History
0/16 key findingsAsk the questions your differential demands — not just the ones the case volunteers. Every diagnosis you intend to list owes you one discriminating question.
Opening
Priya Raman, 23, is referred to your outpatient clinic by her primary care physician. Six weeks ago she was started on sertraline for what was documented as depression. Her PCP's referral note says she has become "wired and not sleeping" since the dose was increased, and asks you to reassess the diagnosis. She is pleasant, talks quickly, and describes herself as having "mood swings my whole life."
Referral note
Sertraline 50 mg started six weeks ago, increased to 100 mg two weeks ago. PCP notes "patient reports feeling great, sleeping 3–4 hours, several new projects." No prior psychiatric care.
Opening statement
"Everyone keeps telling me I have mood swings. I go up and I go down. Right now I feel amazing, honestly — but my sister made me come."