1. Step 1
1.1. Identify terms and cues
1.2. New terms
1.2.1. profuse diarrhea
1.2.1.1. strong, excessive, very watery
1.2.2. fibrile
1.2.2.1. feverish
1.2.3. lethargy
1.2.3.1. fatigue
1.2.3.2. lack of energy
1.2.4. pale and drowsy
1.2.4.1. sleepy, less councious
1.3. cues
1.3.1. 6 yo male
1.3.2. profuse diarrhia
1.3.3. dowsiness
1.3.4. progrissive symptoms
1.3.5. paleness
1.3.6. ED
1.3.7. headahce and fever since 2 days
1.3.8. lethargy
1.4. 10 minutes
2. Step 4
2.1. Hypothesis organization (tentative solution)
2.1.1. Infectious causes
2.1.1.1. Malaria
2.1.1.1.1. edemic areas
2.1.1.1.2. transmitted by mosqitoes
2.1.1.2. Menengitis
2.1.2. Other
2.1.2.1. anemic patient developed infection causing diarrhea
2.1.2.1.1. accuired
2.1.2.1.2. conginital
2.2. 20 minutes
3. Step 5
3.1. Formulate learning objectives
3.1.1. Malaria
3.1.1.1. pathophysiology and etiology
3.1.1.2. symptoms and signs
3.1.1.3. diagnosis
3.1.2. Diarrhia
3.1.2.1. pathophysiolgy
3.1.3. hemolytic aemias
3.1.3.1. thalassemia
3.1.3.1.1. is it discovered early?
3.2. 10 minutes
4. Step 2
4.1. Problem formulation (put it in a senates)
4.1.1. 6 years old boy presented to ED looking pale and lethargic complaining of progrissive fevere, profuse dirhhea, and drowsiness
4.2. 10 minutes
5. Step 3
5.1. Hypothesis generation (brainstorming)
5.1.1. fever
5.1.1.1. infection
5.1.1.1.1. viral, bacterial, or fungul
5.1.1.1.2. fungul is not fast
5.1.2. diarrhia
5.1.2.1. GI infection
5.1.2.2. intestine cells (absorbtion)
5.1.2.3. bilirobin
5.1.2.4. same organism affecting different tissues
5.1.3. lethargy and drowsiness
5.1.3.1. low O2
5.1.3.2. fever may alsow drowsiness
5.1.4. pallor
5.1.4.1. RBCs related
5.1.4.2. low Hb
5.1.4.3. ineffective hematopoisis
5.1.4.3.1. low WBCs, causing the infection
5.1.4.4. might be caused from dehydration from diarrhia
5.1.5. Headach
5.1.5.1. fever can cause it
5.1.5.2. no enough O2 reaching the brain, like in anemia
5.1.5.3. menegitis
5.1.6. THEORY 1
5.1.6.1. GI infecion causing diarrhia and fever, affecting absorbsion
5.1.6.2. how to explain pallor?
5.1.6.3. how to explain late dirrhea?
5.1.7. THEORY 2
5.1.7.1. Blood related
5.1.7.2. A: pancytopenia
5.1.7.2.1. causing pancytpenia, low RBCs
5.1.7.2.2. leukocytopenia, high risk of infection
5.1.7.2.3. but then why fever if immunity is low?
5.1.7.2.4. also this is acute
5.1.7.3. B: infection to blood cells
5.1.7.3.1. blood cell destruction
5.1.7.3.2. plasmidium, causing malaria
5.1.7.3.3. endemic, rural area
5.1.7.3.4. going to the liver
5.1.7.4. C: conginital RBCs hemolysis