Munchausen's Disorder Flashcards
3 Types of Munchausen’s Disorder
Munchausen’s Syndrome
Munchausen’s Syndrome by Proxy (MSBP)
Munchausen’s Syndrome by Internet (CyberMunch)
Define Munchausen’s
Factitious disorder in which a person exaggerates or creates symptoms of illnesses in themselves to gain investigation, treatment, attention, sympathy, & comfort from medical personnel
Define Malingering
Feigning illness & has an external incentive (Avoiding work, obtaining money)
Define Factitious Disorder
No other incentive than to be a patient & experience the sick role (looking for attention)
Patient’s know they are not sick
Hypochondriasis
Patients believe they actually have the disease
Etiologies of Munchausen’s Disorder
History of abuse or neglect as a child
History of frequent illness requiring hospitalization when they were younger
Symptoms of Munchausen’s Disorder
Dramatic but inconsistent medical history
Unclear symptoms that are not controllable
Predictable relapses
Extensive knowledge of hospitals or med terms (textbook descriptions of illnesses)
Multiple surgical scars
New/additional symptoms following negative tests
Presence of symptoms only when patient is alone
Willingness to have medical tests, operations, or procedures
Seeking treatment at numerous hospitals
Reluctance by patient to meet with family or prior doctors
Common Presentation of Muchausen’s Syndrome by Proxy
Illness that is unexplained, unusual, prolonged, & resistant to treatment
Problem only originates in presence of perpetrator
Perpetrator less concerned about child’s illness than clinicians providing care
Signs/Symptoms of Munchausen’s Syndrome by Proxy
Bleeding from various sites
Seizures
CNS depression
Apnea
Self-induced Infections
Wounds Abscesses Bacteremia Sepsis Fever
Surreptitious Ingestion of Medicines, Vitamins, Minerals
Diarrhea Vomiting Hypokalemia Renal failure Hypomagnesemia Salt poisoning Bartter's syndrome Hypoglycemia Pheochromocytoma Hyperthyroidism Bleeding or purport from coagulation disorder Bone marrow depression Liver Disease
Self-Induced Injury
Unhealed wounds
Deformities
Dermatoses
Reflex sympathetic dystrophy
Phlebotomy (Self or Animal)
Anemia Melena Hematochezia Hematemesis Hematuria
Thermometer Manipulation or Substitution fo Thermomter
Fever
Simulation of the Clinical Manifestations of Specific Diseases or Syndromes
CA AIDS CF Pancreatitis Insanity Depression MS Seizures Pain syndromes Renal stones Proteinuria
Define Munchausen by Proxy
Fabricating or inducing illness in a child by the parent or primary caregiver in order to get attention
Characteristics of Perpetration for Munchausen by Proxy
Biological mother
Usually 20-30
Seem to be loving & caring when around medical staff
Marital conflict
50% have medical training
Little emotion when child in distress/pain
Common Presentations of Munchausen’s Syndrome by Proxy
GI bleed or UTI Vomiting or reflux Diarrhea Apnea Hypoglycemia
Diagnosis fo Munchausen’s Syndrome
Recognition
Common Presentations: feign, simulate, exaggerate, aggrevate, incude
Complete H&P
Management of Munchausen’s Patient
Multidisciplinary approach
Multidisciplinary child protection team
Hospitalization
Safety of child most important
Define Munchausen’s by Internet (CyberMunch)
Join support groups on the internet and then falsify stories about themselves so that others will show sympathy towards them & talk to them about their “misfortunes”
Conclusion of Munchausen’s Syndrome
Real disorder High chance of serious health problems 70% chance of dying if lifelong Be loyal & compassionate with these patients Take time for complete H&P
