Organic mental disorders: neurochemistry of delirium: 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 mental disorders: neurochemistry of delirium

Sample item

An 80-year-old develops delirium after being given a drug with strong anticholinergic activity. Which neurochemical imbalance is considered central to delirium?

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

The answer and the reasoning

A. Reduced cholinergic and relatively excess dopaminergic activity

The leading hypothesis for delirium is acetylcholine deficiency with relative dopamine excess. This explains why anticholinergic drugs precipitate delirium and why dopamine blockers such as haloperidol are used for symptom control.

Option by option

  • A. Reduced cholinergic and relatively excess dopaminergic activity (correct)

    Correct. Cholinergic deficiency with dopamine excess is the accepted model.

  • B. Excess cholinergic and reduced dopaminergic activity

    This reverses the imbalance and would not explain precipitation by anticholinergics.

  • C. Excess glutamate with reduced noradrenaline

    Excess glutamate and low noradrenaline is not the principal model for delirium.

  • D. Reduced serotonin and excess GABA

    Low serotonin and high GABA is not the established model and it fails to explain anticholinergic-induced delirium.

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 A, Reduced cholinergic and relatively excess dopaminergic activity. The leading hypothesis for delirium is acetylcholine deficiency with relative dopamine excess.

Why is "Excess cholinergic and reduced dopaminergic activity" not the answer?

This reverses the imbalance and would not explain precipitation by anticholinergics.

Why is "Excess glutamate with reduced noradrenaline" not the answer?

Excess glutamate and low noradrenaline is not the principal model for delirium.

Why is "Reduced serotonin and excess GABA" not the answer?

Low serotonin and high GABA is not the established model and it fails to explain anticholinergic-induced delirium.

What concept does this question test?

It tests Organic mental disorders: neurochemistry of delirium in Psychiatry. This explains why anticholinergic drugs precipitate delirium and why dopamine blockers such as haloperidol are used for symptom control.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. 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 mental disorders: neurochemistry of delirium?

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.