The best way to prepare for neurology questions on the ABPN psychiatry boards and PRITE is to continue to read on neurological disorders (see a book suggestion in our “Top Psychiatry Review Textbooks” Post) while seeing psychiatry patients. The basics of CNS lesions, including upper motor and lower motor neuron disorders is a good start. Besides the basic bread and butter neurology topics, it helps to study psychogenic neurological deficits like the “face-hand” test as well as “astasia-abasia”, psueodoseizures and psychogenic sensory loss patterns.
Impairments of cranial nerves, especially the second nerve, commonly appear on both the PRITE and psych boards. Using the cranial nerves, you can isolate the location of a stroke. Peripheral nerve disorders cause readily observable patterns of changes in tendon reflexes, sensory impairments and muscle weakness. Mononeuropathies, nutritional deficiencies, ALS, poliomyelitis, orthopedic diseases and infectious diseases all cause peripheral nerve disorders. Muscle disorders including myasthenia gravis, Lambert-Eaton Syndrome, tetanus, muscular dystrophy, metabolic myopathies also appear as well as the laboratory tests used to diagnose them.
Dementia is a highly tested topic on the PRITE and psychiatry boards and a good review includes all of the normal changes of aging, EEG/MRI changes with dementia, defining/diagnosing dementia and its causes, laboratory evaluation, pathological signs, risk factors and the differences in the subtypes of dementia. Other related topics include normal pressure hydrocephalaus, neurosyphilis and Prion disease. With aphasia, it is important to know how to test for it, the subtypes of aphasias and the related disorders like dyslexia, apraxia, aprosody and split-brain syndrome.
Headaches are commonly seen clinically and testable items on psychiatry boards include: tension headaches, migraines, cluster headaches, temporal arteritis, mass lesions, meningitis, trigeminal neuralgia and pseudotumor cerebri. Epilepsy is also a large topic with testable items including EEG waves, toxic encephalopathy, the types of seizures, psychiatric changes associated with seizure disorders, treatments like VNS or surgery and childhood seizure disorders. TIA’s and stroke make up a sizable portion of bread and butter neurology and testable items include: arterial localization of stroke, risk factors for stroke, hemorrhagic/embolic/thrombotic strokes, sequelae of stroke and vegetative states. Visual disturbances are likely to appear and commonly include abnormalities of the nerve/lens, types of glaucoma, visual perceptual disturbances including agnosia, hallucinations, visual field loss and other disorders.
Commonly tested congenital cerebral impairments on the psychiatry boards and PRITE include: cerebral palsy, neural tube closure defects, neurocutaneous disorders like tuberous sclerosis or neurofibromatosis, mental retardation s, and heavy metal exposures.
Chronic pain is also a hot topic on psychiatry board exams and testable subjects include: pain pathways, analgesic pathways, treatments, chronic pain and pain syndromes.
Multiple sclerosis is a large topic and items to cover in a review include: etiology, clinical symptoms, ocular impairments, psychiatric comorbidity, diagnostic testing, treatment, and syndromes that mimic MS.
Sleep disorders are also commonly tested on psychiatry boards and include subjects such as: normal sleep, melatonin, effects of medications and aging, dyssomnias including narcolepsy, sleep apnea, restless leg, periodic limb movement disorder, circadian rhythm disorders, parasomnias including sleepwalking, sleep terrors, the pathological changes in sleep seen with psychiatric disorders and treatment of sleep disorders.
Involuntary movement disorders include: Parkinson’s, Huntington’s Disease, Sydenham’s Chorea, hemiballismus, dystonias, essential tremors, tic disorders, myoclonus, tardive dyskinesias, and psychogenic movements. Other topics that also show up include brain tumors and metastatic cancers.
Besides reading on the above-listed topics, do as many practice questions as you can, and you will do fine.
Kaufman, D. M. (2007). Clinical neurology for psychiatrists, 6th Edition. Philadelphia: W.B. Saunders.