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  • All of the following are factors contributing to continence EXCEPT.
  • What is a common method to monitor SNM device functioning overnight?
  • What is a typical range for SNM stimulation amplitude in milliamps (mA)?
  • Which structure is among the three key features to evaluate on SNM AP imaging?
  • Which considerations are essential in sterile processing of implantable devices?
  • Which of the following is a common cause of obstructive urinary retention?
  • Which gender is more commonly affected by urinary retention?
  • Which statement correctly defines sensitivity and specificity?
  • In hypothesis testing, what does a p-value indicate?
  • Sacral neuromodulation (SNM) is indicated for which of the following conditions?
  • Which of the following is a symptom of urinary retention?
  • Which test may help distinguish a device fault from patient nonresponse during programming?
  • What is the difference between a rechargeable SNM system and a non-rechargeable one for patients?
  • Urge incontinence is best described as a sudden, compelling urge to urinate that leads to involuntary urine loss.
  • Which of the following is a factor relating to nerve supply that contributes to continence?
  • Dominant innervation for the bladder is through which type of activity?
  • What is the primary goal of sacral neuromodulation therapy in Axonics devices?
  • What does ICH-GCP stand for and why is it relevant?
  • CAPA in quality management stands for Corrective and Preventive Action. What is its purpose?
  • Which statement best defines per-protocol analysis?
  • The bladder is the only WHAT TYPE OF muscle in the body that we gain WHAT TYPE control over?
  • In the software lifecycle for a medical device, which stage focuses on ensuring the product meets design inputs and user needs before release?
  • In a CAPA plan, which element is used to confirm that corrective actions have actually resolved the issue?
  • Which of the following best describes why sterile technique affects implant safety?
  • Sacral nerve modulation has been proven to be effective for fecal incontinence and improves quality of life.
  • Which of the following is NOT a first-line conservative therapy for overactive bladder?
  • Which statement about sacral nerve modulation and fecal incontinence is supported by the material?
  • Over months, a stable impedance reading most directly suggests what about the SNM system?
  • During SNM programming, which principle guides parameter selection?
  • Which term describes an object that shows up clearly on X-ray due to high density?
  • What is the goal of human factors usability testing in medical devices?
  • Moving the C-ARM toward the feet is called?
  • Muscarinic receptors relevant to bladder function are primarily located in which tissue?
  • Which of the following is NOT a factor influencing the battery life of an implantable neuromodulation device?
  • Which design feature helps prevent accidental damage to implanted components during MRI?
  • Which standard guides biocompatibility assessment for implanted medical devices?
  • Which of the following is NOT one of the four core symptoms of overactive bladder?
  • Which describes 'lead impedance drift' in Axonics SNM systems?
  • Which of the following is NOT one of the four core symptoms of overactive bladder?
  • Which statement best describes 'remote programming' in Axonics SNM systems?
  • In SNM programming, what does the term 'on time' refer to?
  • What is the primary purpose of a telemetry test in SNM device programming?
  • What is the purpose of device labeling and user instructions?
  • Which of the following is not a typical goal of device labeling and user instructions?
  • In SNM therapy, which statement best describes the role of patient diaries?
  • According to the American College of Gastroenterology, sacral nerve modulation is a strong recommendation for the treatment of fecal incontinence.
  • What does FMEA stand for and what is its purpose?
  • Which statement best describes intention-to-treat analysis?
  • What are the two primary bladder receptors involved in bladder function?
  • Which statement best defines an adverse device event (ADE)?
  • What is the role of impedance checks during clinic visits?
  • No sensation of bladder fullness is a symptom of urinary retention.
  • In device safety, what does 'electrical isolation' refer to?
  • Which three structures are the most important to identify on SNM AP x-ray images?
  • What is the role of regulatory submissions in post-market changes?
  • How do hazard analysis and risk assessment differ?
  • In a noninferiority trial, which statement correctly describes the analysis goal?
  • SNM therapy targets which nerves to influence bladder function?
  • If a test has high specificity, what does this imply about false positives?
  • Why is software validation essential in implantable medical devices?
  • SNM stimulation amplitude is typically described as being what?
  • How is MRI safety addressed for implanted SNM devices?
  • In the event of a device failure, what is the recommended escalation pathway?
  • In SNM management, which of the following best describes the role of the external programmer?
  • What is a typical follow-up window for assessing sacral neuromodulation outcomes after implantation?
  • Which of the following is NOT used to determine the S3 level on the lateral image?
  • Overactive bladder impacts quality of life in all of the following domains EXCEPT:
  • Which of the following is NOT typically considered a reportable SNM device adverse event?
  • Which term describes leakage that occurs when the bladder overfills?
  • Which term describes a secondary outcome used as a proxy for a clinical outcome?
  • Which muscle group contracts during the pelvic floor bellows action?
  • Which component delivers controlled electrical pulses to the sacral nerves in SNM therapy?
  • What is the expected patient outcome before considering hardware revision?
  • What is the main purpose of lead integrity monitoring in SNM systems?
  • What practice helps ensure the long-term reliability of a rechargeable SNM system?
  • Which adverse event is commonly monitored as a potential complication of sacral neuromodulation therapy?
  • Which practice supports effective root cause analysis when a defect is found in a component?
  • Which regulatory standard defines essential electrical safety for medical devices like Axonics implants?
  • What is the typical clinical sign that leads to consideration of SNM therapy?
  • What is the dominant innervation of the Detrusor?
  • What does ISO 13485 address in relation to medical devices?
  • Why is patient education on charging important for Axonics rechargeable systems?
  • Which neurotransmitter system primarily drives detrusor contraction?
  • Compared with optimal medical management, sacral nerve modulation is at least as effective for fecal incontinence.
  • Which component of the Axonics system stores stimulation parameters for patient use?
  • During testing for sacral neuromodulation, why is therapeutic response testing performed?
  • In sacral nerve modulation therapy, how is the duty cycle defined?
  • Stimulation of muscarinic receptors on the bladder most directly causes which response?
  • Which statement about biocompatibility testing is false?
  • Symptomatic chronic urinary retention (CUR) is defined by which of the following?
  • What is a surrogate endpoint? Give an example relevant to SNM.
  • Which statement best describes the FDA clearance pathways for medical devices, particularly 510(k) vs PMA?
  • ISO 13485 applies to what aspect of the Axonics product lifecycle?
  • Which tissue is NOT listed as a soft tissue layer potentially covering the S3 foramen?
  • The small bumps on the anterior sacrum that correlate with the transverse lines or fusion plates are called what?
  • What % of patients that are given a medication for AB, will discontinue it within 6 months?
  • What is post-market surveillance (PMS) and why is it important?
  • What is the primary anatomical target for sacral neuromodulation in Axonics therapy?
  • Which of the following statements about continence factors is true?
  • The Axonics INS should be located how far below the iliac crest?
  • In the context of data interpretation, what would a stable impedance reading across months suggest?
  • Describe the software lifecycle stages for a medical device.
  • How does post-implant follow-up typically proceed in SNM therapy?
  • Which of the following is NOT a side effect of overactive bladder medications?
  • Which measure indicates success with sacral neuromodulation for urinary retention?
  • What is a noninferiority trial?
  • Which document or regulation governs post-market surveillance for medical devices in the US?
  • What Center controls storage and void of urine?
  • Which statement about software verification and validation is most accurate?
  • What is ISO 13485 and why is it relevant to medical devices?
  • How does Axonics ensure MRI compatibility for its SNM system?
  • Moving the C-ARM cephalad means moving toward the direction of the?
  • What does CE marking indicate for a medical device?
  • What maintenance difference exists for patients with non-rechargeable SNM systems?
  • Overactive bladder is due to the bladder being lazy and not wanting to contract?
  • Which of the following is NOT a key consideration in sterile processing of implantable devices?
  • Urge incontinence is best described as which of the following?
  • If a diagnostic test has high sensitivity, what does this imply about false negatives?
  • Which clinical measurement is often used to evaluate SNM impact on bladder function?
  • What is the typical purpose of an 'implantable pulse generator' (IPG) in SNM therapy?
  • Sacral Neuromodulation electrically stimulates which nerves in the sacral spinal root?
  • In impedance monitoring, which reading would most likely indicate a healthy lead contact?
  • Which condition is commonly considered for SNM therapy after failing conservative treatment?
  • What ducts carry urine from kidneys to the bladder?
  • The shadow of the greater sciatic notch is a useful landmark to help locate which sacral foramen?
  • Which statement best describes the role of impedance testing prior to programming in sacral neuromodulation?
  • The fibers that travel from the bladder to the brain are the:
  • If SNM device shows signs of malfunction, what is the recommended course of action?
  • Which feature of Axonics SNM devices extends the interval between surgical replacements?
  • What smooth muscle forms the wall of the bladder?
  • What is the purpose of sterile labeling and packaging validation?
  • In clinical practice, which adverse event should be promptly reported for SNM devices?
  • What is the difference between a device-related adverse event and a patient-related adverse event?
  • What is hazard analysis in risk management?
  • Electrical impedance testing in SNM devices helps detect what?
  • Why is sterile technique crucial during implantation?
  • Which protective measure is a key component of radiation safety?
  • In programming for patient comfort, which parameter is typically adjusted first?
  • What endpoints are commonly used in sacral neuromodulation trials for overactive bladder?
  • Define root cause analysis (RCA) and give a basic method.
  • Which statement correctly differentiates FDA 510(k) clearance from Premarket Approval (PMA)?
  • What is the purpose of titration curves in SNM programming?
  • Which of the following is listed as a potential cause of fecal incontinence?
  • A metallic object such as a surgical implant or tied lead marker will show as WHAT on an ×-ray image?
  • What is a common reason for post-implant follow-up visits after SNM therapy?
  • What is the PGI-I scale?
  • Why is long-term follow-up important after neuromodulation device implantation?
  • Which sacral nerve root is primarily targeted by sacral neuromodulation to treat lower urinary tract symptoms?
  • An impedance measurement of 700 ohms is most consistent with which assessment?
  • What is lead migration and why is it problematic?
  • During programming, which data point most directly indicates successful stimulation?
  • What are the three keys to radiation safety?
  • The Pontine Micturition Center is associated with controlling which aspects of urination?
  • Bladder emptying is mediated by the stimulation of muscarinic receptors in the brain?
  • Which muscle is NOT considered part of the anal sphincter complex?
  • If a stimulation pulse has a width of 210 microseconds and operates at 100 Hz, what is the duty cycle?
  • During lead testing for sacral neuromodulation, what is a key step?
  • What is the least invasive treatment option for fecal incontinence?
  • Which statement best reflects considerations when selecting lead placement for sacral neuromodulation?
  • Long-term use of some medications is a listed cause of obstructive urinary retention.
  • Which standard governs the software life cycle processes for medical devices?
  • Approximately how many Americans are affected by overactive bladder?
  • What is ISO 14971 and its purpose?
  • Which method is commonly used to verify proper lead placement during sacral neuromodulation implantation?
  • Which muscles contract in the bellows response?
  • Which programming parameter most directly affects the perceived strength of stimulation?
  • Which of the following are typical adverse events associated with sacral neuromodulation?
  • Which muscles form the anal sphincter complex?
  • What clinical information is most useful to determine if SNM therapy is effective during a programming visit?
  • Urge incontinence results from increases in intra-abdominal pressure that are transmitted to the bladder that pushes the urine out?
  • There is LITTLE DATA supporting SNM for urinary retention.
  • The degree of sphincter defect is the main cause of fecal incontinence.
  • What should a corrective action plan in CAPA typically include?
  • What is the most direct effect of increasing stimulation amplitude in SNM?
  • Which patient factor is important when selecting SNM therapy?
  • The Axonics INS is placed 4 cm below the iliac crest in the hollow of the ileum. Which bone region is this?
  • Name two common risk controls used in sacral neuromodulation implantation.
  • Beyond symptom relief, which outcome is commonly monitored during programming to assess SNM effectiveness?
  • In SNM AP imaging, which of the following is one of the three key structures?
  • Which statement about the process of adjusting SNM therapy during titration is true?
  • Which aspect of the sacroiliac joint is used as a landmark to identify the S3 foramen?
  • What does telemetry refer to in SNM devices?
  • Which regulatory body oversees medical devices in the United States?
  • What does PMCF stand for and entail?
  • Muscarinic receptors in the bladder primarily mediate which action?
  • There are typically how many posterior sacral foramina on each side for lead insertion?
  • What is the main purpose of Failure Modes and Effects Analysis (FMEA) in risk management for medical devices?
  • In rechargeable SNM systems, which factor most influences battery longevity besides stimulation parameters?
  • What is the primary purpose of MRI exposure guidelines in patients with SNM implants?
  • During the initial SNM activation, what is typically titrated to achieve the desired effect?
  • Abnormal communication between the bladder and the brain can be the results of which of the following?
  • What is source data verification (SDV) in clinical trials?
  • Injectable bulking agents are minimally invasive and have a high recommendation as an early treatment option for fecal incontinence.
  • Urinary retention is defined by which condition?
  • Which clinical outcome best reflects the therapeutic aim of SNM in overactive bladder?
  • Which statement about risk assessment approaches is true?
  • Post-void fullness is a symptom of urinary retention.
  • What clinical outcome would indicate a successful SNM trial before permanent implantation?
  • Biocompatibility testing assesses tissue compatibility; name two common tests.
  • CE marking stands for Conformité Européenne and indicates compliance with what?
  • What is the triangular region at the base of the urinary bladder between the openings of the ureters and urethra called?
  • The trigone of the bladder is formed by the openings of which structures?
  • What is a typical symptom that SNM aims to reduce in patients with urinary incontinence?
  • Which statement about risk management in medical devices is true?
  • Trial length and stimulation parameters for SNM in urinary retention are well established.
  • Which regulatory pathway is commonly used for class III medical devices in the United States?
  • How many individual muscles make up the levator ani?
  • Sacral neuromodulation is on-label to treat all types of urinary retention.
  • What is one reason radiation safety is easily taken for granted?
  • Approximately what percentage of patients discontinue overactive bladder medication within six months?
  • What is the clinical rationale for using sacral neuromodulation (SNM) therapy in overactive bladder?
  • ISO 14971 covers which critical activity in medical device risk management?
  • Which organization is cited as supporting sacral nerve modulation as a strong treatment option for fecal incontinence?
  • What is a standard first step in troubleshooting when a patient reports no stimulation?
  • Muscarinic receptors are responsible for what in the bladder?
  • What is data integrity in clinical research?
  • What is the purpose of impedance testing in sacral neuromodulation?
  • What is the first line of treatment in the patient care pathway for treatment of OAB according to guidelines?
  • What is the main distinction between a high-level risk assessment and a detailed FMEA?
  • Urinary retention is more common in men than in women.
  • Which of the following is a factor in continence?
  • Which factor most influences battery longevity in a rechargeable SNM system?
  • Which outcome is associated with sacral nerve modulation in patients with fecal incontinence?
  • What is the primary mechanism by which sacral neuromodulation modulates bladder activity?
  • In data integrity, which characteristic ensures that data remains accurate over its entire lifecycle?
  • Which of the following is NOT an indication for sacral neuromodulation (SNM)?
  • What is the purpose of a power analysis?
  • Which data point is most valuable in judging long-term SNM efficacy?
  • Fecal incontinence is defined as the involuntary loss of liquid or solid stool that causes a social or hygiene problem.
  • Which regulatory concept is defined by 21 CFR Part 803?
  • Urinary retention can be caused by both non-neurogenic and neurogenic etiologies.
  • Impedance monitoring helps determine lead health by indicating which of the following?
  • What does a 95% confidence interval mean in statistical terms?
  • Which features are used to determine the level of S3 in the lateral image?
  • Which tissue safety consideration is particularly important for implanted neuromodulation leads?
  • Where is the trigone located?
  • What does the term 'titration' refer to in SNM programming?
  • The detrusor muscle is which type of muscle?
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