Jackofknives
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A 35 year old nurse is brought to the emergency room after fainting outside of a pt’s room. The pt notes that she has had fainting episodes before and that she often feels weak and shaky. Laboratory studies reveal hypoglycemia, very high insulin level, and suppressed plasma C peptide. Which of the following best fits the clinical picture?
A sleep disorder
A seizure disorder
A somatoform disorder
Malingering
An endocrine disorder
A factitious disorder
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| po
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A factitious disorder
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| new_n_lost
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A factitious disorder
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| titly
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y not malingering?
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| Jackofknives
Ipwnpoker.com
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(6) B126
"The triad of hypoglycemia, very high insulin level, and suppressed plasma C peptide indicates that this nurse has self-administered insulin, a situation known as factitious hyperinsulinism. In hyperinsulinism due to medical causes, e.g., insulinoma (pancreatic B-cell tumor), plasma C peptide is typically increased, not decreased. Factitious disorder is more common in people associated with the health professions. There is no evidence in this woman of a sleep disorder, seizure disorder, somatoform disorder, or endocrine disorder such as diabetes. Becuase there is no obvious gain for this woman in being ill, malingering is unlikely."
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