My New Mind Map

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My New Mind Map by Mind Map: My New Mind Map

1. diagnostic decision

1.1. down syndrom with ventricular defect with congestive heart failure

2. step 1: identify and difficult words

2.1. difficult words

2.1.1. Sluggish: slow

2.2. kews

2.2.1. newborn baby

2.2.2. trouple in feeding

2.2.3. diagnosed with down syndrom

2.2.4. 8 week age

2.2.5. breastfeeding difficulty

2.2.6. slow weight gain

2.2.7. sweating and shortness of breath ( about 5 - 10 min) and spend 1 hour during feeding

3. step3: hypothesis generation

3.1. Down syndrome ( congenital problem)

3.2. problem on swallowing or gi ( digestion is affected)

3.3. intolerance of milk

3.4. people with down syndrome will have many conginetal heart problems and also macroglossa

3.5. disease related to blood for example acute megaloblastic leukemia

3.6. breathlessness because he is using neck muscle to respirate

3.7. slow weight gain because he is taking enough milk

3.8. cystic fibrosis

3.9. cyanosis in right to left shunt

3.10. he spends very much effort when breastfeeding that why he is sweaty and takes time to feed.

3.11. tetralogy of fallot ( congenital heart defect)

3.12. patent ductus arteriosus

3.13. av septal defect

3.14. down syndrom patient will have mental retardation

3.15. dudental atresia

4. step4: hypothesis organization

4.1. GI

4.2. cardiopulmonary system

5. step5: learning objectives

5.1. 1- to define down syndrome, genetic basis, manifestation, risk factors, and complication( gi and cvs).

5.2. 2- to describe the normal process of breastfeeding and abnormalities related to down syndrome.

5.3. 3- to know the normal developmetl structure of the heart.

6. step2: problem formulation

6.1. an 8 week newborn male with down syndrome presented to the doctor after his mother noticed that he has trouble that is breastfeeding is associated with sweating, shortness of breath and gaining weight.

7. Step 6 Review of Last Session

7.1. dwon syndrom patient

7.1.1. Long duration of feeding

7.1.2. extra effort for breastfeeding

7.2. heart development

7.2.1. develop in cardiogenic area

7.2.2. placental circulation two art and one vein the blood eighter come from svc or from an area to join to the the ivc

7.3. step6

7.3.1. difintion: most common genetic problem with a problem in chromosome 21

7.3.2. cause translocation to other chromosom problem in the chromosome

7.3.3. charactersitics amternal myotic dysfuntion: problem in the second stage. most of the problem in the mental retardation

7.3.4. clinical prsentation congenital heart disease Atrioventricular defect tetralogy of falop gi problem dudenal atresia vomoting dysmorphic feature flat face slant palpaular fissure ear and eye proble short neck problem in the extremeties neurological defect alzahaimar disease speach difficulty loss of hear vision problem hematological anemia psychiatric autism

7.4. breast feeding problem

7.4.1. duration of 20 to 35

7.4.2. frequency is 8 of 12 a day

7.4.3. improves the immunity

8. Step 7 Inquiry Plan

8.1. history

8.1.1. problem in feeding

8.1.2. any baby has previous problem

8.1.3. pregnancy is normal

8.1.4. us: no abnormality detected

8.1.5. vaginal delivery

8.1.6. weight:

8.1.7. family history

8.1.8. parents: no smoking

8.2. physical examination

8.2.1. wt; 3.5

8.2.2. pulse: 140

8.2.3. bp: 90 \ 60

8.2.4. respirtory rate 42

9. Step 9 REview

10. Step 10 Management

10.1. GOAL

10.1.1. TO increase theheart.

10.2. medication

10.2.1. to keep the heart rater in nomral rat digixon ace dirutics increase the na+ and water lose in the body gaba receptor Improve learning antioxidant zinc

10.3. surgery

10.3.1. goal pulmonary vascular resistance assement refractory congestive heart failure failure to thrive we give them calori

10.3.2. dependant on the size open heart surgery it is the best cathetarization through femoral artery ventricles

10.3.3. be careful from the infection give antibiotic eve

10.3.4. vsd sometime benefatial Preventing the closure

10.4. guidlines

10.4.1. diurtic and ace ( low doses)

10.4.2. beta blocker contraindication if it decrease the heart rate more than the normal

10.5. non drug related

10.5.1. education of the family

10.5.2. family support

10.6. refer him

10.6.1. pediatric cardiologist avoid cyanosis and murmar

11. Step Feedack

11.1. resource

11.1.1. uptodate

11.1.2. e-mdecine


11.1.4. WHO

11.1.5. medscape

11.1.6. divitson

11.1.7. cdc

11.1.8. american heart association