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Mixed Questions

2

QuestionAnswer
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