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CLTM Study Guide – Complete With Solutions
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CLTM Study Guide – Complete With SolutionsBAEP / R ✔️Ans - 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 ✔️Ans - 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 ✔️Ans - 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 ✔️Ans - Initial sensation(s) of a seizure that the patient is aware of in
the absence of observable signs. Provides localizing information in some
cases. Precedes temporal lobe seizures in many cases
The Principle of Beneficence ✔️Ans - An ethical principle that addresses the
idea that a medical professional's actions should promote good by having the
welfare of the patient as a goal of any treatment. Actions should weigh
possible benefits to risks and prevent and remove harm in any situation and
should advocate for high standards for the greater good.
QEEG ✔️Ans - Type of EEG that allows visualization of up to several hours of
EEG data in a single screen display. Commonly referred to as a trend analysis.
This type of EEG trending for seizure detection is based on amplitude,
frequency, rhythmicity and degree of asymmetry.
Coup ✔️Ans - 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 ✔️Ans - 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 deficit in one visual field indicates a lesion in the: ✔️Ans - Contralateral
occipital lobe (or optic pathway posterior to the optic chiasm
According to guideline 12, the clinical indications for ambulatory continuous
EEG recordings ✔️Ans - Appropriate for documentation and quantification of
ictal (clinical and subclinical) and interictal EEG features and assessment of
their relationship to reported behavior. 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: ✔️Ans - Loss of brainstem fuction
Occulocephalic reflex testing: In a comatose patient, when the head is rotated
to the side and the eyes do not follow the head movement, but lag or remain
as if fixed on an object. This indicates: ✔️Ans - The reflex is positive,
brainstem function is present
Oculocephalic reflex testing: In a comatose patient, when the head is rotated
to the side and the eyes stay in the same position relative to the head as they
would in a conscious patient. This indicates: ✔️Ans - The reflex is absent,
brainstem function is impaired
Cold caloric testing: Cold water squirted into the ear canal produces a beating
nystagmus toward the stimulated ear. This indicates: ✔️Ans - The reflex is
positive, brainstem function (pons, medulla) is present
Cold caloric testing: Cold water squirted into the ear canal produces no eye
movement. This indicates: ✔️Ans - The reflex is absent, brainstem function
(pon, medulla) is impaired
The babinski sign or plantar response consists of: ✔️Ans - 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
,To be considered oriented x3, what questions does the patient need to be able
to answer ✔️Ans - Who they are, where they are, and the current date
4 aspects of the neurological exam that help to determine brain death: ✔️Ans
- 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: ✔️Ans - Stiffen and extend at the
patient's side, wrists will flex
In decorticate posturing, the arms will ✔️Ans - flex over the chest and rotate
inward
Stereognosis ✔️Ans - Ability to recognize objects by touch
Graphesthesia ✔️Ans - Ability to recognize numbers and letters written on
skin by the sensation of touch
AED treatment options for absence seizures ✔️Ans - First line: Ethosuximide
(Brand name: Zarontin), Methsuxmide (brand name: Celontin)
First line AED treatment option for infantile spasms: ✔️Ans - ACTH
(Adrenocorticotropic hormone)
First line AED treatment options for partial seizures ✔️Ans - 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:
✔️Ans - 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:
✔️Ans - Phenobarbital
Types of seizures the AED, Clobazam (Brand name: Onfi), used to treat: ✔️Ans
- 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 ✔️Ans
- Phenobarbital
Type of seizure the AED, Oxcarbazepine (Brand names: Trileptal, Oxtellar XR),
used to treat: ✔️Ans - AED types for Focal (Partia) seizures
First line AED treatment option for Juvenile myoclonic epilepsy: ✔️Ans -
Valproic Acid
AED used for treating seizures that occur in the temporal lobe ✔️Ans -
Carbamezipine (Brand names: Carbatrol/Tegretol/Epitol/Equestro)
Indications for Corpus Callosotomy ✔️Ans - 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 ✔️Ans - 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 with age, the posterior region decreases in voltage
B. Increase attenuation due to an alteration in factors between the brain and
scalp, such as bone density and electrical impedance
C. The PDR amplitude does not generally decrease with age.
D. Decreased voltage generated by the cortex due to age related degenerative
factors ✔️Ans - Decreased voltage generated by the cortex due to age related
degenerative factors
Recommended minimum length of recording for neonates at high risk of
seizures ✔️Ans - 24 Hours, continuing until seizure-free for 24 hours
Trace discontinu which appears in a 42-week CA neonate is considered:
A. Abnormal
B. Normal
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