Hey, remember when I told everybody that an insulinoma would explain my Insta-Bitch? Well, all that self-awareness made me actually pay attention to insulinoma as a disease, even though it is very rare. It paid off, though, because it was the answer on my exam last week! The question was a case presentation of a woman brought in by her friend, because the woman had been eating tons and gaining weight suddenly, acting generally irritated and anxious, and had a headache lasting weeks. I was reading it and not understanding what the question was trying to hint at, and thought, “Huh, that sounds like me when I’m hungry…. OH HEYYYY, insulinoma is an answer choice!” Very exciting. Good job, unfounded paranoia!
For the record, though, I did not see an insulinoma while on my Internal Medicine rotation. So really, the exam was not representative of my actual Internal Medicine rotation at a certain Big City Hospital. Had the test been truly representative, the patient in the question would have been a 50-something-year-old male, probably homeless, with hypertension or high cholesterol or poorly-controlled diabetes (or all three), current or former smoker/drinker, coming in for shortness of breath or chest pain after drinking all weekend/doing cocaine/losing his medications (all things that happened). It’s like a really tedious and frustrating game of Mad Libs.
