CLTM Exam Questions And Answers (Updated And Verified)

CLTM Exam Questions And Answers (Updated And Verified) Kindling - answerDevelopmental of epileptic seizures (in rats) that results from repeated focal stimulation and leads to the development of a predisposition to epileptiform convulsions Just as a large log will not burn unless kindled, the theory suggests epilepsy requires a similar kind of kindling by a sequential series of small electrical stimuli BAER - answerBrainstem auditory evoked response (also called BAEP brainstem auditory evoked potentials). Useful in diagnosis of cerebellopontine angle tumors, multiple sclerosis, brainstem lesions, metabolic and toxic encephalopathies, and early prediction of outcome in postraumatic coma. AED - answerAntiepileptic drug SUDEP - answerSudden unexpected death in epilepsy Most important, direct epilepsy-related cause of death, and excludes deaths resulting from status epilepticus Describe a spike - answerTransient, clearly distinguishable from background activity with pointed peak and a duration: <70 ms Describe a sharp wave - answerTransient, clearly distinguishable from background activity with pointed peak and a duration of 70-200ms Describe a Slow Wave - answerBest described in frequency (3-5hz) or according to frequency bands it occupies (theta, delta activity) Decreases in prominence with age Mirror Focus Phenomenon - answerConcept that an actively discharging epileptiform region may induce similar paroxysmal 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 callosum Aura - answerInitial sensation 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. What is the principle of beneficence - answeran ethical principle that addresses the idea that a medical professionals actions should promote good by having the welfare of the patient as a goal of any treatment. Actions remove harm in any situation and should advocate for high standards for the greater good. qEEG - answerQuantitative EEG allows for visualization of up to several hours of EEG data in a single screen display. Commonly referred to as 'trend analysis'. qEEG trending for seizure detection is based on; amplitude, frequency, rhythmicity, and degree of asymmetry Coup and Contracoup - answerClosed head injury / whiplash. A coup injury is when the brain area damaged is on the same side as the external force of injury. Contracoup is when the 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. For neonates, how is the postmenstrual age (PMA) determined/calculated? - answerPMA = gestational age, measured from the time of the last menstrual period and chronological age. Term = 37 up to 44 weeks of PMA Preterm = <37 weeks of PMA Post-term = 44 to 48 weeks of PMA At what conceptional age do active (REM) and quiet (non-REM) stages of sleep begin to emerge in the EEG of neonates? a. Less than 29 weeks b. 30-32 weeks c. 33-34 weeks d. At 35 weeks - answerb. 30-32 weeks. At this age, wakefulness and active sleep may be differentiated electrographically from quiet sleep, but much is still considered transitional. What is the fastest growing epilepsy population? - answerElderly What is the most common cause of seizures in neonates? Elderly? - answerNeonates: HIE Elderly: Cerebrovascular disease. Especially acute hemorrhagic stroke At what age do most children reach a PDR of 8 Hz? - answer36 Months The amplitude of the PDR (alpha rhythm) generally decreases with age due to: a. Next balance of voltage shift = 0; as the frontal region of cortex increases in voltage with age, the posterior region decreases in voltage. b. increased 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. d. decreased voltage generated by the cortex due to age related degenerative factors. - answerd. decreased voltage generated by the cortex due to age related degenerative factors What is the recommended minimum length of recording for neonates at high risk for seizures? - answer24 hours, continuing until seizure-free for 24 hours. Trace discontinu which appears in a 42 week conceptual age neonate is considered? a. abnormal b. normal c. trace discontinu is not a neonatal EEG pattern - answerA. abnormal Trace discontinu is the defining feature of quiet sleep first emerging around 28 weeks PMA. By 34-36 weeks trace discontinu is seen only in quiet sleep. the amount of time with a trace discontinu pattern decreases with increasing PMA so that a term infant has rare, if any, periods of trace discontinu in quiet sleep By 37-40 weeks trace alternant fully replaces trace discontinu what are some 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. What is the duration of a sleep-wake cycle for a term infant?