reveal] Abundant positive sharp waves and fibrillation potentials Fasciculation potentials Normal needle EMG Decreased motor unit recruitment patterns None . 23. [EEG in a patient with progressively deepening coma can show] Reactive high-voltage delta activity Reactive background attenuation with stimulation Nonreactive high-voltage delta activity All of the above None . 24. [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 . 25. [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 .
