Organic mental disorders: subcortical vascular 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 mental disorders: subcortical vascular dementia

Sample item

A 68-year-old man with long-standing poorly controlled hypertension has slow thinking, apathy, shuffling gait and urinary urgency over three years. MRI shows extensive periventricular white matter change and lacunes, with preserved hippocampi. What is the likely diagnosis?

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

The answer and the reasoning

D. Subcortical ischaemic vascular dementia

Small-vessel disease from hypertension causes subcortical ischaemic vascular dementia, with psychomotor slowing, executive dysfunction, gait disturbance and early urinary symptoms. Alzheimer disease causes early hippocampal memory loss, and Creutzfeldt-Jakob disease is rapidly progressive.

Option by option

  • A. Frontotemporal dementia

    Frontotemporal dementia begins with personality change or language loss and focal frontotemporal atrophy.

  • B. Alzheimer disease

    Alzheimer disease begins with episodic memory loss and hippocampal atrophy.

  • C. Creutzfeldt-Jakob disease

    Creutzfeldt-Jakob disease progresses over weeks to months with myoclonus.

  • D. Subcortical ischaemic vascular dementia (correct)

    Correct. White matter change, lacunes and a slow subcortical picture fit.

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 D, Subcortical ischaemic vascular dementia. Small-vessel disease from hypertension causes subcortical ischaemic vascular dementia, with psychomotor slowing, executive dysfunction, gait disturbance and early urinary symptoms.

Why is "Frontotemporal dementia" not the answer?

Frontotemporal dementia begins with personality change or language loss and focal frontotemporal atrophy.

Why is "Alzheimer disease" not the answer?

Alzheimer disease begins with episodic memory loss and hippocampal atrophy.

Why is "Creutzfeldt-Jakob disease" not the answer?

Creutzfeldt-Jakob disease progresses over weeks to months with myoclonus.

What concept does this question test?

It tests Organic mental disorders: subcortical vascular dementia in Psychiatry. Alzheimer disease causes early hippocampal memory loss, and Creutzfeldt-Jakob disease is rapidly progressive.

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: subcortical vascular 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.