🧠 Neuroanatomy & Physiology
Which of the following is NOT a major structure of the limbic system?
A) Amygdala
B) Hippocampus
C) Cerebellum
D) Hypothalamus
Answer: C) Cerebellum
A 65-year-old patient presents with sudden onset of right-sided weakness and aphasia. The EEG shows focal delta slowing over the left hemisphere. What is the most likely diagnosis?
A) Migraine with aura
B) Left middle cerebral artery stroke
C) Generalized tonic-clonic seizure
D) Subdural hematoma
Answer: B) Left middle cerebral artery stroke
What is the primary purpose of intraoperative SSEP monitoring according to ACNS Guideline 11B?
A) To monitor cardiac function during surgery
B) To assess the function of somatosensory pathways and localize the sensorimotor cortex during procedures where the spinal cord, brainstem, or cerebrum is at risk
C) To monitor blood pressure
D) To guide anesthetic dosing
Answer: B) To assess the function of somatosensory pathways and localize the sensorimotor cortex during procedures where the spinal cord, brainstem, or cerebrum is at risk
According to ACNS guidelines, how should epileptiform discharges be reported?
A) Only if they occur more than once
B) With details about their location, frequency, and morphology
C) By simply stating "present" or "absent"
D) Only if the patient has a known seizure disorder
Answer: B) With details about their location, frequency, and morphology
What is the primary purpose of including a clinical correlation statement in an EEG report?
A) To summarize the patient's insurance coverage
B) To relate EEG findings to the patient's clinical presentation and history
C) To provide billing codes
D) To list all medications the patient has ever taken
Answer: B) To relate EEG findings to the patient's clinical presentation and history
What is the primary function of the limbic system?
A) Processing visual information
B) Regulation of emotions and memory
C) Control of voluntary movements
D) Regulation of body temperatur
Answer: B) Regulation of emotions and memory
A 7-year-old child is brought in for evaluation after several episodes of staring spells. During hyperventilation, the EEG shows 3 Hz generalized spike-and-wave discharges. What is the most likely diagnosis?
A) Benign Rolandic Epilepsy
B) Absence epilepsy
C) Juvenile myoclonic epilepsy
D) Complex partial seizures
Answer: B) Absence epilepsy
Which type of stimulator is recommended for intraoperative SSEP monitoring?
A) Constant voltage stimulator
B) Constant current stimulator
C) Variable frequency stimulator
D) Manual stimulator
Answer: B) Constant current stimulator
Which of the following is NOT a recommended section in the EEG report according to ACNS Guideline 7?
A) Indication for the study
B) Technical summary
C) Interpretation and impression
D) Patient's social security number
Answer: D) Patient's social security number
According to ACNS Guideline 7, which of the following is a required element in a standard EEG report?
A) The patient's insurance information
B) The technical description of the recording,
including electrode placement and montage
C) The patient's dietary habits
D) The manufacturer of the EEG machine
Answer: B) The technical description of the recording, including electrode placement and montage
The amygdala is primarily responsible for:
A) Coordinating balance
B) Processing fear and aggression
C) Language comprehension
D) Visual processing
Answer: B) Processing fear and aggression
A 45-year-old patient with a history of liver failure is admitted for confusion and asterixis. The EEG shows generalized triphasic waves. What is the most likely underlying condition?
A) Hepatic encephalopathy
B) Creutzfeldt-Jakob disease
C) Nonconvulsive status epilepticus
D) Alzheimer's disease
Answer: A) Hepatic encephalopathy
What is the recommended pulse duration and intensity for peripheral nerve stimulation during SSEP monitoring?
A) 10-50 μs duration, 5-10 mA intensity
B) 100-300 μs duration, 30-40 mA intensity
C) 500-1000 μs duration, 1-5 mA intensity
D) 50-100 μs duration, 100-200 mA intensity
Answer: B) 100-300 μs duration, 30-40 mA intensity
According to the ACNS Nomenclature, which of the following best describes a "Generalized Periodic Discharge" (GPD)?
A) Repetitive, uniform waveforms occurring over one hemisphere
B) Repetitive, uniform waveforms occurring synchronously and symmetrically over both hemispheres
C) Irregular, low amplitude activity
D) Focal spikes in the temporal region
Answer: B) Repetitive, uniform waveforms occurring synchronously and symmetrically over both hemispheres
Which of the following should be documented regarding artifacts in the EEG report?
A) Only if the artifact is caused by the EEG technologist
B) All significant artifacts that may affect interpretation
C) Artifacts should never be mentioned
D) Only muscle artifacts
Answer: B) All significant artifacts that may affect interpretation
Which structure of the limbic system is most closely associated with forming new memories?
A) Thalamus
B) Hippocampus
C) Fornix
D) Cingulate gyrus
Answer: B) Hippocampus
A 3-year-old child presents with developmental delay and frequent clusters of sudden flexor spasms. The EEG shows hypsarrhythmia. What is the most likely diagnosis?
A) Lennox-Gastaut syndrome
B) West syndrome (infantile spasms)
C) Benign childhood epilepsy
D) Ohtahara syndrome
Answer: B) West syndrome (infantile spasms)
Where may the ground electrode be placed to minimize stimulus artifact during SSEP monitoring?
A) On the scalp
B) On the limb being stimulated
C) On the chest
D) On the contralateral limb
Answer: B) On the limb being stimulated
What is the minimum duration required for a pattern to be classified as "periodic" according to the ACNS Nomenclature?
A) 1 second
B) 5 seconds
C) 10 seconds
D) 20 seconds
Answer: C) 10 seconds
When describing the background activity in an EEG report, which detail is most important?
A) The patient's favorite color
B) The frequency, symmetry, and reactivity of the background rhythm
C) The time of day the EEG was performed
D) The patient's family history
Answer: B) The frequency, symmetry, and reactivity of the background rhythm
The hypothalamus is involved in all of the following EXCEPT:
A) Homeostasis
B) Autonomic nervous system regulation
C) Emotional responses
D) Voluntary muscle movement
Answer: D) Voluntary muscle movement
A 60-year-old patient is found unresponsive after a cardiac arrest. The EEG shows burst-suppression pattern. What does this finding most likely indicate?
A) Good prognosis for neurological recovery
B) Deep coma with poor prognosis
C) Nonconvulsive status epilepticus
D) Normal sleep pattern
Answer: B) Deep coma with poor prognosis
Which of the following changes in SSEP is most concerning for possible neural injury during surgery?
A) Increase in amplitude by 10%
B) Decrease in amplitude by 50% or more and/or increase in latency by 10% or more
C) Slight change in waveform shape
D) No change in amplitude or latency
Answer: B) Decrease in amplitude by 50% or more and/or increase in latency by 10% or more
Which of the following is a defining feature of "Rhythmic Delta Activity" (RDA) in the ACNS Nomenclature?
A) Frequency of 4 Hz or greater
B) Frequency less than 4 Hz, lasting at least 6 cycles, with regular morphology
C) Isolated sharp waves
D) Only present during sleep
Answer: B) Frequency less than 4 Hz, lasting at least 6 cycles, with regular morphology
After a collodion spill, what is the recommended method for cleaning up the material?
A) Use water and detergent
B) Absorb with non-reactive material and dispose as hazardous waste
C) Sweep into regular trash
D) Allow to evaporate
Answer: B) Absorb with non-reactive material and dispose as hazardous waste