184. A 42-year-old woman with recurring episodes of hypoglycemia comes to the physician for a follow-up examination. She says that the episodes occur regardless of how much or how little she has eaten. The patient is on medical leave from her job as a licensed practical nurse. She recently underwent an exploratory laparotomy to confirm the diagnosis of insulinoma, but no abnormalities were found. She is 173 cm (5 ft 8 in) tall and weighs 55 kg (120 lb); BMI is 18 kg/m². She appears mildly anxious. Her 2-hour postprandial serum glucose concentration is 70 mg/dL. Which of the following is the most likely diagnosis? A) Conversion disorder B) Factitious disorder C) Hypoglycemia D) Insulinoma E) Metabolic syndrome
184. A 42-year-old woman with recurring episodes of hypoglycemia comes to the physician for a follow-up examination. She says that the episodes occur regardless of how much or how little she has eaten. The patient is on medical leave from her job as a licensed practical nurse. She recently underwent an exploratory laparotomy to confirm the diagnosis of insulinoma, but no abnormalities were found. She is 173 cm (5 ft 8 in) tall and weighs 55 kg (120 lb); BMI is 18 kg/m². She appears mildly anxious. Her 2-hour postprandial serum glucose concentration is 70 mg/dL. Which of the following is the most likely diagnosis? A) Conversion disorder B) Factitious disorder C) Hypoglycemia D) Insulinoma E) Metabolic syndrome
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