10 worked questions mapped to RCPsych §8.
Common Example Questions
Q1A man in his 70s has just been diagnosed with Lewy body dementia of mild severity and needs drug treatment. Which agent is first-line?
- A Rivastigmine
- B Haloperidol
- C Memantine first-line
- D A benzodiazepine
- E No treatment
Reveal answer
Correct answer: A
Reason: A cholinesterase inhibitor such as rivastigmine is first-line in Lewy body dementia and can reduce hallucinations; antipsychotics are hazardous.
Q2A clinician assesses for dementia with Lewy bodies. Which is a core clinical feature?
- A Recurrent formed visual hallucinations
- B Early prominent amnesia only
- C Stepwise decline
- D Early aphasia
- E Chorea
Reveal answer
Correct answer: A
Reason: Core features of DLB include fluctuating cognition, recurrent formed visual hallucinations, parkinsonism and REM sleep behaviour disorder.
Q3An elderly woman living alone believes people and gases pass through the walls from the neighbours. What is this type of belief called?
- A A partition delusion
- B A grandiose delusion
- C A nihilistic delusion
- D An overvalued idea
- E A delusion of reference
Reveal answer
Correct answer: A
Reason: Partition delusions are characteristic of very-late-onset schizophrenia-like psychosis.
Q4After several years of Parkinson's disease, a patient develops both dementia and troublesome psychotic symptoms. What is a sensible first step?
- A Review anti-parkinsonian medications and consider a cholinesterase inhibitor
- B Start a first-generation antipsychotic
- C Add an anticholinergic
- D Stop all treatment
- E Start lithium
Reveal answer
Correct answer: A
Reason: Review the anti-parkinsonian drugs (which can cause psychosis) and consider a cholinesterase inhibitor (rivastigmine).
Q5Depression coexisting with dementia is hard to assess. Which rating scale is designed for this?
- A Cornell instrument
- B PHQ-9
- C Hamilton scale
- D EPDS
- E GAD-7
Reveal answer
Correct answer: A
Reason: Identifying low mood in someone who also has dementia is hard; the Cornell tool was built for this purpose, combining a patient interview with an informant account.
Q6A patient aged 55 woman is diagnosed with REM sleep behaviour disorder. Which condition is it most associated with developing?
- A Dementia with Lewy bodies
- B Alzheimer's disease
- C Vascular dementia
- D Frontotemporal dementia
- E Normal-pressure hydrocephalus
Reveal answer
Correct answer: A
Reason: REM sleep behaviour disorder is strongly associated with later synucleinopathies, particularly dementia with Lewy bodies.
Q7A patient aged 65 man has two years of progressive personality change, disinhibition and apathy with relatively preserved memory. Which dementia is most likely?
- A Frontotemporal (frontal-variant) dementia
- B Alzheimer's disease
- C Vascular dementia
- D Lewy body dementia
- E Delirium
Reveal answer
Correct answer: A
Reason: Early personality/behavioural change with preserved memory suggests frontotemporal dementia.
Q8A patient aged 66 woman has recurrent small strokes, migraine and a family history, with subcortical white-matter changes. Which inherited cause is likely?
- A CADASIL
- B Alzheimer's dementia
- C Huntington's chorea
- D Wilson's disease
- E Idiopathic Parkinson's
Reveal answer
Correct answer: A
Reason: CADASIL is an inherited small-vessel arteriopathy causing migraine, recurrent subcortical strokes and vascular cognitive impairment.
Q9A man has mild cognitive impairment and his family ask about the risk of dementia.
- A About 10%
- B About 1%
- C About 50%
- D About 90%
- E None progress
Reveal answer
Correct answer: A
Reason: Roughly 10% of people with mild cognitive impairment progress to dementia each year, though some remain stable or revert.
Q10A patient aged 46 man with heavy alcohol use and poor nutrition is hypoglycaemic in hospital. What must be given before or with glucose?
- A Parenteral thiamine
- B Folate only
- C Magnesium alone
- D An antipsychotic
- E A benzodiazepine
Reveal answer
Correct answer: A
Reason: Give parenteral thiamine before glucose to avoid precipitating Wernicke's encephalopathy.