Preparation & Recording Flashcards
(254 cards)
1
Q
The standard epoch length used in polysomnography recordings is?
A
10mm/sec-30 sec epoch or 15mm/sec- 20 sec epoch.
2
Q
The initial recording equipment calibration for polysomnography should show?
A
The filters (high, low and 60Hz) and sensitivity for each channel to be the same.
3
Q
In addition to EEG, EOG and EMG (submental) monitoring what is crucial for the interpretation of a polysomnographic recording in infants?
A
Behaviors and observation.
4
Q
Selet from the following the best initial amplifier conditions for a routine polysomnogram?
A
EMG; LFF-5
HFF-90-120
TC-0.03
EEG/EOG; LFF-0.3
HFF-35
TC-0.4
5
Q
Patient Joe Brown has typical complaints of non restorative sleep. Prior to starting his sleep study he reports that he has recently been treated with sedative medications. During the PSG, you might expect the?
A
EEG activity to show increased alpha and background fast activity.
6
Q
Electrode impedance should not exceed?
A
5,000 ohms
7
Q
The biological calibration at the start of the PSG should include:
A
eyes open, eyes closed, look left, look right,up,down,blink eyes 5X slowly;grit teeth,clench jaw or smile; inhale, exhale,hold breath 10 sec; flex left foot,right foot; and documentation of each action.
8
Q
When calibrating an analog EEG system, it is necessary to?
A
Allow time for the pens to return to baseline.
9
Q
An alternating EEG pattern seen in full-term, sleeping (NREM) in fats consisting of both high and low voltage activity is termed?
A
Trace alternant.
10
Q
Unequal spacing between lines of the various channels with the amplifiers in the “off” or “standby” position requires an adjustment in the?
A
Mechanical baseline.
11
Q
What should be documented on the record at the start of every recording?
A
Time of recording onset and body position.
12
Q
What is the minimum recording time required for a polysomnograph from “ lights out” to “lights on”
A
6.5 hours.
13
Q
In this illustration, channel “2” needs and adjustment in the?
A
Electrical baseline
14
Q
When observing the adult patient during a polysomnography recording, the technologist should document all of the following except:
A
Facial expression.
15
Q
The minimum study duration for an accurate assessment of neonatal sleep is?
A
3 hours and or 2 feeding.
16
Q
Prior to the sleep study, electrodes are applied to the chin to record EMG activity. These are?
A
Placed beneath the chin, overlying the mentalis/submentalis muscles.
17
Q
During the polysomnogram, all of the following should be monitored and documented except?
A
Sleep stages, physiologic calibrations,and dream content.
18
Q
The ECG is recorded during sleep for the following reasons except?
A
to determine the patient’s ejection fraction.
19
Q
If abnormal EEG waveforms appear during the PSG, the paper speed should be changed to?
A
60 mm/sec
20
Q
Why should backup recording electrodes be placed on the patient?
A
To prevent waking the patient to reapplying electrodes.
21
Q
The standard chart or paper speed for PSG is?
A
10 mm/sec.
22
Q
With eye leads placed at the left outer canthus (1 cm out and 1cm down) and at the right outer can thus (1 cm out and 1 cm up), the eye movements in the diagram are?
A
eyes closed.
23
Q
At 10 mm per second, each epoch represents how many seconds?
A
30 sec.
24
Q
Short time constants should be used when recording which of the following physiologic variables?
A
EMG.
25
Out-of-phase signals in the LOC-A2 and ROC-A1 derivations indicate?
eye movements.
26
The most appropriate time constant to use when recording respirations is?
1.00 sec.
27
The eye movements in the diagram could be produced by?
right prosthetic eye.
28
With the right outer can thus eye lead (ROC) positioned 1cm lateral to and 1cm above the outer canthus, eye opening will result in the ROC becoming?
negatively charged.
29
Sleep transients recorded with a C3-A1 derivation, rather than a C3-A2 derivation, will result in?
lower amplitude sleep spindles.
30
The location of electrode "X" is:
F7
31
A complete absence of effort in respiratory monitoring channels indicates?
a central apnea event.
32
The most appropriate high frequency filter to use when recording EMG is?
70 Hz.
33
All of the following devices monitor airflow on a polysomnogram except?
inductive plethysmography utilizing a conductive wire.
34
All of the following areas must be monitored during routine polysomnography except:
F3-A2
35
During instrumentation calibration, one pen deflection lagging behind the others requires correction of the?
time axis.
36
REM periods become shorter and less intense throughout the sleep period?
false.
37
Sleep staging in infants can be defined as?
indeterminate sleep, active REM sleep, quiet sleep.
38
When scoring an MSLT, sleep onset is defined as the elapsed time from?
lights out to the first epoch scored sleep.
39
ASDA criteria for scoring an arousal include?
an EEG frequency shift of at least 3 seconds.
40
REM sleep tends to predominate?
during the latter third of the sleep period.
41
When scoring an MSLT, "mean sleep latency", is defined as the?
average of the sleep latency for all naps recorded.
42
How many sleep-onset REM episodes in a series of five sleep latency tests are diagnostic of narcolepsy?
2
43
The following are hallmarks of stage 1 sleep except?
rhythmic 12-14 hertz activity lasting >0.5 seconds.
44
For the scoring technologist, the primary reason to record eye movement activity is?
All of the above.
45
Which nap was terminated incorrectly according to established criteria?
Lights out---160 200 -280 340 400
Sleep onset-164--220--0----342 410
REM onset--170---0-----0---344 412
End -194--260--320--372--440
Nap 2
46
```
What is the mean sleep latency, rounded to the nearest minute?
Lights out---160 200 -280 340 400
Sleep onset-164--220--0----342 410
REM onset--170---0-----0---344 412
End -194--260--320--372--440
```
8 minutes
47
```
What is the REM latency in Nap 1?
Lights out---160 200 -280 340 400
Sleep onset-164--220--0----342 410
REM onset--170---0-----0---344 412
End -194--260--320--372--440
```
3 minutes.
48
```
What is the sleep latency in Nap 2?
Lights out---160 200 -280 340 400
Sleep onset-164--220--0----342 410
REM onset--170---0-----0---344 412
End -194--260--320--372--440
```
10 minutes.
49
```
When calculating mean sleep latency, how is Nap 3 scored?
Lights out---160 200 -280 340 400
Sleep onset-164--220--0----342 410
REM onset--170---0-----0---344 412
End -194--260--320--372--440
```
20 minutes.
50
```
Does this MSLT meet criteria for a diagnosis of narcolepsy?
Lights out---160 200 -280 340 400
Sleep onset-164--220--0----342 410
REM onset--170---0-----0---344 412
End -194--260--320--372--440
```
yes.
51
The following waveform is a marker for stage 2 sleep (in the absence of >20% 75uV delta activity?
sleep spindles.
52
The scoring of stage 3 sleep requires the following?
20 to 50% activity of 2 hertz or slower and greater than 75uV.
53
A 30-second epoch scored as stage 1 sleep can contain any of the below except?
20 seconds of 75uV 2 Hz activity in the first half of the epoch.
54
When scoring the MSLT, "REM latency" is defined as the?
time from sleep onset to the first epoch that can be scored as REM.
55
The adult sleep tracing you are scoring shows sleep spindles and /or K-complexes that stop for seven consecutive, 30 second epochs with stable, relatively high amplitude chin EMG. The period following the last spindle or K-complex should be scored as?
stage 1
56
Following MSLTs, a mean sleep latency of less than 5 minutes indicates?
a pathological level of daytime sleepiness.
57
Amplitude criteria for scoring of stage 4 sleep are influenced by?
Electrode resistance,Time constants,Interelectrode distances.
ALL OF THE ABOVE.
58
The staging of REM sleep requires?
A coincidence of all of the above.
59
"Sawtooth waves" are?
Seen during REM sleep in some patients.
60
Delta sleep is?
stages 3 and 4 combined.
61
Movement time is scored when?
50% of the epoch contains movement artifact and epochs before and after are scored as sleep.
62
An MSLT nap period during which no sleep is recorded would be scored as?
20 minutes in duration.
63
Generally in non-REM sleep, the patient will exhibit a decrease in?
Heart rate and blood pressure.
64
An epoch with 20% delta activity(>75uV combined with relatively high amplitude 7-10Hz activity?
is termed alpha-delta sleep, may be seen in patients with fibrositis, is frequently associated with subjectively "non restorative" sleep.
65
Limb movements must include the following to qualify as PLMS?
four or more consecutive movements.
66
An obstructive apnea is scored when?
cessation of airflow is accompanied by continued effort.
67
Sleep latency is calculated?
From lights out until the first 3 consecutive epochs of stage 1 sleep or any other sleep stage epoch.
68
Total sleep time is?
total of non-REM +REM sleep time.
69
The percentage of stage REM is based on the?
total sleep time.
70
When scoring the PSG, the REM latency is generally calculated?
from sleep onset.
71
Scoring of an obstructive hypopnea may be aided greatly by?
Esophageal pressure measurements, intercostal EMG recording, diaphragmatic EMG.
72
Sleep efficiency is?
the ratio of total sleep time to time in bed.
73
The duration of an apenic episode is calculated from the?
end of exhalation to the beginning of the next inhalation.
74
Body movement(s)?
are discrete physiologic events, which can occur during stages or movement time.
75
The average number of apneas + hypopneas per hour of sleep is the?
respiratory disturbance index.
76
The formula for calculation of the PLM arousal index is?
the number of PLMS with arousal time 6 divided by total sleep time.
77
The occurrence of multiple K-complexes at the termination of an apnea without an accompanying EEG frequency shift?
does not meet criteria for scoring of an arousal.
78
The major goal for defying movement arousals is to?
signal the possibility of a stage change.
79
Sleep stage percentages may be calculated by using?
total recording time (dark time),total sleep time(total non-REM+total REM), sleep period time (time from sleep onset to sleep offset including intervening arousals)
80
A REM latency of ----------------------- would be considered normal in an adult.
90 - 120 minutes.
81
The total time scored as wakefulness occurring between sleep onset and the final wake up is called?
wake time
82
REM cycles are calculated?
from the end of one REM period to the beginning of the next.
83
REM sleep occurring at 7.5 minutes after sleep onset is?
defined as sleep onset REM (SOREM)
84
When scoring an apnea/hypopnea event of short duration the technologist may notice?
no evident desaturation.
85
While recording at a sensitivity setting of 5 uV/mm, in order for slow wave to meet R & K scoring criteria for stages 3 or 4 sleep, how many millimeters in amplitude must they measure?
15 mm.
86
EMG from which muscle groups are used as a criterion for staging REM sleep?
mentalis/submentalis.
87
During this stage of sleep, the EEG converts to a relatively low-voltage, mixed-frequency pattern, theta activity appears, and eye movements became slow, rolling and disconjugate?
stage 1
88
These two stages are often combined and termed "slow-wave sleep" (SWS)?
3 and 4
89
When scoring stage 3 sleep, the amplitude and frequency of the slow waves must be a minimum of?
75uV, and < 2 Hz.
90
Sleep spindles and K-complexes appear on the EEG what stage of sleep?
stage 2
91
REM sleep is associated with dreaming and fleeting eye movements as well as?
muscle twitching, a generalized decrease in body tone, irregular respiration, heartbeat, and blood pressure.
92
Sleep spindles?
are 9-13cps waveforms,wax and wane in amplitude,are at least 0.5 second in duration.
93
Stage 2 sleep makes up aha percentage of the total sleep time in healthy young adults?
45-55%
94
When scoring the PSG of an apneic patient, the respiratory disturbance index reflects the?
average number of respiratory events per hour of sleep.
95
The scoring of a hypopnea requires?
an amplitude reduction in respiratory channels, a drop in 02 saturation.
96
Arousal thresholds are higher in stage 2 than in stage 1.
true.
97
REM sleep makes up what percentage of the total sleep time in healthy young adults?
20-25%
98
K-complexes?
have an initial negative deflection, followed by a positive deflection.
99
In normal, healthy, young adults, sleep is entered through-----------------sleep, whereas infants normally enter sleep through-------------sleep.
NREM,REM
100
The intermittent demostration of sinus block on the ECG should alert the technologist to?
document the occurrence for the polysomnographer.
101
Before any standard CPR techniques are started on a patient, "Basic Life Support" (BLS) protocols require the healthcare provider to?
establish the patient's unresponsiveness.
102
All of the following are Universal Precautions recommended by the Centers for Disease Control except?
the isolation of patients with disease-specific infections in private rooms.
103
A chest compression land-mark for the adult is the?
lower half of the sternum.
104
The following is true of sodium hypochlorite as a liquid chemical disinfectant?
it is inexpensive, and fast acting.
105
The "Heimlich Maneuver" on the adult consists of?
giving abdominal thrusts to the patient.
106
BLS protocols state that the rate of resuscitative breathing for the adult should be?
12 breaths/minute.
107
In the event of a major tonic-clonic seizure occurring while the patient is in the lab, the technologist is responsible to?
leave the recording running and keep the patient from physical harm, leave the side rails in the up position, carefully observe and document all clinical patient signs.
108
Items considered to require high to intermediate level disinfection in the sleep lab include?
surface electrodes (if the skin is abraded with a blunted syringe tip). nasal/oral thermocouples and CPAP/BiPAP mask and tubing.
109
Which of the following defines "microshock"?
low value current passing directly through the heart with a potential difference existing between two separate points of contact.
110
BLS protocols suggest the rate of resuscitative breathing for the infant (less than one year of age) should be?
20 breaths/minutes.
111
A commonly used liquid chemical disinfectant is?
glutaraldehyde.
112
According to BLS protocols, the place of choice to check for a pulse in the adult is?
the carotid at the neck.
113
The worst possible result of microshock occurring to a catheterized patient (inserted into an artery or vein) is?
ventricular fibrillation.
114
The responsibility for electrical safety within any sleep disorders center or medical institution rests with?
administration,biomedical engineers,and technicians,sleep disorders center technical staff, nursing and and ancillary support staff. sleep disorders center medical/professional staff..
115
If while recording a polysomnogram, the technologist touches bare metal of the instrument and receives a tingling shock?
d. the technologist has just received a macroshock , the technologist must report the incident immediately to the appropriate designated people.
116
Should chest compressions become necessary, the recommended BLS compression rate for the adult is?
a. 80-100/minute
117
One of the greatest contributors to the potential for patient microshock is?
d. broken power cable/plugs, faulty power receptacles,poor ground connections
118
OSHA has set the permissible short-term exposure limit for ethyl ether (agent in collodion) at 500 parts per million. The typical application for a sleep study exposes the technologist and patient to?
d. 45 ppm
119
According to Basic Life Support protocols, after confirming the patient's unresponsiveness, the next immediate step for the healthcare provider is to?
c. open the patients airway
120
Needles and "sharps" used in the sleep lab should be?
b. disposable whenever possible and discarded in biohazard containers
121
ECG arrhythmias that require immediate implementation of emergency life saving procedures without delay would be?
d. ventricular standstill/asystole,ventricular tachycardia, and ventricular fibrillation
122
Standards for electrical safety in patient recording areas include?
d. removing any electrical devices and checking the physical condition of all equipment , keeping all liquids away from instruments.
123
What is the minimum number of naps to be performed during the MSLT study?
b. 4
124
Paradoxical breathing is defined as?
c. respiratory effort from the chest and abdomen in opposition exchange.
125
What is the goal of the MSLT?
c. to measure the speed of falling asleep in a sleep inducing environment and in the absence of competing stimuli
126
The average duration for an apneic event is?
b. 20-30 seconds
127
CPAP pressure set too low may result in?
d. continued hypoventilation and hypoxemia
128
Epileptiform activity during the polysomnogram is?
c. best displayed utilizing additional eeg channels
129
When determining the proper CPAP mask size for the patient it is important to check that?
c. leaks are not present
130
The patient position that usually requires a higher CPAP pressure is?
b. supine
131
MSLT studies performed after nocturnal recording should begin?
a. 1 1/2- 3 hours after the end of the nocturnal recording
132
When performing a CPAP titration you would increase the pressure if?
c. snoring is heard
133
The objectives of CPAP/BiPAP are all of the following except?
c. the improvement of total lung capacity
134
When snoring affects sleep onset during MSLT, what monitors should be utilized?
c. measures of respiratory flows/respiratory sounds
135
The most frequently observed cardiac arrhythmia seen with obstructive sleep apnea during polysomnography is?
a. bradytachycardia
136
Effective treatment with CPAP is evidenced by all of the following except the?
a. restoration of arousals
137
The initial pressure setting for CPAP titration should be?
b. 3-5 cm h20
138
In order to evaluate the occurrence of REM during an MSLT, the recording should continue?
b. 15 minutes after the first epoch of sleep
139
A complete absence of effort in respiratory monitoring channels indicates?
a. a central apnea event
140
During the NPT, penile circumference changes are monitored using?
d. mercury-filled strain gauge electrodes
141
A desaturation during an apnea/hypopnea can be related to all of the following except?
d. chin movement
142
The patient effectively treated with CPAP for the first time must be observed for the undesirable occurrence of?
c. severe hypoxia or hypercarbia
143
Supplemental 02 may be required with CPAP treatment for the following disorder(s)?
b. chronic lung disease and congestive heart failure
144
During a respiratory event it is possible to observe all the following except?
d. ringing in the ears
145
CPAP pressures set too high may cause?
b. intolerance of the treatment and triggering of central apneas
146
A specific scenario for a clinical MSLT could be?
c. lights out, no sleep recorded, end nap in 20 minutes
147
In the patient with a history of moderate, habitual, chronic use of alcohol, what considerations should be present to lead to permission for the patient to continue the habit prior to the sleep study (with physician approval)?
d. it is the first night evaluative psg testing, this is a non-nucturnal hypoexmia patient, there is no opportunity for a second night evaluative study.
148
Drugs known to affect sleep latency or REM latency should be?
a. withdrawn 2 weeks prior to the mslt study
149
The main objective of CPAP is to?
c. mechanically splint the airway to avoid occlusion during sleep.
150
MSLTs for evening and night shift workers should be scheduled?
a. 1 1/2 to 3 hours after waking from their routine scheduled sleep.
151
Which of the following is not true of end tidal CO2 monitoring?
B. it measures inspired Co2.
152
Which cardiac finding is likely to be associated with desaturation during a sleep apnea episode ?
a. A mixed apnea.
153
An apneic event with both a central and an obstructive component is?
a. A mixed apnea
154
Subcutaneous monitoring devices have an approximate delay in detection of arterial saturation of?
c. 10 - 20 second.
155
Snoring seen with obstructive sleep apnea syndrome is?
b. loud and alternating with periods of silence.
156
To prepare properly for a full night PSG recording in a patient who has suspected sleep terrors and sleepwalking, some of the following precautions might be considered?
e. remove anything potentially hazardous from the bedroom. Cover glass windows/mirrors with heavy drapes/cloth.
157
The goal of raising the head of the bed in cases of suspected sleep related esophageal reflux is to?
Reduce the possibility of pulmonary aspiration.
158
One of the contraindications for the use of CPAP is?
Communication between the nasal pathway and cerebrospinal fluid (pneumocephalus).
159
Hospitalization in an intensive care unit,and the scheduling of a PSG as soon as possible, are indicated for a patient with suspected obstructive sleep apnea and?
Respiratory failure, obtundation, severe carbon dioxide retention.
160
Various ventilatory effort monitoring devices include all of the following except?
Limb electromyography.
161
Which of the following conditions are known to adversely affect breathing during sleep in patient with suspected sleep apnea?
Chronic bronchitis, bronchial asthma, heart disease.
162
To attempt to reduce the chance of broncho-constriction in the patient with nocturnal asthma, it may be best to?
c. Increase the room temperature by 10 degrees and the humidity to 90-100 percent.
163
On the average,when using a bilevel system, the expiratory pressure level should be?
5 cm H2o less than inspiratory pressure.
164
When performing a CPAP titration it is important for the sleeping patient to have?
All stages of sleep.
165
Oxygen added to a CPAP titration should be delivered as?
c. Low flow.
166
Periodic breathing in premature newborns occurs more frequently during which sleep stage?
a. REM sleep.
167
Desaturation below 65% is considered severe and reduction to 85%are considered?
c. Mild.
168
When measuring oxygen saturation it is important to include all of the following except?
d. An exercise saturation level.
169
Which of the following instrumentation changes should be made when recording nocturnal seizures?
a. Increase paper speed.
170
The home care groups distributing CPAP units should?
b. be able to identify and rectify problems.
171
A side effect of CPAP use can be?
c. Nasal congestion.
172
An esophageal pressure monitor is not?
a. A high-frequency electrical signal applied to the chest wall.
173
Sleep walking and night terrors can develop at what age?
c. At any age.
174
Patient John jones has come in for his polysomnogram. While discussing the patient's history, John states he drinks one pot of coffee per day and smoke two packs of cigarettes per day. His chief complaint is not being able to fall asleep. His caffeine and nicotine intake may cause his EEG to show?
d. An increase in beta activity and a decrease in the voltage of alpha.
175
Which of the following is not a parasomnia of childhood?
d. SIDS
176
Lorazepam, a benzodiazepine, generally affects sleep by?
b. suppressing slow wave sleep but has no consistent effect on REM sleep.
177
A Cheyne-Stroke breathing pattern on the PSG can appear as?
c. Central apnea occurring without arousals or snoring.
178
When interviewing patient Mary Jones during set-up in the sleep lab, Mary states that Eisenhower is the President, she wants to know why you are in her home, and she wonder why Bod ( her deceased husband) is not with her. You speculate that Mary may have?
c. Dementia, with her major complaint being insomnia.
179
A sleep pattern associated with nonrestorative sleep, possibly in association with fibrositis, rheumatoid arthritis and other pain disorder is called?
d. Alpha-delta sleep.
180
Seizures that appear by age 10 and typically occur at sleep onset and just prior to waking are?
d. Benign rolandic.
181
The relationship between premature ventricular complex (PVC) frequency and SaO2 in patient with moderate to severe sleep apnea is:
b. in patients desaturating 90%.
182
All of the following are known to affect REM sleep patterns except?
a. Diuretics.
183
Patient Bobby Jones, age 45, states he cannot sleep and that he is awake most of the night.
He is approximately 40 pounds overweight and is 'always tired' his spouse states he is a "night owl" and sleeps very little.
b. the PSG should be run to rule out an insomnia with an underlying sleep apnea or periodic limb movement disorder.
184
In patient with a history of possible seizures during the night, the PSG should?
c. Include more channels for EEG recording and periods with 30 mm/sec paper speeds.
185
Episodes of recurrent, excessive somnolence, overeating, sexual dysfunction, and mental disturbances in adolescent boys may indicate a diagnosis of?
c. Kleine-levin syndrome.
186
The most common cardiac dysrhythmia observed in patients with obstructive sleep apnea is?
d. Sinus arrhythmia.
187
When does the manifestation of narcolepsy typically become apparent?
b. age 15 to 25.
188
The onset of epilepsy most commonly occurs during?
a. Infancy through adolescence.
189
An ECG arrhythmia waveform that has a rate of 100-220 beats/minutes approximately and has a wide, slurred complex typical of repetitive PVCs is defined as?
c. Ventricular tachycardia.
190
In children, central, mixed, and obstructive events during sleep can be associated with?
a. Esophageal reflux.
191
Sleep onset REM episodes during an MSLT can indicate?
a. Fragmented nocturnal sleep, narcolepsy, and sleep apnea.
192
Which of the following drugs are know to affects sleep latency?
c. Antihistamines
193
In children between 2 and 6 years of ages, a respiratory distress index (RDI) is considered to be?
a. High.
194
The following are criteria for the diagnosis of REM behavior disorders except?
b. absence of chin EMG?
195
All of the following are true of cataplectic attacks except?
c. They occur in REM sleep?
196
Bradycardia is defined as a?
b heart rate <60 beats per minute.
197
In children, sleep talking occurs during wich sleep stage of sleep?
d. Stage 1-2 sleep, REM sleep, slow wave.
198
The narcoleptic patient may experience sleep paralysis, which can occur with all of the following except?
c. Hyperventilation.
199
An absence of all ECG electrical waveforms for a duration greater than ten seconds represents?
d. Ventricular standstill/asystole
200
Which of the following is not a possible cause of life threatening sleep apnea in an infant?
d. Parasomnias.
201
Sleep walking usually begins?
a. During stage 4 sleep.
202
An increase in 14-18 Hz spindles has been noted in?
a. Hypnotic dependent sleep disorder.
203
Consistent asymmetry of sleep spindles is considered?
b. abnormal.
204
A heart rate greater than 100 is called?
a. Tachycardia.
205
Epileptiform discharges during sleep?
c. Are suppressed during REM sleep.
206
An ECG arrhythmia waveform that displays no uniformity but a rapid, repetitive series of bizarre chaotic waves is defined as?
a. Ventricular fibrillation.
207
A patient history of episodic, uncontrollable screaming and amnesia during the first third of the night suggests?
c. Sleep terrors.
208
Spindles usually appear during which month of life?
b. second.
209
A patient history that reflects complaints of nocturnal awakenings with chest discomfort, choking, heartburn and a sour taste in the mouth are indications of the presence of?
b. sleep related esophageal reflux.
210
After 2 years of CPAP therapy the patient returns to the doctor with complaints of excessive daytime sleepiness. The cause could be?
d. Alcohol use, a damaged mask, nasal obstruction.
211
During normal sleep, the need for oxygen is?
b. decreased by 10-25%.
212
Nocturnal hypoxemia associated with sleep disordered breathing may contribute to all of the following except?
c. Manic depression.
213
A patient with generalized anxiety disorder may typically have all of the following except?
c. Increased REM.
214
A patient having complaints of insomnia, drinks nine cups of coffee per day, and has two cigarettes with a beer before bedtime?
b. needs instruction on proper sleep hygiene.
215
Caffeine leads to all of the following except?
a. Increased PLMS.
216
Which of the following is not a good indicator of obstructive sleep apnea on physical exam?
d. Depth of orbits.
217
A patient with complaints of fatique, hypnagogic hallucinations, personality changes, and headaches may have the diagnosis of?
c. EDS.
218
When discussing the patient's reason for referral for polysomnography, the patent states he has morning headaches, choking,gasping for air and awakenings during the night. You analyze this information and determine that the patient may be dealing with?
b. sleep apnea.
219
Narcolepsy is characterized by all of the following except?
d. Muscle twitching in REM
220
Sleepwalking and night terrors have all but one of the following characteristics?
a. Occur only in children.
221
Patient with REM behavior disorder may have all of the following except?
c. Seizure activity before arousal during REM.
222
Hypnic myoclonia is a term used to describe generalized or localized involuntary muscle contraction that may occur during the transition from wakefulness to sleep. These hypnic jerks are?
Often associated with altered perceptions or images of falling, a normal occurrence, may appear more frequently during times of stress and altered or irregular sleep-wake schedules.
223
this disorder is characterized by the intrusion of REM sleep into the waking state or into the transition periods between waking and sleep.
c. narcolepsy
224
__________ occur(s) just ater awakening or when relaxing before sleep. although it last inly seconds to minutes, it can be very frightening because consciousness is maintained, but muscle tone is lost.
d. sleep paralysis
225
the evaluation of premature neonatal EEG is based on the _____ age.
c. conceptional
226
drowsiness becomes a recognizable state on the EEG at what age ?
c. 6 to 8 months.
227
in central sleep apnea, there is an intermittent obstruction of the oropharyngeal airway.
b. false
228
cessation of airflow through the nose and mouth, with respiratory effort continuing in the chest or abdomen suggests which type of sleep apnea ?
b. obstructive
229
this disordered of characterized by rhythmic extensions of the big toe and ankle, occurring in clusters.
b. periodic movements
230
in obstructive apnea,
b. the respiratory drive is unchanged and thoracoabdominal movements continue.
231
what is the most commonly encountered spindle frequency?
d. 14/sec
232
patients with restless leg syndrome .
d. experience nagging,itching,roving dysesthesias in the legs , may have delayed sleep onset, experience excessive daytime sleepiness.
233
vertex waves and k complexes of considerable voltage are usually seen around what age?
a. 5 months
234
characterized by a loss of body tone without loss of consciousness, these briefs attacks may occur during periods of sudden excitement and emotional change.
a. cataplexy
235
an infant's gestational age pus the age after birth equals the _____ age.
a. conceptional
236
the most common cause of sudden death in patients with coronary heart disease is
c. ventricular fibrillation
237
Gastroesophageal reflux is identified when the esophageal pH falls below
b. 4 for greater than 30 seconds
238
the infant's ______ age is calculated from the first date of the last menstrual period to birth.
c. gestational
239
the patients should be referred for more complete neurodiagnostic studies when that occurs?
d. the patient has seizure during the night.
240
a 50uv calibration signal at a sensitivity of 5uv/mm causes a .pen deflection
a. 10 mm
241
the use of the 60 Hz filters during the PSGH is appropriate
d. 1mm
242
a direct current (DC) amplifier is characterized by the
a. absence of the low frequency filter
243
the review of computer acquired PSG data is affected by the
d. digitizing rate, length of displayed epoch, type,size and resolution of the monitor.
244
what is a common cause of electrode artifact?
b. unequal electrode impedances
245
the electrical baseline in a DC channel may be adjusted to its lowest position in order to
c. offer a wider pen deflection range for the oxygen saturation scale.
246
the time-axis alignment on an analog instrument is most easily evaluated at a paper speed of
d. 60 mm/sec
247
what creates the appearance of "sweat artifact" on the PSG tracing?
b. a change in skin resistance
248
one of the most important factors in digitization of polysomnographic data is
b. adequacy of sampling rates
249
the common mode rejection ratio of a differential amplifier should be at least:
c. 10,000:1
250
the advantages to recording with digital instrumentation include
c. the ability to store large amounts of data on computer disks.
251
at the standard polysomnography paper speed of 10mm/sec, the time between one bold line to the next bold line on the recording paper represents how many milliseconds
d. 3000
252
which of the following low filter settings has the longest time constant?
d. 0.1 Hz
253
the electrode pair, C4-Al represents a
a referential montage
254
an underdamped pen will make a recorded activity appear
b. sharp
