RPSGT EXAM / RPSGT LATEST EXAM TEST BANK COMPLETE TEST BANK WITH ACTUAL EXAM QUESTIONS A, Exams of Physics

Download RPSGT EXAM / RPSGT LATEST EXAM TEST BANK COMPLETE TEST BANK WITH ACTUAL EXAM QUESTIONS A and more Exams Physics in PDF only on Docsity! RPSGT EXAM / RPSGT LATEST EXAM TEST BANK COMPLETE TEST BANK WITH ACTUAL EXAM QUESTIONS AND CORRECT DETAILED ANSWERS (VERIFIED ANSWERS) NEW UPDATED VERSION LATEST 2024/2025 GUARANTEED A+ (REVISED EXAM) What is the purpose of the Low Frequency Filter? - ANSWER ->Eliminating undesired slow frequencies If G1 receives a signal of -100uV at the same time G2 receives a signal of -50uv, what is the output signal? - ANSWER ->-50uV The E2 electrode is placed out and up from the outer canthus of the right eye, and E1 is placed out and down from the outer canthus of the left eye. If the E2 channel on the polysomnograph is channel 4, and E1 is channel 5, what will the waves on these channels do when the patient looks up? - ANSWER ->Move toward each other The frequency of an EEG signal - ANSWER ->Can be determined by counting the number of waveforms recorded during one second How is the amplitude of a wave determined? - ANSWER - >By comparing the height of the waveform against a calibration signal if known value The purpose of a high frequency filter is - ANSWER ->To attenuate undesirable fast frequencies In polysomnography, what is the sensitivity setting? - ANSWER ->The ratio of input signal voltage to the amplitude of the pen deflection Which of the following filter settings should be used for recording airflow and respiratory effort? - ANSWER ->LFF = .1Hz, HFF = .5Hz If the low frequency filter is increased from 0.3Hz to 1Hz in an EEG channel, how will this affect the recording? - ANSWER ->The 1Hz setting will decrease the amplitude of slow waves Alpha - ANSWER ->8-13 Hz Beta - ANSWER ->13-30 Hz Delta - ANSWER ->0.5-4 Hz The optimal method of correcting undesirable artifacts while the patient is asleep is by - ANSWER ->Changing the input signal derivations During a recording, an identical slow wave artifact appears in three EEG channels sharing a common reference. The appropriate response is to - ANSWER - >Eliminate the artifact by re- referencing the input signal derivation to a back-up reference electrode If a high frequency artifact appears in a single EEG channel that shares a reference electrode with other channels, the appropriate response is to - ANSWER - >Eliminate the artifact by changing the input signal derivation to a back-up exploring electrode In an EKG the P wave represents - ANSWER ->atrial contraction During the MSLT , when is the nap terminated following sleep onset? - ANSWER ->15 minutes from the 1st epoch of sleep In infants, 3 or more periods of repetitive short apneas separated by less than 20 seconds of normal breathing is termed: - ANSWER ->Periodic Breathing the height of a waveform Measured in mV (millivolts or microvolts) - ANSWER ->Amplitude No sleep spindles or K- complexes or 3 min or more between episodes are seen in what stage of sleep? - ANSWER ->N1 What is likely to cause a 35min REM latency? - ANSWER - >Alcohol consumption prior tio testing >90/min - ANSWER ->Tachycardia What is considered the standard for verifying CPAP pressures? - ANSWER ->Water column manometer REM behavior disorder is primarily characterized by - ANSWER ->Lack of atonia The brain stem consists of: - ANSWER ->Pons Medulla oblongata Midbrain What is major difference between AC and DC amplifiers? - ANSWER ->AC amplifiers have a high frequency filter, while DC amplitudes Do Not Nocturnal polysom. that's completed in a sleep center is what type of PSG? - ANSWER ->Type 1 What is the range of normal scores on the Fatigue Severity Scale? - ANSWER ->9-35 Patient compliant w/CPAP for 2yrs returns complaining of mask leak - ANSWER ->Review current mask options w/ patient During a multiple sleep latency test, how is sleep onset defined? - ANSWER ->the first 30-second epoch in which there is more than 15 seconds of cumulative sleep What device is employed to convert physiological activity into electrical signals? - ANSWER ->Transducer When a signal starts blocking and squaring off at the top it is caused by - ANSWER ->the gain being set too high Stage 1,2,3 can be scored in most infants at what age? - ANSWER ->5-6 months or older How far apart are the EMG electrodes? - ANSWER ->3cm Stage 1(N1) if sleep contains which of the following characteristics in the adult patient? - ANSWER ->theta waves K complexes Required characteristic for snoring rhythmic movement disorder? - ANSWER ->Max freq. of 2.0Hz What is signal derivation? - ANSWER ->Signal obtained from a pair of electrodes or sensors. What neurotransmitter is increased during the wake state; decreases during stage 1,2,3, non REM sleep absent during REM? 22 - ANSWER ->Nonepinephrine Controls smooth muscle and regulates the rate and digestive system. - ANSWER ->Parasympathetic nervous system a measure of the amount of work done by a certain amount of current at a certain voltage (pressure). - ANSWER ->Watts At least one OSA or hypopneas per hr of sleep Sometimes associated w/SIDS - ANSWER ->Pediatric OSA What parameter is useful in part sleep questionnaire? - ANSWER ->Subjective sleep perception Sleeping periods lasting more than 10 hours in duration, EDS, and short sleep latency - ANSWER ->Idiopathic Hypersomnia w/Long Sleep Time Resp. event that requires O2 desat and/or arousal? - ANSWER ->hypoventilation or hypopnea 3% Formula for calculating Plm index - ANSWER ->PLM ÷ MIN OF SLEEP X60 Sleep disorder characterized by the patient reporting eating and drinking during sleep often several times during the night. - ANSWER ->Define Sleep Related Eating Disorder When looking at a calibration wave, what is the rise time? - ANSWER ->the amount of time it takes for the wave to travel from its baseline to 63% of its peak. This is usually measured in hundredths of a second. Which of the following filter combinations would be most appropriate for recording the EMG? - ANSWER - >LFF = 10Hz HFF= 100Hz What is the Time Constant? - ANSWER ->the amount of time for a calibration wave to fall from its highest point, or peak, to 37% of the peak. What is the timing onset of LM? - ANSWER ->the point where there is an 8uV increase above resting EMG Bedwetting - ANSWER ->Enuresis What are two key factors in reducing noise and improving signal quality in a differential amplifier? - ANSWER ->Low and equal impedances at the ampifier Benzodiazepines - ANSWER ->Decrease REM & N3, increase latency to REM and N3 Awakenings from SWS with feelings of intense fear, loud screams, and sometimes violent behaviors. The pt then Alcohol - ANSWER ->Suppresses REM, increases stage N3 & apneas Increases sleep fragmentation A normal sinus rhythm is characterized by a P wave and QRS complex present w/each beat having a QRS interval of? - ANSWER ->0.04-0.11 sec Recommended low frequency filter for EMG ? - ANSWER ->10Hz What is the maximum recommended difference between IPAP & EPAP? - ANSWER ->10 Heroin - ANSWER ->Decreases REM, N1 & limb movements. Increases apneas. The purpose of intentional leak is to? - ANSWER ->Wash out CO2 and prevent re- breathing Morphine - ANSWER ->Decreases REM & leg movements RDI is reduced from 55 to 8 per hour on CPAP w/ 43mins of interrupted supine REM guidelines say? - ANSWER - >Adequate Cocaine - ANSWER ->Stimulating Effects Amphetamines - ANSWER ->Suppress REM. Delay REM onset When are low amplitude, mixed frequency waves seen? - ANSWER ->Mostly during sleep (when they fall asleep) Depressants - ANSWER ->Decreases REM & N3, increase latency to REM & N3 Behaviorally Induced Insufficient Sleep Syndrome - ANSWER ->Commonly known as sleep deprivation or sleep restriction, and is self induced. Usually related to lifestyle choices Similar to sleep starts but mainly involve body movements in the neck or trunk areas. Usually occurs at sleep onset. - ANSWER ->Propriospinal Myoclonus at Sleep Onset (PSM) Atrial rate usually 250-400 bpm -Sawtooth P waves -Normal QRS - ANSWER ->Atrial Flutter A mixed apnea in adult PSG is characterized by respiratory monitors that show.... - ANSWER ->no airflow or effort followed by a period of no airflow w/resp. effort Additional parameter most helpful to monitor when recording pt w/COPD? - ANSWER ->Capnography How do beta blocked affect the PSG? - ANSWER - >Increasing sleep onset latency & awakenings Bi-PAP S/T stands for - ANSWER ->Bilevel positive pressure spontaneous /timed An increase P-R interval indicates? - ANSWER ->AV block What should be included when monitoring Ped. patient's? - ANSWER ->end-tidal CO2 Apnea Hypopnea Index (AHI) - ANSWER -># apneas + hypopneas x 60 ÷ TST in min What is the frequency range for slow waves in N3? - ANSWER ->0.5-2Hz How much & how often should CPAP be increased? - ANSWER ->1cm H20 about every 15 min When a person sleeps > 10hrs per 24hrs. (excluding infants) - ANSWER ->Long Sleeper Excess levels of carbon dioxide(CO2) in the blood - ANSWER ->Hypercapnea 0.36-0.44 - ANSWER ->QT Interval What is the amplitude requirements for a K-complex? - ANSWER ->there is no amplitude requirement for a K- complex Primary reason for instructing pt to clean masks daily is to? - ANSWER ->Minimize skin Irritation Irregularly, irregular ventricular rhythm w/consistent P waves and rapid coscillations - ANSWER ->Atrial Fib Slow wave activity frequency? - ANSWER ->0.5-2Hz In an EKG the QRS complex represents - ANSWER - >Ventricular contraction Ensure that the channels are set correctly - ANSWER - >Amplifier calibrations Adjusting the sensitivity from 5uV/mm to 10uV/mm will - ANSWER ->Reduce the pen deflection by one half If a low frequency appears in all the EEG and EOG channels, the appropriate response is to - ANSWER - >Attempt to cool the patient by using a fan or air conditioner; then if necessary, temporarily raise the frequency filters to 1Hz. A fixed PR interval, with AV conduction, followed by a non- conducted P wave on an EKG tracing denotes which? - ANSWER ->Second -degree AV heat block (Morbitz type II) When the amplitude of a signal exceeds the physical limits of a channel most important adjustment the tech can make to optimize waveform display is to? - ANSWER ->Decrease sensitivity The waveform that has total duration greater than 0.5sec with a well-delineated negative sharp wave followed by a positive component. - ANSWER ->Define K complex The sleep technologist scores the first ten epochs of a sleep study as Awake(W). Which of the following should the technologist observe? - ANSWER ->Alpha waves over the occipital area Eye movements Nocturnal paroxysmal dystonia is characterized by - ANSWER ->Sudden, random, violent movements during NREM sleep What is the difference between fatigue and sleepiness? - ANSWER ->Fatigue deals with a lack of energy whereas sleepiness is the inability to stay awake Double-referencing may be beneficial for - ANSWER - >Reducing EKG artifact in the EEG or Eye channels A pt that intentionally engages in behavioral patterns that are inconsistent w/ sleeping well is demonstrating? - ANSWER ->Inadequate sleep hygiene A change in sleep to a later period in the 24- hour sleep wake cycle - ANSWER ->Phase Delay Which of the following is a causative microorganism for tuberculosis? - ANSWER ->Mycobacterism To diagnose there needs to be an RDI >5 along w/EDS, choking, gasping or snoring or an RDI >15 without these complaints - ANSWER ->Adult OSA What distinguishes brain waves from each other? - ANSWER ->Frequency The sleep technologist scores a patient's montage and believes that the epoch being reviewed reveal that the patient is in Stage N1. Which of the following should the technologist observe? - ANSWER ->-slow eye movements - V waves over the central areas -Theta waves - Hypnagogic hallucinations Disorder involves sudden or gradual onset of loss of language skills & is characterized by nocturnal multifocal spikes & spike wander discharge? - ANSWER ->Landau- Kleffner syndrome Recommended guideline for duration of significant leg movement - ANSWER ->0.5 Decrease REM & N3, increase latency to REM and N3. - ANSWER ->Benzodiazepines What filter directly impacts the Fall time? - ANSWER - >the low frequency filter too fast to count - ANSWER ->Fibrillation An amplifier setting that allows the user to multiply ther height of a wave. - ANSWER ->Gain Control What is the predominant frequency of waves in N3 sleep? - ANSWER ->high voltage slow waves Sleep Related Hypoventilation Due to Lower Airways Obstructions - ANSWER ->Refers to the obstructions in the airway below the laryngeal apparatus. A vital capacity ratio <70%. What will increase resolution of EEG spikes with improved definitions of waveforms? - ANSWER - >increase sampling rate The rise time is the time it takes the pen to reach what percentage of its deflection? - ANSWER ->63% What does a Frequency Respnse Curve show? - ANSWER ->The amplifier's ability tio eliminates unwanted signals through the use of filters. Respiratory inductive plethysmography - ANSWER - >*Gold standard* When it comes to recording respirations from the thoracic and abdominal areas. MSLT score of 10 - ANSWER ->Troublesome very active during times of stress - ANSWER - >Sympathetic nervous system What % of sleep is REM sleep? - ANSWER ->20-25% In most sleep systems, which of these devices is the patient head box directly plugged into? - ANSWER ->AC amplifer Where are the reference electrodes M1&M2 placed on the head? - ANSWER ->On the earlobes In the pre-auricular area behind the ear. What might be seen in a Pt with lesions in the suprachiasmatic nucleus? - ANSWER ->Altered circadian Rhythm How can you decrease the amount of condensation in humidifier tubing? - ANSWER ->-Heat tubing -Reduce the level of humidifications - Insulate the tubing A change in sensitivity produces a change in the - ANSWER ->Height of the wave A device used to measure movement, usually over long periods if time - ANSWER ->Actigraph An abnormal rhythm in the EKG channel - ANSWER ->EKG Dysrhythmia The rate at which a wave repeats itself or oscillates is called the - ANSWER ->Frequency What is rhythmic anterior theta activity(RAT)? - ANSWER ->Runs of 5-7Hz rhythmic theta activity over frontal or frontocentral regions. What is the frequency of PDR in infants by 3yrs of age? - ANSWER ->7.5-9.5 Hz sudden, random, violent movements during NREM sleep. - ANSWER ->Nocturnal paroxysmal dystonia is characterized by Periodic breathing is shown/ seen in what stage(s) of sleep? - ANSWER ->N1 & N2 A pen's vertical position when the power to the polysomnography is turned off is called the - ANSWER - >Mechanical baseline Dopamine agonists,opioids, anti-convulsant, & benzodiazepines are therapeutic interventions for? - ANSWER ->RLS Obstructive apnea in ped patients is most often associated with? - ANSWER ->hyperactivity Antidepressants suppress which stage of sleep? - ANSWER ->REM Most appropriate setting a tech would use to control the frequency band of waveforms on a recording is the? - ANSWER ->low filter an electric current flowing in one direction only. Simple form of electricity low voltage. - ANSWER ->Direct Current (DC) What is a characteristic of sleep during the 2nd trimester? - ANSWER ->TST decreases to pre- pregnancy levels the time constant - ANSWER ->The low frequency filter is most closely associated with A time constant of 1 second is equal to a LFF setting of - ANSWER ->0.16Hz Scalp electrodes use to record sleep stages are typically referenced to the - ANSWER ->Mastoid Process Used to report EDS used multiple times per day - ANSWER ->Stanford Sleepiness Scale Flutter - ANSWER ->>200/min loud snoring x 3min - ANSWER ->When should IPAP be increased ? (adult bilevel titration How do you score hyperventilation in PEDS? - ANSWER - >>25% of TST spent w/ PCO2 > 50mmHg Sudden muscle jerks or movements at sleep onset, often accompanied by feelings of surprise or fear. - ANSWER - >Sleep Starts (Hypnic Jerks) Which impedance level is considered acceptable for EMG channels, such as the limbs or chin? - ANSWER ->Less than or equal to 10 What is the danger of using two ground wires on a piece of diagnostic equipment? - ANSWER ->Electric Shock The best method for detecting apneas & hypopneas during PAP titration is to use? - ANSWER ->Thermal sensor placed under an original interface A ___________ study is used to look for seizure activity during sleep. - ANSWER ->Nocturnal Seizure Pt med Hx shows hypotension. The tech should? - ANSWER ->Maintain awareness of potential for false oximetry values Inadequate sleep hygiene - ANSWER ->Due to practices that encourage poor sleep such as changing bedtimes , watching TV in bed, too much noise & light during & light during sleep, drinking alcoholic beverages before sleep. The three stages of sleep in infants are - ANSWER - >Active sleep, indeterminate sleep and quiet sleep A sleep specialist is defined as someone who - ANSWER - >had passed an ABSM recognized sleep board examination Audible vibrations of the upper airway during respirations in sleep. - ANSWER ->Snoring Cortical activity seen in middle of graphic? - ANSWER - >Spontaneous Arousal According to recommended PED titration guidelines CPAP should be increased after observing - ANSWER ->3 RERAS CPAP should be increased @ an interval no lesss than? - ANSWER ->5 min A chemical in the brain responsible for activation of the cortex. - ANSWER ->Acetylcholine a device produces its own electricity? - ANSWER ->Piezo- electric crystal band The loss of muscle tone that accompanies a strong emotion. - ANSWER ->Cataplexy is A short term insomnia that is often associated with a specific stressor. Usually corrects itself when the stressor is eliminated. Sometimes called Acute Insomnia - ANSWER - >Adjustment Insomnia (Acute Insomnia) Define time constant - ANSWER ->The response time to the selected high and low frequency filter setting during the calibration procedure. Hallucinations either at sleep onset or upon awakening, often associated w/ SOREMP'S (sleep onset rapid eye movement periods) these occur in the absence of Narcolepsy. - ANSWER ->Sleep Related Hallucinations What is the most desirable sampling rate for respiratory airflow signal? - ANSWER ->100Hz Which of these is not required for in-home CPAP use? - ANSWER ->A humidifier As they age men experience more deterioration in sleep than women? - ANSWER ->True The importance of selecting sampling rates is? - ANSWER ->Minimizing aliasing effect Patient complains pressure is too high& makes difficult to exhale the 1st step is? - ANSWER ->Verifying correct pressure with manometer Getting up to do something relaxing after 20mins in bed - ANSWER ->What constitutes good sleep hygiene? Paradoxical Breathing - ANSWER ->Chest & Abdomen moving in opposite directions while breathing PR Interval - ANSWER ->0.12-0.20 seconds What characteristic is NOT a feature of relaxed wakefulness with the eyes open? - ANSWER ->Vertex sharp wave Improve CPAP utilization - ANSWER ->Heated humidification is indicated to Pittsburgh sleep Quality Index - ANSWER ->Self-reporting tool to eval subjective sleep quality with disturbance in the past month? Supraventricular Tachycardia - ANSWER ->>100 bpm The P wave is present but may not be clearly defined *can result in CHF What are characteristics is stage N1 sleep? - ANSWER - >Relatively low voltage, mixed frequency EEG , slow - rollling eye movements and a normally active chin EMG Most memorable dreams occur here - ANSWER ->In describing REM sleep, which of the following are true? Distinctive waxing & waning in the airflow. A crescendo- decrescendo pattern in the depth of respirations. - ANSWER ->Cheyne -Stokes Breathing Pattern According to recommended guidelines respiratory effort should be recorded with - ANSWER ->Inductance Plethysmography What condition is not likely to contribute to episodes of hypoventilation and/or hypoxemia? - ANSWER - >Diabetes Pulse ox - ANSWER ->In direct monitoring of O2 level by the user of sensors that detect light wave absorption? Sleep-related Groaning (Catathrenia) - ANSWER ->During exhalation typically in REM Consists of groaning sound. During stage R sleep score arousal if there is an increase in the chin EMG @ the same time for ________ seconds? - ANSWER ->1 or more What statements is true regarding hypoventilation during sleep? - ANSWER ->It is identified by measuring a reduction in amplitude in the airflow channel tracings normal PO2 levels - ANSWER ->> 57 Primary benefit of heated humidification - ANSWER - >Help reduce nasal congestion normal SaO2 - ANSWER ->>90 What does the SaO2 measure? - ANSWER ->The percentage of hemoglobin that is saturated with oxygen What would a low PO2 be likely to contribute to? - ANSWER ->A decreased SaO2 Patient falls asleep late/ can't go to sleep earlier May require multiple alarms to wake up - ANSWER - >Delayed Sleep Phase Increased acidity in the blood produces which of the following? - ANSWER ->A decreased pH What structure of the brain blocks signals from the thalamus to the cortex? - ANSWER ->Reticular Activating neurons What happens to the Chin EMG at sleep onset? - ANSWER ->It decrease at amplitude A loud noise will most likely awaken an adolescent during which stage of sleep - ANSWER ->It makes no difference What is the required oxygen desaturation for a hypopnea with a 50% or greater decrease in airflow? - ANSWER - >3% Which of these EEG waveforms is seen as a result of signals from the thalamus being blocked? - ANSWER - >Sleep spindles Use oronasal interface - ANSWER ->A patient reports complete nasal obstruction prior to PAP titration.... What respiratory event is characterized by opposite effort patterns in the chest and abdomen (the abdomen contracting while the thorax is expanding, and vice versa? - ANSWER ->Paradoxical Breathing What respiratory event is characterized by a cessation in respiratory effort at the same time as a cessation in airflow? - ANSWER ->Central Apnea There is a sustained rhythm of three or more PVC's in a row. - ANSWER ->Ventricular Tachycardia Patients with a hypoxic drive - ANSWER ->Do not respond well to CPAP Which neurotransmitter is at its highest levels during wakefulness and REM sleep? - ANSWER ->Acetylcholine What age group has more N3 sleep? - ANSWER - >Pediatric There is a suddenly dropped QRS complex without prior PR lengthening. - ANSWER ->2nd Degree AV Block Morbitz 2 the sleep of normal healthy young adults - ANSWER - >Stage N2 sleep generally comprises approximately 25% of the night What does blood pressure do during sleep? - ANSWER - >Decreases Research using MSLT's has shown that physiological sleepiness in normal human adults is - ANSWER - >Greatest in the afternoon The P wave may or may not be present. There is no conduction of the atrial impulse to the ventricles. QRS complexes are absent. - ANSWER ->Asystole The optimal method of correcting undesirable artifacts while the patient is asleep is by - ANSWER ->Changing the input signal derivations EEG's in older adults typically have a ________ than EEG'S in younger adults. - ANSWER ->Lower amplitude structure that is responsible for sending signals from the body to the cortex? - ANSWER ->Thalamus An atrial rhythm that is characterized by disorganized atrial activity without discernible P wave. - ANSWER - >Atrial Fibrillation Where are alpha waves mainly seen? - ANSWER ->During Wake Which of these suppresses REM? - ANSWER ->Alcohol Which of these is responsible for EEG arousals and awakenings? - ANSWER ->Reticular Activating system A circadian rhythm that is not consistent w/the 24 hour clock the patient's rhythm is often longer than 24 hours and is apparently not related to the light dark cycle. - ANSWER ->Free-Running Circadiam Rhythm Sleep Disorder In what age group are high amplitude low frequency EEG waves most often seen? - ANSWER ->Infants When patient is on optimal CPAP pressure and has the SPO2 remaining less than 89% for at least 5 minutes - ANSWER ->When do you titrate w/supplemental O2? During what stage of sleep does the core body temperature drop? - ANSWER ->REM How many limb movements are required in a series of Periodic Limb Movements? - ANSWER ->4 Contaminated M1 - ANSWER ->What can negatively impact all bioelectric channels? There is a rapid, disorganized depolarization of the ventricles. The EKG tracing consists of a wavy baseline. Large waves indicate coarse fibrillation, and small waves indicate fine fibrillation. - ANSWER ->Ventricular Fibrillation The P-P intervals are constant. The PR interval progressively lengthens with each cycle until a P wave appears without a QRS complex. The QRS complex is within mental limits. - ANSWER ->2nd Degree AV Block Mobitz 1 Which of these helps increase the depth of sleep in narcoleptics? - ANSWER ->Increased exercise Height; Speed - ANSWER ->Amplitude is a measurement of the _________ of a waveform, while frequency is a measurement of the _________ of a waveform. There is a progressive lengthening of the PR interval with intermittently dropped beats - ANSWER ->2nd Degree AV Block Morbitz 1 wake after sleep onset - ANSWER ->WASO high voltage activity in chin is similar or less than during stage w - ANSWER ->Stage 1 EMG What type of waves have a frequency of 13-35Hz, an amplitude of less than 30uV and are present during normal wakefulness when the pt is alert? - ANSWER - >Beta Waves AASM recommends HST devices include? - ANSWER - >Blood oxygen Histogram - ANSWER ->Best tool that a physician can use to more clearly explain results of sleep study ? It occurs mostly in Stage 2 There should be an increase in masster muscle activity - ANSWER ->For the patient w/bruxism what should the sleep technologist look for on the patient's montage to diagnose this disorder? What is the purpose of the AWAKE program? - ANSWER - >To provide education guidance, and ongoing support for sleep apnea There is a complete block of all supraventricular impulses from reaching the ventricles. The atrial rate is usually faster than ventricular rate. There is no relationship between the atrial and ventricular rhythms. - ANSWER - >3rd Degree AV Block Shortened P-R interval indicates? - ANSWER ->junctional beat or accessory pathway syndrome When the exploring electrode and reference electrode are very close to each other, the amplitude of the resulting wave is _______. When they are apart from each other, the amplitude of the resulting wave is ________. - ANSWER ->low, high Over compensation for mask or mouth leaks on APAP is most likely to result in - ANSWER ->Unnecessarily high pressure Patient Education - ANSWER ->What has the largest impact on adherence to PAP therapy? For home treatment w/ PAP proper humidifier care includes? - ANSWER ->Rinsing and air drying the reservoir EEG waves with frequencies of 4 to 7.5Hz are - ANSWER - >-Most common in children under 4 years of age -Briefly seen in drowsynormal patients Reducing EKG artifact in the EEG or eye channels - ANSWER ->Double-referencing may be beneficial for What stages can alpha waves appear in? - ANSWER ->Any stage What improves patient comfort with PAP therapy? - ANSWER ->heated humidification Which of the following can be used as an epoch score? - ANSWER ->Major body movement An important part of a scoring tech is to? - ANSWER - >Confirm accuracy of report components Sometimes called Noctural Myoclonus. Affects 1/3 of adults over 60 and cause involuntary limb movements during sleep. A series of at least 4 events within 5 to 90 seconds of each other. - ANSWER ->Periodic Limb Movement Disorder (PLMD) Central forehead on line between nasion and hairline on flat area of skin - ANSWER ->Ground electrode placement If 30% of an epoch consists of EEG slow waves, but K- complexes and sleep spindles are also in the same epoch, what should it be scored as? - ANSWER ->Stage 3 Call physician - ANSWER ->During testing patient has BP of 220/120 What do you do? The frequency of a waveform can be altered by adjusting the - ANSWER ->Filter What are voltages originating from living tissues? - ANSWER ->Bio-electrical Potentials Oronasal thermal sensor - ANSWER ->Device used to monitor airflow and detect apnea during PSG? Beta - ANSWER ->Which EEG signal will be attenuated the most with a high filter setting of 15Hz? A patient is in Stage N2 when the chin EMG increases dramatically in amplitude for 5 seconds, then returns to its orginal amplitude. How should this 5- second period be scored? - ANSWER ->It should not be scored If OSA relates to a narrowed airway what procedure can be done? - ANSWER ->UPPP duration longer than 10sec and both respiratory effort and airflow drop by >90% of pre-event baseline - ANSWER ->How to score a central apnea? REM behavior disorder is most often seen in - ANSWER - >Males over the age of 60 Dissociative disorders that exist during wakefulness but are carried out during the sleep period. Often these patients were victims of personal attacks from abuse or rapes. - ANSWER ->Sleep Related Dissociative Disorders Which of these best describes beta spindles? - ANSWER - >High amplitude bursts of EEG activity greater than 13Hz A three-second long period of alpha intrusion during sleep - ANSWER ->is not considered an EEG arousal unless it is preceded by at least 10 seconds of uninterrupted sleep Difficulty breathing as a result of a chest wall or neuromuscular disorder such as muscular dystrophy or Eaton-Lambert syndrome. - ANSWER ->Sleep Related Hypoventilation Due to Neuromuscular and Chest Wall Disorder Patient eats during the night w/no recollection Risk of choking - ANSWER ->Sleep Related Eating People with obstructive sleep apnea have a higher risk of - ANSWER ->Stroke What is the normal range of O2 sat? - ANSWER ->95%- 98% Ectopic beats that originate below the bundle of HIS and occur earlier than expected are - ANSWER ->premature ventricular contraction (PVC) 5 seconds - ANSWER ->In scoring PLM'S maximum duration of the event must be? This is a rare disorder that is usually a case of Klein-Levin syndrome and includes repeating episodes of hypersomnia. Patients may sleep 16-18 hours a day during these periods, which may last as long as 4 weeks. - ANSWER ->Recurrent Hypersomnia The primary function of EPAP - ANSWER ->Maintain upper airway patency through inspiration What brain structure is involved in automatic functions, homeostasis, endocrine processes, emotions and the regulation of sleep? - ANSWER ->Hypothalamus Electrical interference can best be prevented if which of the following actions are taken? - ANSWER ->The impedances of input electrodes are similar A patient with Post Traumatic Stress Disorder (PTSD) often complains of what disturbance during sleep? - ANSWER ->Persistent Nightmares Rely on F3-M2 Do not wake the patient - ANSWER ->When intermittent 60Hz activity occurs in the F4-M1 electrodes during REM the best immediate action would be to? The baseline wave is irregular, and P waves are absent. Ventricular response (QRS) is irregular, slow or rapid - ANSWER ->Atrial Fibrillation The time in minutes from lights out to the first epoch of any stage of sleep - ANSWER ->Sleep latency What is posterior dominant rhythm (PDR)? - ANSWER - >Dominant reactive EEG activity rhythm over occipital regions in relaxed wakefulness eith eyes closed Upon awakening pt sees an imaginary noise or explosion sometimes with flash of light, jerking and freight - ANSWER ->Exploding Head Syndrome Metabolic - ANSWER ->Pt medical Hx indicates obesity, hyperlipidemia, HTN and insulin resistance What syndrome does this represent? The electrical potential difference between the cornea and the retina - ANSWER ->the recording of eye movements is based on What EKG rhythm can be described as atrial beats that arise earlier than expected, with a normal QRS complex? - ANSWER ->Premature atrial contraction (PAC) Increases or decreases the signal size of the amplifier signal - ANSWER ->Gain Rarely - ANSWER ->Do elderly people have Stage N3 sleep? RERA looks like a hypopnea but.... - ANSWER ->There is NO desat Conjugate irregular, sharply peaked eye movements with an initial deflection usually lasting <500msec - ANSWER - >Define rapid eye movements What is the minimal # of consecutive cycles of crescendo/descendo changes in breathing required tio score Chenyne-Stokes? - ANSWER ->3 There is no relationship between the P waves and the QRS complexes. The QRS rate is slower than P rate. - ANSWER ->3rd Degree AV Block Cheyne Stokes are associated w/what medical condition? - ANSWER ->Congestive Heart failure The P wave is seen as rapid flutter waves. The ventricular rate is regular or irregular and slower. The QRS complex is within normal limits. - ANSWER ->Atrial flutter Vertex waves are found in what area of the brain? - ANSWER ->Central Pt with unilateral diaphragmatic paralysis is @ most risk for? - ANSWER ->Sleep disordered breathing during REM History indicates dx of overlap syndrome. The tech can anticipate the pt has? - ANSWER ->COPD & OSA ECTOPIC BEATS ORIGINATING LOW IN THE VENTRICLES OCCUR EARLIER THAN EXPECTED - ANSWER ->Premature Ventricular Contraction There is a total absence of ventricular activity, although some activity may be present in the atria. There is a flat line on the EKG. - ANSWER ->Asystole Time in minutes in each sleep stage - ANSWER ->AASM guidelines recommend that the PSG report include There is a P wave for every QRS complex, The rate is 70 beats per minute and the QRS complex is within normal limits. - ANSWER ->Normal Sinus Rhythm During CPAP titration at 15cmH20 patient is restless and continues to have frequent obstructive resp. events Best action? - ANSWER ->Switch to bi-level (BiPAP) The P wave is saw-toothed. The atrial rate is rapid (250- 350 beats per minute). The ventricular rhythm is usually regular. The ventricular rate is 40-90bpm but may be higher. The QRS complex is within normal limits - ANSWER ->Atrial Flutter There is no P wave. The QRS complex occurs earlier than expected, is wide (0.12sec or greater), and has a bizarre looking configuration and an increased amplitude. - ANSWER ->Premature Ventricular Contraction Causes of Cheyne Stokes breathing include - ANSWER - >Central apnea Meningitis Congestive heart failure increased intracranial pressure Max duration of leg movements? - ANSWER ->10 sec Follow protocol for supplemental O2 - ANSWER ->During CPAP titration @ 10cmH20 SPO2 values range between 80-85% for 10 min despite absence of respiratory events. What to do? Sudden loss of muscle tone - ANSWER ->Cataplexy What begins the cardiac cycle? - ANSWER ->Discharge of the SA node which causes the atria to depolarize Diencephalon - ANSWER ->Thalamus Hypothalamus Epithalamus Pineal gland Following an oversight polysomnogram, when should the 1st nap of a MSLT begin? - ANSWER ->1.5 to 3 hours after the overnight polysomnography In pts with severe sleep disordered breathing the most commonly seen response resulting from successful PAP titration - ANSWER ->REM & Slow wave rebound The P wave is normal in size. The ventricular rate is less than 40 bpm. The QRS complex is within normal limits. - ANSWER ->Sinus Bradycardia The P wave is not discernible. The atrial rate and rhythm cannot be determined. The ventricular rhythm is chaotic, with no pattern or regularity. The ventricular rate cannot be determined. The duration of the QRS complex is not discernible. - ANSWER ->Ventricular Fibrillation a bluish discoloration of the skin resulting from poor circulation or inadequate oxygenation of the blood - ANSWER ->Cyanosis the movement of atoms or molecules from an area of higher concentration to an area of lower concentration- occurs when oxygen moves from the lungs into the blood vessels and carbon dioxide moves from blood vessels into the lungs. - ANSWER ->Diffusion daily; of each day; of or during the day - ANSWER - >Diurnal the cause, set of causes, or manner of causation of a disease or condition - ANSWER ->Etiology in medicine, exacerbation may refer to an increase in the severity of a disease or its signs and symptoms - ANSWER ->Exacerbation having or showing the symptoms of a fever - ANSWER - >Febrile the tendency toward a relatively stable equilibrium between interdependent elements- the body always seeks balance or equilibrium (homeostasis) - ANSWER - >Homeostasis excessive carbon dioxide in the bloodstream, typically caused by inadequate respiration - ANSWER - >Hypercapnia Relating to the state immediately before waking up - ANSWER ->Hypnopompic Relating to the state immediately before falling asleep - ANSWER ->Hyponagogic Relating to or denoting any disease or condition that arises spontaneously or for which the cause is unknown - ANSWER ->Idiopathic a form of respiratory drive in which the body uses oxygen chemoreceptors instead of carbon dioxide receptors to regulate the respiratory cycle - ANSWER ->Hypoxic Drive Relating to seizures - ANSWER ->Ictal Delay or prevent (someone or something) by obstructing them; hinder - ANSWER ->Impede the delay from input into a system to desired outcome- in sleep medicine, latency has to do with sleep reporting. Time from lights out to first epoch of sleep latency; time from sleep onset to first epoch of REM sleep is REM latency. - ANSWER ->Latency symbol for mercury. Used in measuring carbon dioxide, atmosphere pressure, blood pressure and other measurements - ANSWER ->mmHg form, shape or structure; the shape of a brain wave; multifocal PVCs have different morphologies - ANSWER - >Morphology the lowest point; related to measuring respiratory events; start with nadir of the first clearly reduced breath - ANSWER ->Nadir nostrils - ANSWER ->Nares occurring or active at night - ANSWER ->Nocturnal (of disease) originating in a hospital - ANSWER - >Nosocomial A cue given by the environment, such as a change in light or temperature, to reset the internal body clock - ANSWER ->Zeitgeber - ANSWER ->According to accepted sleep scoring standards, if other scoring criteria are met, which of the following activities would be considered an event when each is 0.5 seconds in duration? 1. PLM 2. arousal 3. spindle 4. K-complex - ANSWER ->A patient's EKG tracing shows an irregular R-R rhythm without alterations to the P, QRS, and T waves. Which of the following arrhythmias fits this description? - ANSWER ->The horizontal position of the pens with polysomnograph amplifiers turned off is referred to as: - ANSWER ->An MSLT nap starts at epoch 28. The patient never initiates sleep. What epoch should you terminate the nap on. - ANSWER ->The narcolepsy tetrad includes all the following except - ANSWER ->According to AASM guidelines, which of the following best defines an arousal during NREM sleep? - ANSWER ->A "saw tooth" or "picket fence" appearance on the EKG baseline suggests which type of rhythm? - ANSWER ->The electro- occulogram is based on recording which of the following? - ANSWER ->According to the principles of differential amplification, electrical interference can best be prevented if <5 k - ANSWER ->The recommended EEG scalp electrode impedance levels are : 2 obstructive apneas and 3 obstructive hypopneas - ANSWER ->According to the AASM, the tech should increase CPAP pressure when there are: LFF =10 Hz; HFF= 100Hz - ANSWER ->Recommended setting for EMG channel is: 500Hz - ANSWER ->The desired sampling rate for EEG signals is: The ratio of input signal voltage to the amplitude of pen deflection - ANSWER ->In polysomnography, what are the sensitivity setting? Negative - ANSWER ->With respect to the cornea, retina has a more _________ charge. It attenuates faster frequencies such as spindles - ANSWER ->The problem with setting the HFF too low is LFF - ANSWER ->Time constant is related to which filter? Increased acidity - ANSWER ->Your patient's pH level goes from a baseline of 7.40 to 5.7 during the PSG. This would indicate: N2 - ANSWER ->On a standard 30 second epoch you observe a theta background, one spindle, two 100uV K- complexes, a run of 100uV delta waves that take up 5 seconds of the epoch. What stage is this ?