While I'm here - session 2

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While I'm here - session 2 by Mind Map: While I'm here - session 2

1. Step 6

1.1. Review session 1

1.2. Report new knowledge

1.2.1. lymphoma and leukemia

1.2.1.1. causes

1.2.1.1.1. viruses, radiation, genetic abnormalitis

1.2.1.2. mechanism

1.2.1.3. manifestations

1.2.1.4. how to differentiate

1.2.1.4.1. leukemia starts in bone marrow and might spread to blood while limphoma prolifration starts at tissue with some overlap

1.2.2. causes of cervical lymph nodes (right)

1.3. 30 minutes

2. Step 8

2.1. Diagnostic decision

2.1.1. chronic lymphoid leukemia

2.2. Mechanism

2.2.1. malignancy due to gene mutation from bone marrow affecting mature lymphocytes causing rbc hemolysis

2.3. Presentation

2.3.1. sob, dyspnea, node enlargment

2.4. Supporting data

2.4.1. cbc and coomb test

2.5. 10 minutes

3. Step 7

3.1. Inquiry plan and info gathering

3.1.1. History of presenting complain

3.1.1.1. what brought him to hospital

3.1.1.1.1. due to fatigue and sob

3.1.1.2. any upper lieft quadrant pain

3.1.1.3. when did fatigue and sob start

3.1.1.4. exxerbation

3.1.1.5. progression

3.1.1.6. why heart problem

3.1.1.7. specific time

3.1.1.7.1. at work at night (tirdeness)

3.1.1.8. severity

3.1.1.9. associated symtopms, fever or wieght loss, nocturnal sweating

3.1.2. Previous medical / surgical history

3.1.2.1. any assoiciated symtopms like sob or fatigue

3.1.2.2. why the visit

3.1.2.3. any major disease (chronic)

3.1.2.3.1. had his of chronic low back pain 9 years ago related to work

3.1.2.4. recurrent infections

3.1.2.4.1. bad influenz last winter that took many weeks to clear

3.1.2.5. his of malignancy

3.1.2.6. was there a diagnosis

3.1.2.7. any surgery

3.1.3. Drug history / allergy

3.1.4. Family history

3.1.5. Social / occupational history

3.1.5.1. self employed builder in last 8 years

3.1.6. Systemic review

3.1.7. Physical examination

3.1.7.1. 70kg weight

3.1.7.2. 120/80 bp

3.1.7.3. 72 pulse

3.1.7.4. rr 14

3.1.7.5. t 37

3.1.7.6. 1cm enlargment

3.1.8. tests results

3.1.8.1. hb 84g/l

3.1.8.1.1. low

3.1.8.2. white cell count 30.5

3.1.8.2.1. HIGH

3.1.8.3. 2.7 neutrophils

3.1.8.3.1. NORMAL

3.1.8.4. lymophocytes 26.5

3.1.8.4.1. HIGH

3.1.8.5. throbocyte 151

3.1.8.5.1. NORMAL

3.1.8.6. increase reticulocytes

3.1.8.7. POS DIRECT ANTIGLOBULIN TEST

3.2. 50 minutes