STEP 1 Content Outline

Central and Peripheral Nervous Systems


Normal processes

  • embryonic development, fetal maturation, and perinatal changes, including neural tube derivatives, cerebral ventricles, neural crest derivatives
  • organ structure and function
    • spinal cord, including gross anatomy, blood supply, and spinal reflexes
    • brain stem, including cranial nerves and nuclei, reticular formation, gross anatomy, and blood supply
    • brain, including gross anatomy and blood supply; cognition, language, memory; hypothalamic function; limbic system and emotional behavior; circadian rhythms and sleep; control of eye movement
    • sensory systems, including proprioception, pain, vision, hearing, balance, taste, and olfaction
    • motor systems, including brain and spinal cord, basal ganglia and cerebellum
    • autonomic nervous system
    • peripheral nerve
  • cell/tissue structure and function
    • axonal transport
    • excitable properties of neurons, axons and dendrites, including channels
    • synthesis, storage, release, reuptake, and degradation of neurotransmitters and neuromodulators
    • pre- and postsynaptic receptor interactions, trophic and growth factors
    • brain metabolism
    • glia, myelin
    • brain homeostasis: blood-brain barrier; cerebrospinal fluid formation and flow; choroid plexus
  • repair, regeneration, and changes associated with stage of life

Abnormal processes

  • infectious, inflammatory, and immunologic disorders (eg, meningitis, multiple sclerosis, myasthenia gravis)
  • traumatic and mechanical disorders (eg, subdural and epidural hematomas, cord compression, peripheral nerve injury)
  • neoplastic disorders, including primary and metastatic
  • acquired metabolic and regulatory disorders (eg, delirium, Reye syndrome)
  • vascular disorders (eg, cerebrovascular occlusion, venous sinus thrombosis, arterial aneurysms, hemorrhage)
  • systemic disorders affecting the nervous system (eg, lupus, diabetic neuropathy)
  • idiopathic disorders affecting the nervous system
  • congenital disorders, including metabolic (eg, neural tube defects, cerebral palsy, mental retardation, Down syndrome)
  • degenerative disorders (eg, peripheral neuropathy, Alzheimer dementia, Parkinson disease, Huntington disease, amyotrophic lateral sclerosis)
  • paroxysmal disorders (eg, epilepsy, headache, pain syndromes, and sleep disorders including narcolepsy, restless legs syndrome/periodic limb movement, circadian rhythm disorders, parasomnias)
  • disorders of special senses (eg, blindness, deafness)
  • psychopathologic disorders, processes and their evaluation
    • early-onset disorders (eg, learning disorders)
    • disorders related to substance use
    • schizophrenia and other psychotic disorders
    • mood disorders
    • anxiety disorders
    • somatoform disorders
    • personality disorders
    • physical and sexual abuse of children, adults, and elders
    • other disorders (eg, dissociative, impulse control)

Principles of therapeutics

  • mechanisms of action, use, and adverse effects of drugs for treatment of disorders of the nervous system
    • anesthetics
    • hypnotics
    • psychopharmacologic agents (eg, anxiolytics, antidepressants, antipsychotic agents, mood-stabilizing agents)
    • anticonvulsants
    • analgesics
    • stimulants, amphetamines
    • antiparkinsonian drugs
    • skeletal muscle relaxants, botulinum toxin
    • neuromuscular junction blocking agents (postsynaptic)
    • antiglaucoma drugs
    • drugs used to decrease intracranial pressure (eg, mannitol, high-dose glucocorticoids)
    • antimigraine agents
    • drugs affecting autonomic nervous system (eg, anticholinesterases)
  • other therapeutic modalities (eg, radiation, CFS shunting, surgery)

Gender, ethnic, and behavioral considerations affecting disease treatment and prevention, including psychosocial, cultural, occupational, and environmental

  • emotional and behavioral factors (eg, drug abuse, dementia, sleep deprivation, accident prevention, pets)
  • influence on person, family, and society (eg, developmental disabilities, dementia, generation reversal, nutrition, seizures, sleep disorders)
  • occupational and other environmental risk factors (eg, boxing, carbon monoxide exposure)
  • gender and ethnic factors