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CLTM ASAP (ADVANCED SUPERVISION AND ASSESSMENT
PROTOCOL) BOARD EXAM 2025/2026 ACTUAL EXAM WITH
QUESTIONS AND CORRECT ANSWERS ALREADY GRADED A+
A 40 year old is experiencing an epigastric aura, which EEG contacts would most likely show an abnormality - ANSWER-- 36 - 44 The Rolandic fissure separates the: - ANSWER--Precentral and postcentral gyrus Which contacts would show an abnormality if the patient was experiencing expressive aphasia - ANSWER-- 33 - 34 The common goal of functional mapping is to identify: - ANSWER--Sensorimotor and language area What functions as the lowest risk of being affected if a temporal lobectomy is performed in the dominant hemisphere? - ANSWER--Supplementary Motor Deficits If a patient was experiencing tongue numbness, which contacts would most likely show an EEG abnormality? - ANSWER-- 28 - 29 Cortical responses recorded over the primary somatosensory cortex to median SSEPs are: - ANSWER--Negative near field responses
What is the gold standard test for identifying the motor cortex? - ANSWER--Direct cortical stimulation Thrombosis of the anterior cerebral artery is most likely to cause: - ANSWER-- Contralateral lower extremity weakness The primary motor and sensory cortices surround what landmark? - ANSWER-- Central Sulcus The tracts connecting the right and left hemispheres are called the: - ANSWER-- corpus callosum The central sulcus divides what areas in the cortex? - ANSWER--Frontal and parietal lobes Brocas area lies in the: - ANSWER--Posterior part of the inferior frontal gyrus Which contacts would most likely show an abnormality if the patient was experiencing receptive aphasia - ANSWER-- 38 - 46 What type of seizure often consists of early and prominent motor activity? - ANSWER--Frontal lobe
Cortical potentials for the median nerve Somatosensory Evoked Potentials (SSEPs) are recorded from: - ANSWER--Contralateral parietal lobe Wernicke's area lies in: - ANSWER--Posterior part of the superior temporal gyrus Foramen ovale electrodes provide intracranial EEG near the: - ANSWER--Medial temporal lobe The most common area depth electrodes are inserted in surgical patients: - ANSWER--Medial temporal lobe What is a type of phase 1 pre surgical evaluation for refractory focal epilepsy when paired with a video-EEG (VEEG)? - ANSWER--Ictal SPECT Sphenoidal electrodes are used to record from what region of the brain? - ANSWER--Anterior temporal Functional brain mapping is used to define and confine the excision to - ANSWER-- non-eloquent cortex Stereotatic frames are used to: - ANSWER--place depth electrodes
Long term monitoring in the ICU is most helpful for: - ANSWER--nonconvulsive status epilepticus Intraoperative cortical mapping is performed for identification of: - ANSWER-- Eloquent cortex Basal extra cranial electrodes for recording mesial temporal or frontal discharges are placed in the region of the: - ANSWER--Foramen ovale Cortical stimulation near the inferior frontal gyrus will most likely result in: - ANSWER--Expressive aphasia The purpose of bilateral medial temporal depth electrodes is to: - ANSWER-- Lateralize hippocampal seizures focus Where are sphenoidal locations used to record epileptiform activity - ANSWER-- the medial or anterior aspects of the temporal lobe When identifying the central sulcus, what is the time frame that the phase reversal must occur from the original stimulation in order to prove an actual phase reversal? - ANSWER--Within 2msec
In patient with intracranial grids, excessive widespread polymorphic slowing with attenuated waveforms raises the question of: - ANSWER--Cerebral edema under the grid An appropriate anesthetic regimen for language mapping: - ANSWER--Awake with local Relative to P7, the P9 electrode placement is placed: - ANSWER--10% lateral to P T1 and T2 electrode placement: - ANSWER-- 1 cm superior to 1/3 of the distance from the external eye canthus and the tragus (third closet to tragus) Which electrode from he 10 - 10 system would be useful on a patient with suspected benign rolandic epilepsy - ANSWER--CP EEG changes can be seen when cerebral blood flow falls below: - ANSWER-- 25 - 30ml/100g/minute In the proposed 10 - 10 system what is the designation of the intermediate chain between the fronto polar and frontal leads? - ANSWER--Anterior frontal (AF)
Strip electrodes are usually inserted through a - ANSWER--Burr hole Risks associated with foramen ovale electrodes include: - ANSWER--Facial numbness Which electrodes are used to record from the amygdala, hippocampus, or areas of cortical dysplasia? - ANSWER--Depth Subdural electrodes are commonly composed of: - ANSWER--platinum Depth electrodes are used primarily in patients with: - ANSWER--Medial temporal lobe epilepsy The homunculus is a: - ANSWER--Representation of motor and sensory cortex of the brain Electrode that consist of a row of disks embedded in silastic, or a bundle of fine wires, each tip of which is a recording point known as: - ANSWER--Strip Cortical responses recorded over the supplementary motor cortex to median nerve SSEPs is: - ANSWER--Positive near field responses
Strip and grid electrodes are composed of: - ANSWER--Stainless steel or platinum Strip and grid electrodes contacts are typically separated by inter-electrode distances of: - ANSWER--0.5 cm to 1 cm In the 10 - 20 international electrode system, which electrode is placed halfway between Fp2 and O2 when measuring the circumference? - ANSWER--T The most feared complication of intracranial electrode placement - ANSWER-- Hemorrhage Per ACNS guidelines, what is the m minimum number of EEG channels required for LTME equipment capability? - ANSWER-- 32 - 64 channels According to the international League Against Epilepsy (ILAE) 2015 guidelines for Status Epilepticus (SE) SE can result in neuronal injury and function deficits are likely after: - ANSWER--30 Minutes **ACNS Guidelines recommends that the reference electrode for localization of sensorimotor cortex should be placed - ANSWER--Contralateral scalp or ear
Per ACNS guidelines, LTME equipment must be able to record video for a minimum of: - ANSWER--24 hours ACNS guidelines recommends the following filter performance specifications: - ANSWER--LFF? 1 Hz- HFF 70 HZ PEr ACNS guidelines, an important aspect of montage design for LTME is to clearly separate activity from the: - ANSWER--Basal temporal and 10/20 cortical derivations ACNS Guidelines recommends the following filter performance specifications - ANSWER--LFF 0.5 Hz- HFF 70 Hz According to the international League Against Epilepsy (ILAE) 2015 Guidelines for Status Epilepticus (SE), SE treatment should begin after - ANSWER--5 minutes Digital long term monitoring equipment must be able to record for a minimum of how many hours? - ANSWER-- 24 Crossing of cables is a troubleshooting technique that helps to eliminate what? - ANSWER-- 50 - 60 Hz interference
What does LPD+R stand for in the 2012 ACNS EEG terminology - ANSWER-- lateralized periodic discharges + superimposed rhythmic activity What is the best high frequency filter setting during invasive EEG monitoring - ANSWER--150 Hz **LPDs is the new terminology for what EEG term - ANSWER--PLEDS Checking the impedance of intracranial electrodes poses a risk to a patient because: - ANSWER--alternating current is passed through the electrodes Per ACNS guidelines, epidural, subdural, intracerebral, forâmen ovale- impedance measurements can be safely performed with currents in the range of: - ANSWER-- 10nA Impedance measurements can be safely performed in intracranial electrodes only if: - ANSWER--performed with low currents in the range of 10nA Continuous EEG is more sensitive for seizure detection than routine EEG in which population of patients? - ANSWER--Infants
A typical surgical treatment that is considered for Temporal Love Epilepsy - ANSWER--Focal resection Seizures characterized by hyper salivation, oral-facial apraxia, and at times facial clinic activity, originate: - ANSWER--Frontal operculum Electrical Status Epilepticus in Sleep (ESES) is linked to: - ANSWER--Landau- Kleffner syndrome What EEG pattern is a result of the treatment of status epilepticus - ANSWER-- Burst Suppression the single most definitive localizing feature of the epileptogenic region is - ANSWER--Ictal Onset Zone Automatisms are generally associated with activity generated from which lobe? - ANSWER--Temporal Lennox-Gastaut syndrome is associated with what type of seizure? - ANSWER-- Atypical Absence
Delayed cerebral ischemia occurring after aneurysmal subarachnoid hemorrhage (SAH) is a result of a: - ANSWER--Vasospasm Vasospasm is associated with - ANSWER--Arterial vessel constriction Therapeutic hypothermia is indicated for better outcome in adult patients with: - ANSWER--cardiac arrest What is primarily limited to selected catastrophic infant and early childhood epilepsies - ANSWER--Hemispherectomy One way to differentiate rhythmic epileptic seizure from that of a rhythmical biologic artifact is: - ANSWER--Identification of postictal slowing What should be done in the case of pulse artifact? - ANSWER--Slightly displace the electrode Glossokinetic artifact is considered what type? - ANSWER--Biological An EEG finding that can be seen with Absence epilepsy - ANSWER--OIRDA
Artifact seen when an electrode is sitting over a vessel - ANSWER--Pulse artifact The EEG pattern seen with Ohtahara syndrome is: - ANSWER--burst suppression In comparison to surface EEG, recording from ECoG will present: - ANSWER-- Faster frequencies and higher amplitude During functional brain mapping, a brief train of repetitive spikes following the stimulation at the electrodes closest to the stimulation site represents: - ANSWER--afterdischarges One way to differentiate rhythmic epileptic seizures from that of rhythmic biologic artifacts is: - ANSWER--Identification of postictal slowing ICU patients with a history of hypoxic injury having an EEG characterized by monotonously continuous frontocentral alpha activity that is nonreactive - ANSWER--Alpha coma Landau-Kleffner syndroms usually presents with seizure in which lobe? - ANSWER-
The best trend for evaluation of ischemia is: - ANSWER--alpha variability Triphasic waves are seen when a patient has: - ANSWER--metabolic encephalopathy Subarachnoid Hemorrhage (SAH) causes EEG what? - ANSWER--slowing Rhythmic occipital delta may commonly be seen in: - ANSWER--Children Per ACNS Guidelines, an important aspect of montage design for LTME is to clearly separate activity from the - ANSWER--Basal temporal and 10/20 cortical derivations Based on the 2015 American Red Cross Guidelines for CPR, compression rate for adults is - ANSWER--100/min Based on the 2015 American Red Cross Guidelines for CPR, compression depth for adults is - ANSWER--at least 2"
Based on the 2015 American Red Cross Guidelines for CPR, compression to breaths ratio for adults is: - ANSWER--30 to 2 Olfactory hallucinations are not associated with: - ANSWER--inferior occipital lobe Ictal weeping and pelvic thrusting are characteristics of: - ANSWER--psychogenic seizures Hypothalamic Harmaomas are associated with: - ANSWER--Gelastic seizures Patient with microcephaly presents with flapping hand movements, frequent laughing or unusual smiling and an unusual happy demeanor what syndrome might they have? - ANSWER--Anglelman syndrome Hypsarrhythmia is a pattern most often associated with: - ANSWER--Infantile spasms A patient who experiences epigastric rising followed by a 10 second oral and/or manual automatisms, is unable to respond to verbal commands and has postictal confusion for several minutes most likely indicates: - ANSWER--Complex partial
