Most commonly used in Australia. Can be used as an insult to anybody, but generally laid off at your friends or acquaintances in a jokingly manner.
Can also have the potential for appraisals, such as another Australian colloquialism fully sick('fully sick, mate' after can be used as well).
"Your such a sick rat."
"Your such a sick rheeet" (emphasize on the rat to show even more disgust)
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