2020 Electrodiagnostic Self-Assessment Examination-2020 Exam Answers

2020 Exam Answers
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The document is a detailed commentary on a 2020 AANEM (American Association of Neuromuscular & Electrodiagnostic Medicine) Electrodiagnostic Medicine Self-Assessment Examination, with specific focus on the answers and accompanying explanations for each question in the Video Clip Examination part of the test.<br /><br />Key Topics Covered:<br /><br />1. **Myotonic Discharges** (Questions 1, 16): Common in myotonic dystrophy, myotonia congenita, Pompe's disease, and specific myopathies.<br /><br />2. **Fasciculations** (Questions 2, 11): Described as spontaneous discharges of individual motor units, typically slow and irregular.<br /><br />3. **Sinusoid 60-Hz Activity** (Question 3): Eliminated by turning on the 60-Hz notch filter.<br /><br />4. **MUAP (Motor Unit Action Potentials) Morphology** (Questions 4, 20, 21): Used to distinguish between various neuromuscular conditions and stages of reinnervation.<br /><br />5. **Needle Electromyography** (EMG) Techniques (Questions 5, 14): Describes the physiological sounds and procedures involved when inserting needles into different tissues.<br /><br />6. **Endplate Activity** (Question 6): Associated with a characteristic sound and patient pain during EMG evaluations.<br /><br />7. **Single-Fiber Electromyography (SFEMG)** (Question 7, 83): Provides diagnosis based on jitter and blocking for neuromuscular junction disorders.<br /><br />8. **Complex Repetitive Discharges** (CRDs) (Questions 8, 9, 21, 75): Characterized by sudden onset and cessation, often seen in chronic disorders.<br /><br />9. **Myokymia** (Question 10): Rhythmic grouped discharges with a firing frequency within a burst of 5-60 Hz.<br /><br />10. **Electrode Placement and Signal Interpretation** (Questions 18, 22-31, 62, 68-70): Importance of correct anatomical positioning and technique to ensure accurate diagnostic outcomes.<br /><br />11. **Pathological Conditions and Electrophysiologic Findings**: Discusses numerous conditions such as peripheral neuropathies, radiculopathies, inclusion body myositis, Guillain-Barré syndrome, Lambert-Eaton myasthenic syndrome, and their respective electrophysiologic markers (Questions 32-39, 44-52, 76-78, 97-98, 102-107, 109-111, 114).<br /><br />12. **Nerve Injuries and Recovery** (Questions 58, 103, 124): Differentiates between grades of nerve injuries like neurapraxia, axonotmesis, and neurotmesis and their implications for recovery.<br /><br />13. **Diagnostic Techniques** (Questions 47, 48): Such as Blink Reflex Studies and Sympathetic Skin Response in evaluating autonomic and peripheral nerve integrity.<br /><br />14. **Ethical Considerations** (Question 66): On presumed consent during medical emergencies.<br /><br />Each section provides specific electromyographic or nerve conduction study insights, revealing patterns, and diagnostic determinants for various neuromuscular conditions. The references include seminal texts and studies in clinical electrophysiology, supporting the detailed explanations.
Keywords
AANEM
Electrodiagnostic
Myotonic Discharges
Fasciculations
MUAP Morphology
Needle EMG Techniques
Single-Fiber Electromyography
Complex Repetitive Discharges
Nerve Injuries
Diagnostic Techniques