ACNS Self-Assessment PDF

**Select all correct options for Main Term 1 (localization of a pattern):** A. Lateralized B. Multifocal C. Bilateral asymmetric D. Bilateral asynchronous E. Generalized F. Unilateral independent G. Bilateral independent H. Regional 2. **Select all correct options for Main Term 2:*...

**Select all correct options for Main Term 1 (localization of a pattern):** A. Lateralized B. Multifocal C. Bilateral asymmetric D. Bilateral asynchronous E. Generalized F. Unilateral independent G. Bilateral independent H. Regional 2. **Select all correct options for Main Term 2:** A. Sharply contoured B. Spike-and-Wave/ Sharp-and-Wave C. Rhythmic delta activity D. Irregular/polymorphic delta activity E. Periodic Discharges F. Paroxysmal Fast Activity G. Epileptiform Discharges 3. **A pattern is considered to be present only when it continues for at least \_\_\_\_ cycles.** A. 3 B. 4 C. 5 D. 6 E. 10 F. None of the above; it has to be present for at least 10 seconds 4. **If a pattern is seen in Fp1 and Fp2 equally and synchronously but not seen in posterior head regions (and is not artifact) this is best described as:** A. Lateralized, bifrontal predominant B. Lateralized, bilateral asymmetric C. Lateralized, bilateral asynchronous D. Focal, bifrontal E. Generalized, frontally predominant F. Bilateral independent G. Bifrontal maximal 5. **If a rhythmic or periodic pattern is seen mostly on the left, but with a synchronous lower voltage component on the right, this is best described as:** A. Lateralized, bifrontal predominant B. Lateralized, bilateral asymmetric C. Lateralized, bilateral asynchronous D. Generalized, left predominant E. Bilateral independent, left\>right 6. **The main difference between a rhythmic pattern and a periodic pattern is:** A. Frequency B. Morphology C. Sharpness D. Regularity E. Presence or absence of an interdischarge interval 7. **A \"discontinuous\" record is defined as:** A. A record with periods of suppression/attenuation of up to 3 seconds B. A record with periods of suppression/attenuation of up to 5 seconds C. A record with periods of suppression/attenuation of up to 10 seconds D. A record with a suppression/attenuation percent of 1-9% E. A record with a suppression/attenuation percent of 10-49% F. A record with a suppression/attenuation percent of 50-99% 8. **If a pattern qualifies as PDs and RDA simultaneously and both are equally prominent, it should be classified as:** A. Electrographic status epilepticus B. PDs and RDA separately C. PDs D. RDA E. PDs+R F. RDA+S G. PDs+FR 9. **In an 1-hour EEG recording with many 1-minute long electrographic seizures, how many total minutes of seizure activity are required within that hour for it to qualify as electrographic status epilepticus (ESE)?** A. 5 B. 10 C. 12 D. 15 E. 20 F. 30 10. **Which of the following patterns is NOT on the Ictal-Interictal Continuum (IIC)?** A. GPDs at 2 Hz B. GPDs at 3 Hz C. Fluctuating LRDA at 2 Hz D. LPDs+R at 1 Hz E. LPDs+R at 0.5 Hz 11. **An isolated 8 second focal evolving pattern that starts at 6 Hz, slows to 2 Hz, and has no clinical correlate is best characterized as:** A. Very brief electrographic seizure B. Highly epileptiform burst C. Evolving LRDA D. Fluctuating LRDA E. Possible Brief potentially Ictal Rhythmic Discharges (BIRDs) F. Definite Brief potentially Ictal Rhythmic Discharges (BIRDs) 12. **Which of the following does NOT qualify as electrographic status epilepticus?** A. 12-minutes of continuous electrographic seizure B. 31-minutes of continuous electrographic seizure C. Five 3-minute long electrographic seizures in an hour D. Ten 2-minute long electrographic seizures in an hour E. 30-minutes of 2-Hz GPDs that resolves with administration of an IV benzodiazepine 13. **8-second runs of 0.5-Hz LRDA that are consistently associated with speech arrest are best classified as:** A. LRDA B. Evolving LRDA C. Electrographic seizures D. Electroclinical seizures E. Brief potentially Ictal Rhythmic Discharges (BIRDs) 14. **An IV anti-seizure medication is given to an unresponsive patient whose EEG shows \>1 hour of 1-2 Hz GPDs+R. The pattern resolves and the patient begins to follow commands. This is best referred to as:** A. Ictal-interictal continuum B. Electrographic status epilepticus C. Electroclinical status epilepticus D. Possible electrographic status epilepticus E. Possible non-convulsive status epilepticus 15. **A background that consists of continuous 6-7 Hz activity of 70 uV on the right and continuous 6-7 Hz activity of 50 uV on the left is best described as:** A. Symmetric B. Mild asymmetry C. Marked asymmetry D. Fluctuating asymmetry E. Static asymmetry 16. **If a patient goes unstimulated for the entire duration of their 6-hour record and the EEG demonstrates continuous unchanging 7-Hz activity, reactivity is best described as:** A. Reactive B. Unreactive C. Minimally reactive D. SIRPIDs-only E. Unknown F. Asleep 17. **A patient has sporadic epileptiform discharges that occur roughly every 20-30 seconds in a non-regular fashion. The prevalence of these discharges is best described as:** A. Rare B. Periodic C. Occasional D. Frequent E. Abundant F. Continuous 18. **A Rhythmic and Periodic Pattern that is present for 8% of the record is best described by what prevalence?** A. Brief B. Abundant C. Intermediate duration D. Occasional E. Rare F. Frequent 19. **A patient has several hours of a pattern characterized by a blunt delta wave through the left hemisphere occurring every 5 seconds.  Each delta wave is time-locked with a twitch of their right thumb. This is best described as:** A. Slow LPDs B. Blunt LPDs C. Hemispheric LPDs D. Extreme delta brush E. Electrographic seizure F. Electrographic status epilepticus G. Electroclinical status epilepticus 20. **For patients with a Developmental and Epileptic Encephalopathy, which of the following is sufficient to qualify as Electroclinical Status Epilepticus?** A. An increase in prominence or frequency of epileptiform discharges compared with baseline, with an observable decline in clinical state B. EEG improvement with a parenteral (typically IV) antiseizure medication to a record without any epileptiform findings C. EEG improvement with a IV benzodiazepine to a record without any epileptiform findings D. Altered mental status associated with abundant multifocal epileptiform discharges on their EEG E. Altered mental status associated with an electrographic pattern that falls on the ictal-interictal continuum 21. **Over the course of a 6 hour EEG a patient is stimulated several times in accordance with a standardized stimulation protocol. Each time they are stimulated there is EMG artifact but there is no change to cerebral rhythms. This would be best described as:** A. Reactive B. Unreactive C. Minimally reactive D. SIRPIDs-only E. Asleep 22. **If LPDs were present for 50% of the first 16 hours and 25% of the following 8 hours, what would the daily pattern burden be for that 24 hour period?** A. 2 hours B. 4 hours C. 8 hours D. 10 hours E. 15 hours F. 16 hours 23. **If a left hemispheric population of LPDs occurs at the same time (i.e., present on the same page of EEG) as an independent population of periodic discharges (PDs) occurring in the midline, this should be characterized as:** A. LPDs B. Two populations of LPDs C. left hemispheric LPDs and GPDs D. UIPDs E. BIPDs F. MfPDs 24. **For Brief potentially Ictal Rhythmic Discharges, which is NOT sufficient on its own for the pattern to qualify as definite BIRDs?** A. Similar morphology and location as interictal epileptiform discharges in the same patient B. Similar morphology and location as seizures in the same patient C. Evolution of a pattern from 2 Hz to 6 Hz, lasting less than 10 seconds D. Evolution of a pattern from 5 Hz to 3 Hz, lasting less than 10 seconds E. Frequency of 6 Hz lasting less than 10 seconds 25. **A 6 hour EEG recording consists of continuous 6-Hz activity together with 15-Hz spindle-like activity. The only time there was a change in the EEG was at the time of stimulation that resulted in 2.5-Hz high voltage GRDA for 30 seconds. The state changes for this patient are best described as:** A. Present with normal stage N2 sleep transients B. Present with abnormal stage N2 sleep transients C. Present but without stage N2 sleep transients D. SIRPIDS-only E. Absent 26. **Which letter is the appropriate measure of the voltage of the circled discharge? (assuming a bipolar montage)** A. A B. B C. C D. D E. T  27. **The above pattern is best described as:** A. Electrographic seizure B. Fluctuating periodic discharges C. Abundant sharp waves D. Ictal-interictal continuum E. Brief potentially Ictal Rhythmic Discharges (BIRDs) 28. **The above pattern is best described as:** - Electrographic seizure - RDA no plus - RDA plus fast (RDA+F) - Definite extreme delta brush - Possible extreme delta brush  29. **If the above pattern was abundant through a record this would be best described as:** A. Electrographic seizure B. RDA plus fast (RDA+F) C. PDs no plus D. Definite extreme delta brush E. Possible extreme delta brush 30. **If the above pattern was abundant through a record this would be best described as:** A. Electrographic seizure B. PDs no plus C. PDs plus fast (PDs+F) D. PLEDs-plus E. Definite extreme delta brush F. Possible extreme delta brush  31. **How many phases does this burst have when assessed in the highlighted channel?** A. 1 B. 2 C. 3 D. 4 E. 5 F. 8