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CPSGT 1 BEST STUDYING MATERIAL WITH
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Which EEG electrode is half the distance from F8 to Fz?
- ANSWER F What is a pattern of recurrent central apneas alternating with a crescendo- decrescendo of tidal volume?
- ANSWER Cheyne-Stokes respiration Sleep state misperception is also known as:
- ANSWER Paradoxical insomnia. Bob Smith completes a diagnostic PSG. Using the following information what is the patient's AHI? AHI = Apneas + Hypopneas ÷ TST x 60RDI = Apneas + Hypopneas + RERAs ÷ TST x 60
- ANSWER 12 What is the purpose of the low frequency filter? ANSWER Eliminating undesired slow frequencies
What is the RECOMMENDED decrease in SpO2 needed for an event to be scored as a hypopnea?
- ANSWER 3% What category of sleep disorders does sleepwalking belong to?
- ANSWER Parasomnias What is the normal percentage of TST spent in REM?
- ANSWER 20-25% What is the RECOMMENDED number of observed hypopneas needed in an adult patient before increasing the pressure during a titration?
- ANSWER 3 For an average adult, what stage of sleep is predominately found in the last third of the night?
- ANSWER REM According to RECOMMENDED guidelines, portable monitoring is an appropriate choice for:
- ANSWER Monitoring a patient's response to oral appliance therapy. Which of the following would be a contraindication of PAP therapy?
- ANSWER Tracheostomy What is the frequency of Beta waves?
- ANSWER There is no required decrease in SpO What is the frequency of Alpha waves?
- ANSWER 8-13Hz What occurs during hypoventilation?
- ANSWER Increased PCO Which of the following is the RECOMMENDED impedance level for EEG electrodes?
- ANSWER Less than 5k ohms What cardiac arrhythmia would require immediate intervention?
- ANSWER Asystole What is the recommended number of observed hypopneas needed for a pediatric patient before increasing pressure during a titration?
- ANSWER 1 The purpose of physiologic calibrations is to
- ANSWER All the above Establish certain scoring references for the sleep study Confirm the integrity of the signals Verify signal derivations for each channel
What is the RECOMMENDED starting pressure for CPAP?
- ANSWER 4cm H The circumference of the patient's head is 56cm. What is the distance from Oz to O1?
- ANSWER 2.8cm Good sleep hygiene includes:
- ANSWER Regular daily activities INCREASING the gain would result in what change in the EEG waveform? - ANSWER Increase the height of the waveform What is the normal NREM to REM cycle?
- ANSWER 90-120 minutes What is the frequency at which eye blinking occurs
- ANSWER 0.5-2Hz The ability of a differential amplifier to minimize signals similar to both inputs in known as:
- ANSWER Common mode rejection What is the definition of a K complex?
- ANSWER Negative wave followed by a positive wave, at least 0.5 seconds duration
- ANSWER predisposing, precipitating, and perpetuating A sleep study would be appropriate for an insomnia patient:
- ANSWER Who fails to respond to treatment An actigraph can be used to monitor patients with insomnia. In interpreting the output, sleep is presumed to occur when:
- ANSWER There is little to no movement The most common treatment for narcolepsy is:
- ANSWER Medications to counteract sleepiness Jactatio capitis is another name for what? - ANSWER Head banging, rhythmic movement disorder Sinus arrhymia tends to be seen more in: - ANSWER Young and physically fit adults Fuses and circuit breakers respond to which of the following? - ANSWER Circuit overloads Which of the following is most attenuated by a low pass filter or high frequency of 15 Hertz? - ANSWER 30 Hz If a single spindle or K complex is recorded during an epoch where the chin EMG is at REM level and the preceding and succeeding epochs are REM and contain no sleep spindles, the epoch is scored what stage? - ANSWER REM
Sensitivity effects what? - ANSWER Amplitude-height Frequency - ANSWER width What physiological parameters will be most affected by a 60 Hz notch filter? - ANSWER EMG The number of intervals in a period of time defines which of the following? - ANSWER Sampling Rate A 30 second epoch, sleep spindles occur at the 8th and 17th seconds. The preceding and succeeding epochs were REM. This epoch is scored as: - ANSWER REM What are the stages for scoring sleep in infants? - ANSWER Quiet sleep, indeterminate sleep, active sleep, and wake During a sleep study rhythmic EMG artifact in the EEG with associated chin EMG bursts is noted. The episodes meet the definition of: - ANSWER Bruxism During the first REM period, significant eye movements are noted along with a lack of atonia in the chin EMG, and the patient is yelling and waving his arms. The activity meets the criteria for which of the following? - ANSWER REM behavior disorder Which is the most dangerous rhythm? - ANSWER Ventricular Fibrillation
While scoring a PSG study, a technologists notes a 30-second apneic event accompanied by a 3-second burst of four abnormally wide QRS complexes on the EKG channel. What action should be taken by the scoring technologist? - ANSWER Provide documentation on the record and in the report. Sleep initiation in newborns usually begins with: - ANSWER Active Sleep The PRIMARY function of EPAP is to: - ANSWER Prevent the upper airway from being occluded An EKG artifact occurs in the C3-A2 recording channel. What is the BEST intervention to attenuate/eliminate this artifact? - ANSWER Use combined A1-A reference A patient presents in the sleep laboratory with 5 year documented diagnosis of HIV that is controlled by immuno-suppressive medication. What considerations would be required to render care to the patient? - ANSWER Practice Standard Precautions What is the most common treatment of obstructive hypopneas, hypopneas, etc. in children? - ANSWER Adenotonsillectomy What is true regarding CPAP therapy in children? - ANSWER It should include parent education, desensitization, and modeling After an all night PSG the patient asks the technologist about the results or possible diagnosis of their study what is most appropriate to tell them? - ANSWER Tell the patient that the Dr. will review their study and go over the results with them.
What is the BEST help to distinguish Central apneas from Cheyne-Stokes apnea? - ANSWER Observe for a crescendo-decrescendo sequence in the effort channels PSG is ordered as a split-night titration. What is indication to initiate PAP therapy?
- ANSWER 40/2hours The presence of electrical interference can MOST EASILY be determined by: - ANSWER Decreasing the time base to 5mm/sec and counting the exact frequency. Which of the following is the MOST important reason to perform physiologic calibrations prior to performing a PSG study? - ANSWER Assess function of the devices hooked up to the patient. A uniform method to protect patients and personnel against infectious disease will require: - ANSWER High level disinfection of all electrodes used in a sleep study. What is the MOST appropriate way to sterilize virus-contaminated electrodes? - ANSWER Bleach and Water What sleep disorder is associated with intermittent interruptions of REM sleep related atonia, and intense dream mention? - ANSWER REM behavior disorder Nocturnal paroxysmal dystonia - ANSWER Rare and NREM Nocturnal myoclonus - ANSWER repetitive jerks of lower limbs
During setup for a PAP titration study, a patient states that he has restless leg syndrome. The technologist should expect that the patient will have: - ANSWER Difficulty initiating sleep The distance from pre-auricular crease to pre-auricular crease is 35 cm. What is the distance in cm between C3 and CZ? - ANSWER 3. According to the recommended guidelines, unattended portable monitoring devices must include: - ANSWER What is an example of an electrical artifact? - ANSWER pulse* Which arrhythmia would require activation of the Emergency Response System? - ANSWER Ventricular Fibrillation * Kcomplexes and sleep spindles are most prevalent in what stage of sleep? - ANSWER N2 * What is the minimum duration in seconds of an apnea/hyponea? - ANSWER 10 seconds hyp. down 30% for 10 seconds According to recommended titration guidelines, CPAP should be increa sed after observing at least: - ANSWER Which PAP interface is the best option for a patient with a nasal obstruction? - ANSWER
a-fib - ANSWER atrial fibrillation AHI - ANSWER Apnea Hypopnea Index APAP - ANSWER Auto Positive Airway Pressure ASV - ANSWER adaptive servo-ventilation AV - ANSWER atrioventricular bpm - ANSWER beats per minute cm H2O - ANSWER centimeters of water pressure CNS - ANSWER central nervous system CO2 - ANSWER carbon dioxide COPD - ANSWER chronic obstructive pulmonary disease CPAP - ANSWER continuous positive airway pressure nCPAP - ANSWER nasal continuous positive airway pressure
IPAP - ANSWER Inspiratory Positive Airway Pressure LFF - ANSWER Low Frequency Filter MSLT - ANSWER multiple sleep latency test mV - ANSWER millivolt mV/cm - ANSWER Millivolts per centimeter MWT - ANSWER Maintenance of Wakefulness Test uV - ANSWER microvolt uV/mm - ANSWER Microvolts per Millimeter NPPV - ANSWER noninvasive positive pressure ventilation NREM - ANSWER non rapid eye movement OSA - ANSWER obstructive sleep apnea OSAS - ANSWER obstructive sleep apnea syndrome
O2 - ANSWER Oxygen PAC - ANSWER premature atrial contraction PAP - ANSWER positive airway pressure PCO2 - ANSWER partial pressure of carbon dioxide PaCO2 - ANSWER partial pressure of CO2 in arterial blood PLM - ANSWER periodic limb movement PLMD - ANSWER periodic limb movement disorder PLMS - ANSWER periodic limb movements in sleep PM - ANSWER unattended portable monitor POSTS - ANSWER Positive Occipital Sharp Transients of Sleep PSG - ANSWER polysomnogram PVC - ANSWER premature ventricular contraction
TST - ANSWER total sleep time UARS - ANSWER Upper Airway Resistance Syndrome V tach - ANSWER ventricular tachycardia WASO - ANSWER Wake After Sleep Onset During the PSG, if a patient ask the technologist whether he has obstructive sleep apnea, the technologist should: - ANSWER Suggest to the patient that this information should be provided by the physician. A patient who has been compliant with PAP therapy for 9 months stops by the lab during the day complaining of a minor skin irritation around his nose, the technologist should: - ANSWER Check mask size During an MSLT the patient should be instructed that the following MUST be avoided between nap trails: - ANSWER Caffeine, Napping, Smoking 30 minutes prior to test The most important reason more monitoring limb movements from both the left and right leg anterior tibialis muscles is that the movements: - ANSWER Can occur in only one leg or can switch from one leg to the other throughtout the night. AIMS A patient comes in with an open cut, sore, or ulcer located on the patients right anterior tibialis. Where should the technologist place the leg EMG electrode? - ANSWER Move the electrode to another part of that muscle. amputees
All is true about the EMG electrodes EXCEPT: The electrodes must be placed 2-4 cm apart. Can detect muscle activity by placing the electrodes on the masseter and submentalis. Can detect muscle activity from the anterior tibialis Can detect muscle activity from the mastoid. - ANSWER Can detect muscle activity from the mastoid. The standard minimum duration for scoring an apnea/hypopnea in a child: - ANSWER 6 A patient with low-amplitude submentalis chin EMG and low-voltage, mixed frequency, mixed frequency EEG activity would MOST LIKELY be in what stage of sleep? - ANSWER REM Sleep efficiency is defined as: - ANSWER Total sleep time relative to total recording time The minimum voltage of a K-complex is 75uv peak to peak. The amplitude requirements needed to identify it as a K-complex would be: - ANSWER There is no criteria The scoring criteria for stage 1 sleep includes all of the following accept:
