Geriatric and Neuropsychiatric Syndromes (Pseudodementia, Frontal Syndromes) MCQs

Psychiatry · 15 free questions with answers & explanations.

1. A 70-year-old retired teacher presents with a 3-month history of poor memory, inability to concentrate, loss of interest in activities, and weight loss. His Mini-Mental State Examination (MMSE) score is 22/30. He states he 'cannot remember anything' and makes no attempt during memory testing. Previous function was normal. His GDS-15 score is 12. What is the most likely diagnosis?
2. A 62-year-old male is brought by his family for personality change. He was formerly polite and conscientious but now makes sexually inappropriate comments to strangers, shoplifts small items, has poor hygiene, and laughs incongruously. His episodic memory and visuospatial functions are preserved on testing. MRI shows prominent frontal and anterior temporal atrophy. What is the most likely diagnosis?
3. An elderly patient with Parkinson's disease develops vivid, formed visual hallucinations of children playing in his garden (non-threatening), fluctuating cognitive impairment, and daytime sleepiness. His family notes he 'acts out his dreams.' He subsequently develops mild resting tremor. What sequence of events described here most specifically suggests Dementia with Lewy Bodies over Parkinson's disease dementia?
4. In geriatric psychiatry, the Geriatric Depression Scale-15 (GDS-15) differs from PHQ-9 in an important way that makes it more suitable for older patients. Which statement is correct?
5. A 72-year-old retired teacher presents with 3-month history of poor memory, poor concentration, and inability to manage his finances. He is deeply distressed and answers 'I don't know' to most cognitive questions. MMSE is 18/30. His wife notes he has also lost interest in all activities he previously enjoyed. His symptoms improve with a trial of antidepressant. What is the MOST likely diagnosis?
6. A 60-year-old man with frontotemporal dementia (FTD) shows marked disinhibition, perseveration, utilisation behaviour, and lack of empathy. Which frontal lobe circuit is primarily implicated in his disinhibition and social inappropriateness?
7. An 80-year-old woman with Parkinson's disease develops visual hallucinations of small animals and children in her room. Her cognition fluctuates significantly day-to-day. She is unusually sensitive to haloperidol. What is the MOST likely diagnosis?
8. Which of the following is TRUE regarding Huntington's disease (HD) neuropsychiatric manifestations?
9. A 72-year-old retired teacher presents with a 3-month history of cognitive decline with prominent memory complaints, psychomotor retardation, and refusal to attempt tasks. Her family notes she was recently widowed. Neuropsychological testing shows variable performance with effort-dependent failures. She scores 26/30 on MMSE when encouraged. Her CT brain is normal. The MOST likely diagnosis is:
10. A 60-year-old man with a frontal lobe meningioma demonstrates disinhibition, sexual inappropriateness, hyperorality, and utilisation behaviour. Which specific frontal circuit is primarily implicated in this presentation?
11. Lewy body dementia is distinguished from Parkinson's disease dementia primarily by:
12. An 80-year-old retired teacher presents with a 3-month history of cognitive decline, psychomotor retardation, and poor concentration. She says 'I don't know' to most questions. MMSE is 18/30. She sleeps excessively and has lost 5 kg. Her CT head is normal. Hamilton Depression score is 28. The MOST likely diagnosis is:
13. A 65-year-old man with frontal lobe meningioma exhibits socially inappropriate behavior, perseveration, impaired abstract reasoning, and disinhibition, but retains relatively intact memory and language. This presentation is consistent with dysfunction of which prefrontal circuit?
14. Lewy body dementia (DLB) is distinguished from Parkinson's disease dementia (PDD) primarily by which temporal criterion?
15. An 82-year-old woman with moderate Alzheimer's dementia develops agitation, physical aggression, and sleep disturbance. After non-pharmacological measures fail, which antipsychotic has the MOST evidence for behavioral and psychological symptoms of dementia (BPSD), despite the class-wide black box warning?