1. Step 5
1.1. Formulate learning objectives
1.1.1. smoking
1.1.1.1. related to respiratory disease
1.1.2. sputum analyzing
1.1.3. shortness of breath
1.1.3.1. definition
1.1.3.2. causes
1.1.3.3. classification
1.1.3.4. clinical indication
1.1.4. Chronic Obstructive Pulmonary Disease
1.1.4.1. causes
1.1.4.2. mechanisim
1.1.4.3. manifestation
1.1.4.4. diagnosis
1.1.4.5. complications
1.1.5. hypertension and its effect on the respiratory system
1.2. 10 minutes
2. Step 4
2.1. Hypothesis organization (tentative solution)
2.1.1. COPD
2.1.1.1. causes airways to obstruct
2.1.1.2. many types
2.1.1.2.1. based on the pathology
2.1.1.2.2. emphyzema( centry lobular )
2.1.1.2.3. chronic brinchitis
2.1.2. lung neoplasia
2.1.2.1. manifest as COPD ?
2.1.3. infection
2.1.3.1. acute bronchitis
2.1.3.1.1. explain the productive coughing and yellow sputum
2.1.3.1.2. brinchulolitis
2.1.4. hypertension
2.1.4.1. systemic hyertension
2.1.4.1.1. pulmonary edema
2.1.4.2. sowllen ankle
2.2. 20 minutes
3. Step 1
3.1. Identify terms and cues
3.2. New terms
3.2.1. handkerchief
3.2.1.1. like a napkin
3.2.2. clerical
3.2.2.1. works in an office
3.2.3. semi- retired
3.2.3.1. working in only part time basis
3.3. cues
3.3.1. 62 y female
3.3.2. brought to ER by ambulance
3.3.3. shortness of breathh
3.3.4. unable to walk more than 5 meters
3.3.5. productive cough and wheezing for 7 days
3.3.6. yelow sputum
3.3.7. history of smoking and hypertension
3.3.8. usually, productive cough of a small amount of sputum ,most morning
3.3.9. part time clerical work
3.3.10. swollen ankle
3.4. 10 minutes
4. Step 2
4.1. Problem formulation (put it in a senates)
4.1.1. a 62 years old female smoker and hypertensive (semi retired clerical worker). brought to ER complaining of shortness of breath, wheezing and productive cough with yewllow sputum for 7 days in addition to swollen ankle.
4.2. 10 minutes
5. Step 3
5.1. Hypothesis generation (brainstorming)
5.1.1. acute
5.1.1.1. infection
5.1.1.1.1. more prone to infection
5.1.1.2. turning to sever
5.1.2. chronic
5.1.2.1. COPD (bronchitis?)
5.1.2.1.1. obstruction due to smoking
5.1.2.1.2. inflammation in the airway caused the yellow sputum
5.1.2.1.3. allergen in the enviroment
5.1.2.1.4. hyperatrophy in the gland (goblet cells) which lead to more secretion
5.1.2.1.5. smoking cause irritation
5.1.2.1.6. sputum in morning
5.1.2.1.7. mucus blocks the airways
5.1.2.1.8. pulmonaty hypertension
5.1.2.1.9. emphyzema caused by smoking
5.1.2.1.10. wheezing
5.1.2.1.11. productive cough
5.1.2.1.12. yellow sputum
5.1.3. cancer
5.1.3.1. cause obstruction