Organic mental disorders: Parkinson disease dementia treatment: 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: Parkinson disease dementia treatment

Sample item

A 74-year-old man with Parkinson disease for eight years develops progressive cognitive decline, fluctuating attention and visual hallucinations. Which drug is licensed to treat the dementia?

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

The answer and the reasoning

A. Rivastigmine

Parkinson disease dementia involves a marked cholinergic deficit, and rivastigmine, a cholinesterase inhibitor, is the licensed treatment. Anticholinergic antiparkinsonian drugs worsen cognition, and conventional antipsychotics such as haloperidol worsen motor features.

Option by option

  • A. Rivastigmine (correct)

    Correct. A cholinesterase inhibitor improves cognition and hallucinations in this dementia.

  • B. Haloperidol

    Haloperidol blocks D2 receptors and can severely worsen parkinsonism.

  • C. Trihexyphenidyl

    Trihexyphenidyl is an anticholinergic and worsens confusion and cognition.

  • D. Memantine

    Memantine has weaker evidence and is not the licensed treatment for this condition.

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 A, Rivastigmine. Parkinson disease dementia involves a marked cholinergic deficit, and rivastigmine, a cholinesterase inhibitor, is the licensed treatment.

Why is "Haloperidol" not the answer?

Haloperidol blocks D2 receptors and can severely worsen parkinsonism.

Why is "Trihexyphenidyl" not the answer?

Trihexyphenidyl is an anticholinergic and worsens confusion and cognition.

Why is "Memantine" not the answer?

Memantine has weaker evidence and is not the licensed treatment for this condition.

What concept does this question test?

It tests Organic mental disorders: Parkinson disease dementia treatment in Psychiatry. Anticholinergic antiparkinsonian drugs worsen cognition, and conventional antipsychotics such as haloperidol worsen motor features.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. 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: Parkinson disease dementia treatment?

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.