American Board of Internal Medicine (ABIM) Certification Practice Exam

Which of the following is NOT a nondegenerative cause of dementia to evaluate with imaging?

1. Cerebrovascular disease

2. Neoplasm

3. Subdural hematoma

4. Generalized anxiety disorder

The correct answer is: Generalized anxiety disorder

The option that is not a nondegenerative cause of dementia to evaluate with imaging is generalized anxiety disorder. Dementia refers to a decline in cognitive function severe enough to interfere with daily life, and it can be caused by both degenerative and nondegenerative factors. Nondegenerative causes that should be evaluated with imaging often include conditions like cerebrovascular disease, neoplasms, and subdural hematomas. Cerebrovascular disease can lead to vascular dementia, where blood flow to areas of the brain is compromised, and imaging can reveal infarcts or other vascular changes. Neoplasms or tumors within or adjacent to the brain can disrupt normal brain function and lead to cognitive deficits that may be mistaken for dementia; thus, imaging is essential for diagnosis. Subdural hematomas, often resulting from trauma, can also mimic dementia symptoms due to increased intracranial pressure; imaging is necessary to identify and manage this condition. Generalized anxiety disorder, while it can lead to cognitive impairments or difficulties with concentration and memory, does not produce structural changes in the brain that would be visible on imaging studies. Instead, it is a psychiatric condition that is primarily treated through therapy and medication without requiring imaging to identify brain abnormalities. Therefore, it is not