Question 21

25 year old nurse complaints of dizziness and sweating in the ER. A few days ago she had similar complaints and was adviced to go home from work after stabilizing. She joined work yesterday after leave. This is her third episode of similar complaints. She usually have such complaints whenever she is stressed due to patient overload, and feels better with rest and some juice. Today, her BP is 124/88 mm Hg, pulse is 102/min. She is sweating profusely. The doctor requests for blood chemistry, glucose level, and C- peptide level. The electrolytes levels are as follows, Na 134, K 3.4, Cl 98, Ca 9.2, Mg 2.4, BUN 20, Creat 0.9. Her Glucose level is 54 mg %, and C peptide levels are high. The doctor orders her 5 % Dextrose 100 cc, and she is stabilized subsequently. What is the most likely diagnosis?

A) Factitious disorder
B) Insulinoma
C) Glucagonoma
D) Manchausen Syndrome
E) Hypochondriasis

Answer will be posted soon under comments section.