Station - Instructions for candidate
You are an intern working in the Emergency Department of a metropolitan hospital in Perth. It is 9 am.
Jess Whitford, 34, has been brought in by her partner, Tom, who is worried that she has barely slept for over a week. Jess says there is nothing wrong with her. Tom is in the waiting room. She has agreed to 'a quick chat'.
| Triage note | 34 F, brought by partner. Not sleeping for 10 days. Restless, over-familiar, no aggression. Says she is fine and wants to leave. Category 3. |
|---|---|
| Observations | HR 104 /min, BP 134/84 mmHg, T 37.0 degrees C, RR 18 /min, SpO2 99% on room air, bedside glucose 5.6 mmol/L |
| GP summary (from the shared health record) | Depressive episode 2023, sertraline 6 months, recovered. Sertraline 50 mg restarted 6 weeks ago for low mood; increased to 100 mg 3 weeks ago. No other medicines. No allergies. |
Your tasks are to:
- Take a focused psychiatric history from Jess, including her medicines, 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 respond to Jess wanting to leave.
- 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 Tom 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.