CLTM Exam Study Guide 2023
BAEP / R - AnswerBrainstem 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 - AnswerDevelopment 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 - AnswerConcept 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 - AnswerInitial 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 - AnswerAn 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 - AnswerType 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 - AnswerClosed head injury / whiplash. The injury is when brain are damage is
on the same side as the external force of the injury
/.Contra Coup - AnswerBrain 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: - AnswerContralateral occipital
lobe (or optic pathway posterior to the optic chiasm
/.According to guideline 12, the clinical indications for ambulatory continuous EEG
recordings - AnswerAppropriate 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: - AnswerLoss 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: - AnswerThe 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: - AnswerThe 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: - AnswerThe 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: - AnswerThe reflex is absent, brainstem function (pon,
medulla) is impaired
/.The babinski sign or plantar response consists of: - AnswerUpgoing 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 - AnswerWho they are, where they are, and the current date
/.4 aspects of the neurological exam that help to determine brain death: - Answer1.
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: - AnswerStiffen and extend at the patient's
side, wrists will flex
/.In decorticate posturing, the arms will - Answerflex over the chest and rotate inward
/.Stereognosis - AnswerAbility to recognize objects by touch
/.Graphesthesia - AnswerAbility to recognize numbers and letters written on skin by the
sensation of touch
/.AED treatment options for absence seizures - AnswerFirst line: Ethosuximide (Brand
name: Zarontin), Methsuxmide (brand name: Celontin)
, /.First line AED treatment option for infantile spasms: - AnswerACTH
(Adrenocorticotropic hormone)
/.First line AED treatment options for partial seizures - AnswerFirst 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: -
AnswerCarbamezipine (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: -
AnswerPhenobarbital
/.Types of seizures the AED, Clobazam (Brand name: Onfi), used to treat: -
AnswerLennox-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 - AnswerPhenobarbital
/.Type of seizure the AED, Oxcarbazepine (Brand names: Trileptal, Oxtellar XR), used
to treat: - AnswerAED types for Focal (Partia) seizures
/.First line AED treatment option for Juvenile myoclonic epilepsy: - AnswerValproic Acid
/.AED used for treating seizures that occur in the temporal lobe - AnswerCarbamezipine
(Brand names: Carbatrol/Tegretol/Epitol/Equestro)
/.Indications for Corpus Callosotomy - AnswerRefractory 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 - AnswerSlowing 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.
BAEP / R - AnswerBrainstem 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 - AnswerDevelopment 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 - AnswerConcept 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 - AnswerInitial 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 - AnswerAn 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 - AnswerType 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 - AnswerClosed head injury / whiplash. The injury is when brain are damage is
on the same side as the external force of the injury
/.Contra Coup - AnswerBrain 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: - AnswerContralateral occipital
lobe (or optic pathway posterior to the optic chiasm
/.According to guideline 12, the clinical indications for ambulatory continuous EEG
recordings - AnswerAppropriate 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: - AnswerLoss 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: - AnswerThe 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: - AnswerThe 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: - AnswerThe 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: - AnswerThe reflex is absent, brainstem function (pon,
medulla) is impaired
/.The babinski sign or plantar response consists of: - AnswerUpgoing 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 - AnswerWho they are, where they are, and the current date
/.4 aspects of the neurological exam that help to determine brain death: - Answer1.
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: - AnswerStiffen and extend at the patient's
side, wrists will flex
/.In decorticate posturing, the arms will - Answerflex over the chest and rotate inward
/.Stereognosis - AnswerAbility to recognize objects by touch
/.Graphesthesia - AnswerAbility to recognize numbers and letters written on skin by the
sensation of touch
/.AED treatment options for absence seizures - AnswerFirst line: Ethosuximide (Brand
name: Zarontin), Methsuxmide (brand name: Celontin)
, /.First line AED treatment option for infantile spasms: - AnswerACTH
(Adrenocorticotropic hormone)
/.First line AED treatment options for partial seizures - AnswerFirst 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: -
AnswerCarbamezipine (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: -
AnswerPhenobarbital
/.Types of seizures the AED, Clobazam (Brand name: Onfi), used to treat: -
AnswerLennox-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 - AnswerPhenobarbital
/.Type of seizure the AED, Oxcarbazepine (Brand names: Trileptal, Oxtellar XR), used
to treat: - AnswerAED types for Focal (Partia) seizures
/.First line AED treatment option for Juvenile myoclonic epilepsy: - AnswerValproic Acid
/.AED used for treating seizures that occur in the temporal lobe - AnswerCarbamezipine
(Brand names: Carbatrol/Tegretol/Epitol/Equestro)
/.Indications for Corpus Callosotomy - AnswerRefractory 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 - AnswerSlowing 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.
