Station - Instructions for candidate
You are an intern working in the Emergency Department of a metropolitan hospital in Perth. It is 10 am.
Rahul Iyer, 20, has been brought in by his mother, who told the triage nurse that he has been shutting himself in his room for months and was talking to himself and shouting at the neighbours yesterday. Rahul has agreed to be seen. His mother is in the waiting room.
| Triage note | 20 M, brought by mother. Withdrawn for months, 'talking to himself', shouted at neighbours yesterday. Calm, cooperative, no aggression at triage. No known medical history. Category 3. |
|---|---|
| Observations | HR 96 /min, BP 128/78 mmHg, T 36.9 degrees C, RR 16 /min, SpO2 98% on room air, bedside glucose 5.2 mmol/L |
Your tasks are to:
- Take a focused psychiatric history from Rahul, including substance use and a screen for medical causes.
- Present the mental state findings you have observed during the interview, and your assessment of risk, to the examiner.
- State your most likely diagnosis and the differential diagnoses to the examiner.
- Outline your initial management plan to the examiner, including how you would proceed if Rahul declined to stay.
- You do NOT need to perform a physical examination, and you do not need to summarise the history to the examiner - only the mental state findings and risk.
- Collateral history from Rahul's mother is available from the examiner on request.
- State drug, dose and route where relevant.
This is a 15-minute station, with 2 minutes of reading time.