Resources
Up To Date
-For your patients-the more you read on your patients the better your overall preparation.
Student American Academy of Neurology exam
- https://www.aan.com/NeuroSAE/PublicSite/ExamDetails/152
- twenty five dollars
- for the student looking for more questions that are challenging and cover the majority of areas for the Neuro exam
NBME exam: very helpful, some questions seemed to appear on the shelf however no explanations.
Case files Neurology– gives clear cut pictures on basic presentations, no nuance or depth that shelf questions will often probe at. Case files-most normal presentations of the biggest disease, the breadth of coverage is insufficient, also clunky if you wish to reference a specific illness.
Blueprints Neurology: great for a firm basis of pathology and knowledge for reference, not a quick read.
Pretest Neurology-will provide questions on all the areas of neuro but not in SHELF format.
Pathoma: worth reading over for neurology diseases since every shelf exam will build on basic pathology knowledge. If you used this during step 1 preparation, reading over it should be more of a review process.
Kaplan Notes Neurology-found online or in the shared dropbox, broken up by topic but not all inclusive.
Goljan Rapid Review Pathology: very useful for quick reference of pathology. Just because it is year 3 does not make this useless! Many of your attendings will ask you basic physiology found in this book.
USMLE World Internal Medicine Subsection Neurology.
-not all encompassing but reading the explanations as always is to your benefit.
MKSAP questions on Neurology
-a quick review 26 questions but to your benefit.
MKSAP questions on rheumatology
-questions related to weakness permeate this exam, you are often tasked with discerning rheumatological vs true neurological processes.
First Aid for Step 1
-often reviewing your basic pathophysiology will pay dividends on clinical medicine exams.
Step Up to Medicine-neuro and ambulatory sections
-this exam will have ambulatory patients with MSK (back) problems that need to be discerned from neurological concerns
High Yield Question Areas
Note: There will always be “zebra” questions but these are not worth mentioning since it could just be said to know everything in a field. The following are what you WILL see and if you know all of these you will most certainly pass and likely honor.
As with every other shelf, the exam is testing on what a medical student NOT going into the field should know, very specific treatments in the field are not usually tested, except big red flags as noted below.
0. The basics of neurology: First you have to figure out if the issue is central (CNS) or peripheral. Then you have to figure out the level of the lesion: muscle, nerve, neuromuscular junction. THIS IS THE BASIS OF HOW TO THINK ON NEURO, IT IS ABOUT LOCALIZING THE PROCESS.
1. Make sure to review your basic path for strokes for different areas of the brain and spinal cord via pathoma, goljan, and the trauma from pestana. This is also high yield and helpful for when you are in the stroke ICU at Ford for inpatient.
2. There will probably be 7 MS questions, all of them women with optic neuritis or another major manifestation and then something else is wrong, maybe pathology or maybe dx or treatment.
3. There will be 3-4 guillane barre questions
4. There will be a lot of questions that have to do with old people and whether or not they have Alzheimer’s or another form of dementia induced by hypothyroid, syphilis, b12 or front temporal, jc virus, hiv dementia,
5. There will be 30% psych questions on this exam somewhat already covered by the dementias, related to how “crazy” people can be due to medications (alcohol psychosis, drug psychosis).
6. DEMENTIA VS. DELIRIUM IS HUGE.
7. BIG part of the psych questions is to know what neurotransmitters or chemicals are changed with different conditions. Such as ACH is increased in PD and there is a loss of dopamine and the reverse for HD, dopamine is in excess for schizophrenics, etc.
8. Parkinsons and Huntingtons and hemiballismus, review that diagram dr. walker made from neuro during first year, it's on wikinotes here: http://wikinotes.osmso.org/index.php/Neuroscience:_Basal_Ganglia
9. Know your tumors, although this is minor, I would use goljan and pathoma and that is it.
10. 10. You will have a lot of questions on weakness in a person and have to figure out why that is. Follow the neuro thought process in number 0.
11. For the weakness (peripheral neuropathies) it can be MS, myasthenia gravis, lambert eaton, hypothyroidism is actually a cause, dermatomyositis, polymyositis, viral polymyositis. This is all rheumatology and it is all on this exam.
12. Meningitis in a baby, in a sexually active teenager, in an old person
13. peripheral nerve lesion syndromes (klumpke, common peroneal, brachial plexus injuries, I would review First Aid for these and call it a day.
14. other nerve lesion issues (wallenberg syndrome, bells palsy, brown sequard, als, transverse myelitis,
15. back issues (paralumbar muscle strain vs spondylothesis vs disc herniation, there's a piece on the back in the ambulatory step up to medicine.
16. Metabolic causes of dementia nieman picks, PKU, galactosemia,
17. Seizures: If it is a young adult it is most likely herpes encephalitis in the temporal region, a kid has absence seizures and if it is tonic clonic it COULD just be cardio syncope (probably not) and it could be vasovagal or a real seizure.
18. Malignant hyperthermia (answer-dantrolene), drug overdoses, fixing drug overdoses, knowing the mechanism of action of different drug overdoses.
19. cervical dystonia
20. botulism
21. vitamin b12, thiamine deficiencies
22. consequences of diabetes (every exam has diabetes and alcohol in medical school) for peripheral neuropathy, diabetic retinopathy and strokes.
23. be able to read a CSF reading
24. know what Idiopathic intracranial hypertension is, treatment as well
25. what an eeg pattern will tell you for different seizure definition.
26. emg for telling if a lesion is peripheral vs central, know the different demylenating diseases in depth!
27. General knowledge of the applicability of Alcohol, Smoking, and Diabetes (the big three of medical school) to the exam in question. Always good for 5-10 questions on the shelves.
Regarding Step 2
-most likely your uworld and medicine questions will cover the neurology you need to know. Specific preparation books on neurology for step 2 are not high yield.
Up To Date
-For your patients-the more you read on your patients the better your overall preparation.
Student American Academy of Neurology exam
- https://www.aan.com/NeuroSAE/PublicSite/ExamDetails/152
- twenty five dollars
- for the student looking for more questions that are challenging and cover the majority of areas for the Neuro exam
NBME exam: very helpful, some questions seemed to appear on the shelf however no explanations.
Case files Neurology– gives clear cut pictures on basic presentations, no nuance or depth that shelf questions will often probe at. Case files-most normal presentations of the biggest disease, the breadth of coverage is insufficient, also clunky if you wish to reference a specific illness.
Blueprints Neurology: great for a firm basis of pathology and knowledge for reference, not a quick read.
Pretest Neurology-will provide questions on all the areas of neuro but not in SHELF format.
Pathoma: worth reading over for neurology diseases since every shelf exam will build on basic pathology knowledge. If you used this during step 1 preparation, reading over it should be more of a review process.
Kaplan Notes Neurology-found online or in the shared dropbox, broken up by topic but not all inclusive.
Goljan Rapid Review Pathology: very useful for quick reference of pathology. Just because it is year 3 does not make this useless! Many of your attendings will ask you basic physiology found in this book.
USMLE World Internal Medicine Subsection Neurology.
-not all encompassing but reading the explanations as always is to your benefit.
MKSAP questions on Neurology
-a quick review 26 questions but to your benefit.
MKSAP questions on rheumatology
-questions related to weakness permeate this exam, you are often tasked with discerning rheumatological vs true neurological processes.
First Aid for Step 1
-often reviewing your basic pathophysiology will pay dividends on clinical medicine exams.
Step Up to Medicine-neuro and ambulatory sections
-this exam will have ambulatory patients with MSK (back) problems that need to be discerned from neurological concerns
High Yield Question Areas
Note: There will always be “zebra” questions but these are not worth mentioning since it could just be said to know everything in a field. The following are what you WILL see and if you know all of these you will most certainly pass and likely honor.
As with every other shelf, the exam is testing on what a medical student NOT going into the field should know, very specific treatments in the field are not usually tested, except big red flags as noted below.
0. The basics of neurology: First you have to figure out if the issue is central (CNS) or peripheral. Then you have to figure out the level of the lesion: muscle, nerve, neuromuscular junction. THIS IS THE BASIS OF HOW TO THINK ON NEURO, IT IS ABOUT LOCALIZING THE PROCESS.
1. Make sure to review your basic path for strokes for different areas of the brain and spinal cord via pathoma, goljan, and the trauma from pestana. This is also high yield and helpful for when you are in the stroke ICU at Ford for inpatient.
2. There will probably be 7 MS questions, all of them women with optic neuritis or another major manifestation and then something else is wrong, maybe pathology or maybe dx or treatment.
3. There will be 3-4 guillane barre questions
4. There will be a lot of questions that have to do with old people and whether or not they have Alzheimer’s or another form of dementia induced by hypothyroid, syphilis, b12 or front temporal, jc virus, hiv dementia,
5. There will be 30% psych questions on this exam somewhat already covered by the dementias, related to how “crazy” people can be due to medications (alcohol psychosis, drug psychosis).
6. DEMENTIA VS. DELIRIUM IS HUGE.
7. BIG part of the psych questions is to know what neurotransmitters or chemicals are changed with different conditions. Such as ACH is increased in PD and there is a loss of dopamine and the reverse for HD, dopamine is in excess for schizophrenics, etc.
8. Parkinsons and Huntingtons and hemiballismus, review that diagram dr. walker made from neuro during first year, it's on wikinotes here: http://wikinotes.osmso.org/index.php/Neuroscience:_Basal_Ganglia
9. Know your tumors, although this is minor, I would use goljan and pathoma and that is it.
10. 10. You will have a lot of questions on weakness in a person and have to figure out why that is. Follow the neuro thought process in number 0.
11. For the weakness (peripheral neuropathies) it can be MS, myasthenia gravis, lambert eaton, hypothyroidism is actually a cause, dermatomyositis, polymyositis, viral polymyositis. This is all rheumatology and it is all on this exam.
12. Meningitis in a baby, in a sexually active teenager, in an old person
13. peripheral nerve lesion syndromes (klumpke, common peroneal, brachial plexus injuries, I would review First Aid for these and call it a day.
14. other nerve lesion issues (wallenberg syndrome, bells palsy, brown sequard, als, transverse myelitis,
15. back issues (paralumbar muscle strain vs spondylothesis vs disc herniation, there's a piece on the back in the ambulatory step up to medicine.
16. Metabolic causes of dementia nieman picks, PKU, galactosemia,
17. Seizures: If it is a young adult it is most likely herpes encephalitis in the temporal region, a kid has absence seizures and if it is tonic clonic it COULD just be cardio syncope (probably not) and it could be vasovagal or a real seizure.
18. Malignant hyperthermia (answer-dantrolene), drug overdoses, fixing drug overdoses, knowing the mechanism of action of different drug overdoses.
19. cervical dystonia
20. botulism
21. vitamin b12, thiamine deficiencies
22. consequences of diabetes (every exam has diabetes and alcohol in medical school) for peripheral neuropathy, diabetic retinopathy and strokes.
23. be able to read a CSF reading
24. know what Idiopathic intracranial hypertension is, treatment as well
25. what an eeg pattern will tell you for different seizure definition.
26. emg for telling if a lesion is peripheral vs central, know the different demylenating diseases in depth!
27. General knowledge of the applicability of Alcohol, Smoking, and Diabetes (the big three of medical school) to the exam in question. Always good for 5-10 questions on the shelves.
Regarding Step 2
-most likely your uworld and medicine questions will cover the neurology you need to know. Specific preparation books on neurology for step 2 are not high yield.