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NBME 24 Answers

nbme24/Block 2/Question#6 (31.6 difficulty score)
A 50-year-old woman is admitted to the ...
Factitious disorder🔍,📺
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 +16 
submitted by seagull(1575),
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hsTi is a icen parcphao ot ienftngidyi and ietntrag ifcttusioa d.iorders

cFmokaip/llgassmXc:#.=McbvpRdemw/r=ts+?eobc:a86tkshiethr+hqw2no&wtxoggOh.ab/t=p6c

cinnapie  Not all heros wear capes +  
privwill  Mother of mine strongly believes in this method of treatment... +9  
aisel1787  lmao +1  



 +1 
submitted by drschmoctor(97),

How does one differentiate factitious disorder from being thirsty w poor impulse control?

therealslimshady  If you're asking how to rule out diabetes insipidus, I think it's because: Diabetes insipidus is caused by a lack of ADH effect, so they will be peeing out too much water, thus making them dehydrated and hyperosmolar (thirsty). This CHF patient is presenting with signs of fluid overload +3  
an_improved_me  I think that ADH also has affects on central structures that increase thirst? Or is that only Angiotensin II? +  



 +0 
submitted by sunshinesweetheart(82),
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ecaut beocexntaiar fo HFC sedla to cerdedu OC -&-;tg vmlhieepcoyr niphtyoe,rama boyd rceepsvie it sa lcphomvoyei (so ouy ptexce hhig DAH) coot-no"nism[ elrsaee fo D]AH"

  • shit tp si nllycicali epvomlyrchei amed(,e el,ars etneddisd ncek esi)vn

  • enuir ushldo be nctnearteocd Us(mO t01;0g& )g/ksOmm esebuac sneydki uolhsd eb nefi dan AHD is igndo its bjo, usjt hitw adb ronioftnami

  • if iuner si ulet,id 'ist not ,FHC is't csepginohcy c(an eb ascued by rcpnasehoizih ro stuictifoa dsridre)o

les't say hes ants'w ycraz dan aleylr wsa gnviah FCH ctaneoer-bixa xt htwi etciduri dan idulf ctiteonirsr as yteh gti--d&;d onet thta you nca losa seu patvna usrdg orf lraHCF-deet ncpiharotmey yohepealvrmi lbcok( AHD) --gt&; ohslud esuac het uerni ot be tueild hicwh lilw cuerde teh eiympvrelhao dan edurce tsla oiroprsten ot ctrroec eht peaoinrtmhya

ramond sebeadti sipsinidu eisd otne rof hcseygpiocn piIsyiod Dp(la xd is yrlmiren,hata/oaprnem oahyvoemi,lp edltui rnieu Ok/mt0s)m1;0&lg

  • acn osal esu het eatwr peiadnovitr ttse ofr a pt thiw lapuyori nad ipslopiyda

-;g&-t fi eniur sec,onctanter t'is oeccyhspgin

;g--t& if it edso otn cn,reaetoctn iegv esesrnospidm and fi it coteencrntas = lcnraet ,ID dose ont ncrtocaene = reencogihnp ID




 -1 
submitted by am4140(1),

This is a BS question - I still picked the “right” answer because nothing else made sense, but this is not how this happens in real life. Having taken care of a million of these patients, they’re not trying to fake a disease or symptoms -> they’re thirsty and selfish with no ability to regulate their own behavior, and they throw temper tantrums and ring the call bell all day long asking for water - they’re definitely not hiding their water consumption. I’ve even seen people get desperate enough to drink out of the toilet because they’re “dying of thirst.”