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Dysmenorrhoea — UKMLA MCQ

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EasyObstetrics & GynaecologyDysmenorrhoeaUKMLAMRCGP AKTPARA

A person with Parkinson’s disease and no cognitive impairment has persistent hallucinations after appropriate assessment and optimisation of antiparkinsonian treatment. Which statement preserves the precise NICE recommendation strength and sequence for antipsychotic treatment?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: C — Consider quetiapine initially; offer clozapine after treatment failure; do not offer olanzapine

Explanation lettering: E = shown as A · C = shown as B · B = shown as C · A = shown as E

B is correct. NICE says to consider quetiapine for hallucinations or delusions in a person with Parkinson’s disease who has no cognitive impairment, to offer clozapine if standard treatment is ineffective, and not to offer olanzapine. A reverses the recommendation strengths by offering quetiapine and merely considering clozapine. C understates the clozapine recommendation by changing 'offer' to 'consider'. D overstates the initial quetiapine recommendation and permits olanzapine, which should not be offered. E reverses the quetiapine–clozapine sequence.

Reference: NICE NG71, recommendations on hallucinations and delusions: https://www.nice.org.uk/guidance/ng71/chapter/recommendations#pharmacological-management-of-non-motor-symptoms