I must be getting old session 2

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I must be getting old session 2 by Mind Map: I must be getting old session 2

1. Step 6

1.1. Review session 1

1.1.1. Summary of step 5 Skin cancer: Causes and Risk Factors (in relation to symptoms) Many types of skin cancers: Sqamous cells, melanoma, basal cell(the easiest to handle) --> UVB is the most harmful Melanoma: most serious. Rare: Kaposi sarcoma, sepacious sarcoma Basal cell: do not metasize Squamous cell cancrinoma: From exposure to sun Risk factors Mechanism Causes Chronic nonhealing wounds Osteoarthritis: Causes and Risk Factors (in relation to symptoms) Defined Osteoarthritis Articular cartilage Stages Common Radiographic Symptomatic Changes: Risk factors Underlying cause of the throbbing pain Fast Slow Study Related to tissue destruction Arthritis Knee tendenosis Osteomeyalitis Osteoarthritis Common in females in menstrual cramps Chronic infection in the skin Folliculits Impetigo Excema Leishmania What causes the presented symptoms Osteomyelaitis can lead to sqamous cell cancrinoma r endocarditis Osteomyelitis Similar sites- Baker's cyst

1.2. Report new knowledge

2. Step 7

2.1. Inquiry plan and info gathering

2.1.1. History of presenting complain 55 y/o No symptoms related to infections e.g. fever Pain Goes with rest, Click sounds morning stiffness Skin sore --> non painful when sore scratched--> bleeds knee pain --> 3 months Sore--> more than 3 months

2.1.2. Previous medical / surgical history BEFORE-> sore was diagnosed with skin infection Trauma--> while playing tennis Site of injury --> knee

2.1.3. Drug history / allergy ONLY painkillers for the knee pain

2.1.4. Family history Dad had part of skin removed Close relatives --> dad had knee pain no chronic diseases in the family

2.1.5. Social / occupational history single Teacher lives in a flat not near any factories Whenever he plays tennis, when weather is good --> exposed to sun Social drinker Smoker a pack a day for the last 20 years Straight

2.1.6. Physical examination Vital signs Nromal BP and HR BMI = 180 cm, 110 kg Knee Gait= limp towards the affected knee affected knee is a bit swollen and also tender Limited flexion and pain when doing it Skin Diameter = 6m, circular, irregular Site: left leg Inguinal Lymph node involvment Blackage discolouration No Birthmarks

2.1.7. tests results Xray Both knees while standing. Narrowing Chemistry normal Skin bipsy Poorly differentiated Sqamous cell cancrinoma Normal CBC CT scan Metastatic spread in the abdomin

3. Step 8

3.1. Diagnostic decision

3.1.1. Osteoarthritis

3.1.2. Metastatic squamous cell canrcinoma

3.2. Mechanism

3.2.1. Metastatic squamous cell canrcinoma smoking, continous exposure to the sun Muation in sqamous layer caused the invasionm the basal layer and metastasis through lymphatics to inguinal and abdominal

3.2.2. Osteoarthritis Mechanical trauma with multiple risk factors

3.3. Presentation

3.3.1. Knee pain

3.3.2. Limping

3.3.3. Clicks

3.3.4. Limited range of motion

3.3.5. SCC 6cm diameter circular, irregular bleeding painless non tender progressive

3.4. Supporting data

3.4.1. Knee xray physical examination normal biochemistry test

3.4.2. Sore Skin bipsy, CT scan