Organic mental disorders: CADASIL: 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: CADASIL

Sample item

A 45-year-old woman has migraine with aura, recurrent lacunar strokes, mood disturbance and progressive cognitive decline. Her mother had similar problems. MRI shows white matter hyperintensities in the anterior temporal poles and external capsules. Which gene is most likely mutated?

AAPPBMAPTCPRNPDNOTCH3

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

The answer and the reasoning

D. NOTCH3

CADASIL, cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy, is due to NOTCH3 mutations. It causes migraine with aura, recurrent subcortical strokes, mood disorder and a subcortical vascular dementia.

Option by option

A. APP
APP mutations cause early-onset familial Alzheimer disease.
B. MAPT
MAPT mutations cause familial frontotemporal dementia with tau pathology.
C. PRNP
PRNP mutations cause inherited prion disease.
D. NOTCH3 (correct)
Correct. NOTCH3 mutations cause hereditary small-vessel disease with these MRI findings.

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.

Questions about this Psychiatry question

What is the answer to this Psychiatry question?

The best answer is D, NOTCH3. CADASIL, cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy, is due to NOTCH3 mutations.

Why is "APP" not the answer?

APP mutations cause early-onset familial Alzheimer disease.

Why is "MAPT" not the answer?

MAPT mutations cause familial frontotemporal dementia with tau pathology.

Why is "PRNP" not the answer?

PRNP mutations cause inherited prion disease.

What concept does this question test?

It tests Organic mental disorders: CADASIL in Psychiatry. It causes migraine with aura, recurrent subcortical strokes, mood disorder and a subcortical vascular dementia.

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: CADASIL?

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.