A.

Week 1
1. Describe major components of forebrain, brainstem, spinal cord
2. Mention major sulcus and gyrus of the surface of the brain
Mention 5 cerebral lobes
Mention 3 meningeal layers and spaces between them
3. Explain organization of ventricular system and circulation of CSF; its production, flow, and
absorption
4. Explain pathophysiology of hydrocephalus and its classification
5. Mention and explain abnormalities in the development of CNS

B. Week 2
1. Draw and explain function of BBB
2. Describe the mechanism of increased ICP and its signs and symptoms
3. Seizure definition and classification
4. Describe epileptic and status epilepticos
5. Mention some of etiologies of unconscious patient

C. Week 3
1. Explain the origin of carotid arteries and its main branches
Explain circle of willis with images and specify the origin of each blood vessels
2. Describe the pathophysiology of neuronal damage (ischemic cascade) in the brain due to blockage
of blood vessel
3. Describe stroke classification based on etiology and vascular system
4. Explain how patient with chronic hypertension have a risk of hemorrhagic stroke
Explain how patient with diabetes mellitus have a risk of ischemic stroke
5. How to differentiate hemmorhagic stroke and ischemic stroke in clinical practice
(The difference sign and symptom between them)

D. Week 4
1. Mention cranial nerves with motor component
Mention cranial nerve involved in eye movement
2. Explain vestibuloocular reflex
3. Explain difference in clinical symptom between peripheral facial nerve disorder and central facial
nerve disorder
4. Explain function of cerebellum and clinical symptoms due to cerebellum disorders
5. Explain neurological exam to assess cerebellum function

E. Week 5
1. Draw and explain cross-section of cervical spinal cord and its pathway components
2. Explain with picture corticospinal tract/pathway from the cortex to the spinal cord, including its
function and areas.
3. Explain differences of clinical symptoms of UMN and LMN lesion
4. Describe clinical symptoms due to lesion of radial nerve, median nerve, and ulnar nerve.
5. Explain about Brown Sequard Syndrome (with images)

F. Week 6
1. What is the definition of aphasia? Describe pathophysiology and classification
2. Describe location of language area in the cortex cerebrii (Draw it)
3. Describe pathophysiology of alzheimer disease and clinical symptoms
4. Describe pathophysiology of parkinson disease an dclinical symptoms

G. Week 7
1. Explain signs and symptoms of : Hallucination, delusion, - symptoms, + symptoms, Insight
2. Meaning of mental organic disorder
3. Explain variosu substance abuse disorder, and mechanism in neurotransmitter
4. Whats neurotransmitter disorder of schizophrenia?
Please describe dopamine pathway of schizophrenia.
5. Schizophrenia : Criteria diagnostic, antipsychotic typical and atypical
6. Explain about : schizoaffective, schizopreniform, brief psychotic disorder, delusional disorder

H. Week 8
1. Explain various mood disorder
2. Describe HPA axis (Hypothalamic Pituitary Adrenal axis) limbic system and role of serotonin
3. Explain criteria diagnostic of Manic disorder and depressive disorder
4. Explain meaning of : Phobia, Post traumatic stress disorder, Somatoform dissociative
5. Explain difference of anorexia nervosa and bulimia nervosa
6. Explain various drugs of mood stabilizer, antidepressant, antianxiety
7. Describe :
Borderline, avoidance, OCD, Antisocial, histrionic, schizoid, narcisstic
8. Explain meaning of paraphilia and its example

Hydrocephalus
patofisiologi :
1. obstruction flow csf
2. reduce absorptioncsf
3. overproduction csf

Non Communicating (intraventricular)

- caused by obstruction in csf flow
- bisa krn congenital abnormalities : stenosis aquaductus sylvii, Dandy Walker malformation
(atresia luschka and magendi -> defect 4th ventricle)
- bisa karena tumor

Communicating (extraventricular)
- caused by overproduction csf or impaired absorption
- tumor choroid : overproduction
- bacterial/viral meningitis, inflamm, subarachnoid hemorrhage : impaired absorption

Clinical
bulging fontanel, sunset eyes, scalp skin thin, dilated vein, crack pot sign, sign ICP naik (vomit
lethargy irritability)

Diagnostic
- translumination test
- definitive : CT
Treatment
- acetazolamide or mannitol or furosemide
- VP shunt

Congenital Toxo
- chorioretinitis, hydrocephalus, intracranial calcification
- treatment :
1. pyrimethamine & leucovorin (folinic acid)
2. pyrimethamine + sulfadiazine
additional : prednisone buat chorioretinitis

Spina bifida occulta : defect in vertebrae, ga ada jendol tapi dekok ke dalem, bisa ad rambut
Meningocele : defect in vertebrae, meninges kluar jadi jendol
Myelomeningocele : defect vertebrae, meninges + spinal cord cord keluar, jendol uda tmbh gede
Encephalocele : di occipital
- Cranial meningocele : CSF sac only
- Cranial encephalocele : CsF sac + cerebral cortex, cerebellum, or brainstem
Anencephaly : defect calvarium, meninges, scalp, brain ilang
Syringomelia: tubular cavitation di spinal cord, associated with Chiari malformation : cerebellar
vermis

MCA - aphasia, hemiphlegia

ACA - kaki lemes
PCA - loss of vision

Aphasia :
Global aphasia
Fluent aphasia : wernicke
Non fluent : broca
Conduction : arcuate fasciculus
Transcortical motor : watershed di frontal
Transcortical sensory : watershed di temporal

Transient Ischemic Attack - mini stroke, symptoms nya akan hilang dalam bbrp menit sampe satu
jam

Stroke, di bagi menjadi 2 :

1. Ischemic stroke 80% of stroke cases
Caused by thrombosis due to atherosclerosis, atau embolism form atrial fibrillation (blood stasis)
Sign and symptoms -> classic triad ( face dropping, arm weakness, slurred speech)
Diagnosis : CT, MRI, angiography
Treatment : rt-PA within 3 hours onset, insulin if hyperglycemia and oxygen
Prevention : First Line - aspirin
2. Hemorrhagic stroke 20% cases
Intracerebral and subarachnoid hemmorhage
Caused by prolonged hypertension, aneurysm, AVM
Sign and symptoms : sudden onset of severe headache, nuchal rigidity, nausea and vomiting,
syncope
Diagnosis : CT, MRI
Treatment : anticonvulsant (benzodiazepine if seizure), BP control ( B blocker - labetalol, ACEi -
enalapri), if ICP increase ( fowler position, mannitol and hyperventilation), if life threatening
surgery
Prevention : diuretic, CCB, ACEI, ARB, statin, lifestyle modification

Guillain barre syndrome - clinical syndromes that manifests as an acute inflammatory

polyradiculoneuropathy
Caused by C jejuni, cytomegalovirus, epstein barr
Classifications :
1. Acute Inflammatory demyelinating polyneuropathy
The most common form because jejuni infection. It demyelination and there is lymphocytic
infiltration
2. Acute Motor Axonal Neuropathy
Motor disorder, wallerianlike degeneration without lymphocytic infiltration
3. Acute Motor-sensory Axonal neuropathy
Like AMAN but also affect sensory
4. Miller Fisher syndrome
Classicaly presents as a triad of ataxia, areflexia and ophthalmoplehoplegia

Sign and symptoms :

Weakness is ascending, shortness of breath, diplopia, dysarthria, dysphagia, tachy/bradycardia,
facial flushing, paroxysmal hypertension, orthostatic hypotension, dyspnea on exertion
Diagnosis :
EMG shows prolongation of F wave, albumin cytologic dissociation in LP
Treatment :
Resporatory therapy, cardiac monitoring, IV immunoglobulin, and plasmapheresis

Myasthenia gravis : rare autoimmune disorder in which antibodies form against ACH nicotinic
postsynaptic receptors at the neuromuscular junction of skeletal muscle

Sign and symptoms : muscle weakness and ptosis (dropped eye lid), weakness is least severe at
morning and worsen as day progress, weakness is increase in exertion and decrease by resting
Diagnosis : anticholinesterase test, lab test ( anti-acethylcholine receptor antibody test), CT scan
(thymoma)
Treatment : acethylcholine esterase inhibitor (pyridostigmine, neostigmine), corticosteroid,
immunomodulatory and plasmapheresis

Poliomyelitis
Caused by RNA virus known as poliovirus transmit by fecal-oral
Patof: the infection cause inflammation and destroy the anterior cell horn in spinal cord
Sign and symptoms :
Fever, nuchal rigidity, and pleocytosis in CSF, asymmetrical muscle weakness
Treatment : no treatment only for the paralyzed leg using splinter
Prevention : sabin vaccine

Amyotrophic lateral sclerosis

Degenerative disease of the motor neuron system
Sign and symptoms :
Paralysis begin from limb, upper limb and finally bulbar weakness
Diagnosis : UMN and LMN sign in at least 3 body segments
Treatment : riluzole (glutamate pathway antagonist), noninvasive ventilation but eventual life
span only 3 years

Duchene muscular dystrophy

Muscle degeneration because of recessive x-linked
Symptoms : muscle weakness, hyperlordosis, hypertrophy with weak muscle, gower sign
Treatment : corticosteroid, splinting