Each question in this book has a corresponding answer，a reference to a text that provides background for the answer，and a short discussion of varions issues raised by the question and its answer.A listing of references for the entire book follows the last chapter.For multiple-choice questions，the one best response to each question should be selected.For matching sets，a group of questions will be preceded by a list of lettered options.For each question in the matching set，select one lettered option that is most closely associated with the question.
PreTest is the closest you can get to seeing the test before you take it Great for clerkship review and the USMLE Step 2 CK！ Neurology： PreTest asks the right questions so youll know the right answers. Open it and start learning whats on the test. student tested and reviewed ...contains much of the relevant high-yield information that a student should amass during their Neurology clerkship. I believe a student that does well on the PreTest questions is set up to do well on their board or shelf exam. ——Michael Allison, Medical Student, SUNY Downstate ...covers the essentials needed for successfully mastering the shelf exams as well as the USMLE. The questions cover the most high-yield topics in Neurology and are an excellent review for exam taking. ——Alexis Dallara, Medical Student, SUNY Downstate 500 USMLE-style questions and answers Detailed explanations for right and wrong answers Targets what you really need to know for exam success Student tested and reviewed
Introduction
The Neurological Examination and Diagnostic Tests
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Answers
Cerebrovascular Disease
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Answers
Epilepsy and Seizures
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Answers
Headache and Facial Pain
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Traumatic and Occupational Injuries
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Infections
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Neoplasms
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Nutritional and Metabolic Disorders
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Dementia and Cognitive Disorders
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Movement Disorders
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Disorders of Myelination
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Developmental and Hereditary Disorders
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Neuromuscular Disorders
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Toxic Injuries
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Eye Disease and Visual Disturbances
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Disturbances of Hearing，Balance，Smell，and Taste
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Spinal Cord and Root Disease
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Peripheral Neuropathy
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Neurological Emergencies
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Appendix
Bibliography
7. The answer is b. （Popper, pp 237-239.） Most rhythmic to-and-fro movements of the eyes are called nystagmus. Nystagmus has a fast component in one direction and a slow component in the opposite direction. Nys- tagmus with a fast component to the right is called right-beating nystagmus. Phenytoin （Dilantin） may evoke nystagmus at levels of 20 to 30 mg/dL. The eye movements typically appear as a laterally beating nystagmus on gaze to either side; this type of nystagmus is called gaze-evoked. If the patient has nystagmus on looking directly forward, he or she is said to have nystagmus in the position of primary gaze. Therapeutic levels for phenytoin are usually 10 to 20 mg/dL, and some patients develop asymptomatic nystagmus even within that range. Ataxia, dysarthria, impaired judgment, and lethargy may also occur at toxic levels of phenytoin. Many other drugs, such as alcohol, barbiturates, and other sedatives, also evoke nystagmus. Weakness of abduction of the left eye, or abducens palsy, is due either to injury to the sixth cranial nerve or to increased intracranial pressure. Impaired convergence can occur normally with age or may be a sign of injury to the midbrain. Papilledema is a sign of increased intracranial pres- sure. Impaired upward gaze may occur in many conditions, but would not be expected to occur due to a toxic phenytoin level.
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