USMLE-Rx Step 1 Qmax Challenge #1121

Check out today’s Step 1 Qmax Question Challenge.

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USMLE-Rx Step 1 Qmax Challenge #1121An 83-year-old man is brought to the family physician by his daughter, because the patient has become “increasingly forgetful” over the past few months. His medical history includes mild hypertension that has been well controlled. He does not smoke. The patient complains that his joints hurt a bit and he feels “run down lately.” He has lost weight, has forgotten to go grocery shopping and pay his bills, and has lost track of his medication intake. Neurologic examination is notable for impaired short-term recall, but motor and sensory functioning are intact. A mini-mental state exam is performed, and the patient scores 22/30. An MRI of the head is shown in the image.

Which of the following is the most likely cause of the patient’s symptoms?

A. Alzheimer disease
B. Benzodiazepine use
C. Normal aging
D. Parkinson disease
E. Vascular dementia


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4 thoughts on “USMLE-Rx Step 1 Qmax Challenge #1121”

  1. B

    for Benzo (he mixed up his pills)

    I see no atrophy on MRI, and it is only few months ( so, A out)
    BP controlled, MRI symmetric, no focal deficiencies (so E out)
    nothing else supports C or D
    by exclusion — B

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