CLTM EXAM STUDY GUIDE 2024
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 chest and rotate inward
Stereognosis - Ability to recognize objects by touch
Graphesthesia - Ability to recognize numbers and letters written on skin by the
sensation of touch
, AED treatment options for absence seizures - First line: Ethosuximide (Brand name:
Zarontin), Methsuxmide (brand name: Celontin)
First line AED treatment option for infantile spasms: - ACTH (Adrenocorticotropic
hormone)
First line AED treatment options for partial seizures - 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: -
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: -
Phenobarbital
Types of seizures the AED, Clobazam (Brand name: Onfi), used to treat: - 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 - Phenobarbital
Type of seizure the AED, Oxcarbazepine (Brand names: Trileptal, Oxtellar XR), used to
treat: - AED types for Focal (Partia) seizures
First line AED treatment option for Juvenile myoclonic epilepsy: - Valproic Acid
AED used for treating seizures that occur in the temporal lobe - Carbamezipine (Brand
names: Carbatrol/Tegretol/Epitol/Equestro)
Indications for Corpus Callosotomy - 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 - Slowing 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 - 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 chest and rotate inward
Stereognosis - Ability to recognize objects by touch
Graphesthesia - Ability to recognize numbers and letters written on skin by the
sensation of touch
, AED treatment options for absence seizures - First line: Ethosuximide (Brand name:
Zarontin), Methsuxmide (brand name: Celontin)
First line AED treatment option for infantile spasms: - ACTH (Adrenocorticotropic
hormone)
First line AED treatment options for partial seizures - 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: -
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: -
Phenobarbital
Types of seizures the AED, Clobazam (Brand name: Onfi), used to treat: - 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 - Phenobarbital
Type of seizure the AED, Oxcarbazepine (Brand names: Trileptal, Oxtellar XR), used to
treat: - AED types for Focal (Partia) seizures
First line AED treatment option for Juvenile myoclonic epilepsy: - Valproic Acid
AED used for treating seizures that occur in the temporal lobe - Carbamezipine (Brand
names: Carbatrol/Tegretol/Epitol/Equestro)
Indications for Corpus Callosotomy - 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 - Slowing 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.
