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Depression-related cognitive impairment — SCE Neurology MCQ

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HardCognitive NeurologyDepression-related cognitive impairmentSCE Neurology

A 55-year-old woman presented with subjective memory complaints with low mood and sleep disturbance. On examination, effort was variable and delayed recall improved with cueing. Initial investigations showed: MRI and blood tests were unremarkable. What is the most likely underlying mechanism?

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Correct answer: B — impaired attention and retrieval from depressive illness

The best answer is “impaired attention and retrieval from depressive illness”. UK stroke guidance supports urgent vascular imaging and reperfusion selection, short-course dual antiplatelet therapy for eligible minor stroke or high-risk TIA, decompression for life-threatening swelling, and secondary prevention matched to mechanism. The alternatives “Functional abnormality of motor prediction networks”, “Granulomatous vessel wall inflammation, when the phenotype supports it”, “Raised intracranial pressure from impaired CSF dynamics”, “Small-vessel lipohyalinosis, after excluding important mimics” are clinically adjacent possibilities, but they do not match the defining chronology, localisation, physiology, investigation result or UK management sequence in this stem.

Reference: National Clinical Guideline for Stroke: acute care: https://www.strokeguideline.org/chapter/acute-care/