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100 Cards in this Set
- Front
- Back
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Proximal
A. Above B. below C. Near to D. Far from |
C . Near to
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Dysarthria
A. Painful joints B. impaired speech C. Shortness of breath D. Inability to formulate ideas |
B. impaired speech
When you have difficulty saying words because of problems with the muscles that help you talk. |
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What is indicated by the presence of unilateral Babinski signs?
A. Tic douloureux B. cerebellar dysfunction C. Homonymous hemianopsia D. Pyramidal tract dysfunction |
D. Pyramidal tract dysfunction
The Babinski reflex occurs after examination of lateral plantar boarder and plantar arch with wood stick. Result: Dorsiflextion of the great toe separately from the rest toes . Interpretation: problem with the upper motor neurons in the pyramidal tract level |
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What is the most common seizure type in Lennox Gastaut syndrome?
A. Tonic B. absence C. Focal motor D. Complex partial |
A. Tonic
Any condition that produces major brain abnormalities is a potential cause of Lennox-Gastaut syndrome, which has three defining characteristics: multiple seizure types, a distinctive brain-wave pattern and mental deficiency that can range from slight to profound cognitive impairment. The peak age of onset is between ages 3 and 5, with a slightly greater prevalence in males than females. Lennox-Gastaut syndrome is rare, occurring in about 0.3 in 1,000 live births. Estimates of 20 percent to 60 percent of children with this syndrome have a prior history of infantile spasms. Diagnosis and treatment are difficult and seizure remission is rare. Symptoms The onset of Lennox-Gastaut does not typically begin with a specific type of seizure, although the first sign in about 1/3 of children with this syndrome is a prolonged or non-stop episode (status epilepticus). Tonic (muscle stiffening), atonic (loss of muscle tone / drop attacks) and absence (staring) seizures are common. Tonic-clonic (grand mal), myoclonic (sudden muscle jerks) and other seizure types can also occur. The seizures are usually repeated multiple times throughout the day. Tonic seizures are most common, especially during sleep when they may occur throughout the night. These seizures range in duration from a few seconds to one minute, with an average of about 10 seconds. They disturb sleep but do not awaken the child. The episodes often go undetected because of their brevity. Among signs parents might observe are a stiffening of muscles that throw the child off balance causing the child to fall, a slow forward motion of the head accompanied by drooling, sudden fall of the head only or sudden collapse of the body as a whole. Because the falls pose a serious risk of injury, the child might want to wear protective headgear. The child's condition may not be identified as Lennox-Gastaut syndrome until the falls and behavioral changes—also typical of this syndrome—are observed. |
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Diplopia
A. Double vision B. drooping eye C. Blurred vision D. Decreased vision in both eyes |
A. Double vision
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In children, most intracranial tumors are found in
A. Optic chiasm B. frontal lobe C. Temporal lobe D. Posterior fossa |
D. Posterior fossa
Most childhood tumors (more than 60%) are located in the posterior fossa (the back compartment of the brain). This area is separated from the cerebral hemispheres by a tough membrane called the tentorium. The posterior fossa includes the cerebellum, the brainstem, and the fourth ventricle. Tumors in this area include medulloblastomas (also called primitive neuroectodermal tumors, or PNETs), cerebellar astrocytomas, brainstem gliomas, and ependymomas. Although less common, other rare types of tumors have also been observed in this area, such as rhabdoid tumors and ganglioglioma; these are not discussed in detail below. The remaining 30% to 40% of brain tumors occur within one of the two cerebral hemispheres or in the spinal cord. |
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Homonymous hemianopsia
a. loss of peripheral vision b. loss of the left or right visual field in both eyes c. loss of the left visual field in one eye d. loss of the interior visual field |
b. loss of the left or right visual field in both eyes.
Homonymous hemianopia (HH) is a visual field defect involving either two right or the two left halves of the visual field of both eye. It results from the damage of the visual pathway in its suprachiasmatic part. The causes of HH include stroke, brain tumors, head injuries, neurosurgical procedures, multiple sclerosis and miscellaneous conditions. |
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Complex partial seizure
a. rhythmic theta discharge in one temporal region b. irregular 17 delta-theta in one temporal region c. diffuse slow wave activity without definite localization d. diffuse polyspike bursts followed by SSW |
a. rhythmic theta discharges in one temporal regions
Complex partial seizures occur in children and adults with certain forms of epilepsy. They are the most common type of seizure in adults. An aura may occur at the beginning of a seizure. It may consist of a strange smell, taste, sound, or visual disturbance, an unexplained feeling of fear or anxiety, or a sense that everything seems strangely familiar, like it has all happened before (dejavu), or strangely unfamiliar (jamais vu). The seizure changes the person's level of consciousness. The person may appear awake but cannot respond to anything or anyone around him or her. The person usually stares into space. The seizure may include involuntary movements called automatisms, such as lip-smacking, chewing, hand wringing, picking, and swallowing. The seizure lasts 30 seconds to 2 minutes. Most people who have complex partial seizures do not remember having them. After a seizure, the person will be confused or disoriented and may have a hard time speaking and swallowing for several minutes. Complex partial seizures are often confused with absence seizures, a type of generalized seizure. Absence seizures, though, never begin with an aura and last only 5 to 15 seconds. Also, a person is fully alert after an absence seizure and may continue with whatever he or she was doing before the seizure as though nothing has happened. |
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Bell's palsy is characterized by
a. monoplegia b. paraparesis c. tinnitus d. facial paralysis |
d. facial paralysis
Bell's palsy is a disorder of the nerve that controls movement of the muscles in the face. This nerve is called the facial or 7th cranial nerve. Damage to this nerve causes weakness or paralysis of these muscles. |
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If a patient presents with symptoms of shewing and hand automatism , which of the following types of seizures is indicated?
a. atonic b. myoclonic c. complex partial d. typical absence |
c. complex partial
Complex partial seizures occur in children and adults with certain forms of epilepsy. They are the most common type of seizure in adults. An aura may occur at the beginning of a seizure. It may consist of a strange smell, taste, sound, or visual disturbance, an unexplained feeling of fear or anxiety, or a sense that everything seems strangely familiar, like it has all happened before (dejavu), or strangely unfamiliar (jamais vu). The seizure changes the person's level of consciousness. The person may appear awake but cannot respond to anything or anyone around him or her. The person usually stares into space. The seizure may include involuntary movements called automatisms, such as lip-smacking, chewing, hand wringing, picking, and swallowing. The seizure lasts 30 seconds to 2 minutes. Most people who have complex partial seizures do not remember having them. After a seizure, the person will be confused or disoriented and may have a hard time speaking and swallowing for several minutes. Complex partial seizures are often confused with absence seizures, a type of generalized seizure. Absence seizures, though, never begin with an aura and last only 5 to 15 seconds. Also, a person is fully alert after an absence seizure and may continue with whatever he or she was doing before the seizure as though nothing has happened. |
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which of the following tumors is most likely to provoke EEG abnormalities?
a. chordoma b. meningioma c. glioblastome d. acoustic neuroma |
c. glioblastoma
Glioblastomas (GBM) are tumors that arise from astrocytes—the star-shaped cells that make up the “glue-like,” or supportive tissue of the brain. These tumors are usually highly malignant (cancerous) because the cells reproduce quickly and they are supported by a large network of blood vessels. Location Glioblastomas are generally found in the cerebral hemispheres of the brain, but can be found anywhere in the brain or spinal cord. |
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Decorticate posturing is characterized by
a. dorsiflexion of both feet b. bilateral flexion at the elbows c. bilateral extension at the elbows d. flexion of one upper extremity |
b. bilateral flexion at the elbow
Decorticate posture is an abnormal posturing that involves rigidity, flexion of the arms, clenched fists, and extended legs (held out straight). The arms are bent inward toward the body with the wrists and fingers bent and held on the chest. This type of posturing is a sign of severe damage to the brain. It requires immediate medical attention. Considerations Decorticate posture indicates damage to the corticospinal tract, the pathway between the brain and spinal cord. Although a serious sign, it is usually more favorable than decerebrate posture. Decorticate posture may progress to decerebrate posture, or the two may alternate. The posturing may occur on one or both sides of the body. Common Causes Stroke Bleeding in the brain (intracranial hemorrhage) Primary brain tumor Secondary brain tumor Encephalopathy Head injury Increased intracranial pressure from any cause Brain stem tumor Liver-induced brain dysfunction (hepatic encephalopathy) |
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Delta activity
a. less than 4 Hz b. 4-7 Hz c. 8-13 Hz d. more than 13 Hz |
a. less than 4 Hz
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precocious puberty is associated with pathology of the
a. fomix b. hippocampus c. hypothalamus d.lateral geniculate body |
c. hypothalamus
Precocious puberty is the appearance of signs of pubertal development at an abnormally early age. In girls this has traditionally been considered to be 8 years, although guidelines from the USA have recommended that puberty be considered precocious only with appearance of breast development or pubic hair before age 7 in white girls and before age 6 in black girls. In boys, the onset of puberty before age 9 is considered to be precocious.[1] Precocious puberty is often a benign central process in girls but precocious puberty is rarely idiopathic in boys and early signs of puberty in boys are a particular cause for concern. Thelarche is the beginning of breast development and pubarche is the first appearance of pubic hair. Early appearance of these characteristics is more common than true precocious puberty. causes Premature activation of the hypothalamic-pituitary-gonadal (HPG) axis. Most children (especially girls) suspected of having CPP do not have any specific abnormality but lie at one end of the normal distribution curve. |
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A lateral ventricle is connected to the third ventricle by the
a. foramen magnum b. foramen of Monro c. foramen of Luschka d. lateral geniculate body |
b. foramen of Monro
The ventricles are four fluid-filled cavities located within the brain; these are the two lateral ventricles, the third ventricle, and the fourth ventricle. The two lateral ventricles communicate through the interventricular foramina (of Monro) with the third ventricle. The third ventricle is connected to the fourth ventricle by the narrow cerebral aqueduct (aqueduct of Sylvius). The fourth ventricle, in turn, is continuous with the narrow central canal of the spinal cord and, through the three foramina in its roof, with the subarachnoid space. The central canal in the spinal cord has a small dilatation at its inferior end, referred to as the terminal ventricle |
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Broca's area
a. receptive aphasia b. expressive aphasia c. retrograde amnesia d. anterograde amnesia |
b. expressive aphasia
Broca's area is one of the main areas of the cerebral cortex responsible for producing language. This region of the brain was named for French neurosurgeon Paul Broca who discovered the function of Broca's area while examining the brains of patients with language difficulties. This brain area controls motor functions involved with speech production. Persons with damage to Broca's area of the brain can understand language but cannot properly form words or produce speech. Broca's area is connected to another brain region known as Wernicke's area. Wernicke's area is associated with processing and understanding language. Function: Broca's area is involved in several functions of the body including: Speech Production Facial Neuron Control Language Processing Location: Directionally, Broca's area is located in the lower portion of the left frontal lobe. |
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The occipital lobe receives it's blood supply directly from which artery?
A. Middle cerebral B. internal carotid C. Posterior cerebral D. Posterior cerebellar |
C. Posterior cerebral
Major Blood Vessels Click Image to Enlarge Normal function of the brain’s control centers is dependent upon adequate supply of oxygen and nutrients through a dense network of blood vessels. Blood is supplied to the brain, face, and scalp via two major sets of vessels: the right and left common carotid arteries and the right and left vertebral arteries. The common carotid arteries have two divisions. The external carotid arteries supply the face and scalp with blood. The internal carotid arteries supply blood to the anterior three-fifths of cerebrum, except for parts of the temporal and occipital lobes. The vertebrobasilar arteries supply the posterior two-fifths of the cerebrum, part of the cerebellum, and the brain stem. Any decrease in the flow of blood through one of the internal carotid arteries brings about some impairment in the function of the frontal lobes. This impairment may result in numbness, weakness, or paralysis on the side of the body opposite to the obstruction of the artery. Occlusion of one of the vertebral arteries can cause many serious consequences, ranging from blindness to paralysis. Click Image to Enlarge Circle of Willis At the base of the brain, the carotid and vertebrobasilar arteries form a circle of communicating arteries known as the Circle of Willis. From this circle, other arteries—the anterior cerebral artery (ACA), the middle cerebral artery (MCA), the posterior cerebral artery (PCA)—arise and travel to all parts of the brain. Posterior Inferior Cerebellar Arteries (PICA), which branch from the vertebral arteries, are not shown. Because the carotid and vertebrobasilar arteries form a circle, if one of the main arteries is occluded, the distal smaller arteries that it supplies can receive blood from the other arteries (collateral circulation). Click Image to Enlarge Anterior Cerebral Artery The anterior cerebral artery extends upward and forward from the internal carotid artery. It supplies the frontal lobes, the parts of the brain that control logical thought, personality, and voluntary movement, especially of the legs. Stroke in the anterior cerebral artery results in opposite leg weakness. If both anterior cerebral territories are affected, profound mental symptoms may result (akinetic mutism). Middle Cerebral Artery The middle cerebral artery is the largest branch of the internal carotid. The artery supplies a portion of the frontal lobe and the lateral surface of the temporal and parietal lobes, including the primary motor and sensory areas of the face, throat, hand and arm, and in the dominant hemisphere, the areas for speech. Click Image to Enlarge The middle cerebral artery is the artery most often occluded in stroke. Posterior Cerebral Artery The posterior cerebral arteries stem in most individuals from the basilar artery but sometimes originate from the ipsilateral internal carotid artery [Garcia JH et al., In Barnett HJM at al (eds) Stroke Pathophysiology, Diagnosis, and Management New York Churchill Livingstone 1992 125]. The posterior arteries supply the temporal and occipital lobes of the left cerebral hemisphere and the right hemisphere. When infarction occurs in the territory of the posterior cerebral artery, it is usually secondary to embolism from lower segments of the vertebral basilar system or heart. Click Image to Enlarge Clinical symptoms associated with occlusion of the posterior cerebral artery depend on the location of the occlusion and may include thalamic syndrome, thalamic perforate syndrome, Weber’s syndrome, contralateral hemplegia, hemianopsia and a variety of other symptoms, including including color blindness, failure to see to-and-fro movements, verbal dyslexia, and hallucinations. The most common finding is occipital lobe infarction leading to an opposite visual field defect. Lenticulostriate Arteries Small, deep penetrating arteries known as the lenticulostriate arteries branch from the middle cerebral artery Occlusions of these vessels or penetrating branches of the Circle of Willis or vertebral or basilar arteries are referred to as lacunar strokes. About 20% of all stokes are lacunar [Stoke/Brain Attack reporter's Handbook. Englewood, Colo: National Stroke Association, 1995] and have a high incidence in patients with chronic hypertension. Click Image to Enlarge In the elderly, CT scanning shows signs of infarction in only approximately half of the most of the common form of lacunar stroke (pure motor stroke), but MRI has increased the yield: the probability that CT or MRI will be positive is generally a function of the severity of the deficit [Mohr JP and Sacco RL, 1992]. The cells distal to the occlusion die, but since these areas are very small often only minor deficits are seen. When the infarction is critically located, however, more severe manifestations may develop, including paralysis and sensory loss. |
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nystagmus most often indicates a lesions of the
a. thalamus b. brain stem c.optic tract d. facial nerve |
b. Brain Stem
Nystagmus is a term to describe fast, uncontrollable movements of the eyes that may be: Side to side (horizontal nystagmus) Up and down (vertical nystagmus) Rotary (rotary or torsional nystagmus) Depending on the cause, these movements may be in both eyes or in just one eye. The term dancing eyes has been used to describe nystagmus. Nystagmus demonstrates the CONNECTIONS BETWEEN THE VESTIBULAR APPARATUS AND NUCLEI IN THE BRAIN STEM THAT INNERVATE MUSCLES THAT MOVE THE EYES IN THE HORIZONTAL DIRECTION |
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Cerebrospinal fluid is produced in the
a. brain stem b. central canal c. choroid plexus d. arachnoid villi |
c. choroid plexus
cerebrospinal fluid (CSF), clear, colourless liquid that fills and surrounds the brain and the spinal cord and provides a mechanical barrier against shock. Formed primarily in the ventricles of the brain, the cerebrospinal fluid supports the brain and provides lubrication between surrounding bones and the brain and spinal cord. When an individual suffers a head injury, the fluid acts as a cushion, dulling the force by distributing its impact. The fluid helps to maintain pressure within the cranium at a constant level. An increase in the volume of blood or brain tissue results in a corresponding decrease in the fluid. Conversely, if there is a decrease in the volume of matter within the cranium, as occurs in atrophy of the brain, the CSF compensates with an increase in volume. The fluid also transports metabolic waste products, antibodies, chemicals, and pathological products of disease away from the brain and spinal-cord tissue into the bloodstream. CSF is slightly alkaline and is about 99 percent water. There are about 100 to 150 ml of CSF in the normal adult human body. |
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Inability to detect finger movement of the left from either eye is probably caused by damage in the
a. left optic nerve. b. right optic nerve. c. left optic radiation d. right optic radiation |
d. right optic radiation
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The primary visual area is near the
a. calcarine fissure b. superior temporal gyrus c. parietooccipital sulcus d. temporo-occipital transition area |
a. calcarine fissure
Striate cortex, or simply V1, the primary visual cortex is located in the most posterior portion of the brain's occipital lobe . In fact, a large part of the primary visual cortex cannot be seen from the outside of the brain, because this cortex lies on either side of the calcarine fissure. This fissure, however, is clearly visible in a sagittal section made between the two cerebral hemispheres. The primary visual cortex, with its distinctive cell architecture, also corresponds to Area 17 described by the anatomist Brodmann in the early 20th century (link to Tool module from the sidebar to the left). The primary visual cortex sends a large proportion of its connections to the secondary visual cortex (V2), which consists of Brodmann's areas 18 and 19. Though most of the neurons in the secondary visual cortex have properties similar to those of the neurons in the primary visual cortex, many others have the distinctive trait of responding to far more complex shapes. The analysis of visual stimuli that begins in V1 and V2 continues through two major cortical systems for processing visual information. The first is the ventral pathway, which extends to the temporal lobe and is thought to be involved in recognizing objects. The second is the dorsal pathway, which projects to the parietal lobe and appears to be essential for locating objects. |
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Precentral Gyrus
a. motor area b. visual area c. somatosensory area 4. receptive speech area |
a. motor area
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Which of the following is a blood clot formed at the site of an atherosclerotic plaque?
a. ischemia b. thrombus c. embolus d. aneurism |
b. thrombus
Atherosclerosis refers to the build up of fatty deposits called plaques in the walls of the arteries. Over time these deposits of cholesterol, fat and the smooth muscle cells that line the arteries are transformed into a thickened and sometimes calcified mass (atheroma). Atheroma causes the arteries to narrow and lose their elasticity, which leads to a reduction in blood flow through the vessels. The hardening and narrowing process of atherosclerosis takes many years, indeed decades, and initially causes no symptoms. But when fatty deposits build up to an extent that the artery is significantly damaged, it can result in any of the following. Blood clots (thrombus): a blood clot can form on the cholesterol plaque leading to a blockage in the artery, so preventing blood flow down the artery and depriving tissues of vital nutrients. The fatty deposits of atheroma in the arteries are sited within the wall of the artery and are completely covered by a lining of protective cells from the flowing blood. If this protective cell barrier breaks down – in other words if the plaque ruptures – then blood is exposed to a very high concentration of cholesterol in the artery wall This leads to activation of the blood cloting system around the rupture, and the development of a blood clot that may be large enough to block the artery and seal off the blood supply to whatever organ is supplied by that artery. Depending on where the block is, it may cause stroke, angina (chest pains because the heart lacks oxygen) or a heart attack. When rupture of the atherosclerotic plaque occurs, blood clots can form very quickly, within minutes of the rupture. Ischaemic stroke: a blood clot can cut off the supply of oxygen to an area of the brain. Depending on the size of the affected area and amount of damaged brain tissue, this can cause paralysis, typically affecting only one side of the body. Most strokes are ischaemic; there is evidence that treatment of stroke with clot busting drugs improves the chances for recovery, provided such treatment is given very early (within 3 hours) of the onset. Haemorrhagic stroke: arteries that are diseased by the atherosclerotic process are not only prone to developing blood clots within them, they are also weaker than normal, and can burst open due to the pressure of the arterial blood.When a brain artery affected by atherosclerosis ruptures, usually in someone who also has high blood pressure, considerable brain damage can occur This can cause a particularly severe form of stroke. Reduced heart function (heart failure): when the narrowed artery causes damage to the heart muscle. Swelling (aneurysms) in parts of the aorta, the main artery that sends blood to other parts of the body. A segment of blood vessel balloons out, making it weak and prone to rupture. Common sites for these swellings are in the chest (thoracic) and abdominal sections of the aorta. As these arteries enlarge, the walls weaken further, predisposing to further enlargement. Once the wall is too weak, these arteries can burst open, leading to torrential bleeding into surrounding tissues and an immediately life threatening illnesses. Immediate surgery may save the situation. High blood pressure and renal failure if the kidney arteries are affected. Leg pains from narrowed arteries in the lower limbs. In extreme cases, insufficient blood supply may result in the leg having to be amputated. |
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Wernicke's area is located in which of the following lobes
a. frontal b. parietal c. occipital d. temporal |
d. temporal
Wernicke area, region of the brain that contains motor neurons involved in the comprehension of speech. This area was first described in 1874 by German neurologist Carl Wernicke. The Wernicke area is located in the posterior third of the upper temporal convolution of the left hemisphere of the brain. Thus, it lies close to the auditory cortex. This area appears to be uniquely important for the comprehension of speech sounds and is considered to be the receptive language, or language comprehension, centre. Damage to the temporal lobe may result in a language disorder known as Wernicke aphasia. An individual with Wernicke aphasia has difficulty understanding language; speech is typically fluent but is empty of content and characterized by circumlocutions, a high incidence of vague words like “thing,” and sometimes neologisms and senseless “word salad.” |
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Anosmia may result from an injury to cranial nerve
a. I b. II c. VII d. IX |
a. I
Loss of smell — anosmia (an-OHZ-me-uh) — can be partial or complete, although a complete loss of smell is fairly rare. Loss of smell can also be temporary or permanent, depending on the cause. |
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Rolandic fissure
a. insula b. Falx cerebri c. central sulcus d. Kernohan's notch |
c. Central Sulcus
The central sulcus is a fold in the cerebral cortex in the brains of vertebrates. Also called the central fissure, it was originally called the fissure of Rolando or the Rolandic fissure, after Luigi Rolando. |
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A patient with unilateral blindness is most likely to show which of the following responses to intermittent photic stimulation?
a. bilateral occipital driving response b. unilateral occipital driving response c. photomyogenic responses d. photoparaxysmal responses |
a. bilateral occipital driving response
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EEGs obtained during sleep are of most value in the study of
a. vascular diseases b. psychiatric disturbances c. complex partial seizures d. space occupying lesions |
c. complex partial seizures
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Which of the following is characteristic of an electrographic seizure ?
a. episodic rhythmic activity b. intermittent temporal spikes c. irregular polymorphic delta activity d. single bifrontal spike and wave complex |
a. episodic rhythmic activity
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The purpose of the Wada test is to
a. measuring the biomagnetic fields b. evaluate the blood flow to the brain c. evaluate language and memory function d. measure the metabolic changes throughout the brain |
c. evaluate language and memory function
Most epilepsy patients considering surgery undergo the Wada (WAH-dah) test first. This test is officially known as the intracarotid sodium amobarbital procedure (ISAP), but the nickname "Wada test" is commonly used. The name comes from the physician who first performed it, Dr. Juhn Wada. The Wada test looks at language and memory on one side of the brain at a time. Language (speech) is controlled by one side of the brain (in most people, the left side), and the Wada will tell the doctors which side controls language in your brain. Memory can be controlled by both sides of the brain; the Wada tells which side of your brain has better memory. If the side that controls language or has better memory is where your seizures may be coming from, the surgeon may consider performing an fMRI or brain mapping before surgery. |
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Which of the following electrode positions would MOST likely record the cortical eeg activity associated with focal motor twitching of the left leg and foot?
a. C3 b.C4 c.C6 d.Cz |
d. Cz
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In the international 10-20 electrode placement s, C6 is located on which part of the head?
a. left b. right c. anterior d.posterior |
b. right
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What is the indentation between the nose and the forehead?
a. inion b. zygoma c. nasion d. preauricular point |
c. nasion
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In an abnormality is focal to the right anterior temporal region, which of the following electrode placements would be most involved?
a. Fz Cz Pz b. O1 O2 Pz c.F8 T8 A2 d. Fp1 , F7, P7 |
c. F8 T8 A2
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If the Fp1 to F3 measurement is 6cm, what is the total measurement from Fp1 to O1
a. 12mm b. 24mm c.12cm d. 24cm |
d. 24cm
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By what age are sleep spindles first more synchronous than asynchronous?
a. 3 months b. 6 months c. 18months d. 30months |
c. 18 months
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Which of the following electrode metals is best able to record slow frequency activity?
a. tin b. gold c.stainless steel d. silver-silver chloride |
d. silver -silver chloride
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Interelectrode impedance levels during and electrocerebral inactivity recording should be
a. below 100 Ohms b. between 100 and 10000 Ohms c. between 10,000 and 20,000 Ohms d. above 20,000 Ohms |
b. between 100 and 10,000 Ohms
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The polarity convention for EEG states that the deflection is up if input
a. 1 is more negative than input 2 b. 1 is more positive than input 2 c. 2 is less negative than input 1 d. 2 is equal to input 1 |
a. 1 is more negative than input 2
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What is most common cause of generalized beta?
a. Sleep b. Burr holes c. medication d. HV |
c. medication
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Seizures commonly result from withdrawal of which of the following?
a. alcohol b. nicotine c. ibuprofen d. antihistamine |
a. alcohol
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Infratentorial tumors would most likely show which of the following EEG pattern?
a. focal spikes b. bilateral SSW c. focal irregular polymorphous slowing d. synchronous rhythmical bilateral slowing |
d. synchronous rhythmical bilateral slowing
The brain tumors which arise below the cerebrum are known as infratentorial brain tumors. They are called that because they exist below the brain sheath known as tentorium. These tumors take place in the part of the brain known as cerebellum and the brain stem. The cerebellum mostly controls the balance function in your body whereas the brain stem is responsible for breathing, heart funtion, consciousness, hunger and involuntary muscle movement etc. The brain tumors arising above the tentorium sheath are called supratentorial tumors. They usually exist in the part of the brain known as cerebrum which is responsible for movement coordination, judgement, problem solving, learning, reasoning, and personality etc. Usually the brain tumors could be supratentorial or infratentorial in nature in an adult human, but in children they are mostly infratentorial. It is a rare case if a child comes up with a supratentorial brain tumor. |
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Deja vu
A. Absence seizure B. focal motor seizure C. Complex partial seizure D. Generalized tonic clonic seizure |
C. Complex partial seizure
Complex partial seizures can begin in any lobe of the brain, but cause alteration of awareness due to spreading of seizure activity. Complex partial seizures are often preceded by a simple partial seizure (aura). An aura is often described as a warning and can manifest in several different ways, such as a sense of fear, a funny feeling in the body, déjà vu, etc. Patients experiencing a complex partial seizure may stare blankly into space, or experience automatisms (non-purposeful, repetitive movements). |
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Which of the following occur during a typical absence seizure?
A. Impaired consciousness B. aura C. Generalized tonic clonic activity D. Prolonged pstictal depression |
A. Impaired consciousness
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Intermittent rhythmic delta activity is most likely seen in which of the following?
A. Parkinsonism B. Huntington disease C. Metabolic encephalopathy D. Benign rolandic epilepsy |
C. Metabolic encephalopathy
The metabolic encephalopathies comprise a series of neurological disorders not caused by primary structural abnormalities; rather, they result from systemic illness, such as diabetes, liver disease, renal failure and heart failure. Metabolic encephalopathies usually develop acutely or subacutely and are reversible if the systemic disorder is treated. If left untreated, however, metabolic encephalopathies may result in secondary structural damage to the brain. There are two major types of metabolic encephalopathies, namely those due to lack of glucose, oxygen or metabolic cofactors (which are usually vitamin-derived) and those due to peripheral organ dysfunction. |
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Which of the following is most likely clinical correlate?
A. Generalized epilepsy B. west syndrome C. Tourette's syndrome D. Metabolic encephalopathy |
A. Generalized epilepsy
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What is activity in segment x?
A. Glossokinetic artifact B. eye movement artifact C. Generalized spike and wave , maximum central D. Generalized spike and wave, maximum frontal |
D. Generalized spike and wave , maximum frontal
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The initial tonic phase of a generalized seizure is characterized electrically by
A. Focal poly spike discharge B. synchronous spike and wave activity C. Generalized voltage suppression without spike D. Generalized delta theta activity with focal spike and wave discharge |
C. Generalized voltage suppression without spikes
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The ictal eeg of absence seizure is most likely to have which of the following characteristics?
A. Maximal discharge over the parietal midline B. generalized synchronous 3 sec spike and wave discharge C. Every generalized spike and wave representing a seizure D. Primarily frontal post octal slowing |
B. generalized synchronous 3 sec spike and wave discharge
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Which of the following is characteristic of the ictal phase of a tonic-clonic seizure?
A. Diffuse rhythmic slowing without spikes B. diffuse 3 HZ spike and wave discharge C. Diffuse rhythmic spikes followed by diffuse SSW activity. D. Diffuse delta activity associated with focal SSW discharges. |
C. Diffuse rhythmic spikes followed by diffuse SSW activity.
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Which of the followingis most characteristic of the EEG in a patient with herpes simplex encephalitis ?
A. Pattern is abnormal about 50% of the time B. discharges have 1:1 relationship with myoclonus jerks C. Pseudo periodic discharges repeat at 1-5 second intervals D. Abnormalities are commonly parieto- occipital |
C. Pseudoperiodic discharges repeat at 1-5 second intervals
Herpes simplex encephalitis (HSE) is an acute or subacute illness that causes both general and focal signs of cerebral dysfunction. Brain infection is thought to occur by means of direct neuronal transmission of the virus from a peripheral site to the brain via the trigeminal or olfactory nerve. The exact pathogenesis is unclear, and factors that precipitate HSE are unknown. Imaging tests The following are imaging studies used in the evaluation of suspected HSE: MRI of the brain: The preferred imaging study CT scanning of the brain: Less sensitive than MRI EEG: Low specificity (32%) but 84% sensitivity to abnormal patterns in HSE |
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At what age do sleep spindles appear in the full term infant?
A. 5-6 weeks B. 12-14 weeks C. 5-6 month D. 12-14 month |
A. 5-6 weeks
Sleep spindles, as defined in the international electroencephalography (EEG) glossary, are distinguished from spindle bursts seen in the EEGs of premature infants. Classical sleep spindles do not occur in prematures. They first appear clearly in the EEG during slow wave sleep from the 4th week postterm (44 weeks conceptional age) and are normally present in all infants' EEGs by 9 weeks postterm. During the first year of life they may be of high voltage relative to their appearance in older children and adults and are commonly characterized by variable degrees of interhemispheric asymmetry and asynchrony. Individual differences are great. Some features of clinical significance are discussed |
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Differential amplifiers are needed to
A. Reduce grounding problems B. allow both referential and bipolar recordings C. Improve the low frequency responses D. Provide for rejection of In phase signals |
D. Provide for rejection of in phase signals
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If a common mode rejection ratio is reduced , which of the following will occur
A. 60 HZ artifact will be eliminated B. 60 HZ artifact will be reduced C. 60 HZ artifact will be enhanced D. The amplifier will not function |
C. 60 HZ artifact will be enhanced
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What is harmonic response to photic stimulation
A. Half the flash rate B. same as the flash rate C. 1 1/2 times the flash rate D. 2 times the flash rate |
D. 2 times the flash rate
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If an EEG is recorded on a very tense and anxious patient it is likely to exhibit
A. Widespread low voltage activity B. an alpha rhythm of unusually high amplitude C. An alpha rhythm of unusually widespread distribution D. Bursts of rhythmic slow activity over the posterior regions. |
A. Widespread low voltage activity
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In the EEG, the state of the patient is most likely
A. Awake B. drowsy C. REM sleep D. Stage N2 sleep |
C. REM sleep
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Hypsarrhythmia
A. Down syndrome B. absence attacks C. Reye's syndrome D. Infintile spasm |
D. Infintile spasm
Email this page Share on Twitter Share on Facebook View/Print content What is it like? Here's a typical story: "At first I thought Chris was just having the little body jerks when he was moved or startled, like my other children had when they were infants. But then I knew something was wrong. The jerks became more violent, and his tiny body was thrust forward and his arms flew apart. They only lasted a few seconds but started to occur in groups lasting a few minutes. It was so hard to see such a young baby having these things." Infantile spasms (also called West syndrome because it was first described by Dr. William James West, in the 1840s) consist of a sudden jerk followed by stiffening. Often the arms are flung out as the knees are pulled up and the body bends forward ("jackknife seizures"). Less often, the head can be thrown back as the body and legs stiffen in a straight-out position, or movements can be more subtle and limited to the neck or other body parts. Each seizure lasts only a second or two but they usually occur close together in a series. Sometimes the spasms are mistaken for colic, but the cramps of colic do not occur in a series. Infantile spasms are most common just after waking up and rarely occur during sleep. Who gets it? Infantile spasms begin between 3 and 12 months of age and usually stop by the age of 2 to 4 years. They are uncommon, affecting only one baby out of a few thousand. About 60% of the affected infants have some brain disorder or brain injury before the seizures begin, but the others have had no apparent injury and have been developing normally. There is no evidence that family history, the baby's sex, or factors such as immunizations are related to infantile spasms. Tell me more When a baby with infantile spasms has an EEG, the doctor usually will see an unusual pattern called hypsarrhythmia (HIP-sa-RITH-me-ah) when the seizures are not occurring. This chaotic, high-voltage pattern is often helpful in confirming the diagnosis. Babies with infantile spasms seem to stop developing and may lose skills that they had already mastered, such as sitting, rolling over, or babbling. How is it treated? Steroid therapy (adrenocorticotropic hormone [ACTH] or prednisone) is the primary treatment for infantile spasms. Some experts recommend trying a seizure medicine such as Sabril (vigabatrin, not available in the United States), Depakote (valproate), or Topamax (topiramate) before steroid therapy. In countries where it is available, Sabril is often used as the initial therapy because it is relatively safe (especially for short-term use) and effective. It is especially effective for children with tuberous sclerosis (a disorder associated with abnormalities involving the brain, skin, heart, and other parts of the body). Sabril is associated with damage to the retina of the eye and should be used with caution in children. What's the outlook? Most children with infantile spasms are mentally retarded later in life. Those whose spasms are related to an underlying developmental brain disorder or injury have a higher likelihood of moderate to severe retardation. The outlook is brighter for those who were developing normally before the spasms started: 10 to 20% will have normal mental function and some others may be only mildly impaired. Some children with infantile spasms develop autism. Many doctors believe that the quicker the seizures are controlled, the better the results will be. When the spasms stop, many children later develop other kinds of epilepsy. About one-fifth of children who have had infantile spasms will have the Lennox-Gastaut syndrome |
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Which of the patterns is present in the sample?
A. Periodic lateralized Epileptiform discharges B. occipital rhythmic delta activity C. Positive occipital sharp transients of sleep D. Frontal intermittent rhythmic delta activity |
A. Periodic lateralized Epileptiform discharge
These consists of lateralized complexes usually recurring every 1-2 sec. The complex often consists of sharp waves or spikes that may be followed by a slow wave. The clinical picture associated with PLEDS is usually obtunation, focal seizure and focal neurological signs. Majority of patient with PLEDS will have seizures during the acute stage of illness . Acute stroke is the most common etiology of PLEDS , also any acute brain injury that tends to cause seizures can manifest as PLEDS. Most patient with herpes simplex encephalitis develop PLEDS , maximal in temporal regions and often consisting of prolonged complexes recurring every 1-4 s |
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Artifact present in this sample is most likely a result of
A. Tongue artifact B. eye mvmnt C. Head movement D. Muscle tension |
D. Muscle tension
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Which of the following clinical conditions is most likely present?
A. Primary epilepsy B. acute focal tension C. Chronic encephalopathy D. Secondary progressive multiple sclerosis |
B. acute focal tension
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Acquisition of EEG data should occur at a minimum sampling rate
A. Half the heigh frequency setting B. two times the high frequency setting C. Three times the high frequency setting D. Four times the high frequency setting |
C. Three times the high frequency setting
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Stage N3 sleep
A. No k complex B. 30% delta activity C. Rapid eye movement D.positive occipital transients |
B. 30 % delta activity
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Automatism
A. Psychogenic B. myoclonus seizures C. Complex partial seizures D. Generalized tonic clonic seizures |
C. Complex partial seizure
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Metabolic encephalopathy
A. Generalized beta B. focal abnormalities C. Triphasic waves D. PLEDS |
C. Triphasic waves
Normal brain function depends on normal neuronal metabolism, which is closely related to systemic homeostasis of metabolites, such as glucose, electrolytes, amino acids and ammonia. "Metabolic encephalopathy" indicates diffuse brain dysfunction caused by various systemic derangements. Electroencephalogram (EEG) is widely used to evaluate metabolic encephalopathy since 1937, when Berger first observed slow brain activity induced by hypoglycemia. EEG is most useful in differentiating organic from psychiatric conditions, identifying epileptogenicity, and providing information about the degree of cortical or subcortical dysfunction. In metabolic encephalopathy, EEG evolution generally correlates well with the severity of encephalopathy. However, EEG has little specificity in differentiating etiologies in metabolic encephalopathy. For example, though triphasic waves are most frequently mentioned in hepatic encephalopathy, they can also be seen in uremic encephalopathy, or even in aged psychiatric patients treated with lithium. Spike-and-waves may appear in hyper- or hypo-glycemia, uremic encephalopathy, or vitamin deficiencies, etc. Common principles of EEG changes in metabolic encephalopathy are (1) varied degrees of slowing, (2) assorted mixtures of epileptic discharge, (3) high incidence of triphasic waves, and (4), as a rule, reversibility after treatment of underlying causes. There are some exceptions to the above descriptions in specific metabolic disorders and EEG manifestations are highly individualized. |
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Which of the following activation procedures should be avoided in patient with recent intracranial hemorrhage ?
A. Sleep B. HV C. Photo stimulation D. Mental exertion |
B. HV
Intracranial hemorrhage (ie, the pathological accumulation of blood within the cranial vault) may occur within brain parenchyma or the surrounding meningeal spaces. Hemorrhage within the meninges or the associated potential spaces, including epidural hematoma, subdural hematoma, and subarachnoid hemorrhage, is covered in detail in other articles. Intracerebral hemorrhage (ICH) and extension of parenchymal bleeding into the ventricles (ie, intraventricular hemorrhage [IVH]) are detailed here. Intracerebral hemorrhage accounts for 8-13% of all strokes and results from a wide spectrum of disorders. Intracerebral hemorrhage is more likely to result in death or major disability than ischemic stroke or subarachnoid hemorrhage. Intracerebral hemorrhage and accompanying edema may disrupt or compress adjacent brain tissue, leading to neurological dysfunction. Substantial displacement of brain parenchyma may cause elevation of intracranial pressure (ICP) and potentially fatal herniation syndromes. |
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Which of the following is often caused by prolonged severe cerebral anoxia
A. Appearance of posts B. burst suppression activity C. Increase in voltage of the mu rhythm D. Increase in the frequency of alpha rhythm |
B. burst suppression
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Activity of which electrodes is most likely to contaminate A1 reference?
A. Fp1 B. fp2 C. T7/t3 D. T8/t4 |
C. T7/T3
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What is the focus and polarity of X ?
A. Fp2 and negative B. fp2 and positive C. Fp2 and f8 and positive D. Fp2 and f8 and negative |
A. Fp2 and negative
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If input 1 is receiving a +60 uV signal and input 2 is receiving a +75 uV signal, what will be the direction and amplitude of the deflection at 5 uV/mm
A. Up, 3mm B. up, 27 C. Down, 3mm D. Down , 27 mm |
A. Up, 3mm
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If an 8 year old child develops high voltage bilateral delta activity maximal in the posterior regions during HV, it most likely indicates
A. Metabolic encephalopathy B. increased intracranial pressure C. Normal HV response D. A generalized seizure disorder |
C. Normal HV response
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Which of the following is the most effective way to assess the effect of three seconds of generalized spike and wave on alertness
A. Have the patient clench fist B. ask the patient to count aloud C. Have the patient scan a picture D. Look for slow rolling eye movement |
B. ask the patient to count aloud.
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Which of the following is the most characteristic of the glossokinetic artifact?
A. Are usually unilateral B. do not occur in edentulous patients C. Are reproduced by asking the patient to say lalala D. Can be eliminated by using the HFF |
C. Are reproduced by asking the patient to say lalala
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Stage N2 sleep is characterized by the presence of
A. Posts B. delta waves C. Sleep spindles D. Rapid eye movement |
C. Sleep spindles
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Which of the following time constant would be most appropriate for recording a pt with suspected brain tumor
A. 0.05 sec B. 0.1 sec C. 0.2 sec D. 0.4 sec |
D. 0.4 sec
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If the activity from a drowsy child recorded at a sensitivity of 7 uV/ mm results in a deflection of 20 mm, what is the voltage.
A. 2.9 uV B. 20 uV C. 70 uV D. 140 uV |
D. 140 uV
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What are the recommended filter settings for standard eeg recording
A. 1 and 15 HZ B. 1 and 35 HZ C. 1 and 70 HZ D. 3 and 70 HZ |
C. 1 and 70 HZ
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The 80 HZ notch filter will have the greatest effect on a waveform having a duration of
A. 10 sec B. 16 sec C. 25 sec D. 50 sec |
B. 16 sec
200 msec = 1 HZ X = 80 HZ 200msec x 80 HZ = 16 sec |
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Which of the following settings will provide best visualization of slow wave focus in the EEG
A. LF 0.3 HZ , 15 mm/ sec B. 0.3 HZ, 60 mm/sec C. 5 HZ , 15 mm/ sec D. 70 HZ , 60 mm/ sec |
A. LF 0.3 HZ , 15 mm/ sec
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Which of the following filter settings would be enhanced a 0.5 HZ wave and not affect a spike
A. LF 0.3 HZ B. 1 HZ C. LF 5 HZ D. LF 35 HZ |
A. 0.3 HZ
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The abnormality is focal at
A. C3 B. c4 C. P3 D. P4 |
B. c4
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Which of the following montages would best display phase reversal of the spike
A. Cz reference B. circumferential C. Longitudinal bipolar D. Contraleteral ear reference |
C. Longitudinal bipolar
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The localization is determined by
A. Amplitude B. cancellation C. End of chain D. Phase reversal |
A. Amplitude
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A downward deflection occurs if
A. Input I is equal to input II B. input I is more positive than input II C. Input I is more negative than input II D. Input II is more positive than input I |
B. input I is more positive than input II
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Which of the following montages would best display the amplitude of a left temporal spike?
A. Let temporal to the ipsilateral ear B. left temporal to the Contraleteral ear C. Anterior posterior bipolar temporal chain D. Transverse bipolar chain |
B. left temporal to the Contraleteral ear
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Cz is used as a reference to
A. Determine sleep spindles B. avoid contamination by sleep spindles C. Localize the abnormalities with sleep spindles D. Demonstrate amplitude of discharges |
D. Demonstrate amplitude of discharge
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This pattern is best described as
A. Focal B. generalized C. Periodic D. Temporarily dominant |
A. Focal
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What is the polarity and focus of the spikes?
A. Negative o1 B. positive o2 C. Positive with undetermined focus D. Negative with undetermined focus |
A. Negative o1
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When using the avarage reference, if a spike and wave focus appear at c3 , the abnormality would be best enhanced by
A. Decreasing sensitivity B. using 35 HZ filter and time constant of 0.03 sec C. Switching to Cz referential montage D. Excluding c3 and surrounding electrons from reference |
D. Excluding c3 and surrounded electrons from reference
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Referential recording is most appropriate for measuring
A. Phase B. voltage C. Frequency D. Duration |
B. voltage
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Conceptional age is the
A. Chronological age B. number of days or weeks since the infant wad born C. Estimated gestational age plus chronological age D. Number of weeks from the time on conception until birth |
C. Estimated gestational age plus chronological age
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Digital eeg montages are reformatted by using
A. Fourier analysis B. the nyquist theorem C. An avarage reference D. Referentially recorded data |
A. Fourier analysis
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What should be done with invasive electrodes. After using them?
A. Dispose of them B. gas autoclave them C. Wipe them with bleach D. Soak them with detergent and dry |
A. Dispose them
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Tonic status epilepticus is most commonly seen in patient with
A. Rolandic epilepsy B. creutzeldt Jacob disease C. Lennox Gastaut syndrome D. Alcohol withdrawal seizure |
C. Lenox Gastaut syndrome
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Contaminated needles should be placed in
A. Red biohazard bags B. yellow biohazard bags C. Designated sharps containers D. Cardboard sharps cartons |
C. Designated sharps containers
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Which of the following is required by the ABRET code of Ethics
A. Support the well being of the patient B. take primary responsibility for EEG interpretation C. Discuss patient information only with colleagues D. Use r.eeg.t after passing part 1 - written examination |
A. Support the well being of the patient
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If a telephone call is receiving from a patient requesting a verbal eeg report, what should the technologist do?
A. Give patient the report B. refer patient to ordering physician C. Refuse to give the report via telephone but send to patient D. Review the tracing and report results to patient |
B. refer patient to ordering physician
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Hipaa
A. Hospital accreditation process B. federally funded insurance program C. Health care worker training program D. Legislative act regulating patient privacy |
D. Legislative act regulating patient privacy
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The spread of infection can best be prevented by
A. Wearing a mask B. sterilizing instruments C. Washing hands frequently D. Changing linen frequently |
C. Washing hands frequently
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Which of the following should a technologist do first at the onset of a seizure
A. Attempt to stop the seizure B. turn off the instrument C. Observe seizure, continue recording, and prevent injury D. Call a physician, administer first aid, and observe the patient |
C. Observe seizure, continue recording, and prevent injury
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