N e U R o B e H A V I o R S y S T e M

NEUROBEHAVIOR SYSTEM
BLOCK BOOK
Faculty of Medicine
Pelita Harapan University
Karawaci – Tangerang
2015/2016
OVERVIEW
Neurology and Psychiatry is a medical field dealing with disorders of the nervous system and
mental illness. Specifically, it deals with the diagnosis and treatment of all categories of disease involving
the central, peripheral, and autonomic nervous systems, including their coverings, blood vessels, and all
effector tissue, such as muscle. The main purpose of Neurobehaviour System Block is giving the student
understanding to basic science of Neurology and Psychiatry, including neuroanatomy, neuropathology
and neurophysiology. We use Problem-Based-Learning (PBL) method to help students develop the
reasoning process in integrated way by use some trigger cases. The PBL also developing skill of student
in reasoning process through the patient problem: generating hypotheses, carrying out an inquiry
through history and physical examination, analyzing data obtained from the patient, synthesizing the
data into a meaningful picture of the patient’s problem and making diagnostic and therapeutic decisions.
This method would help students acquire new information by providing them with a context to apply their
knowledge to clinical problems. A further aim of PBL is to provide students with resources in self-
directed learning skills that will persist throughout their careers.
Neurobehaviour Team has developed this Neurobehaviour Block Book which could be used as
a guiding book for lecturers and students. We hope that this book will be useful for all.
Vivien Puspitasari, dr. SpS

Coordinator Block
Neurobehavior Block/MEU-FK UPH Page 1

LIST OF CONTENT
Page
Overview……………………………………………………………………………… 1
I. Course info…………………………………………………………………………… 3
II. Competencies……………………………………………………………………….. 4
III. Teaching and Learning method………………………………………………….. 8
IV. Department……………………………………………………………………………. 9
V. Objectives …………………………………………………………………………… 10
VI. List of disease ………………………………………………………………………. 38
VII. References…………………………………………………………………………… 48
VIII. Assessment………………………………………………………………………… 49
IX. Timetable……………………………………………………………………………. 51
Approval……………………………………………………………………………… 57

CHAPTER I
COURSE INFO
Block : Neurobehaviour
Semester :V
Credits : 8 credits
Duration : 8 weeks
Teaching activity : 28 hours/week
Started : August 10, 2015
Ended : October 2, 2015
Coordinator : Vivien Puspitasari, dr, SpS

CHAPTER II
COMPETENCIES
Standards of Medical Competency

1. Effective Communication
Core competency
Able to explore and exchange information verbally and non-verbally with patients.
The graduate is able to:

1. Establish rapport with the patient and his/her family.
 Greet the patient.
 Make the patient feel comfortable.
 Show empathy and trustworthiness.
 Listen actively
2. Collect information.
 Able to use open-ended and closed questions in acquiring information.
 Ask for clarification from the patient about any of his/her statements.
 Use clinical reasoning in exploring the history of the present illness, family
history, and history of past illness.
 Conduct data exploration logically and efficiently.
 Not give education and explanation prematurely while collecting information.
3. Understand the patient’s perspective.
 Respect the patient’s belief in everything related to his/her illness.
 Explore the patient’s needs, worries, and hopes.
 Respond professionally to the patient’s verbal and non-verbal language.
 Use polite and understandable language which is appropriate to the patient’s
age and level of education.
4. Give explanations and information.
 Anticipate and reduce the patient’s feeling of fright and stress before physical
examination.

 Warn the patient when physical examination and clinical procedures may cause
pain or discomfort.
2. Clinical skill
Core Competency.
Conduct clinical procedures based on the patient’s problems and needs.
Perform history taking for neurology and psychiatry disorders
Collect and record accurate and important information about the patient
Conduct physical examination for neurology and psychiatry disorders.
Conduct physical examination in ways which minimise pain and discomfort for the
patient.
Conduct an appropriate physical examination based on the patient’s problem.
3. Scientific basis of medical knowledge

Core competency.
Identify, explain, and plan a scientific approach to health problem-solving, based on
current medical and health science, to get an optimal result.
Apply the concepts and principles of biomedical, clinical, and behavioural science,
and public health, appropriate to the delivery of primary health care.
Summarize an appropriate interpretation of the history, physical examination, and
laboratory tests for neurology and psychiatry disorders.
Explain the neurology and psychiatry disorders in terms of the principles of the basic
medical sciences, pathogenesis and pathophysiology.
Explain the molecular and cellular aspects of the neurology and psychiatry, based
on an understanding of the normal mechanisms of the human body.
Explain the physiological and the molecular goals of treatment in neurology and
psychiatry disorders.

Explain the rational management of the neurology and psychiatry disorders, based
on clinical-epidemiology, pharmacology, physiology, diet, exercise, and behavioural
change.
Justify the chosen intervention based on pharmacology, physiology, nutrition,
exercise and behavioural change in neurology and psychiatry disorders.
Explain the possibility of drug interactions and side effects.
Explain the benefit of dietary therapy in the management of neurology and
Summarize an appropriate interpretation of the history, physical examination, and
laboratory tests of neurology and psychiatry disorders.
Explain the clinical and laboratory data to determine the diagnosis of neurology and
4. Management of health problem

Core competency:
Manage health problems in a person, family, or community comprehensively, holistically,
sustainably, coordinatedly and collaboratively in the context of a primary health care service

a. Interpret clinical data to formulate provisional and differential diagnoses in neurology
and psychiatry
b. Explain the cause, pathogenesis, and pathophysiology of a neurology and psychiatry
disease
c. Identify the various options for management of the neurology and psychiatry disease
d. Give reasons for the chosen management strategy based on pathophysiology,
pathogenesis, pharmacology, psychology, social and other appropriate factors
e. Know the possibility of drug interactions and side effects
f. Identify the role of the patient’s family, their occupation, and social environment as
factors that may influence the occurrence of neurology and psychiatry disease

g. Identify the behavioural and lifestyle modifications for health promotion which are
appropriate for an age group, sex, ethnic group, or culture
CHAPTER III
TEACHING AND LEARNING METHOD

o Lecture : 6-8 hours/week
o Group discussion and Plenary : 7 hours/week
o Laboratory practice : 4 hours/week
o Clinical skill : 4 hours/week
o Doctor, Professionalism,
Ethics, Society : 2 hours/week
o Clinical Exposure : 3 hours/week
Total teaching activity : 28 hours/week

CHAPTER IV
DEPARTMENTS
1. Department of Anatomy
2. Department of Histology
3. Department of Pathology Anatomy
4. Department of Physiology
5. Department of Microbiology
6. Department of Pharmacology
7. Department of Clinical Pathology
8. Department of Pediatric
9. Department of Neurology
10. Department of Neurosurgery
11. Department of Psychiatry
12. Department of Radiology
13. Department of Health Community

CHAPTER V
OBJECTIVES
WEEK 1 : CENTRAL NERVOUS SYSTEM DEVELOPMENT AND MALFORMATION

Week Chair : Vinia, dr, SpA
Overall Week Objective :
1. Describe the development of the nervous system
2. Describe the histological features of neuron and neuroglia
3. Describe the general organization and function of major components of the nervous system in
human
4. List the component of central nervous system (hemisphere, cerebellum, brain stem, spinal cord),
meningeal layers, and peripheral nervous system
5. Describes the major parts of the brain and the lobes of the cerebral cortex. State functions for each
structure
6. Describe the brain ventricles and cerebrospinal fluid circulation system including embryology of sub-
arachnoid space, CSF production, flow and absorption
7. Describe the patophysiology of CSF circulation disorder (hydrocephalus)
8. Describe the neurological disorders during development process in human nervous system
Lecture 1 : Embriology of Nervous System

Duration : 50 minutes
Lecturer : Bernard, dr, PAK
Objectives : Student should be able to
 Describe the development of cerebral hemisphere, brainstem, cerebellum and spinal cord
 Describe the development of ventricle system, subarachnoid space
 Describe the neurologic disorder during development process of nervous system
Lecture 2 : Physiology of CSF

Lecturer : dr. Herman, SpKP
1. Understand the function of CSF
2. Describe the composition, volume and pressure of CSF
3. Describe the production, circulation and absorption of CSF
4. Describe the patophysiology of CSF and its circulation disturbance
Lecture 3 : Introduction to Neuroanatomy

Lecturer : Bernard, dr, PAK
 Anatomy of the skull including the cranial floor, the surface feature of the brain (lobes), the
ventricle system, the meningeal layer
 Internal anatomy of the brain
Lecture 4 : Basic Neuroimaging in correlation with neuroanatomy

Lecturer : Dr. Julius, dr , SpBS, MKes
Objective : Should be able to
 Know the basic imaging anatomy (CT scan and MRI) of the hemisphere cerebri, cerebelli,
brainstem, and ventricle system.
 Know several imaging features of brain anomaly (hydrocephalus, poreencephaly)
Lecture 5 & 6 : Malformation of CNS

Lecturer : Vinia , dr, SpA
Describe abnormalities in the development of human nervous system (spina bifida,
Syringomyelia, encephalocele, Dandy-Walker syndrome, etc)

LAB PRACTICE
Laboratory : Anatomy
Topic : CNS and ventricle system
Instructor : Bernard, dr, PAK; Deisy, dr, Stefanus, dr, MBiomed
Objective : Student should be able to
List the component of central nervous system (hemisphere, cerebellum, brain stem, spinal cord)
Identified the major parts of the brain and the lobes of the cerebral cortex
Identified the ventricle system & circulation of CSF
Describes parts of cranium and basis cranii

WEEK 2 : SEIZURE AND UNCONSCIOUSNESS
Week Chair : Dr. Julius July, dr, SpBS, MKes
1. Describe the role of blood brain barrier
2. Define consciousness and explain the anatomy and physiology of brainstem, thalamic and higher
cortical structures involved in consciousness
3. Explain the neural basis of the examination of the consciousness patient with the emphasis on level
of the consciousness, brainstem reflexes.
4. Define the etiology and pathophysiology of various causes of unconsciousness.
5. Describe the components of intracranial volume (brain, CSF, circulating blood), explain the
relationship between volume and intracranial pressure (ICP) -- The Monroe Kellie Law
6. Describe the intracranial compartments and explain the anatomical basis, pathology and
patophysiology of cerebral herniations that occur with raised ICP
7. Describe the definition, etiology and patophysiology and classification of seizures (including
pathophysiology of febrile convulsion)
8. Describes the patophysiology and etiology of CNS infection
LECTURE
Lecture 1 : Blood brain barrier
Lecturer : Jan Tambayong, dr, PHK
 Describe the structure and the role of blood brain barrier on nerve system
 Describe the different types of brain edema
Lecture 2 : Infection of the CNS

Lecturer : Dr. Cucunawangsih, dr, SpMK
 Describe the classification and pathogenesis of viral and bacterial CNS infection
 Describe the clinical manifestation of the viral and bacterial CNS infection

 Explain the common etiologic agents of viral and bacterial agents of meningitis and encephalitis
 Describe the general approach to antiviral and antimicrobial therapy of central nervous system
infection
 Understand the vaccine immunoprophylaxis of meningitis
Lecture 3 : Unconsciousness
Lecturer : Dr. Julius July, dr, SpBS, MKes
 Define the etiology and patophysiology of various causes of unconsciousness
 Describe the components of intracranial volume (brain, CSF, circulating blood) and explain
relationship between volume and intracranial pressure (ICP)
 Describe the intracranial compartments and explain the anatomical basis, pathology and
pathophysiology of cerebral herniations that occurred with raised ICP
 Describe the intracranial compartments and explain the anatomical basis, pathology and
pathophysiology of cerebral herniations that occur with raised ICP
Lecture 4 & 5 : Seizure

Lecturer : Erni Iskandar, dr, SpS
 Describe the definition, etiology, and pathophysiology of seizure
 Describe the definition and pathophysiology of status epilepticus
 Describe the classification of seizure
 Differentiate between acute seizure and epileptic seizure
 Describe the mechanism of action of anticonvulsant drugs
Lecture 6 : Febrile convulsion

Lecturer : Vinia, dr, SpA

 Describe the definition of febrile convulsion
 Describe types of febrile convulsion
 Describes evaluation of children who have febrile seizures
 Know the indication for lumbar puncture in febrile convulsion
 Describe specific management of febrile convulsion
LAB PRACTICE
Laboratory 1 : Microbiology
Topic : Pathogenic microbal of the CNS infection ( Neisseria meningitides and rabies virus)
Instructor : Cucunawangsih, dr, SpMK
Identify the causative organism of the central nervous system
Morphology of the causative agents (microscopy and culture)
Understand the procedures and techniques in microbiological diagnosis for identify these
etiologic agents
o Oxidative test
Laboratory 2 : Histology and PA

Instructor : dr. Jan, dr. Darti, SpPA
Identified histological feature of neuron and neuroglia
Identified histological feature of blood brain barrier
Identified pathological feature of subdural hematoma, infection of nerve system

WEEK 3 : CEREBROVASCULAR
Week Chair: Prof. Wahyuni L. Atmodjo,dr, PhD, PAK, PhD
Overall Week Objective:
1. Describe general organization of nervous system, blood supply and venous drainage of the brain
2. Describe some pathologies of brain vascular
3. Describe internal structures and functional localization of cerebral cortex
4. Describe the pathogenesis and pathophysiology of hemorrhagic stroke and its correlation with the
clinical picture in specific location.
5. Describe the pathogenesis and pathophysiology of occlusive stroke and its correlation with the
clinical picture
6. Describe the temporal (time) development of pathogenesis of acute stroke and describe early
management.
7. Describe the risk factor and prevention of CV disease
LECTURE
Lecture 1 : Pathology of brain vascular
Lecturer : Darti Isbandiati, dr, SpPA
Objective : Should be able
 Describe the pathological feature of brain vascular (aneurysm, AVM)
 Describe the pathological feature of intracerebral hematom, infarct cerebri
Lecture 2 & 3 : Gross anatomy of the brain

Circulation of the brain
Overview of cerebral cortex
Lecturer : Prof. Wahyuni L. Atmodjo,dr, PhD, PAK, PhD
Objectives : Should be able to
 Overview of the general organization of nervous system
 Describe the blood supply and venous drainage of the brain

 Explain the organization of Willisi’s circle
 Explain the structure and functional localization of cerebral cortex
Lecture 4 : Brain vascular and surgical aspect of CV disease

Lecturer : Julius July, dr, SpBS, MKes
Know the vascularisation of brain
Know some of neurological diseases associated with vascular anomaly (Aneurysm, AVM)
Know several imaging features of ischemic and hemorrhage stroke
Know the surgical aspect of CV disease
Lecture 5 : Antiplatelet and anticoagulation as secondary prevention on occlusive stroke

Lecturer : Dr. Nicolaski Lumbuun, dr, SpFK
 know the pharmacology of antiplatelet medication (aspirin, clopidogrel, dipyridamole) including
the drug mechanism
 know the pharmacology of anticoagulant medication (warfarin) including the drug mechanism
Lecture 6 : Clinical approach on limb paralysis

Lecturer : Yusak Siahaan, dr.SpS
Objectives : Should be able to
1. Know the terminologies of hemiparesis, paraparesis, tetraparesis, monoparesis and
understands the mechanism from different etiologies
2. Understand the clinical difference between UMN and LMN lesion
3. Understand how to making differential diagnosis patient with limb paralysis

LAB PRACTICE:
Laboratory 1 & 2: Anatomy and Radiology
Topic : CNS, ventricle system and circulation of the brain
Instructor : dr. Bernard Hutabarat, PAK; dr. Deisy, dr. Bryan, SpRad
List the component of central nervous system (hemisphere, cerebellum, brain stem, spinal cord)
Identified the major parts of the brain and the lobes of the cerebral cortex
Identified the ventricle system
Identified the parts of subcortical structures, including ganglia basal , thalamus, hypothalamus,
fonix, hypocampal
Identified the anatomical distribution of the branches of the cerebral and basilar vessels which
arises from carotid and vertebro-basilar vessels
Know the anatomy-imaging of the brain, brainstem, ventricle system and brain circulation
(normal brain CT scan & brain MRI)

WEEK 4
BRAINSTEM, CRANIAL NERVES AND MYELIN
Week Chair : Pricilla Gunawan, dr, SpS

1. Describe the neuroanatomy of the brainstem including major tracts and 12 cranial nerves which
arise from brain stem
2. Describe the location of nuclei of cranial nerves on brainstem and function of each 12 cranial nerves.
3. Describe correlate the clinical findings with specific lesions in the brain stem
4. Explain the anatomy and physiology of the vestibular component of cranial nerve VIII, with emphasis
on the role of the vestibular system in eye movement and equilibrium.
5. Explain the anatomy of cerebellum and its role on equilibrium and coordination
6. Describe some clinical findings in cerebellar disorder
7. Describe the patophysiology of acute demyelinating process in the brain
8. Describe the patophysiology and etiology of cephalgia
Lecture 1 : Anatomy of Brainstem, cranial nerves & cerebellum

Lecturer : Bernard Hutabarat, dr, PAK
 Describe and list components of the brain stem
 Describe anatomical features of the dorsal and ventral areas of the midbrain, pons and medulla
 Describe the location and organization in the brain stem (cranial nerve nucleus, autonomic
centers, reticular formation, ascending & descending tracts)
 Know the 12 cranial nerves and its course in intracranial compartment
 Understand the functional of 12 cranial nerves and its component
 Describe anatomical and function of cerebellum

Lecture 2 & 3 : Physiology of equilibrium
Lecturer : Herman, dr, SpKP
 Explain the components of organs and system that participate in the maintenance of body
balance
 Explain the components of vestibular systems
 Draw the receptors in each component of the vestibular systems and explain how they work
 Differentiate the angular and the linear accelerations
 Explain the component of the vestibular system that sensitive to angular and linear acceleration
 Explain the mechanism of sea sickness
 Explain some experiments to test the function of body balance
 Define nystagmus and explain its mechanism (vestibulo-ocular reflex)
Lecture 4 : Vertigo and disequilibrium

Lecturer : Pricilla Gunawan, dr, SpS
Objective : Studet should be able to
1. Define vertigo and describe its mechanism
2. Describe the classification of vertigo, differentiated between central and peripheral vertigo
3. Describe the etiology of vertigo
4. Know the treatment of vertigo
Lecture 5 : Cephalgia
Lecturer : Astra Dea, dr, SpS
 Understand the underlying mechanism of cephalgia
 Know the etiologies of primary and secondary headache
 Know the classification of cephalgia/headache

Lecture 6 : Facial palsy
Lecturer : Vivien Puspitasari, dr, SpS
 Describe anatomy of facial nerve from its nucleus in the pons until its distal component
 Describe the component and organs innervated by facial nerve
 Understand the pathological process on facial nerve
 List the disease that cause dysfunction of facial nerve
LAB PRACTICE
Laboratory 1 : Anatomy
Topic : Brainstem, Cranial nerves and cerebellum
Instructor : dr. Bernard Hutabarat, PAK, dr. Deisy
1. Identified the components of the brain stem (mesencephalon, pons and medulla
oblongata)
2. Identified the anatomical features of the dorsal and ventral areas of the midbrain,
pons and medulla
3. Identified the location and organization in the brain stem (cranial nerve nucleus,
autonomic centers, reticular formation, ascending & descending tracts)
4. Identified the 12 cranial nerves and its course in intracranial compartment
5. Identified parts of cerebellum
Laboratory 2 : Physiology
Topic : Equilibrium
Instructor : Herman, dr, SpKP
Understand the physiology of equilibrium (vestibulo-ocular reflex)

WEEK 5 : SPINAL CORD AND PHERIPHERAL NERVES
Week Chair : Astra Dea, dr, SpS
1. Describe the anatomy of the vertebral column, spinal cord and 31 pairs of spinal nerves arise from
spinal cord as components of peripheral nerves system
2. Describe the internal anatomy of the spinal cord with emphasis on the clinically relevant regions of
grey matter and the major ascending and descending white matter tracts
3. Explain the clinical findings related to disruptions in the ascending and descending pathways
4. Describe the commonest neoplasm of CNS and PNS
5. Describe the physiology of pain
6. Describe the pharmacology of the major analgesic drugs used in acute pain (acetaminophen,
acetylsalicylic acid, NSAIDs and opioids) and chronic pain.
7. Physiology and pathophysiology of peripheral nerve disorder
LECTURE
Lecture 1 : Neoplasm of the CNS and PNS
Lecturer : Darti Isbandiati, dr, SpPA
Objectives : Student shoul be able to
 Describe the pathogenesis of some neoplasm of CNS and PNS
 Know the pathological features of several CNS neoplasm (Neurilemoma/Schwannoma,
Neurofibroma, Ganglioma, astrocytoma, ependymoma, meningioma)
Lecture 2 : Anatomy of spinal cord, PNS and ANS

Lecturer : Prof. Wahyuni L. Atmodjo,dr, PAK, PhD
 Describe gross anatomy and internal structure of spinal cord
 Describe spinal nerves as components of peripheral nerves system
 Describe the ascending and descending white matter tracts
 Describe the blood supply to the spinal cord

Lecture 3 : Reflexes
Lecturer : Astra Dea, dr, SpS
 Describe the definition and classification of reflex
 Understand the basic mechanism and component of reflex
 Describe abnormality of reflex and its mechanism
 Describe the differentiation between sign and symptom of upper motor neuron and lower motor
neuron
Lecture 4 : Learning from cases

Lecturer : Dr. Julius July, dr, M.Kes, SpBS
Objectives : Learning from cases:
 Neoplasm of CNS/PNS
 Spinal cord Injury
Lecture 5 : Analgesic drugs

Lecturer : Dr. Nicolaski Lumbuun, dr, SpFK
 Describe the pharmacology of analgesic drugs
 Describe the CNS modulation of pain mechanism
Lectur 6 : Pheripheral Nerves Disorder

Lecturer : Vonny Goenawan, dr, SpS
 Know the etiology and pathogenesis of many types of pheripheral neuropathy (diabetic; genetic
predispositions, exposure to toxic chemicals, malnutrition, inflammation (infectious or
autoimmune), injury, and nerve compression; and by taking certain medications

 Know the symptoms of peripheral neuropathy
 Know some peripheral neuropathies (median, radial, ulnar, peroneal neuropathy)
Lecture 7 : Pain
Lecturer : Yusak Siahaan, dr, SpS
 Describe classification of pain
 Understand the peripheral and central mechanism of pain
 Differentiating of inflammation and neuropathic pain
LAB PRACTICE
Laboratory 1 : Anatomy
Topic : Spine, spinal cord, peripheral nerves
Instructor : dr. Bernard Hutabarat, PAK, dr.Deisy
Identified the vertebral column, spinal cord (external anatomy) and peripheral nerves (including
plexus, radial nerve, ulnar nerve, median nerve, tibial nerve, and peroneal nerve)
Know the blood supply to the spinal cord
Laboratory 2 : Clinical Pathology

Instructor : dr. Haryanto, SpPK
Differentiated transudat and exudates
Perform None & Pandy test

WEEK 6 : MEMORY AND AGING OF THE BRAIN
Week Chair : Vivien Puspitasari, dr, SpS
1. Describe the role of the limbic system and temporal lobe structure in memory process and their
relationship with cortical association areas
2. Correlate neuropsychological changes with functional localization of specific regions of the cortex
that are involved in learning and memory
3. Discuss the anatomical correlates to cognitive capacities
4. Describe the role of neurotransmitter in brain
5. Describe the regulation of circadian rhythms and the sleep-wake cycle
6. Discuss common etiologies, pathophysiologies, and genetics of dementia
7. Explain the neurophatological and neurotransmitter changes found in Alzheimer disease
8. List the most common differential diagnoses for patients with cognitive impairment
9. Discuss physiology of normal sleep and the common etiologies of insomnia and other sleep
disorders
10. Changes associated with aging influence their CNS effect
11. Discuss the pharmacology of sedative/hypnotic drugs and explain how the
pharmacokinetic/pharmacodynamic changes associated with aging influence their CNS effect
LECTURES
Lecture 1 : Embryology and microscopic anatomy and structure of cerebral cortex
Lecturer : Jan Tambayong, dr, PHK
 Describe general embryological principles of migration and cortical development
 Describe features of cortical organization and histological anatomy
Lecture 2 : Neurotransmitter in the brain


 Define neurotransmitter and neuromodulator
 Describe the differences of neurotransmitter and neuromodulators
 Group the neurotransmitter according to their effect and their chemical structure
 Give some examples (10-15) of each that work in the central nervous system and in the
peripheral nervous system
 Explain where and how they are produced
 Explain the sites where they work and how they work
 Mention and explain the receptors through which they work
 Explain their possible effects cells on group of cells or tissues
Lecture 3 : Physiology of sleep

 Describe the physiology of normal sleep
 Describe some of abnormal sleep patterns and their causes
Lecture 4 : Social and Health care structures for the elderly in Indonesia
Lecturer : Sherly, dr, MKes
 Discuss social and health care structures in Indonesia for care for the elderly
 Discuss the traditional family structures in different social groups in Indonesia
 Discuss the health care system which supports management and long term care of patients with
dementia
 Describe how changing family social structures impact the long term care of elderly patients with
dementia
Lecture 5 : Parkinson Disease

Lecturer : dr. Rocksy Fransisca, SpS

 Understand the patophysiology of Parkinson Disease
 Differentiated Parkinson Disease and Parkinsonism
 Describe the clinical symptoms of Parkinson Disease
Lecture 6 : Classification and clinical assessment of dementias

Assessment of mental status and cognitive function
Lecturer : Engelberta Pardamean, dr, SpKJ
 Describe the different causes of dementia
 Compare the features of clinical presentations of different types of dementia
 Perform clinical assessment of mental status
LAB PRACTICE
Laboratory 1 : Anatomy and Radiology
Topic : Cortex
Instructor : dr. Bernard Hutabarat, PAK; dr.Deisy, dr. Brian, SpRad
Objective : Student should be able to know
Anatomy of the cortex and Limbic system
Radiologic imaging of dementia 1
Radiologic imaging of dementia 2
Laboratory 2 : Histology and Pathology Anatomy

Topic : Neoplasm of CNS and PNS
Instructor : dr.Jan Tambayong; dr. Darti, SpPA
Normal histology of cortex
Gross and microscopic pathology of dementias

Know the pathological features of Meningioma, Glioma, Neurilemoma/Schwannoma,
Neurofibroma, Ganglioma

CHAPTER VI
LIST OF DISEASE
The list of diseases consist of chosen diseases which are derived from diseases burdens that
arise based on morbidity, mortality, and case fatality rate data estimated in primary health services;
severity of the problems and their effect to individual, family and society. Medical Doctor Graduates who
will be working in primary level should have adequate levels of competencies thus able to refer, to make
a diagnosis, to give an initial management, or to provide a comprehensive management. Therefore on
every chosen diseases, certain level of competency is set, which expected to be accomplished at the
end of Medical Doctor degree program, based on estimated competency which will be given when a
medical doctor work in primary health care, in line with common condition in Indonesia.
Provided, after graduated, a medical doctor would like to work in remote area where health care
services is very minimal, or in certain area which an extra competency is needed; the authority is
expected to give briefing prior to settlement.
The list of diseases is categorized based on systems, organs, and age. The levels of
competencies which are expected to be accomplished at the end of Medical Doctor degree program are
as follow (based on Standar Kompetensi Dokter Indonesia (SKDI), Konsil Kedokteran Indonesia 2012)
Levels of competencies expected to be accomplished at the end of Medical Doctor degree

program:
Level of Competencies 1
A Medical Doctor is able to identify and to situate clinical features of the diseases when reading
references. In correspondences, he is able to identify these clinical features, and know how to obtain
further information. This level indicates overview level. When facing a patient with these clinical features,
and then assuming the diseases, the Medical Doctor directly refers.

A medical Doctor should be able to make a clinical diagnosis based on physical examination and further
examination requested (for example: basic laboratory examination or X-ray). Medical Doctor is able to
refer immediately to relevant specialist and able to manage afterward.
3a. A medical Doctor should be able to make a clinical diagnosis based on physical examination and
further examination requested (for example: basic laboratory examination or X-ray). Medical Doctor
is able to decide and provide initial management and refer to relevant specialist (not an emergency
case).
3b. A medical Doctor should be able to make a clinical diagnosis based on physical examination and
further examination requested (for example: basic laboratory examination or X-ray). Medical Doctor
is able to decide and provide initial management and refer to relevant specialist (emergency case).
A medical Doctor should be able to make a clinical diagnosis based on physical examination and further
examination requested (for example: basic laboratory examination or X-ray). Medical Doctor is able to
decide and independently manage problem comprehensively.

Central and peripheral neural system

Psychiatry and Mental health

CHAPTER VII
REFERENCES
1. Adams and Victor’s Principles of Neurology.Allan H. Roper, Robert H. Brown. Mac Graw Hill,
2014.
2. Harrisons’s Neurology in Clinical Medicine. Mac Graw Hill, 2006
3. Clinical Neuroanatomy. Richard S.Snell. Lipincott Williams & Wilkins.2006
4. Standar Kompetensi Dokter Indonesia. Indonesian Medical Council, 2006.
5. Essential Neuroscience. Allan Siegel. Lipincot Williams & Wilkins, 2006.
6. Fundamentals of Neurology. Mark Mumenthaler et al. Thieme, 2006.
7. Basic Neurology. Gilroy. Mac Graw Hill, 2000.
8. Goodman and Gillman’s the pharmacological basis of therapeutics. Mac Graw Hill 2001
9. Basic Clinical Pharmacology. 8th ed. Katzung, Mc Graw Hill.
10. Synopsis of Psychiatry. Kaplan and Sadock’s. William & Wilkins, 2007
11. Comprehensive Text Book of Psychiatry. Kaplan and Sadock’s

CHAPTER VIII
ASSESSMENT
I. ATTENDANCE REQUIREMENTS
Attendance requirements and eligibility to write examinations:
Problem Based learning is an important and integral component of the UPH curriculum. This
instructional method emphasizes cooperative behavior and small group learning which for many
students, is a new way of learning. Consequently for groups to function successfully, regular full
attendance at tutorials is essential.
Attendance expectations as requirements and prerequisites to sit the examinations:
 100% for tutorials
 70% attendance at lectures
 70% attendance in lab practical sessions
Exemptions permitted with Doctor’s certificate, event of family crisis, disaster or extraordinary reason
with prior permission from tutor. Further criteria are implemented according to UPH criteria for
exemption.
II. ASSESSMENT of STUDENT PERFORMANCE

The system will include assessment of block learning, mandatory courses, assessment of clinical skills
and a comprehensive “end of year” knowledge based examination. Each component will be given a
relative value in calculating a Cumulative Score.
a. Assessment will be conducted for learning in each block and will include:
 Knowledge based MCQ
 Objective Structured Practical Examination (OSPE)
 Tutorial performance
b. Clinical skills learning will be assessed at the end of each semester using the international standard
Objective Structured Clinical Examination (OSCE)
c. A comprehensive knowledge based examination (MCQ) will be conducted at the year end. This will
cover content from all components of the 2 previous semesters.

d. The Cumulative Score calculated based on the components will be the final score and required for a
successful Pass for the YEAR
e. The Cut-off score for Pass will be determined by recognized standard setting processes.
1. Tutorial performance
A. Formative:
 Weekly discussions with tutor in the group
o Preparation
o Participation
o Professional behavior
 Mid-block (course) discussions with tutor in the group and written assessment summary
provided to the student.
o Preparation
o Participation
During this encounter, the tutor will identify any issues of concern with the student and assist in
efforts to improve.
B. Summative:
 Students will be assessed at the end of the block on the following performance in
tutorial sessions:
o Preparation
o Participation
2. Knowledge assessment
Student’s applied knowledge will be assessed at the end of each block using:
 Multiple Choice Questions (MCQ)
 Laboratory practical examination (OSPE)

3. Clinical Skills Assessment
Student’s applied clinical skills will be assessed at the end of the year using:
 OSCE
4. Clinical Exposure
Student’s applied clinical skills will be assessed at the end of the year incorporate to:
 OSCE
 MCQ
5. Comprehensive Assessment
Student’s applied knowledge will be assessed at the end of the year using:
 MCQ comprehensive of Fundamental Medical Science I, II, II, and IV
III. RELATIVE VELUE

At the end of the block, the relative value of the block consists of each component as follows:
Component Percentage
1. PBL tutorials 25 %
2. MCQ 55 %
3. OSPE 20 %
At the end of the year, the relative value of Cumulative Score consists of component as follows:
Component Percentage
1. OSCE (compile value within the year) 20 %
2. MCQ comprehensive (item will cover
knowledge from all block within the year 25%
3. Blocks (compile value within the year) 45 %
4. Longitudinal Course 10%

Passing grade at UPH is 60.00% (C) and will be determined through recognized Standards Setting
processes. Relationship to the Grading system and GPA is as indicated in the table.
GRADE RANGE SCALE

A 90,00 - 100 4,00
A– 85,00 – 89,99 3,70
B+ 80,00 – 84,99 3,30
B 75,00 – 79,99 3,00
B– 70,00 – 74,99 2,70
C+ 65,00 – 69,99 2,30
C 60,00 – 64,99 2,00 (PASS)
C– 55,00 – 59,99 1,50
F 00,00 – 54,99 0,00


N e U R o B e H A V I o R S y S T e M

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NEUROBEHAVIOR SYSTEM

Vivien Puspitasari, dr. SpS

Neurobehavior Block/MEU-FK UPH Page 1

III. Teaching and Learning method………………………………………………….. 8

VI. List of disease ………………………………………………………………………. 38

Neurobehavior Block/MEU-FK UPH Page 2

Neurobehavior Block/MEU-FK UPH Page 3

Standards of Medical Competency

The graduate is able to:

Neurobehavior Block/MEU-FK UPH Page 4

3. Scientific basis of medical knowledge

Neurobehavior Block/MEU-FK UPH Page 5

4. Management of health problem

The graduate is able to:

Neurobehavior Block/MEU-FK UPH Page 6

Neurobehavior Block/MEU-FK UPH Page 7

Total teaching activity : 28 hours/week

Neurobehavior Block/MEU-FK UPH Page 8

Neurobehavior Block/MEU-FK UPH Page 9

WEEK 1 : CENTRAL NERVOUS SYSTEM DEVELOPMENT AND MALFORMATION

Lecture 1 : Embriology of Nervous System

Lecture 2 : Physiology of CSF

Neurobehavior Block/MEU-FK UPH Page 10

Lecture 3 : Introduction to Neuroanatomy

Lecture 4 : Basic Neuroimaging in correlation with neuroanatomy

Lecture 5 & 6 : Malformation of CNS

Neurobehavior Block/MEU-FK UPH Page 11

Neurobehavior Block/MEU-FK UPH Page 12

Lecture 2 : Infection of the CNS

Neurobehavior Block/MEU-FK UPH Page 13

Lecture 4 & 5 : Seizure

Lecture 6 : Febrile convulsion

Neurobehavior Block/MEU-FK UPH Page 14

Laboratory 2 : Histology and PA

Neurobehavior Block/MEU-FK UPH Page 15

Lecture 2 & 3 : Gross anatomy of the brain

Neurobehavior Block/MEU-FK UPH Page 16

Lecture 4 : Brain vascular and surgical aspect of CV disease

Lecture 5 : Antiplatelet and anticoagulation as secondary prevention on occlusive stroke

Lecture 6 : Clinical approach on limb paralysis

Neurobehavior Block/MEU-FK UPH Page 17

Neurobehavior Block/MEU-FK UPH Page 18

Overall Week Objective :

Lecture 1 : Anatomy of Brainstem, cranial nerves & cerebellum

Neurobehavior Block/MEU-FK UPH Page 19

Lecture 4 : Vertigo and disequilibrium

Neurobehavior Block/MEU-FK UPH Page 20

Neurobehavior Block/MEU-FK UPH Page 21

Lecture 2 : Anatomy of spinal cord, PNS and ANS

Neurobehavior Block/MEU-FK UPH Page 22

Lecture 4 : Learning from cases

Lecture 5 : Analgesic drugs

Lectur 6 : Pheripheral Nerves Disorder

Neurobehavior Block/MEU-FK UPH Page 23

Laboratory 2 : Clinical Pathology

Neurobehavior Block/MEU-FK UPH Page 24

Lecture 2 : Neurotransmitter in the brain

Neurobehavior Block/MEU-FK UPH Page 25

Lecture 3 : Physiology of sleep

Lecture 5 : Parkinson Disease

Neurobehavior Block/MEU-FK UPH Page 26

Lecture 6 : Classification and clinical assessment of dementias

Laboratory 2 : Histology and Pathology Anatomy