CLTM Study Questions with Complete Solutions

BAEP / R 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 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 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 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 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 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 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 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: Contralateral occipital lobe (or optic pathway posterior to the optic chiasm According to guideline 12, the clinical indications for ambulatory continuous EEG recordings 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: 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: 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: 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: 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: The reflex is absent, brainstem function (pon, medulla) is impaired The babinski sign or plantar response consists of: 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 Who they are, where they are, and the current date 4 aspects of the neurological exam that help to determine brain death: 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: Stiffen and extend at the patient's side, wrists will flex In decorticate posturing, the arms will flex over the