Neurosciences Module Study Guide

Anatomy

Gross anatomy and functional anatomy will form about half your exam paper. With clinical correlates
and OSPE, the weightage of this discipline goes up to 60-70 percent. You need to start (EARLY) with this
discipline; everything else will make sense accordingly. The available resources are Kaplan, Najeeb,
Snells, BRS neuroanatomy, High Yield Neuroanatomy and Purves. Kaplan should be your mainstay
because most of the questions are from here only. But to understand various topics, you might need to
use other sources as references.

Videos: 2014 ones are generally recommended, and it is recommended to finish them in one go rather
than jumping to other disciplines in the middle. You may do the 2010 ones instead if you want to
though. Najeeb videos are NOT a must for every topic, but I think they compartmentalized some of the
information really well. Do the blood supply, meninges, CSF and ventricles and thalamus ones if you
don’t want to do all. I’ll be guiding you as to where exactly you’ll need these four topics below. You may
also do all of them, this guide highlights the bare minimum.

Clinical correlates: Very important. Make flashcards or reread them multiple times. Questions are lifted
off from these. End of chap summary: Found these to be useful in consolidating scattered information.
Would advise you to read them at the end.

# Topic Where to study this from? Yield

1. Nervous Entire chapter from Kaplan videos+text 8/10
System Pg 249 (Fig III-1-2) and Table III-1-1 should be on your fingertips. They tested these
Organization names a lot.
and Pg 247-8 are also high yield, revise 1st year neurulation concepts before covering this
Development Pg 250 Spina bifida types are important, study them well and google images for
them. You may skip Arnold Chiari. Dandy Walker was in the TA file so it’s advisable to
do this. Go through the entire table and look at what is the distinguishing factor of
each pathology – they almost always test that only
Pg 251 (derivates that are relevant to Neuro need to be rote-learnt, others can be
skipped)
Pg 252-55 A lot of complex concepts but kinda imp. Rewatch the video for this part
multiple times and google this. Most of it will make sense after Head and Neck. You
may also go through Dr Aneela Darbar’s slides on this topic.
2. Histology of Read through this chapter twice – should be enough. Has a lot of extra details. Imp 7/10
the NS stuff: Nissl, Lewy, Negri, kinesin vs dynein, tau protein, subtopic ‘glial and supporting
cells in CNS and PNS’
Pg 263 MS and GB syndrome are important, skip the rest
Pg 264 Ependymal cells (know what they are – imp) Pg 265 – very important
Pg 267 ULTRA high yield. Do the tumors from this table really well, then do them
from Pathoma, then from Kaplan Patho and then finally go through the LCF slides
(26/2/18). They love brain tumors; you must learn to love them too. Guaranteed
questions.
3. Ventricular Kaplan video+text for the entire chapter. I would really recommend Najeeb for this 8/10
System chapter. Give this some extra time and you’ll remember it till prof.
Najeeb topic = CSF and ventricular system (covers CSF production sites, flow,
ventricles, functions, lumbar puncture test, meningitis, types of hydrocephalus,
blood-brain barrier and blood CSF barrier) Beautifully taught
4. Spinal Cord I know you feel like you’ve already done enough for the summative, but this is where 10/10
the real stuff begins. Chap 4 onwards. Do Najeeb or Kaplan, whichever suits you.
Once you are done, take a blank paper or your whiteboard and draw these out:
- corticospinal tract
- dorsal column-medial leminiscus system
- spinothalamic tract
The importance of spinocerebellar pathways is always understated. These need to
be done really well, skip them for now but do them with Cerebellum – it’ll make
more sense that way
- cross section of spinal cord with where each tract is
Pg 295-298 are also important. Learn which tract is affected and where exactly is the
disease common (thoracic, lumbar, and cervical). Read up Tabes Dorsalis, B12
deficiency (subacute combined degeneration) and BS syndrome well.
What I didn’t like about this chapter was that the diagram of the SC was spread over
a lot of pages. They did that to make it easy to understand. If any of you want a
complete diagram with everything imp on one page, do let me know, I’ll send you a
picture of the final diagram I made.
5. Brain Stem 301-313. Highest yield for this entire module. Take some time with this, it’s a lot to 11/10
understand and you will need multiple reads of these pages to actually understand
what’s going on. The two-page table on 306 and 307 needs to be ratta-ed really well.
The nuclei are very high yield also. Loads of questions on which nucleus has what
function.
314-315. Understand what corticobulbar tract is, draw parallels with corticospinal
tract. The clinical correlate is very important – difference between a corticobulbar
lesion and a facial nerve lesion and difference between upper half and lower half of
the face need to be understood well.
Auditory system: Skip 316-320 Vestibular system: Most of it is part of Head and Neck
but I would still recommend watching the video at the very least. Horizontal
Conjugate Gaze is important. The three tables on pg325-327 and associated
diagrams need to be done. Do Caloric test (COWS) also, they might ask this.
Blood Supply – VERY high yield again. Najeeb was exceptionally brilliant for this, do
that. If you don’t have time, do page 328 really well.
Brain Stem lesions – Most of these will automatically make sense if you’ve done the
nuclei and blood supply well. Knowing the actual syndromes for Wallenberg and
Weber is important.
RAS (reticular activating system) – will cover in physio
I have typed notes with pictures of cross sections from other books; will upload
those if you guys need them.
For cranial nerves, you need to know the names, nuclei, functions from the table on
306 and 207 and anatomical course WITHIN the cranium. Peripheral course is part of
head and neck, so wherever you see that you’ve left the cranium, stop right there –
you’ve studied too much; leave that for head and neck. This is for those of you who
are doing Kaplan with other books/videos. Study smart, not hard.
6. Cerebellum Saadia Fatima – ‘Kaplan is great for everything except for Cerebellum; it’s insufficient 9/10
and poorly organized’. She did not say this to me but this is what I heard and
ignored. Regretted it during the exam. Please do not quote me on this, just letting
you guys know what I heard from someone. Personally, I HATED this chapter is
Kaplan – when I did it for prof from High Yield, it made complete sense for the first
time.
Kaplan is not enough for this chapter, it’s too muddled up. But you must watch
Kaplan videos for this to know what tf is going on. Read through the text and then do
this chapter from High Yield Neuroanatomy. Cerebellar Lesions and the clinical
correlate on page 344 are examiner’s favorite. Know why the net effect is ipsilateral.
Histology (all types of cell layers) is ultraimportant.
7. Basal Ganglia Know the difference between the indirect and direct pathway (both in terms of the 8/10
pathway itself and the function) Dopamine and Parkinson’s is a for-sure tested topic.
Table on page 351 – these were the ones that seniors marked for us: Parkinson,
Huntington and Hemiballism. Wilson and Tourette can be skipped.
8. Visual Skip this entire chapter. Or do it if you’re a rebel. Will not show up for sure. 0/10
Pathways
9. Diencephalon Nuclei of thalamus are important. Najeeb was apparently brilliant for thalamus. I 4/10
didn’t get time to do it myself but I’ve heard that he explained the entire topic very
very well. The table on pg 365 is important. Hypothalamus is low yield but is a part of
your syllabus. Do it if you want to but don’t think you should consider looking at
other sources for it. The table on 367 is way more than you need. Skipped it myself.
Epithalamus pg 371 – give it a read, again very low yield – don’t remember seeing
totes on this but just know what the epithalamus and subthalamus are.
10. Cerebral Huge chapter. Leave some time for this please. You should ideally do all of it. 7/10
Cortex Marking the important stuff: Pg 375, blood supply (if you’ve done Najeeb for blood
supply, this would be a breeze – again, would recommend doing it – it was actually
very well compartmentalized), table on 380, difference between Brocas and
Wernickes, between expressive and receptive aphasias, table and figure on pg387,
table on pg389 and 390.

11. Limbic System I do not know why this topic is part of the syllabus. I do not know why they test it
(moderately). I do not know why they teach us something they do not understand
themselves yet. This topic is still not understood well globally but AKU ki Curriculum
Committee ko pasand hai, toh hamein bhi pasand karna parega.
High yield – Papez Circuit, DIAGRAMS, functions, amgydala. Found high yield
neuroanatomy to be really good for this. Google images for this.
Learn this well and draw it out on your whiteboard/piece of paper. Make a
mnemonic for this. I think (vaguely remember) that there was one in the soft copy of
the tote files.
12. Meninges, Kaplan 236-241 (till before orbital muscles) 8/10
Sinuses and The Najeeb videos on this were also really good.
Hematomas Either source is fine, do this well for the OSPE
13. Skull Look up diagrams of the skull – what exits what foramina. Very high yield for OSPE. 9/10
14. Radiological MRI and CT – important for the OSPE. LCF slides should suffice 5/10
Anatomy
15. Zehra Jamil Do her slides on intracranial pathways (there’s also a document that she prepared, 6/10
ask your curriculum rep to get it and upload it), blood supply and embryo. Have
Kaplan/Brs with you if her slides do not make sense.
Most of this would be a review of what you’ve already covered above. This extra
effort can help with honors/a thorough revision.

Biochemistry

Weird, irrelevant stuff that does not link with the other disciplines – yeah, that’s biochem. Except for
neurotransmitters. I have my own complied neuro biochem notes with tote annotations; let me know if
you guys want that handout. Covers topics 1, 3 and 5. Did not bother doing the other two topics myself,
they did not show up in our year/previous years.

1. Glycolipid and glycoprotein
synthesis and degradation
2. Metabolic Requirements of
the CNS
3. Proteins: Folding,
degradation and Prions
4 Neurotransmitters
5. Biochemical basis of
memory and learning
PI LCF + Kaplan Biochem (257-250; table on 249 is high yield). 8/10
Difference between O-linked and N-linked, matching of diseases (Tay
Sach’s, Gaucher’s, MCD, others) with the associated enzyme
deficiencies. SAQ on this can also show up.
AA Siddiqui taught us this and there was just one question in every 3/10
tote file that they’d test from his LCF. Skipped the topic myself but
Hani Abidi took your LCF on this topic so go through his slides. Can
show up now.
Here’s what I did. Printed out important slides from KG’s LCF and 6/10
annotated them from youtube videos. Easy topic, mostly same totes
tested. But with the tote-mess that has happened this year, KG might
add a few questions of her own. Steps of ubiquitination are kind of
medium-yield, prions are more complex to understand. Do this if you
are the type to complete every single thing in the syllabus.
My strategy: pick a neurotransmitter and do everything about it. Site 9/10
of synthesis, pathway, removal mechanism, function and clinical
relevance/pathology. BRS neuroanatomy, Faezah’s notes and FA
tables should cover this. Some people also recommended Purve’s for
this. Use whichever source you are comfortable with, as long as you
are able to answer totes. There’s also a list somewhere in one of the
tote files, do that too. Re-read multiple times, very high yield. A lot of
it makes sense if you’ve done basal ganglia well.
Dr. Bushra Chaudhry takes this LCF. I skipped it because none of it 1/10
made sense. Ask someone from your batch who attended the LCF to
upload notes on this. Refer to the end of Asra’s document for existing
2009 notes on that topic if you must do it.

CHS

CHSME; we simply cannot thank this legend enough for letting us sleep on Thursday mornings. Try to
make mnemonics for the ratta part
 Microbiology

1. Nisseria Meningitidis, H
Influenza, M TB, HSV, Strep
Pneumo
Meningitis, Encephalitis and
Brain Abscess
MRS + Kaplan Microbio (if you could annotate your Kaplan with 8/10
MRS+/- Lange, that’ll save you a lot of time when IID comes – all
these will be tested again and your mainstay will be Kaplan)
You can do Lange if you want to be sure but the above two should
suffice imo. KJ LCF is important, do attend it. Do her slides too.
Do meningitis encephalitis and brain abscess with this only, it’ll make
more sense. Pathoma +/- Goljan. Sites of brain abscess are also
medium-yield.
Physiology

1. NMJ Physiology Zone videos are enough. Whatever you did in MSK. 8/10
2. Action Potential Kaplan Physio Section 2 Chapter 2. Easy stuff, you’ve sort of done this 7/10
before.
3. Synaptic Transmission Physiology Zone/Kaplan 8/10
There’s a list of 6 videos of PZ that Kaleem found and a lot of us used
those – they were amazing and we covered these LOs very quickly
4. Neuroreceptors Know the difference between ionotropic and metabrotropic. That 5/10
should be enough, just build a basic concept. You may also go
through KG’s incomplete slides on our drive
5. Conduction Studies and LAB manual 3/10
Repetitive Stimulation
6. RAS TJ LCF please. He’s given an entire SAQ on this in the past; someone Either
from your batch who took good notes should upload them. Zuviya a 0/10
made notes for this topic and I briefly skimmed through them, you or
can do that too – they’re on our drive. A lot of it will make sense if 10/10
you’ve done anatomy well. Glasgow Coma Scale is important to
understand as student/doctor because we see it in clinics, don’t think
it’s that important from the tote point of view. But it’s TJ, he can put
a question on this. You may also use Ganongs for this. He asks GCS in
his Viva, do make notes on this topic, it’ll make proffing easier.
7. EEG Don’t remember it to be a high yield topic in totes but you should 4/10
atleast know the difference between alpha, beta, theta and delta
waves. I personally did Guyton for this (not too much) but you can do
Faezah’s notes or Google if you’re short on time.
8. REM and non REM sleep Know the difference and the neurotransmitters of sleep (SAND – 6/10
serotonin, Ach, Norepi, dopa) and what effect they have (initiate etc)
They tested this a lot and our batch was discussing these totes till the
very last day. Stages of sleep is important in clinics, don’t think I saw
too many totes on this
9. Neuronal Circuits Ganongs if you must complete every single LO 4/10
10. Depression and Anxiety Mostly, they are interested in what happens to the 4/10
neurotransmitters. You can quickly skim through BRS behavioral
sciences for this. Also in First Aid
11. Memory/Limbic System Personally feel that the anatomy stuff you’ve done is more than 6/10
enough. You may go through Hamna Shahbaz notes just to be sure.
 Pathology:

Use MRS+Pathoma (and Lange/Goljan if you do big books) for microbio related pathologies
Use Kaplan Patho+Pathoma+Kaplan Anatomy for anatomy related pathologies
Use Pathoma+Goljan for others

1. Meningitis, Brain Abscess (+sites) and Encephalitis – with MRS/Lange/Kaplan. Do pathoma and
Goljan if you want to solidify it. Use the slides for the table of lab values of CSF, glucose and
WBC.
2. Parkinsons – Basal ganglia chapter first then pathoma/goljan. Very important
3. Myasthenia Gravis – very high yield. Pathoma + Goljan for sure. Need to do Goljan for this, there
are 4-5 totes just on this topic even.
4. Multiple Sclerosis – see if you understand pathoma, skim through goljan if you don’t.
5. Cerebrovascular diseases (stroke) – not too high yield but can show up. Kaplan Patho
6. Hemorrhage and hematoma (should’ve covered in Anatomy, was in the above selected Najeeb
videos I mentioned too)
7. Difference between epilepsy and seizure. Do Guyton for this, I remember seeing grand-mal
seizures in totes. Know status epilepticus.
8. Bipolar and unipolar syndrome – faltu topic. Do from BRS behavioral sciences +/- Hamna
Shahbaz notes
9. Alzheimers – VERY VERY high yield. Goljan
10. LCF on types of dementia if you want to (not too high yield)
11. Brain tumors – already covered earlier
12. Hypoxia and mechanism of injury and repair in CNS – BRS histo

Pharmacology

HUGE. Start early, make mnemonics. JJ/SAQ – you know the drill. Some people liked Kaplan pharma
videos but if you can manage to do UNDERSTAND them without videos, don’t waste time. However,
understanding neuro pharma can be a pain. Please do not leave this for the end, it’s a lot and will
require proper attention. SAQ also put up a post on Helping 021s, look at it. Some corrections were
made.

Read this (from Asra’s guide)

Tote note: as far as microbio is concerned this is what KJ said. " we don't give passive immunizations for ANY
microbe of meningitis. We only give active immunizations for H influenza, strep pneumoniae, and n meningititis.
And upon exposure we give rifampin or ciprofloxacin to n meningititis and h influenza. We don't give ANYTHING for
strep pneumoniae. Cus it doesn't Spread through contact. Now I know that's a little weird (and I couldn't say this to
her, cus tote are illiegal) cus 1 tote said, what to give upon exposure of strep. So for now just go with active
immuno if it comes up in the exam. And for that sheldon question that says passive immuno page 51, we will now
go with c. Provide chemoprophylaxis to health care workers. But if active immuno is given that will be the answer.
Don't worry if any of these weird questions turn up in the exam, I will take it up to the curriculum committee. But
for now this is the consensus.