Rosh Psychiatry Board Practice Exam

Which of the following is an important routine assessment for patients with factitious disorder?

1. Fasting serum glucose

2. Glasgow coma scale

3. Magnetic resonance brain imaging

4. Suicide risk

The correct answer is: Fasting serum glucose

In the routine assessment of patients with factitious disorder, fasting serum glucose is an important test to consider because individuals with this condition may engage in behaviors that can lead to alterations in their metabolic state, particularly if they are deliberately inducing symptoms or self-harming. Fasting serum glucose can help detect possible hypoglycemia or hyperglycemia associated with these behaviors, especially if the patient presents with symptoms that might suggest metabolic disturbances. Evaluating metabolic parameters is crucial in understanding the patient's overall health and any potential feigned medical conditions. Although other assessments may be significant in managing a patient's overall health, the direct relevance of fasting serum glucose in detecting potential manipulative behaviors associated with factitious disorder highlights its importance in routine assessment. Options such as the Glasgow coma scale and magnetic resonance brain imaging are less appropriate as routine assessments for factitious disorder. The Glasgow coma scale is primarily used to assess consciousness in patients following head injuries or those with altered mental status, while MRI is more typically utilized in diagnosing structural brain issues rather than evaluating psychological conditions like factitious disorder. Suicide risk assessment is undeniably important in all patient evaluations, particularly in psychiatric disorders. However, while it remains critical to ensure patient safety and explore underlying mental health issues, it is not specifically indicative of the metabolic