Suicidality

A 42-year-old farmer attends because his wife insisted. She left him four months ago and he has been drinking a bottle of wine most nights. He has lost 6 kg, wa…

Pre-internship · common

A 15-year-old girl swallowed twelve of her mother's ibuprofen tablets after a break-up and is now six hours post-ingestion. She is asymptomatic, her observation…

Pre-internship · common

A 32-year-old woman attends her general practitioner for the six-week postnatal check with her healthy son. She says she is coping, sleeping when he sleeps and…

Pre-internship · middle twist

A 15-year-old girl in the emergency department tells you, when seen alone, that for the past month she has often thought she would be better off dead. She has n…

Pre-internship · middle twist

A 16-year-old boy is brought to a regional emergency department by his mother, who found messages in which he described wanting to die. Seen alone, he says he h…

Pre-internship · middle twist

You have been asked to speak about staying safe to Year 11 and 12 students at a metropolitan Western Australian high school. So that the talk targets the bigges…

Clinical rotations · common

A 15-year-old boy who lives on a wheat farm 300 km from Perth is brought in by his mother after she found a note in his room. He tells you that for the past mon…

Pre-internship · middle twist

A 10-year-old boy is seen in a paediatric outpatient clinic. Over six months he has become irritable, has stopped playing soccer, which he loved, and takes over…

Pre-internship · common

The Australian Institute of Health and Welfare reports causes of death for Aboriginal and Torres Strait Islander children and young people. Among Aboriginal and…

Clinical rotations · middle twist

A 16-year-old girl is seen alone at a youth health service, where she has been attending for low mood. Today she tells you that for the past fortnight she has b…

Pre-internship · middle twist

You are the intern on a surgical ward. A 68-year-old woman, four days after mastectomy, tells the night nurse she may as well not wake up in the morning. She ha…

Pre-internship · middle twist

A 44-year-old woman is seen in the emergency department after telling her general practitioner that she felt like giving up. She has four weeks of low mood, poo…

Clinical rotations · middle twist

A 78-year-old man is reviewed four weeks after starting sertraline for a depressive episode that began when his wife died. His mood is unchanged. He tells you h…

Pre-internship · common

A general practice in a regional Western Australian town is auditing its patients aged 65 years and over as part of a suicide prevention programme. None of the…

Clinical rotations · middle twist

A 16-year-old boy is brought by his father because he has gone from the top of his class to failing in six months. He has quit the swimming squad, sleeps until…

Pre-internship · middle twist

A 74-year-old woman is referred with six months of worry, restlessness and broken sleep. She has never been anxious before and can point to no trigger. She has…

Pre-internship · common

A 47-year-old farmer is brought to a regional emergency department by his brother. Over three months he has withdrawn from the family, stopped eating with them…

Pre-internship · common

A 58-year-old man with a three-month depressive episode tells his general practitioner, quietly and without being asked, that he has been thinking about ending…

Clinical rotations · common

A 21-year-old man is brought to a regional emergency department at 2 am by police after he was found standing on a freeway overpass. He says a voice has been te…

Pre-internship · middle twist

A 31-year-old woman is reviewed at home by the perinatal mental health team three weeks after the birth of her first child. She has not slept for four nights, h…

Pre-internship · middle twist

A 19-year-old university student is in the emergency department six hours after her flatmate found her drowsy on the bathroom floor beside an empty blister pack…

Clinical rotations · middle twist

A 22-year-old apprentice is brought to a regional emergency department by friends at 11 pm after telling them he wanted to die. Six hours later his breath alcoh…

Pre-internship · middle twist

A 44-year-old man attends the community mental health clinic. He has recurrent major depressive disorder and came home nine days ago after a two-week admission…

Clinical rotations · middle twist

An intern reviews a 47-year-old man in the emergency department twelve hours after he swallowed twenty paracetamol tablets on the night his wife left him. He is…

Pre-internship · middle twist

A medical student presents a new admission at the morning meeting. She gives his age, occupation and living situation, the presenting complaint and its history,…

Clinical rotations · common

A 61-year-old man was admitted with severe depression and pervasive hopelessness after a near-fatal overdose. Twelve days after starting an antidepressant the n…

Pre-internship · middle twist

An 18-year-old woman took 30 paracetamol tablets after her relationship ended. She has completed acetylcysteine; at 20 hours her alanine aminotransferase is nor…

Pre-internship · middle twist

A 23-year-old woman is medically cleared six hours after taking 20 of her flatmate's quetiapine tablets at the end of a relationship. She says she regrets it, i…

Pre-internship · middle twist

A 46-year-old man with recurrent major depression tells his general practitioner that he intends to take all his prescribed medicines after his partner leaves f…

Pre-internship · common

A 45-year-old man is brought to the emergency department after taking 20 paracetamol tablets following an argument. He is medically cleared and a psychiatric as…

Clinical rotations · common