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Vascular dementia — DGM MCQ

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ModerateDementiaVascular dementiaDGM

An 82-year-old man has stepwise cognitive decline after two lacunar strokes. His family report abrupt drops in function followed by partial recovery. Examination shows mild right-sided pyramidal signs. Current medicines include clopidogrel, atorvastatin and amlodipine. What is the most likely diagnosis?

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Correct answer: C — Vascular dementia

Stepwise decline with focal neurological signs and cerebrovascular disease suggests vascular dementia. Alzheimer's disease is usually gradual, Lewy body dementia features fluctuations and hallucinations, depression has prominent affective symptoms, and delirium tremens follows alcohol withdrawal. Vascular risk factor control remains important after diagnosis.

Reference: NICE NG97