[MCQ] Seizures and Epilepsy- Part 2

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Seizures and Epilepsy- Part 2

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Question 1

Which of the following is typical of EEG of clonic phase of Grand Mal seizure ?

A	High-amplitude activity interrupted by slow waves
B	High-amplitude activity interrupted by fast waves
C	Low-amplitude activity interrupted by slow waves
D	Low-amplitude activity interrupted by fast waves

Question 1 Explanation:

EEG during the tonic phase of Grand Mal seizure shows a progressive increase in generalized lowvoltage fast activity, followed by generalized high-amplitude, polyspike discharges. In clonic phase, high-amplitude activity is typically interrupted by slow waves to create a spike-and-wave pattern.

Question 2

Which of the following is false about atonic seizures ?

A	Sudden loss of postural muscle tone
B	Consciousness is briefly impaired
C	Significant postictal confusion
D	Seen in association with known epilepsy syndromes

Question 2 Explanation:

Atonic seizures are characterized by sudden loss of postural muscle tone lasting 1-2 seconds. Consciousness is briefly impaired, but there is usually no postictal confusion. Atonic seizures are usually seen in association with known epilepsy syndromes.

Question 3

Myoclonic seizure is a type of ?

A	Primary generalized seizure
B	Secondary generalized seizure
C	Simple partial seizure
D	Complex partial seizure

Question 4

Pathologic myoclonus is mostly seen in association with ?

A	Metabolic disorders
B	Degenerative CNS diseases
C	Anoxic brain injury
D	All of the above

Question 4 Explanation:

Pathologic myoclonus is commonly seen with metabolic disorders, degenerative CNS diseases or anoxic brain injury.

Question 5

Giant slow waves relate best with which of the following ?

A	Atonic seizures
B	Myoclonic seizure
C	Epileptic spasms
D	Atypical absence seizures

Question 5 Explanation:

EEG in epileptic spasms shows hypsarrhythmias (diffuse, giant slow waves with a chaotic background of irregular, multifocal spikes and sharp waves).

Question 6

“Electrodecremental response” in EEG is a feature of ?

A	Atonic seizures
B	Myoclonic seizure
C	Epileptic spasms
D	Atypical absence seizures

Question 6 Explanation:

“Electrodecremental response” or a marked suppression of EEG background is a feature of epileptic spasms.

Question 7

Seizures in Juvenile myoclonic epilepsy (JME) are most frequent in ?

A	Morning
B	Afternoon
C	Evening
D	Night

Question 7 Explanation:

Syndrome of JME, also known as Janz syndrome, accounts for ~7% of all cases of epilepsy. It is characterized by onset of myoclonic seizures, generalized tonic–clonic seizures, & absence seizures in adolescents (12 - 18 years) who have normal intellectual function, with EEG findings of rapid, generalized spike-wave & polyspike-wave discharges. They are most frequent in morning and can be provoked by sleep deprivation. Consciousness is preserved

Question 8

Which of the following statements about Lennox-Gastaut syndrome is true ?

A	Multiple seizure types
B	EEG shows slow (<3 Hz) spike-&-wave discharges
C	Impaired cognitive function
D	All of the above

Question 8 Explanation:

Triad of Lennox-Gastaut syndrome includes multiple seizure types, slow (<3 Hz) spike-and-wave discharges on EEG and impaired cognitive function

Question 9

Seizure types in Lennox-Gastaut syndrome include all except ?

A	Generalized tonic-clonic
B	Atonic
C	Myoclonic
D	Atypical absence seizures

Question 9 Explanation:

In children with Lennox-Gastaut syndrome, multiple seizure types include generalized tonicclonic, atonic and atypical absence seizures

Question 10

Most common syndrome associated with focal seizures with dyscognitive features is ?

A	Mesial temporal lobe epilepsy (MTLE)
B	Lennox-Gastaut syndrome
C	Juvenile myoclonic epilepsy (JME
D	All of the above

Question 10 Explanation:

Mesial temporal lobe epilepsy (MTLE) is the most common syndrome associated with focal seizures with dyscognitive features. Formerly it was known as “psychomotor epilepsy” (Gibbs et al, 1940).

Question 11

In Mesial temporal lobe epilepsy (MTLE), the characteristic MRI finding is ?

A	Hippocampal calcification
B	Hippocampal sclerosis
C	Increased signal intensity in frontotemporal region
D	Normal MRI

Question 11 Explanation:

On MRI, characteristic & essential finding of MTLE is hippocampal sclerosis.

Question 12

In Mesial temporal lobe epilepsy (MTLE), the MRI finding include all except ?

A	Small hippocampus
B	Small temporal lobe
C	Small temporal horn
D	Hippocampal sclerosis

Question 12 Explanation:

MRI findings in Mesial Temporal Lobe Epilepsy Syndrome include small hippocampus, small temporal lobe, enlarged temporal horn and hippocampal sclerosis

Question 13

Intracranial amobarbital or Wada test is performed for ?

A	Circulation adequacy of cerebral hemispheres
B	IQ level
C	Cerebral functions are localized to which hemisphere
D	Sleep pattern

Question 13 Explanation:

Named after Canadian neurologist Juhn A. Wada (University of British Columbia), this test is used to establish which cerebral functions are localized to which hemisphere. It is also known as the “intracarotid sodium amobarbital procedure” (ISAP) and is performed prior to ablative surgery for epilepsy and prior to tumor resection. The aim is to determine which side of the brain is responsible for certain vital cognitive functions, namely speech and memory. Sodium amobarbital is injected into one cerebral hemisphere at a time. Material-specific memory deficits on intracranial amobarbital (Wada) test is a feature of MTLE.

Question 14

Which of the following about Generalized epilepsy with febrile seizures plus (GEFS+) is false ?

A	Autosomal dominant inheritance
B	Presents with febrile seizures
C	May have variable seizure types not associated with fever
D	Autosomal recessive inheritance

Question 14 Explanation:

“Generalized epilepsy with febrile seizures plus” is a genetic syndrome consisting of febrile seizures plus at least one other type of seizure (absence, myoclonic, atonic, or afebrile generalized tonic–clonic seizures). It has autosomal dominant inheritance.

Question 15

Which of the following gene is associated with Generalized epilepsy with febrile seizures plus (GEFS+) ?

A	CHRNA4
B	SCN1B
C	KCNQ2
D	LGI1

Question 15 Explanation:

In Generalized epilepsy with febrile seizures plus (GEFS+), mutation occurs in the SCN1B (19q12.1) gene for the voltage-gated sodium channel which modifies gating and inactivation properties of the channel. Mutations in other sodium channel subunits (SCN1A and SCN2A) and GABAA receptor subunit (GABRG2 and GABRA1) have been reported.

Question 16

Which of the following about Benign familial neonatal convulsions (BFNC) is false ?

A	Autosomal dominant inheritance
B	Onset in first week of life
C	Mutations in KCNQ2 (20q13.3)
D	None of the above

Question 16 Explanation:

BFNC has autosomal dominant inheritance with onset in 1st week of life. Infants are normal with no neurologic or metabolic abnormality. Mutations have been identified in KCNQ2, gene for potassium channels on chromosomes 20q.

Question 17

Gene responsible for progressive myoclonus epilepsy (PME) or Unverricht-Lundborg disease is ?

A	LGI1
B	EPM2A
C	CSTB
D	SCN1B

Question 17 Explanation:

Progressive myoclonus epilepsy (PME) (Unverricht-Lundborg disease) has autosomal recessive inheritance with age of onset between 6-15 years presenting as myoclonic seizures, ataxia and progressive cognitive decline. CSTB mutation causes PME.

Question 18

Which of the following is false about Progressive myoclonus epilepsy (Lafora’s disease) ?

A	Autosomal recessive inheritance
B	Age of onset - 6 to 19 years
C	Polyglucosan intracellular inclusion bodies
D	Gene mution in SCN1B

Question 18 Explanation:

Gene mution occurs in EPM2A (6q24). The protein tyrosine phosphatase (PTP) - Laforin influences glycogen metabolism.

Question 19

Gene responsible for Autosomal dominant nocturnal frontal lobe epilepsy (ADNFLE) is ?

A	CHRNA4
B	EPM2A
C	CSTB
D	SCN1B

Question 19 Explanation:

Autosomal dominant nocturnal frontal lobe epilepsy (ADNFLE) occurs during childhood & presents as brief, nighttime seizures with prominent motor movements. Gene responsible is CHRNA4 (20q13.2).

Question 20

Which of the following about Autosomal dominant partial epilepsy with auditory features (ADPEAF) is false ?

A	Type of idiopathic lateral temporal lobe epilepsy
B	Age of onset usually between 10 and 25 years
C	Gene mutation in LGI1 (10q24)
D	None of the above

Question 21

Episodic dyscontrol syndrome is also called ?

A	Rage attacks
B	Time attacks
C	Ground attacks
D	Wall attacks

Question 22

West’s syndrome includes ?

A	Infantile spasms
B	Mental retardation
C	Hypsarrhythmic ÊG
D	All of the above

Question 22 Explanation:

West syndrome is a triad of infantile spasms, mental retardation & hypsarrhythmic EEG pattern

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See all quizzes of Seizures and Epilepsy at here:

1 Which of the following is typical of EEG of clonic phase of Grand
Mal seizure ?
A. High-amplitude activity interrupted by slow waves
B. High-amplitude activity interrupted by fast waves
C. Low-amplitude activity interrupted by slow waves
D. Low-amplitude activity interrupted by fast waves

2 Which of the following is false about atonic seizures ?
A. Sudden loss of postural muscle tone
B. Consciousness is briefly impaired
C. Significant postictal confusion
D. Seen in association with known epilepsy syndromes

3 Myoclonic seizure is a type of ?
A. Primary generalized seizure
B. Secondary generalized seizure
C. Simple partial seizure
D. Complex partial seizure
3 Pathologic myoclonus is mostly seen in association with ?
A. Metabolic disorders
B. Degenerative CNS diseases
C. Anoxic brain injury
D. All of the above

4 Giant slow waves relate best with which of the following ?
A. Atonic seizures
B. Myoclonic seizure
C. Epileptic spasms
D. Atypical absence seizures

5 “Electrodecremental response” in EEG is a feature of ?
A. Atonic seizures
B. Myoclonic seizure
C. Epileptic spasms
D. Atypical absence seizures

6 Seizures in Juvenile myoclonic epilepsy (JME) are most frequent
in ?
A. Morning
B. Afternoon
C. Evening
D. Night

7 Which of the following statements about Lennox-Gastaut syndrome
is true ?
A. Multiple seizure types
B. EEG shows slow (<3 Hz) spike-&-wave discharges
C. Impaired cognitive function
D. All of the above

8 Seizure types in Lennox-Gastaut syndrome include all except ?
A. Generalized tonic-clonic
B. Atonic
C. Myoclonic
D. Atypical absence seizures

9 Most common syndrome associated with focal seizures with
dyscognitive features is ?
A. Mesial temporal lobe epilepsy (MTLE)
B. Lennox-Gastaut syndrome
C. Juvenile myoclonic epilepsy (JME)
D. All of the above

10 In Mesial temporal lobe epilepsy (MTLE), the characteristic MRI
finding is ?
A. Hippocampal calcification
B. Hippocampal sclerosis
C. Increased signal intensity in frontotemporal region
D. Normal MRI

11 In Mesial temporal lobe epilepsy (MTLE), the MRI finding include
all except ?
A. Small hippocampus
B. Small temporal lobe
C. Small temporal horn
D. Hippocampal sclerosis

12 Intracranial amobarbital or Wada test is performed for ?
A. Circulation adequacy of cerebral hemispheres
B. IQ level
C. Cerebral functions are localized to which hemisphere
D. Sleep pattern

13 Which of the following about Generalized epilepsy with febrile
seizures plus (GEFS+) is false ?
A. Autosomal dominant inheritance
B. Presents with febrile seizures
C. May have variable seizure types not associated with fever
D. Autosomal recessive inheritance

14 Which of the following gene is associated with Generalized epilepsy
with febrile seizures plus (GEFS+) ?
A. CHRNA4
B. SCN1B
C. KCNQ2
D. LGI1

15 Which of the following about Benign familial neonatal convulsions
(BFNC) is false ?
A. Autosomal dominant inheritance
B. Onset in first week of life
C. Mutations in KCNQ2 (20q13.3)
D. None of the above

16 Gene responsible for progressive myoclonus epilepsy (PME) or
Unverricht-Lundborg disease is ?
A. LGI1
B. EPM2A
C. CSTB
D. SCN1B

17 Which of the following is false about Progressive myoclonus
epilepsy (Lafora’s disease) ?
A. Autosomal recessive inheritance
B. Age of onset – 6 to 19 years
C. Polyglucosan intracellular inclusion bodies
D. Gene mution in SCN1B

18 Gene responsible for Autosomal dominant nocturnal frontal lobe
epilepsy (ADNFLE) is ?
A. CHRNA4
B. EPM2A
C. CSTB
D. SCN1B

19 Which of the following about Autosomal dominant partial epilepsy
with auditory features (ADPEAF) is false ?
A. Type of idiopathic lateral temporal lobe epilepsy
B. Age of onset usually between 10 and 25 years
C. Gene mutation in LGI1 (10q24)
D. None of the above
20 Episodic dyscontrol syndrome is also called ?
A. Rage attacks
B. Time attacks
C. Ground attacks
D. Wall attacks
21 West’s syndrome includes ?
A. Infantile spasms
B. Mental retardation
C. Hypsarrhythmic EEG
D. All of the above

Seizures and Epilepsy

[MCQ] Seizures and Epilepsy- Part 2

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Seizures and Epilepsy- Part 2

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