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Pbl session 2 by Mind Map: Pbl session 2
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Pbl session 2

Step 6

Review session 1

Summary of step 5, Anatomy, Respiratory system (nerves, blood vessels, lymph vessels), physiology, Respiratory system, pathology, Infection of respiratory system (Airborne), Immune deficiencies in relation with lungs, pathophysiology, Relate the symptoms together to one disease, What causes chest pain in the right area?

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Patholog, pneumonia, epidemiology, most common infections cause of death in the US, 4 million cases per year, 60,000 people die each year, pathophysiology, How does the pathogen get in?, it passes through the defense system, mucous, cilia, weak immune system or strong pathogen, What happens next?, when contaminants enter, the immune system responses, it causes inflammation, alveoli get filled with puss and fluid, this makes it hard for o2 to reach the blood stream, What causes chest pain in the upper right area?, pneumonia in the upper right lobe, Pleural Effusion, Why are infections more common in the right lung?, because the anterior border is vertical, the left lung has the cardiac notch, symptoms, high fever, shacking chills, productive cough, yellow to green sputum, malaise, chest pain, stabbing, gets worse when you breath in, dyspnea, hemoptysis, people at higher risk, very young people (less than 2 years), very old (more than 65), patients with chronic illness, heart disease, immunocompromised patients, AIDS, organ transplantation, immune suppressive drugs, cancer patients, smokers, alcohol abusers, who work in construction or agriculture, dust, chemicals, air pollution or toxic fumes, they damage the lung, they make it susceptible for pneumonia, Native Alaskan or Native American, people in ICU or who had major surgery, Types, community acquired, caught in public places, may develop after you have a cold or the flu, types of bacteria, Streptococcus pneumoniae (most common), Staphylococcus aureus, Moraxella catarrhalis, Neisseria meningitidis, Klebsiella pneumoniae, Haemophilus influenzae, hospital acquired, from the ICU, after chest surgery, Aspiration pneumonia, when inhaling particles into your lungs, from vomiting, Opportunistic pneumonia, normal organisms affecting immune compromised, Pneumocystis jiroveci, pathogen type, viral, less common, symptoms appear gradually, SARS, flu, respiratory syncytial virus, rhinovirus, parasitical, mostly in immune-comramised patients, bacterial, most common, symptoms appear right away, most common bacteria types, diagnosis, stethoscope, chest x-ray or CT, blood test, phlegm culture, bronchoscopy, Pulmonary TB, Mycobacterium tuberculosis, tuberculosis pneumonia, acute bronchitis

Step 7

Inquiry plan and info gathering

history, what did they treat for in the first visits?, They thought it was flu, No antibiotics described, risk factors?, Type 1 diabetic

vital signs, wight 68, hight 150, temperature 39 c, pulse 80, blood pressure 110/60, looks sick

stethoscope, crackling sounds

tests results, o2 saturation 88%, hemoglobin is OK, high WBC count, High neutrophils, ESR: high, LDH: high, phlegm culture, no results yet, C reacting protein: high, Electrolytes are good, Glucose 220, x ray, showing pneumonia

Step 8

Diagnostic decision

Community acquired pneumonia (typical)

probably streptococcus pneumoniae


Inhalation of pathogen

passed to the right upper lobe

immune response causing inflammation

alveoli filled with fluid

decreased O2 passage to blood


productive cough

fever and chills

chest pain in the right upper area

Supporting data

low O2 in blood

chest x-ray

high WBC count

ESR confirms inflammation

LDH proves hemolysis

elevated c reactive protein confirms inflammation

Objectives for next session

Management, keep in mind he is diabetic type 1


intervention and treatment

Areas of improvement

Following the scribe

using the other screen for diagrams and animations

Shy students should be encouraged

citing resources