Organic psychiatry: reversible dementia: practice question

A Psychiatry question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Psychiatry · Organic psychiatry: reversible dementia

Sample item

A 65-year-old has slowly progressive forgetfulness, macrocytosis and paraesthesia in the feet. Which investigation is most important?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Serum vitamin B12

Vitamin B12 deficiency causes cognitive impairment, subacute combined degeneration and macrocytic anaemia, and is a reversible cause of dementia. Other treatable causes are hypothyroidism, neurosyphilis, normal pressure hydrocephalus, subdural haematoma and depression. Early treatment can reverse the deficits.

Option by option

  • A. Serum lithium

    Lithium level is irrelevant without lithium use.

  • B. Serum vitamin B12 (correct)

    Correct. B12 deficiency is a treatable cause matching the picture.

  • C. Serum ceruloplasmin only

    Ceruloplasmin tests for Wilson disease, which occurs in younger patients.

  • D. Urine drug screen

    A drug screen is less relevant to this picture.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Psychiatry question

What is the answer to this Psychiatry question?

The best answer is B, Serum vitamin B12. Vitamin B12 deficiency causes cognitive impairment, subacute combined degeneration and macrocytic anaemia, and is a reversible cause of dementia.

Why is "Serum lithium" not the answer?

Lithium level is irrelevant without lithium use.

Why is "Serum ceruloplasmin only" not the answer?

Ceruloplasmin tests for Wilson disease, which occurs in younger patients.

Why is "Urine drug screen" not the answer?

A drug screen is less relevant to this picture.

What concept does this question test?

It tests Organic psychiatry: reversible dementia in Psychiatry. Other treatable causes are hypothyroidism, neurosyphilis, normal pressure hydrocephalus, subdural haematoma and depression. Early treatment can reverse the deficits.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Organic psychiatry: reversible dementia?

Learn each diagnosis by its core features and its first-line treatment. Then use the flashcards and the other Psychiatry questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.