1. Step 1
1.1. Identify terms and cues
1.2. New terms
1.2.1. eczema
1.2.1.1. mild skin rash, dermatitis, it is a type of allergy
1.2.2. spacer
1.2.2.1. device for the asthma medication
1.2.3. metered dose
1.2.3.1. inhaler with remarked dose
1.2.4. intermittent
1.2.4.1. not continues
1.2.5. wheezing
1.2.5.1. abnormal sound (sharp)
1.3. cues
1.3.1. 4 yo old
1.3.2. female
1.3.3. episodes of wheezing since she is 18 months
1.3.4. cough and wheeze developed over night
1.3.5. eczema
1.3.6. was allergic to cow's milk but now she is not
1.3.7. asthmatic
1.3.8. asthma medication (inhaler and spacer)
1.3.9. cough after exercise
1.4. 10 minutes
2. Step 4
2.1. Hypothesis organization (tentative solution)
2.1.1. acquired
2.1.1.1. wheezing is caused by something obstructing the respiratory tract and cough is normal reaction to get rid of the object
2.1.1.2. asthma
2.1.1.2.1. environment
2.1.1.2.2. chronic irritant
2.1.1.3. medication
2.1.1.3.1. in history
2.1.2. congenital problem
2.1.2.1. small bronchioles
2.1.2.2. premature birth
2.1.2.3. lung malformation
2.1.2.3.1. abnormal development of the lung
2.1.2.4. problem in the pregnancy
2.1.2.5. hypersensitivity or abnormal immune system activation
2.1.2.5.1. hyper active T cell for ex.
2.1.2.6. allergy to cow's milk or something else
2.1.2.6.1. how could allergy become tolerant ???
2.1.2.7. genetic predepsition
2.1.3. others or BOTH
2.2. 20 minutes
3. Step 5
3.1. Formulate learning objectives
3.1.1. mechanism of wheezing
3.1.2. mechanism of asthma
3.1.2.1. genetic predisposition
3.1.2.2. mechanism of hypersensitivity
3.1.2.3. triggers of asthma
3.1.3. medications and allergies that cause these symptoms
3.1.4. how could tolerance happen to allergen
3.1.5. eczema and its relation to asthma
3.1.5.1. relation to allergy also
3.1.5.1.1. cow's milk allergy
3.2. 10 minutes
4. Step 2
4.1. Problem formulation (put it in a senates)
4.2. asthmatic 4 yo old girl presented to the GP with intermittent cough (at night and after exercise) and wheezing (since she was18 months)
4.3. 10 minutes
5. Step 3
5.1. Hypothesis generation (brainstorming)
5.2. wheezing is caused by something obstructing the respiratory tract and cough is normal reaction to get rid of the object
5.3. allergy to cow's milk or something else
5.4. infection
5.4.1. bronchitis (sputum narrow the air way)
5.4.2. pneumonia
5.5. systemic disease
5.6. related to asthma
5.7. stats asthma
5.8. medication
5.9. eczema related to cow's milk and asthma as a consequence
5.10. problem with breast feeding
5.11. chronic irritant
5.12. wrong posture
5.13. environment
5.13.1. exposure to factors like smoking
5.13.2. increase activity
5.14. congenital problem
5.14.1. genetic problem
5.14.1.1. autoimmune disease
5.14.1.2. excessive mucous secretion
5.14.1.2.1. cystic fibrosis
5.14.2. small bronchioles
5.14.3. premature birth
5.14.4. lung malformation
5.14.5. problem in the pregnancy
5.14.6. abnormal development of the lung
5.14.7. hypersensitivity or abnormal immune system activation
5.14.7.1. hyper active T cell for ex.
5.14.8. allergy to cow's milk or something else