The nurse notes that she has had fainting episodes before and that she often feels weak and shaky

A 34-year-old nurse is brought to the emergency room after fainting outside of a patient’s room. The nurse 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 this clinical picture?

    1. An anxiety
    1. Malingering
    1. A factitious disorder
    1. A sleep disorder
    1. A somatoform disorder

0 voters

exp:

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, for example, 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, anxiety disorder, somatoform disorder, or endocrine disorder such as diabetes. Because there is no obvious or practical gain for this woman in being ill, malingering is unlikely.