By Ravish Amin

The neurology shelf exam puts a big emphasis on functional neuroanatomy and using the neurological exam to help localize the lesion(s) responsible for a patient’s signs and symptoms. Our tips for increasing your score on the neurology shelf are:

  1. Terminology: Neurology vocabulary is absolutely necessary for success, as answer choices often have terms such as allesthesia, agraphesthesia, astereognosis, and apraxia. You may want to make flashcards to help you review the meanings of these terms and others, as they will clue you in to specific regions of the neural axis.
  2. Localization and differential diagnosis: Create flashcards to help you identify diseases according to key symptoms and their neurologic localization.
  3. Laboratory studies and imaging: Often, in neurology, nailing down a diagnosis requires laboratory analyses (such as CSF analysis after lumbar puncture) or imaging (such as CT or MRI). Make sure you devote ample time to reviewing the differences between CSF findings in Guillain-Barre, MS, subarachnoid hemorrhage, and the various forms of meningitis. Also, know what to look for when differentiating between a traumatic tap and the true presence of blood in the subarachnoid space. Finally, make sure you know the indications for CT or MRI studies (particularly in the work-up of stroke or MS) and which studies are more sensitive for the detection of certain pathology.
  4. Practice makes perfect: As always, we feel that practice questions give you the best opportunity to assess your knowledge. USMLE-Rx.com has excellent neurology questions along with answer explanations. Supplement your flash cards and/or question bank with Pretest and/or Case Files Neurology and you’ll be set to study neurology. Do more questions and make sure you practice the neurological exam on your patients to help you associate abnormal findings with their associated disease processes.

Good luck!

Got any neurology shelf exam tips or tricks? Share them below!