ABRET-EEG Exam (100 out of 100) Questions and Answers (Latest Update) GRADED A.

ABRET-EEG Exam (100 out of 100) Questions and Answers (Latest Update) GRADED A. Question: What is the typical presentation of CJD? ataxia, dementia and myoclonus. Question: Tuberous sclerosis tumors or growths in the brain or other organs Question: What is the most important to document in the history of your EEG patient? Skull defects Question: Moya Moya disease is associated with decreased blood flow to cerebral tissue Question: Papilledema is most common in what condition? Posterior fossa tumor Question: The central sulcus is the anterior boundary of the Parietal lobe Question: PLEDS are most likely to be seen in a patient with cerebral embolus Question: A childhood disorder characterized by acquired aphasia, multifocal epileptiform abnormalities, and focal or generalized seizures: Landau-Kleffner syndrome Question: Reduction of health care associated infections is addressed by National Patient Safety Goals Question: Balanced electrode impedences are important to: lessen 60 hz. interference Question: FT9 or T1 and FT10 or T2 electrodes record from the anterior temporal lobe Question: What type of electricity provides a steady source of current, flowing in one direction only? direct current Question: Impedance can best be described as the resistance to alternating current Question: Ictal during Question: A Business Associate Agreement is required when medical records are shared Question: A lesion of the uncus may result in olfactory hallucinations Question: When testing an outpatient with active Tuberculosis, it is necessary for the patient to wear a mask Question: According to the ABRET Code of Ethics, a credentialed technologist should report to ABRET if: they have been convicted of a felony related to their work in NDT Question: SDS Safety Data Sheet Question: Vagal nerve stimulators are used to treat seizures and depression Question: A violation of ABRET/Code of ethics? Not striving to keep current in the technology Question: What should be documented in the history the patient had dialysis this morning Question: Broca's area lies in the posterior part of the inferior frontal gyrus Question: Ictal EEG time during the event Question: Most closely related to the measurement of voltage in relation to current and resistance? Ohm's law Question: Febrile seizures age-related Question: This occurs with unbalanced electrode impedences of greater than 20kOhms? marked increase in 60 hz. activity Question: What is the most effective way of preventing nosocomial infections? hand hygiene Question: Homonymous hemianopsia loss of the left or right visual field in both eyes Question: Standard of conduct for credentialed technologists? ABRET Code of Ethics Question: Used to treat infantile spasms ACTH Question: Life threatening current could pass through a patient if the machine ground is not intact Question: Focal or unilateral suppression and slowing: subdural hematoma Question: A meningioma is usually encapsulated Question: Indication of the presence of blood in the CSF? subarachnoid hemorrhage Question: The central aspect of using the minimum amount of protected health information needed to accomplish the intended purpose of the use, disclosure, or request is a part of what Act? HIPAA Question: A patient with a right hemiparesis most likely has a lesion of the left frontal lobe Question: According to OSHA, when most electroneurodiagnostic equipment be checked for leakage current, ground resistance and electrical safety? Semiannually Question: The onset of Sturge-Weber disease is typically during Infancy Question: Scotoma area of visual loss Question: ACTH Infantile spasms Question: A stat EEG has been ordered on a women who experienced a GTC seizure. She is confused. While the tech. is running a baseline, a man enters claiming to be her husband. If he asks about the record the tech. should? ask the man to wait for a physician to speak to him Question: Photic driving is most common in what frequency? alpha Question: Photic stimulation should be performed? While awake Question: What activity does NOT typically cause attenuation of PDR in a normal adult. relaxed wakefulness with eyes closed Question: What type of response to PS is characterized by generalized spike and wave discharges continuing after the flash? Question: An asymmetric photic driving response right greater than left is: Normal Question: When using photic stimulation the flash rate that commonly activates a seizure is? 9-13hz. Question: Atypical Photic response? delta driving Question: An EEG obtained during sleep is most valuable in what condition? Focal seizures or status during sleep Question: A 7 year old presents with spells of spacing out. What activation procedure is the most important? Hyperventilation Question: During HV, a 9 y/o pt. develops generalized 100-300 microvolts slowing. If within 30 seconds post HV, the record returns to preHV state the reaction would be? a normal response to HV Question: Hyperventilation Hypocapnia A subharmonic photic driving response is? half the frequency of the strobe What is a contraindication of for HV? Sickle cell anemia What procedure is a non-standard activation? Listening to music PS is most effective in evoking epileptiform abnormalities in patient's with? a family history of seizures What other EEG pattern would you expect to see in a pt. with prominent photic driving response? LAMBDA Photic induced epileptiform discharges are most likely associated with barbiturate withdrawl What could be the cause for a build up of slowing several minutes after HV has been completed? Moya Moya Abnormal presentation to photic stimulation. photoparoxysmal What activation procedure should be avoided in a patient with intracranial hemorrhage? Hyperventilation Photoparoxysmal response EEG response to light with spikes, spike and wave discharges and/or intermittent slow waves An EEG shows eye blink and muscle artifact. What is likely the state of the patient? Awake What is the first thing that should be done when trying to eliminate 60hz. artifact? attempting to eliminate the technical issue Sweat artifact is severely obscuring the EEG. What is the first step the technologist should take to eliminate the artifact? cool the patient down by removing the patient's blanket and fanning them. Glossokinetic Artifact Biological Sweat artifact slow deflection Glossokinetic tongue movement What is the name of the artifact that appears as a prominent R wave with positivity over the left posterior quadrant of the head and can resemble a spike? ECG artifact Eye movement artifact Vertical eye movements are seen over FP1 and FP2 while horizontal eye movements are seen over F7 and F8. Using the International 10/20 system, if the distance from nasion to inion is 34 cm, What is the distance from Fz to Oz? 20.4cm Tuberous sclerosis genetic What is the typical presentation of CJD? progressive dementia, bilateral ridigity, myoclonus, stupor and death Characterized by dementia, myoclonus and biphasic or triphasic repetitive discharges? CJD If the distance from the right preauricular to the right outer canthus is measures 9cm, where should electrode T2 be placed? 3cm out from the preauricular and 1cm up FT9 or T1 and F10 or T2 record from the anterior temporal lobe If the nasion to inion measurement is 40cm, what is the distance between Cz and Pz? 8cm When a large amount of paste is used to hold down an electrode, the total recording area will be? total scalp surface area of the paste The onset of Surge Weber's? Infancy Moya Moya disease is associated with: decreased blood flow to cerebral tissue When would a normal EEG be expected? MS While performing an EEG, C4 is moved 1cm posteriorly. What else should the tech. do? Move C3 1cm posteriorly If a patient has a circumference of 55cm, which of the following interelectrode distances can be calculated? O1-O2 What electrodes gives the least distortion of low frequencies? silver-silver chloride Balanced electrode impedance is important to? lessen 60 hz interference Balanced impedance allows you to? maximize common mode rejection Impedance can be best described as? resistance to alternating current Extremely low voltage due to phase cancellation may be caused by? salt bridge What occurs with unbalanced electrode impedance greater than 20km? marked increase in 60hz acitivity What measures the opposition to current flow when a known voltage is applied? Impedance meter EEG is most useful in encephalopathy Impedance is the resistance of a part of a circuit passage of? altering current Short interelectrode distance between electrodes will cause what change to the EEG waveform? decrease amplitude Broken lead wire during recording requires replacement What is activity is prominent in T4? electrode pop What should be your first reaction to 60hz artifact in one electrode? check electrode impedence What physiological artifact is in the sample? EKG artifact Artifact that is caused by movement of people near the patient? electrostatic artifact 60 hz. filter notch filter If 60hz. is present in to channels of the EEG, the first step in troubleshooting is? check electrode impedance Non-physiologic artifact electrode The EEG activity seen maximally in the frontal leads is? Bifrontal myogenic artifact While recording using a bipolar montage, you notice that the channel C4-P4 is unusually flat compared to the other channels. What is the cause? the electrodes are too close together Calculate the duration of the waveform 150msec. 1 centimeter 10mm Calculate the voltage of the waveform 20-25uv Duration of a sharp wave? 70-200msec What is the frequency of the activity in the box? Delta Voltage V=SD If theta activity from a drowsy child recorded at 7 uv/mm results in a deflection of 20mm, what is the voltage? 140uv Bandwidth of routine EEG activity? 1-70hz. If the sensitivity is 7uv and the voltage is 20uv. what is the measurement of the deflection? 2.9mm What is the duration of a 10hz. wave at a display of 15mm/sec? 100msec. What is the duration of the waveform? 400msec A 50 microvolt wave at sensitivity 5 microvolts/mm produces a deflection of 10mm What is the voltage of a spike if it measures 15mm peak to peak and the sensitivity value is 10mm/mm? 150 microvolts A 9mm deflection at a setting of 20 microvolts/mm will have an input signal of? 180 microvolts In an EEG display at 30mm/sec. a high voltage transient with a duration of 2mm would be a spike LAMBDA waves Visual input Alpha Coma 8-13hz activity occurring diffusely, maximum anteriorly Photoparoxysmal responses are characterized by: generalized irregular spike and wave discharges or polyspike and wave bursts Subclinical Rhythmic Electrographic Discharge in Adults (SREDA) most often appears suddenly in resting EEG It is common in FIRDA to: react to stimulation Diagnostic value? asymmetrical frequency What are the most significant finding in this sample? Generalized spike and wave What differentiates Lambda and POSTS occurs with eyes open BIPLEDS hypoxia What would be considered a focal abnormality? Unilateral spikes Describes secondary bilateral synchrony reflects rapid generalization from one or multiple sources The red box describes? EMG Important in evaluating background frequency? wakefulness and age Hypsarrhythmia disorganized, continuous high voltage slow waves with interspersed multifocal spike wave During neonatal seizures, the EEG most likely shows focal rhythmic activity 25 y/o male w/TBI. What is seen in the sample? Artifact What is happening in the first 2 seconds and the last 2 seconds in the sample? 60hz artifact An EEG pattern least likely to be associated with clinical symptoms? 6hz. spike and wave Mu rhythm 8-10hz What pattern is eliminated by movement of a limb? Mu rhythm Considered abnormal spikes What is NOT an ANCS guideline for ECI recording? record at a standard 7uv/mm for at least 30 minutes of the recording. What is one of the 10 ACNS guidelines for ECI recording? use of double distance montages What medication increases BETA activity? Xanax Eyelid myoclonia with absences, eye closer induced seizures, EEG paroxysms and photosentivity? Jeavons Syndrome What is important for the technologist to document in order to aid in interpretation? The pt. is awake and alert during the recording The eeg activity in the 2nd epoch? Photic driving Laplacian montage source reference derivation What do MITTENS, midline rhythmic theta and trace alternans have in common? All normal waveforms This wave form is caused by arousals K-complex The amount by which the differential amplifier increases the magnitude of the input signal is the? sensitivity Occipital spikes in response to low frequency flashes are commonly seen in what condition? Batten's disease The waveforms contain frequencies high as 100 hertz. What is the Nyquist sampling rate? >200 samples/second The EEG pattern of a pt. with LGS is mostly to show? 1.5hz spike and wave discharges During an ECI recording, what is the highest sensitivity that must be included in the recording? 2uv/mm What is the focus and polarity of the sharply contoured wave in the box? Fp1 negative What type of monitoring would be useful in an EEG patient with syncope? ECG If a patient starts to have a seizure during PS the technologist should? turn off photic stimulation LPDs lateralized periodic discharges The best reference to be used when recording a suspected temporal lobe epilepsy? Cz EEG pattern most likely associated with seizures? TIRDA A patient has generalized tonic-clonic seizure during EEG recording. If one electrode is pulled off, what is the EEG tech. responsibility? protect the patient from injury and keep the EEG running. What additional monitoring should be done in a middle age patient who repeatedly alerts from sleep during the EEG? respiration Infantile spasms electrodecremental event Common cause of generalized beta medications ADA Arrhythmic delta activity Characteristics of complex partial seizures? Automatisms and impaired consciousness By which age should EEG differentiation of the four stages of non-REM sleep should be identified? 6 months Compared to recording from adult patients, pediatric EEG recordings have amplitudes that are? Higher According to the Adult ACNS EEG terminology, a pattern that has at least three independent lateralized pattern with at least one in each hemisphere. multifocal The polarity convention of EEG states that the deflection is up if? input 1 is more negative than input 2 Why is it not best practice to have the pt. sleep throughout the EEG? Unable to evaluate the background frequency Stage N2 sleep is characterized by the presence of sleep spindles At what conceptional age is a delta brush pattern primarily seen? 32-34 weeks A neonatal EEG showing eye movements, body twitches, absent chin myogram and irregular respirations confirms the pt. is in what state? Active sleep No difference in voltage between input 1 and input 2 Equipotential What normal waveform is not seen in the posterior leads? Wickets An electrographic seizure is characterized by? Episodic rhythmic activity. What is the most prominent clinical feature of Dilantin toxicity? ataxia A pt. with right hemisphesis most likely has a lesion on the left? frontal lobe What is the most important to document in the h/o your EEG pt. ? last seizure What is the most important to document in the history of your EEG pt? skull defects What begins with the head and eyes turning to one side? adversive seizure In evaluating abnormal EEG discharges is the most important to document? Level of consciousness and movement What should be documented in the history? the pt. had dialysis that morning A Business Associate Agreement is required when medical records are shared When is it permissible to release patient information to a third party? When the patient provides written consent Once EEG data is acquired there is an expectation that the information will be protected. This means? all staff are accountable for protecting the patient confidentiality The central aspect of using the minimum necessary amount of protected health information needed to accomplish the intended purpose of the use, disclosure or request is a part of which act? HIPAA Used to treat infantile spasms? ACTH ACTH Infantile spams Effect of Phenobarbital on EEG activity Increase BETA activity Used in treatment of only generalized seizures, commonly in absence seizures? Euthosuximide Vagal nerve stimulation is used to treat? seizures and depression With rapidly increasing dosage, what medication will have the most sedative effect on the pt? Barbiturates Periodic lateralized epileptiform discharges are most likely associated with? herpes simplex encephalitis In the EEG lab the major concern of transmission through infection is? blood Best describes a noncritical infectious instrument? has contact with intact skin Papilledema is most common in what condition? Posterior Fossa tumor When a pt. has active TB it is necessary? for the pt. to wear a mask. According to OSHA, when must END equipment be checked for leakage current, ground resistance and electrical safety? semi-annually Reduction of health care associated infections is addressed by? National Patient Safety Goals SDS Safety Data Sheet What is most related to measurement of voltage in relation to current and resistance? Ohm's law What type of electricity provides a steady source of current, flowing in one direction? Direct current Avoid the use of this in EEG, it may increase capacitive current to a dangerous amount. extension cord Life threatening current could pass through a patient if? the machine ground is not intact Violation of ABRET code of ethics? not striving to keep current with technology What is grounds for disciplinary action according to ABRET code of ethics? being ineligible to take credentialing exam after the credential was earned Standard of conduct for credentialed technologist ABRET code of Ethics What extra electrodes would best demonstrated EEG activity associated with focal motor twitching of the right corner of the mouth? C5 Sphenodial electrodes are used to record activity from the? anterior temporal lobes An abbreviated 10/20 placement, respiration, ECG, EOG monitors should be used when recording? neonates What additional electrodes could be placed to help decipher between artifact and cortical activity in this sample? EOG electrodes Cortical EEG recording can be obscured in patients who are tense or anxious due to? myogenic artifact brain abscess Focal polymorphic delta activity At therapeutic levels, phenytion causes what kind of EEG findings? No change A 25 y/o with new onset psychosis is given Ativan 3mg. prior to EEG. How would this effect the EEG Increased BETA activity Prominent feature in Dilantin toxicity? ataxia What is the most common cause of increased BETA? medications Triphasic waves or periodic discharges can seen due to the toxic effect of what medication? Lithium What medication would increase BETA activity? Xanax Phenobarbital Beta activity What drug shows the most observable effect on the EEG? Benzodiazepam N1 sleep is not characterized by? sleep spindles Characteristic of active sleep in a neonate frequent movements Sharply contoured, surface positivity, and seen in clusters over the occipital lobe during drowsiness, describes: POSTS Stage N3 sleep 30% delta activity Slow Lateral Eye Movement drowsy Small Sharp Spikes (SSS) Stage 1-11 sleep What waveform is seen in stage 2 sleep and during arousals, contains 3 components, sharp, slow and fast. K-complex Narocoplepsy sleep-onset REM The EEG finding during REM sleep: Saw tooth waves Sleep spindles may be more irregular or of lower voltage in: elderly patients Hypnagogic Hypersynchrony can be present during arousal state transitions both prior to sleep, onset and following arousal. The wave form is caused by an arousal? K-complex N2 sleep is characterized by the presence of sleep spindles slow lateral eye movement drowsy Vertex waves Central, high amplitude waves that reverse in the midline. Typical of Stage I of Sleep Sharp waves located at the vertex first indicate what state? N1 sleep Typically the latency to REM is 90 minutes Common frequency of sleep spindles? 14 hz. What is the electrical abnormality associated with Breach rhythm? A focal low impedance pathway through the skull What pattern is most likely to be seen during prolonged recordings of a normal awake 30 year old? Lambda Bancauds phenomenon, alpha squeak and paradoxical alpha all have to do with? a reaction of the background Normal activity prominently at C3 and C4 electrode position? Mu PDR or Alpha Rhythm should not be immediately upon eye closure because of what normal variant? Alpha squeak What environmental factors enhance LAMBDA? scanning high complexity visual scene Mu Rhythm C3 and C4 Rare 6-11hz. negative sharp arciform waves, most commonly seen in adults over 30 years in the midtemporal regions? Wickets Mu rhythm and alpha rhythm differ from each other in all of the following respects EXCEPT? frequency LAMBDA waves are: evoked by eye movement What EEG pattern is NOT a result of cerebral anoxia? phantom spike and wave Skull defect Breach rhythm The clonic phase in a generalized tonic-clonic seizure is characterized by: diffuse rhythmic spikes followed by diffuse SSW activity Delta bursts that reappear 3-5 minutes after cessation of HV is a common feature in what disease? Moya Moya disease What feature is most diagnostic of Psychogenic non-epileptic spells? No disruption of the PDR Pt. with temporal lobe epilepsy may display ictal automatisms, which are, sterotyped, repetitive movements, such as lip smacking or rubbing fingers together What type of seizures are associated with Lennox-Gastaut Syndrome? all of them Periodic lateralized epileptiform discharges are found most commonly in the EEGs of patients with acute cerebral infaction Landau-Kleffner syndromeis characterized by electrical status epilepticus of sleep Beta coma most commonly results from: drug overdose The tonic phase of a generalized tonic-clonic seizure is associated with? low voltage rhythmic beta Immediately following an absence seizure, the EEG is most likely to show? normal activity Anoxic encephalopathy BIPLEDS An electrographic seizure is characterized by Episodic rhythmic activity A prolonged series of generalized convulsions without any period of consciousness between them is referred to as; status epilepticus In patients with myoclonic epilepsy of Janz, seizures are mostly likely to occur: Early in the morning A 7 year old male presents with a 6 month history of spells involving numbness/tingling of his tongue. He remains conscious the entire time and occasionally will drool during the spells. What do you expect to see on the EEG? Centro-temporal spikes Partial seizure disorder anterior temporal spike focus The most common EEG correlation of an epileptic aura? temporal epileptiform discharges Non-epileptic events typically result in? Normal EEG Immediately following a generalized tonic-clonic seizure, the EEG typically shows: generalized slowing Common electrographic correlation of a seizure: Rhythmic activity Rhythmic theta activity in the temporal region is most commonly associated with which seizure type: complex partial A waveform of 0.5 hz. can be best enhanced with a filter of? 0.3hz A slow wave focus is best seen with? LF 0.3hz, paper speed 15mm/sec. When attempting to minimize relentless muscle artifact on a recording, the tech. should be aware that lowering the high filter could cause the artifact to resemble? beta activity What settings could be used to reduce the effects sweat artifact in a patient with asymmetrical low voltage fast activity? S=5 microvolts/mm, LF= 5hz. HF= 70 Hz. What montage would best display the amplitude of a left temporal spike? left temporal to the contralateral ear The best reference electrode in an awake patient with excessive temporal myogenic activity would be? Cz Fourteen and six HZ positive spikes are best recorded with? the contralateral ear reference What combination of settings will help enhance a low voltage slow wave that is being masked by muscle activity? Sens 5, LF .3 HF 35 To enhance the background alpha and beta asymmetry in an EEG record showing moderately high voltage delta activity, the tech. should use a? shorter time constant and increased sensitivity The BEST choice of reference to be used when recording in suspected temporal lobe epilepsy is: CZ The most appropriate instrumentation setting change that should be made in order to enhance cortical slowing? Change the LFF from 1hz to .1hz What montage would best localize occipital spikes by phase reversal? circumferential bipolar montage When using the average reference, if a spike and wave focus appears at C3 the abnormality would be best enhanced by? excluding C3 and surrounding electrodes from reference Referential recording is most appropriate for measuring Voltage