Forensic psychiatry: factitious disorder imposed on another: practice question

A Forensic Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Forensic Medicine · Forensic psychiatry: factitious disorder imposed on another

Sample item

A 3-year-old child is admitted nine times with unexplained fits and vomiting. Investigations are normal, and symptoms occur only when the mother is alone with him. The mother is attentive and medically knowledgeable. What is the most appropriate step?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Consider fabrication or induction of illness by the caregiver and arrange protective, supervised observation with child protection involvement

Factitious disorder imposed on another (Munchausen syndrome by proxy) involves a caregiver who fabricates or induces illness in a child, often with medical knowledge. Clues are repeated unexplained illnesses, symptoms that stop in the caregiver's absence and normal investigations. The child's safety comes first, so supervised observation and child protection services are needed.

Option by option

  • A. Reassure the mother and discharge the child without review

    Discharge without review would leave the child exposed to harm.

  • B. Consider fabrication or induction of illness by the caregiver and arrange protective, supervised observation with child protection involvement (correct)

    Correct. Suspicion with protective observation addresses the child's safety.

  • C. Start long-term anticonvulsants immediately

    Anticonvulsants would treat a seizure disorder that has not been shown and risk harm.

  • D. Confront the mother alone and discharge the child to her care

    Private confrontation and discharge would put the child at risk.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Forensic Medicine question

What is the answer to this Forensic Medicine question?

The best answer is B, Consider fabrication or induction of illness by the caregiver and arrange protective, supervised observation with child protection involvement. Factitious disorder imposed on another (Munchausen syndrome by proxy) involves a caregiver who fabricates or induces illness in a child, often with medical knowledge.

Why is "Reassure the mother and discharge the child without review" not the answer?

Discharge without review would leave the child exposed to harm.

Why is "Start long-term anticonvulsants immediately" not the answer?

Anticonvulsants would treat a seizure disorder that has not been shown and risk harm.

Why is "Confront the mother alone and discharge the child to her care" not the answer?

Private confrontation and discharge would put the child at risk.

What concept does this question test?

It tests Forensic psychiatry: factitious disorder imposed on another in Forensic Medicine. Clues are repeated unexplained illnesses, symptoms that stop in the caregiver's absence and normal investigations. The child's safety comes first, so supervised observation and child protection services are needed.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Forensic psychiatry: factitious disorder imposed on another?

Learn postmortem changes with their timelines, and toxicology as poison, sign, test and antidote. Then use the flashcards and the other Forensic Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.