Check Study Program

#InsideOut_Screening #Eating_Dsiorder

Jade, aged 17 years, attends your surgery as she is looking for a new general practitioner. She has just moved interstate and needs her insulin scripts. She tells you she is looking for a fresh start after an unhappy early family life (her parents divorced when she was nine years of age) and is staying with a friend for the moment until she finds her feet. Jade is doing some casual bar work and seems a bit chaotic but is chatty and engaging. 1.What examination would you undertake at this stage? 2.Is there any further screening you would perform at this stage? 3.What are your plans for Jade’s next visit to further assess her risk for an eating disorder? 4.Are there any particular considerations for patients with concurrent diagnoses of IDDM and an eating disorder? 5.What are some common comorbidities in patients with eating disorders, particularly bulimia nervosa? 6.What would you look for on physical examination? 7.What are the characteristics of bulimia nervosa? 8.What are the treatments for bulimia nervosa and binge eating disorder? 9.How would you prioritise your next management steps for Jade? 10.Who else could be helpful in Jade’s care? #Week19_Case4

#Suicide_Risk_Factors

#SSFC

Louis, aged 16 years, presents to see you for the first time. As per your standard practice, you ask for Louis’s pronouns and note they are ‘he/him’. Louis is completing year 11 and lives at home with his parents. He tells you he has been feeling depressed and is not coping. He has not seen his family general practitioner (GP) for more than nine months and is presenting to you alone on the recommendation of a friend as Louis would like to find his own GP. 1.How would you approach the initial consultation? 2.What are the key findings from a formulation approach in this case? 3.What other screening and assessment tools might be helpful? 4.What are the key guideline recommendations for the use of medication for treating depression in young people? 5.Would you involve Louis’s family at this time? 6.Notwithstanding that Louis presents as a mature minor, given his reluctance to involve family in the treatment decision process, what steps can be taken from here in assisting Louis to consider more deeply the involvement of his family? 7.How can you prepare Louis and his family for an SSFC? 8.If you consider prescribing antidepressant medication for Louis, what is important to include in the consent process and how frequently is monitoring required? #Week19_Case3

You arrive at work to find a message from the practice manager. It states, ‘Siobhan called early this morning; she needs to see you urgently’. You check your schedule and find there are no gaps. Siobhan is one of your regular patients. She is 18 years of age and her father, another one of your patients, died last year as a result of bowel cancer. Siobhan lives with her mother, Trish, and two younger siblings. 1.How would you respond to the practice manager? 2.What would you like to ask Siobhan? 3.How would you assess Siobhan’s risk on a telehealth call? 4.How will you follow up Siobhan? 5.What are the main reasons for young people self-harming? 6.How would you talk to Siobhan about her self-harming? 7.What is your diagnosis? 8.What is your treatment for Siobhan? 9.How can you assess Siobhan’s risk of self-harming in the future? 10.How could you best involve Trish in the process of supporting Siobhan? #Week19_Case2

Do-san, aged 16 years, presents to you with his mother, Na-eun. Na-eun starts the consultation by explaining that Do-san has been having trouble completing his homework for school, is eating less than usual and spends a lot of time alone in his room. Do-san has his arms crossed, looks down at his shoes and appears withdrawn. Do-san tells you he feels sad most of the time; he is stressed about his final exams for school and has been having trouble sleeping for the past few months. 1.What further mental health history would you seek from Do-san? 2.What else would you include in your initial assessment of Do-san? 3.What would be your initial treatment approach for Do-san? 4.How would you approach Do-san’s home situation? 5.What would you do to support Do-san’s safety? 6.How can you support Do-san to find safe housing? #Week19_Case1