In the initial evaluation of every patient presenting with newly diagnosed cognitive decline, which pair of investigations is recommended routinely to detect potentially reversible contributors?

• A Serum ceruloplasmin and copper levels
• B CSF analysis and brain biopsy
• C Serum TSH and vitamin B12 levels ✓
• D Sleep study and carotid Doppler

Explanation

Standard guidelines recommend thyroid function tests and serum vitamin B12 estimation in every initial dementia workup because hypothyroidism and B12 deficiency are common, easily tested, and partially reversible causes of cognitive impairment. Ceruloplasmin is ordered only when Wilson disease is suspected in a young patient. CSF examination is reserved for specific indications such as suspected infection, and sleep studies and carotid Doppler are not routine parts of the dementia screen.

Reference: Harrison's Principles of Internal Medicine, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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