Organic mental disorders: dopamine transporter imaging: 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: dopamine transporter imaging

Sample item

A 70-year-old man has fluctuating cognition, well-formed visual hallucinations, acting out of dreams and mild parkinsonism. Which imaging finding would best support the suspected diagnosis?

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

The answer and the reasoning

D. Reduced striatal dopamine transporter uptake on SPECT

Dementia with Lewy bodies shows reduced dopamine transporter uptake in the basal ganglia on DaT SPECT, along with relative preservation of medial temporal structures. Marked medial temporal atrophy supports Alzheimer disease, and frontotemporal atrophy supports frontotemporal dementia.

Option by option

  • A. Frontal and anterior temporal atrophy

    Frontal and anterior temporal atrophy points to frontotemporal dementia.

  • B. Multiple lacunar infarcts

    Multiple lacunes point to small-vessel vascular dementia.

  • C. Marked medial temporal atrophy on MRI

    Prominent medial temporal atrophy is typical of Alzheimer disease, and is relatively spared in Lewy body dementia.

  • D. Reduced striatal dopamine transporter uptake on SPECT (correct)

    Correct. Loss of nigrostriatal terminals shows as low DaT uptake.

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, Reduced striatal dopamine transporter uptake on SPECT. Dementia with Lewy bodies shows reduced dopamine transporter uptake in the basal ganglia on DaT SPECT, along with relative preservation of medial temporal structures.

Why is "Frontal and anterior temporal atrophy" not the answer?

Frontal and anterior temporal atrophy points to frontotemporal dementia.

Why is "Multiple lacunar infarcts" not the answer?

Multiple lacunes point to small-vessel vascular dementia.

Why is "Marked medial temporal atrophy on MRI" not the answer?

Prominent medial temporal atrophy is typical of Alzheimer disease, and is relatively spared in Lewy body dementia.

What concept does this question test?

It tests Organic mental disorders: dopamine transporter imaging in Psychiatry. Marked medial temporal atrophy supports Alzheimer disease, and frontotemporal atrophy supports frontotemporal 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: dopamine transporter imaging?

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.