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Mixed Questions
2
| Question | Answer |
|---|---|
| When a pt has pseudo-seizures, what should you do? | Encourage a spell to be recorded. |
| Can HV bring out other types of Sz, like Partial? | Occasionally. |
| What was the first known drug in the tx of Epilepsy? | Bromide. |
| What class of drugs is most effective in tx of Status Epilepticus? | Benzodiazephines. |
| Auras are most common in what type of szs? | Simple Partial. |
| What type of condition consists of focal spikes from the centro-temporal head region in children at night? | BRE. |
| What type of condition consists of intractable epilepsy, cognitive delay, and an EEG showing 1.5 - 2.5 Hz spike and wave activity? | LGS. |
| Gingival Hyperplasia is a common side effect of which drug? | Dilantin. |
| Which phase of a TC sz consists of jerking? | Clonic. |
| What is the DOC for CP szs? | Carbamazepine. |
| What is the best activation procedure for CP szs? | Sleep. |
| What is the most important tool in dx epilepsy? | Clinical history. |
| What condition consists of a teen dropping objects in the morning? | JME |
| What EEG pattern will JME show? | Paroxysmal bursts of polyspikes. |
| If a pt has a first sz from ages 20-60, what is the most likely cause? | Brain Tumor. |
| What is the voltage of a calibration signal for 7 uV/mm? | 50 uV. |
| What does the work 'history' mean? | To know. |
| What is the meaning of dizziness? | A term applied to a variety of subjective sensations including true vertigo, unsteadiness, or altercation of mental function. |
| What should the tech do in the event of focal slowing? | Make filter, sensitivity and paper speed changes to enhance this activity. |
| What should a tech do in the event of a head injury, especially with possible contra coup findings? | Make sure that the electrodes have been applied to the correct side of the head. |
| Why is Chloral Hydrate the sedation of choice for EEG testing? | It has little effect on the EEG. |
| 1 kg is equal to: | 2.2 lbs (per hazardous material guidelines). |
| What is the primary chemical component in Collodion? | Ethyl ether. |
| Food, water, drugs and blood are considered what type of transmission route for infection? | Vehicle. |
| The most common source of infection is: | People. |
| Why were Universal Precautions established? | To standardize the way healthcare professionals handle all pts where there might be contact with blood and body fluids. |
| What makes collodion hazardous? | Flammability. |
| What vital signs should be monitored while a pt is sedated with chloral hydrate? | EKG, SaO2, Respiration. |
| What is the most important means of preventing the spread of infection? | Handwashing. |
| What type of sedation should you give to a child taking several AEDs? | Chloral hydrate. |
| According to the guidelines, do you need to wear gloves during electrode application for a routine EEG? | No. |
| What type of bug is lice? | Parasite. |
| What is the first and most important step in infection control? | Cleaning. |
| What would indicate a deeper state of sedation than desired with the use of chloral hydrate? | Failure to withdraw from painful stimulation (because it's supposed to be 'conscious' sedation). |
| A vectorborne virus is transmitted by what? | Animals or insects. |
| Where would you find information regarding ingestion of collodion? | Material Data Safety Sheet. |
| What type of sz has been referred to in the past as a psychomotor or temporal lobe sz? | Complex Partial. |
| Generalized szs can be... | Convulsive or non-convulsive. |
| What are the most common characteristics of a Tonic Sz? | Spasms of the trunk, face, and upper limbs. |
| What are the most common characteristics of a Clonic Sz? | Most common in children. May resemble myoclonus but no loss of consciousnesses and slower repletion rate. |
| What sz type has also been referred to as Pyknolepsy? | Absence. |
| What is another word for idiopathic? | Genetic. |
| What childhood sz type has an excellent prognosis and almost always resolves by age 15? | Benign Rolandic Epilepsy. |
| What is another name for Rolandic Epilepsy? | Benign childhood epilepsy with centrotemporal spikes. |
| What medication is used to tx BRE? | Carbamazepine or Phenytonin. |
| What time of day does BOE (occipital spikes) peak? | Daytime. |
| What is another name for LKS? | Acquired Epileptic Aphasia. |
| What part of the body do Myoclonic szs primarily involve? | Upper extremities. |
| What time of day to Myoclonic szs primarily occur? | Morning. |
| What does the Hypsarrythmia pattern mainly consist of? | A disorganized mixture of spikes and slow waves that are different en each hemisphere. |
| What drugs are best to tx LGS? | Valproate, Benzodiazephines, and Felbamate. |
| Why should only a certain type of AEDs be used to tx LGS? | Monotherapy is best and some drugs may worsen Akinetic and Atypical Absence szs. |
| The background rhythm of a normal waking EEG consists of alpha activity of what voltage? | 20-50 uV. |
| Focal spikes are most often seen in which region? | Temporal. |
| What are some factors that can greatly increase a pt's risk to have a second sz and should be tx with AEDs on the first sz? | Previous CNS insult, sibling w/ szs, prior acute sz, GSW EEG pattern, Todd's Paralysis. |
| What is the most common cause of tx failure? | Noncompliance. |
| Which two sz types are often confused? | Absence and Complex Partial. |
| What doe 'Ictus' mean? | To seize. Greek. |
| Szs can increase what level? | Prolactin. |
| What can AVM cause neurologically? | Sturge-Weber Syndrome, hemorrhage, and szs. |
| What are the advantages of monotherapy over polytherapy? | Enhances compliance, wider therapeutic window, more cost effective, fewer side effects, idiosyncratic reactions (unpredictable drug reactions), and no risk of AED interaction. |
| What defines Intractable Epilepsy? | It is not a specific number, frequency of szs, severity, unpredictability, or side effects of AEDs, but if the szs persist despite attempts to control them. |
| How does Temporal Lobe Epilepsy affect emotional and psychological status (TLE Personality Syndrome)? | It is due to the connection of the cortical and Limbic system regions of the brain. |
| What does the particular connection in TLE produce? | Increased philosiphical concerns, deepened emotionality (right TLE), unusual lack of sexual interest, excessive writing, and interpersonal dependency (viscosity), increased depression, paranoia, (left TLE). |
| What is cortical mapping? | Brain maps derived by administering small electrical currents to a variety of brain regions while the pt is awake. Localization of motor and cognitive functions mapped by production or disruption activity associated with that specific brain region. |
| What is the difference between TLE and FLE? | Complex Partial originates in the first, lasts 1-3 m, followed by distinct post ictal confusion & automatisms. Average is 5/mo. The second also has automatisms and LOC but involve lower limbs, more frequent, last longer, & little post ictal confusion. |
| What is another name for Absence Epilepsy? | Petit-Mal, Spike-and-Wave-Stupor. |
| What are Tonic, Atonic, Clonic, and Akinetic szs usually associated with? | LGS |
| Can be primary or secondary... | TC, Myoclonic. |
| What are the types of Simple Partial Szs? | Motor (epilepsia partialis continua), Sensory (rare), Autonomic (rare), Psychic (emotional content), Aphasic. |
| What are some of the complications associated with Status Epilepticus? | Cardiac: tachycardia, arrhythmia, arrest. Pulmonary: apnea, hypoxia, aspiration. Autonomic: Fever, sweating, hyper-secretion, vomiting. Metabolic: Hyper/hypoglycemia, thrombosis. Endocrine: Increased prolactin, cortisol. Cerebral: damage, edema, pressure. |
| Is a NES a fake sz? | Usually not and appear to the pt as real. |
| What is a good indication of a NES vs. a brain generated sz? | The pts rxn. If there is high emotional concern about the sz, it could be the first. Most rxns to the second are indifferent (la belle indifference). |
| Aliasing of a signal occurs... | When the sampling rate is too low. |
| Why don't we routinely perform calibration on a digital EEG unit? | There aren't any pens. |
| The frequency of a Sleep Spindle... | 12-14 Hz. |
| When recording an ECS, the inter-electrode distance should be at least... | 10 cm. |
| What will you not see in REM sleep? | K-Complexes. |
| Mu Rythem attenuates with... | Clenching of contralateral fist. |
| What is considered to be interpretative? | Epileptogenic. |
| One neuro disorder that does not have a characteristic EEG pattern? | Stroke. |
| In Neurology as a whole, what is the most important tool in dx a pt? | Clinical Hx. |
| Normal waveforms arising from the occipital area and occur with EO... | Lambda |
| A periodic pattern occurring during a wide variety of at a brain insults unilaterally at a regular rate, most often 1-2 Hz and usually associated with impaired consciousness... | PLEDS |
| Occurs in temporal area around 6 Hz with a notched appearance and mostly during drowsiness. Considered a normal variant... | RMTD |
| Delta waves in children 8-14 yrs intermixed with background and diminish with EO... | Posterior Slow Waves of Youth |
| Rhythmic 4-5 Hz high amplitude bursts of slowing seen during drowsiness most often in children and can be accentuated with arousal. | Hypnagogic Hypersynchrony |
| 7-11 Hz and seen in the central head region with EO and sometimes has a notched appearance. Normal variant. | Mu Rhythem |
| Completes that are always abnormal and most often seen in metabolic encephalopathies. Symmetrical, high voltage, and maximal amplitude in the frontal areas. | Triphasic Waves |
| 4-5 Hz and can occur individually or in trains over the occipital regions during drowsiness. | POSTS |
| High voltage sharp waves that are bilaterally symmetrical, often associated with auditory stimuli and occur in stage I or II sleep. | K-Complexes |
| Gingival Hyperplasia is a common side effect of which AED? | Dilantin |
| When recording an ECS, the inter electrode impedances should be between... | 100-10,000 Ohms. |
| According to the guidelines, how many scalp electrodes must be used in an ECS recording? | 8. |
| Atonic | A sudden loss of muscle tone or posture change with head dropping or falling. |
| CPS | Characterized by LOC, blank stares, automatisms and may be preceded with an aura. Ictal period usually lasts 1-2 minutes and pt is unaware of event. |
| Absence | Generalized szs lasting 10-20 seconds consisting of brief loss of consciousness and most often occurring in children. |
| JME | Epilepsy usually beginning after the age of 8-10 yrs in mentally normal pts noted to be clumsy or dropping things in the morning. |
| LGS | This syndrome consists of intractable szs, mental impairment, and a characteristic slow spike and wave pattern at 1-2.5 Hz. |
| SPS | Episodes of localized motor or sensory symptoms of brief duration without any impairment of consciousness. |
| TCS | Szs that are associated with rigid muscle contractions, rhythmic jerking, and LOC. Usually last 1-5 minutes and followed by a long period of post ictal confusion. |
| 6-7 Hz theta slowing is considered normal... | At the onset of drowsiness. |
| A normal waking and sleeping adult EEG will not include... | Vertex sharp waves. |
| A temporary loss of consciousness, followed by confusion, severe ha, and possibly amnesia of accident... | Concussion. |
| Without dietetic tx, this hereditary disease may cause severe mental impairment... | Phenyketonuria. |
| Thrombosis of the right middle cerebral artery would most likely cause... | Left sided paralysis, primarily of the face and arm. |
| Intracerebral hemorrhage from the middle cerebral artery would most likely produce an EEG finding of... | Delta activity maximal over the fronto-temporal area of the affected hemisphere. |
| What frequency would not be considered a slow wave? | 8 Hz |
| When would generalized asynchronous slowing be considered normal? | Adult Sleep |
| Stroke | 55 y.o pt presenting with a sudden onset left hemiplegia and left homonymous hemianopsia with hx of arteriosclerosis. |
| Liver Disease | 46 y.o pt, deeply stuperous, chronic alcoholism and jaundice. |
| IS | 14 m.o. pt with episodes where eyes glaze over and pt falls down, occurring 15-20 dimes daily. |
| Migraine | 20 y.o. pt complaining of sudden onset blurred vision and nausea, sometimes followed by head lain lasting several hours. |
| 7 y.o pt being eval for trouble paying attention in school and occasional eye fluttering. | Absence |
| Stroke | Asymmetrical with slowing in one hemisphere. |
| Liver Disease | Triphasic Waves |
| Drooping of eyelids... | Ptosis |
| Lack of groves in the cerebral cortex... | Lissencephaly |
| Plaques along many pathways causing degeneration... | Multiple Sclerosis |
| An image study performed using a high powered magnetic field. | MRI |
| Indicates spread of disease... | Metastasis |
| Inability to speak... | Aphasia |
| Occlusion of the artery... | Ischemia |
| Bleeding | Hemorrhage |
| Characterized by rigidity and tremors... | Parkinson's Disease |
| Small brain... | Microcephaly |
| Long term condition... | Chronic |
| Sudden onset of condition... | Acute |
| Infection of the coverings of the brain... | Meningitis |
| Rapid eye movements... | Nystagmus |
| Delta driving in PS... | Abnormal. |
| Why was the use of Felbamate abruptly discontinued in the early 80s? | Some pts developed Aplastic Anemia. |
| What is the DOC for CPS? | Carbamazepine. |
| One thing that Ambulatory EEGs are good for capturing... | NES. |
| According to the Nyquist Theory, what is the rate at which a signal is sampled and assigned a number? | Twice as fast as the fastest component. |
| This is caused when sampling rate is too low. | Aliasing. |
| What does the AEEG guidelines say that a sampling rate should be? | At least 3 times higher than the highest frequency setting. |
| What type of 'bit' rate produces the best wave resolution? | The more, the better. |
| What does cerebral activity present in a reference montage? | In Phase activity. |
| Brain activity is usually higher in the frontal electrodes than in the... | Infra-orbital electrodes. |
| The cornea has... | A positive potential. |
| The retina has... | A negative potential. |
| 1958 was when... | The 10-20 System was developed. |
| Common errors in using the 10-20 system? | Inaccurate location of landmarks, mathematical, movement of tape, circumference division. |
| Results of improper electrode location... | Amplitude Asymmetries, Cancellation effect, Inaccurate dx. |
| Modification Techniques | Additional electrodes, Newborn infants, Skull deformity, Scalp lesions. |
| Increments of Measure | CM, MM, IN. |
| How many CM's in an IN? | 2.5 |
| If the pt is sleeping and has spike activity occurring at T3, what is the best reference? | A2 |
| T1 & T2 electrodes record from... | The anterior tip of the temporal lobe. |
| What type of montage consists of a chain of active electrodes connected in an anterior to poster fashion? | Longitudinal Bipolar. |
| Which of these are not considered invasive? Nasopharyngeal, Spenoidal, T1 & T2, Subdermal: | T1 & T2 |
| Which state of sleep will most likely show abnormal activity? | Transition from awake to sleep. |
| How many different montages must be used when recording a routine EEG on either a channel analog unit or a digital unit? | 3. |
| HV causes... | Decrease of CO2. |
| When beginning an EEG, what is the best opening question to ask the pt or the family? | Why did the doctor order this test. |
| Why is good pt rapport helpful? | It helps the pt relax. |
| Which step is omitted when performing an EEG? Obtain hx, measure head, apply electrodes, record EEG, use appropriate activation procedures, clean up. | Introduce self to pt. |
| Which eye lead electrodes are placed directly under the eye on the cheekbone? | Infra-orbital. |
| Rising and falling potentials: | Brain waves. |
| The display on the EEG is showing... | Time (frequency) and Amplitude (index). |
| Attenuation is a consequence of... | Heightened awareness / Visual stimulation. |
| A decrease in voltage which results in faster waves... | Attenuation. |
| Spikes | Very fast waves |
| What type of activity do you normally see in epilepsy? | Spike and wave activity. |
| What type of activity do you normally see with a brain tumor? | Delta. |
| What is the least amount of electrodes you can use on an EEG? | 21. |
| Physiologic Artifact | From pt but not generated by the brain. |
| Minimum EEG recording time: | 20-30 minutes. |
| According to minimal standards, signals should be able to record between what frequencies? | 0.5 and 70 Hz. |
| Sensitivity should be recorded generally between... | 5-10 uV/mm. |
| What is absolute in EEG? | Nothing. |
| Should you always use the 60 Hz filter? | No. Only when necessary. |
| What is the Squeak Phenomenon? | The brief increase in frequency immediately after EC. |
| What is Anabolism? | Synthesis: The combining of 2 or more substances to form a more complex structure. |
| Synovial Membranes | Connective tissue membrane that lines joint cavities. |
| What is the Transverse Fissure? | Separates the cerebrum from the cerebellum. |
| What are the 3 functions of the Cerebellum? | All related to skeletal muscle. Skilled, smooth movements, maintains equilibrium, helps control posture and muscle tone. |
| How many natural elements are there? 92 | 92. |
| What is a Valence Shell? | The outer shell of electrons. |
| How much can you move for an alternative montage of the same class? | 2-3 to the right. |
| Is is better to use how many electrodes? | The more, the better. |
| How many montages do you need for an 16 & 18 channel recording? | LB: 1, TB: 1, R: 1 |
| How many montages do you need for an 8 & 10 channel recording? | LB: 2, TB: 3, R: 2 |
| Two pieces equipment that are required for proper EEG recording: | Grounding and PS. |
| When is it acceptable to use a 'Modified' or 'Estimated' 10/20 system? | Never. |
| Impedance should not exceed... | 5 Kohms or 5,000 Ohms. |
| What should a paper recording have written on the record? | Pt name, age, dos, ID, tech initials. |
| What montage type should be selected for square wave or bio-cal to show alpha and beta range, as well as eye movements in the delta range? | Anterior-posterior (fronto-occipital). |
| What type of pts sometimes need a slower paper speed? | Newborns. |
| Is sleep or awake activity more important to record in a routine recording? | Awake. |
| What type of pts should you use additional stimuli (somatosensory, auditory, etc.)? | Comatose or Stuporous. |
Created by:
kmburg5840
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