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Functional Cognitive Disorder — SCE Neurology MCQ

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HardNeuropsychiatryFunctional Cognitive DisorderSCE Neurology

A 45-year-old woman presents with progressive difficulty concentrating and remembering recent events. She reports that her memory symptoms feel 'different' from typical forgetfulness — she describes internal inconsistency ('I know the information is there but I can't access it') and subjective memory complaints disproportionate to objective findings. Neuropsychological testing shows attention and executive deficits with relatively preserved episodic memory. MRI brain is normal. She has significant anxiety and low mood. What is the most likely diagnosis?

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Correct answer: C — Functional cognitive disorder

The best answer is “Functional cognitive disorder”. Neurological assessment localises the lesion from positive clinical features, selects the test that answers the remaining question, and escalates urgent red flags without repeating an already established investigation. The alternatives “Alzheimer disease”, “Vascular dementia”, “Dissociative amnesia”, “Delirium” are clinically adjacent possibilities, but they do not match the defining chronology, localisation, physiology, investigation result or UK management sequence in this stem.

Reference: NICE NG127 suspected neurological conditions recommendations: https://www.nice.org.uk/guidance/ng127/chapter/Recommendations-for-adults-aged-over-16