CLTM Study Questions And 100% Correct Answers
BAEP / R - ANSWER Brainstem auditory evoked potential / response
-Diagnosis for cerbellopontine angle tumors, mutliple sclerosis, brainstem lesions,
metabolic and toxic encephalopathies,brain death, and early prediction of outcome in
postraumatic coma,
Kindling - ANSWER Development of epileptic seizures (in rats) that results from
repeated focal stimulation and leads to the development of a predisposition to
epileptiform convulsions. Similar to a log will not burn unless it's kindled.
Mirror Focus Phenomenon - ANSWER Concept that an actively discharging epileptiform
region may induce paroxymal behavior in a homologous site. Related to the kindling
phenomena that occur through interhemispheric callosal or commissural connections.
It means that secondary epileptogenic foci develop in the contralateral hemispheric by
the corpus collusum
Aura - ANSWER An initial sensation(s) of a seizure that the patient is aware of in the
absence of observable signs. In some instances provides localizing information. Many
seizures involving the temporal lobe are preceded by
The Principle of Beneficence - ANSWER An ethical principle addressing an action by a
medical professional to promote good, having the welfare of a patient as a goal of any
treatment. An action shall weigh possible benefits to risks and prevent and remove
harm in whatever situation and advocate for high standards for the greater good.
QEEG - ANSWER Type of EEG that allows visualization of up to several hours of EEG
data in a single screen display. Commonly referred to a trend analysis. This type of EEG
trending for seizure detection is based on amplitude, frequency, rhythmicity and degree
of asymmetry.
Coup- ANSWER Closed head injury / whiplash. The injury is when brain are damage is on
the same side as the external force of the injury
,Contra Coup- ANSWER Brain injury is contralateral to the external force of injury. The
brain moves away from the external object along with the head, but the brain eventually
impacts the side of the skull, causing damage
A defect in one visual field indicates a lesion in the: - ANSWER Contralateral occipital
lobe or the optic pathway posterior to the optic chiasm
Guideline 12 indicates the clinical indications for ambulatory continuous EEG
recordings- ANSWER Appropriate for documentation and quantification of ictal (clinical
and subclinical) and interictal EEG features and assessment of their relationship to
reported behaviour. It is also applicable in an inpatient setting, particularly when
characterization of EEG features as is required in presurgical evaluation
Loss of pupillary reflexes indicates:- ANSWER Loss of brainstem fuction
Occulocephalic reflex testing: If a comatose patient's head is rotated to the side and the
eyes do not follow the movement of the head, but lag or remain as if fixed on an object:
This indicates: - ANSWER The reflex is positive, brainstem function is present
Testing of oculocephalic reflexes: In a comatose patient, with rotation of the head to one
side, the eyes remain in the same position relative to the head as would occur if the
maneuver were performed in an awake patient. This indicates: - ANSWER The reflex is
absent, brainstem function is impaired
Cold caloric testing A beating nystagmus toward the side of the stimulated ear is
produced by cold water squirted into the ear canal. This indicates that: - ANSWER The
reflex is positive, brainstem function (pons, medulla) is intact
Cold caloric testing No eye movement results from instillation of cold water into the ear
canal. This indicates that: - ANSWER The reflex is absent, brainstem function (pon,
medulla) is impaired
,Babinski sign or plantar response consists of: - ANSWER Upgoing big toe and/or fanning
of all toes when the sole of the foot is stroked with a blunt object from heel towards toes
What three questions must the patient be able to answer in order to be considered
oriented x3 - ANSWER Who they are, where they are, and the current date
4 aspects of the neurological exam which help determine brain death: -ANSWER 1.
Pupillary reflexes, fixed and dilated 2. Cold caloric testing, Absent 3. Oculocephalic
reflexes, absent 4. Response to painful stimuli, absent, not counting spinal reflexes
In decerebrate posturing the arms will: -ANSWER Stiffen and extend at the patient's
side, wrists will flex
In decorticate posturing, the arms will - ANSWER flex over the chest and rotate inward
Stereognosis - ANSWER Ability to recognize objects by touch
Graphesthesia - ANSWER Ability to recognize numbers and letters written on skin by the
sensation of touch
AED treatment options for absence seizures - ANSWER First line: Ethosuximide (Brand
name: Zarontin), Methsuxmide (brand name: Celontin)
First line AED treatment option for infantile spasms: - ANSWER ACTH
(Adrenocorticotropic hormone)
First line AED treatment options for partial seizures - ANSWER First line: 1.
Carbamezipine (Brand name: Carbatrol/Epitol/Equetro) 2. Gabapentin (Brand
name:Neurontin, Gralise) 3. Lacosamide (Brand name: Vimpat)
First line AED treatment option for generalized tonic-clonic seizures are: - ANSWER
, Carbamezipine (Brand: Epitol, Tegretol), Ehtotoin (Brand: Peganone), Phenytoin
(Brand:Dilantin), Primidone (Brand: Mysoline)
Types of seizures is the AED, Clobazam (Brand name: Onfi), used to treat: - ANSWER
Phenobarbital
Types of seizures the AED, Clobazam (Brand name: Onfi), used to treat: - ANSWER
Lennox-Gastaut syndrome
One of the first and oldest seizure drugs, still used in the treatment of epilepsy, and is a
long-acting sedative drug with anticonvulsant action - ANSWER Phenobarbital
Type of seizure the AED, Oxcarbazepine (Brand names: Trileptal, Oxtellar XR), used to
treat: - ANSWER AED types for Focal (Partia) seizures
First line AED treatment option for Juvenile myoclonic epilepsy: - ANSWER Valproic
Acid
AED used for treating seizures that occur in the temporal lobe - ANSWER
Carbamezipine (Brand names: Carbatrol/Tegretol/Epitol/Equestro)
Indications for Corpus Callosotomy - ANSWER Refractory generalized seizures (tonic,
clonic, atonic), resistance to AED therapy and cognitive decline. Infantile hemiplegia
and frontal lobe epilepsy, Rasmussen syndrome. Primary indications have been drop
attacks (tonic, atonic) and in treatment of Lennox-Gastaut syndrome.
EEG changes associated with normal aging - ANSWER Slowing of dominant rhythm,
increase in temporal slowing, bursts of generalized rhythmic delta activity during
drowsiness, diffuse lower voltage
The amplitude of the PDR generally decreases with age due to:
A. Net balance of voltage shift = 0; as the frontal region of cortex increases in voltage