CLTM Study UPDATED Exam Questions
and CORRECT Answers
BAEP / R - CORRECT 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 - CORRECT 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 - CORRECT 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 - CORRECT ANSWER - 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 - CORRECT ANSWER - 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 - CORRECT ANSWER - 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 - CORRECT 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 - CORRECT 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 deficit in one visual field indicates a lesion in the: - CORRECT ANSWER -
Contralateral occipital lobe (or optic pathway posterior to the optic chiasm
According to guideline 12, the clinical indications for ambulatory continuous EEG recordings -
CORRECT ANSWER - 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: - CORRECT ANSWER - 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:
- CORRECT ANSWER - 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: - CORRECT ANSWER - 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: - CORRECT ANSWER - 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: - CORRECT ANSWER - The reflex is absent, brainstem function (pon,
medulla) is impaired
,The babinski sign or plantar response consists of: - CORRECT 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
To be considered oriented x3, what questions does the patient need to be able to answer -
CORRECT ANSWER - Who they are, where they are, and the current date
4 aspects of the neurological exam that help to determine brain death: - CORRECT
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: - CORRECT ANSWER - Stiffen and extend at the
patient's side, wrists will flex
In decorticate posturing, the arms will - CORRECT ANSWER - flex over the chest and
rotate inward
Stereognosis - CORRECT ANSWER - Ability to recognize objects by touch
Graphesthesia - CORRECT ANSWER - Ability to recognize numbers and letters written
on skin by the sensation of touch
AED treatment options for absence seizures - CORRECT ANSWER - First line:
Ethosuximide (Brand name: Zarontin), Methsuxmide (brand name: Celontin)
First line AED treatment option for infantile spasms: - CORRECT ANSWER - ACTH
(Adrenocorticotropic hormone)
First line AED treatment options for partial seizures - CORRECT 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: - CORRECT
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: - CORRECT
ANSWER - Phenobarbital
Types of seizures the AED, Clobazam (Brand name: Onfi), used to treat: - CORRECT
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 - CORRECT ANSWER - Phenobarbital
Type of seizure the AED, Oxcarbazepine (Brand names: Trileptal, Oxtellar XR), used to treat: -
CORRECT ANSWER - AED types for Focal (Partia) seizures
First line AED treatment option for Juvenile myoclonic epilepsy: - CORRECT ANSWER -
Valproic Acid
AED used for treating seizures that occur in the temporal lobe - CORRECT ANSWER -
Carbamezipine (Brand names: Carbatrol/Tegretol/Epitol/Equestro)
Indications for Corpus Callosotomy - CORRECT 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 - CORRECT ANSWER - Slowing of dominant
rhythm, increase in temporal slowing, bursts of generalized rhythmic delta activity during
drowsiness, diffuse lower voltage
and CORRECT Answers
BAEP / R - CORRECT 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 - CORRECT 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 - CORRECT 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 - CORRECT ANSWER - 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 - CORRECT ANSWER - 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 - CORRECT ANSWER - 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 - CORRECT 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 - CORRECT 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 deficit in one visual field indicates a lesion in the: - CORRECT ANSWER -
Contralateral occipital lobe (or optic pathway posterior to the optic chiasm
According to guideline 12, the clinical indications for ambulatory continuous EEG recordings -
CORRECT ANSWER - 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: - CORRECT ANSWER - 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:
- CORRECT ANSWER - 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: - CORRECT ANSWER - 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: - CORRECT ANSWER - 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: - CORRECT ANSWER - The reflex is absent, brainstem function (pon,
medulla) is impaired
,The babinski sign or plantar response consists of: - CORRECT 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
To be considered oriented x3, what questions does the patient need to be able to answer -
CORRECT ANSWER - Who they are, where they are, and the current date
4 aspects of the neurological exam that help to determine brain death: - CORRECT
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: - CORRECT ANSWER - Stiffen and extend at the
patient's side, wrists will flex
In decorticate posturing, the arms will - CORRECT ANSWER - flex over the chest and
rotate inward
Stereognosis - CORRECT ANSWER - Ability to recognize objects by touch
Graphesthesia - CORRECT ANSWER - Ability to recognize numbers and letters written
on skin by the sensation of touch
AED treatment options for absence seizures - CORRECT ANSWER - First line:
Ethosuximide (Brand name: Zarontin), Methsuxmide (brand name: Celontin)
First line AED treatment option for infantile spasms: - CORRECT ANSWER - ACTH
(Adrenocorticotropic hormone)
First line AED treatment options for partial seizures - CORRECT 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: - CORRECT
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: - CORRECT
ANSWER - Phenobarbital
Types of seizures the AED, Clobazam (Brand name: Onfi), used to treat: - CORRECT
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 - CORRECT ANSWER - Phenobarbital
Type of seizure the AED, Oxcarbazepine (Brand names: Trileptal, Oxtellar XR), used to treat: -
CORRECT ANSWER - AED types for Focal (Partia) seizures
First line AED treatment option for Juvenile myoclonic epilepsy: - CORRECT ANSWER -
Valproic Acid
AED used for treating seizures that occur in the temporal lobe - CORRECT ANSWER -
Carbamezipine (Brand names: Carbatrol/Tegretol/Epitol/Equestro)
Indications for Corpus Callosotomy - CORRECT 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 - CORRECT ANSWER - Slowing of dominant
rhythm, increase in temporal slowing, bursts of generalized rhythmic delta activity during
drowsiness, diffuse lower voltage
