1. Step 1
1.1. Identify terms and cues
1.2. New terms
1.2.1. long-haul
1.2.1.1. long distance
1.2.2. is to blame
1.2.2.1. medication caused these symptoms
1.3. cues
1.3.1. 58 y/o male
1.3.2. overweight
1.3.3. truck driver
1.3.3.1. oil tankers
1.3.4. has hypertension(on treatment) - since 10 years
1.3.5. snoring and lack of energy
1.3.6. less interest in things he used to enjoy (5 years)
1.3.7. change of distance (5 years)
1.3.8. His wife thinks this medication is causing these symptoms
1.4. 10 minutes
2. Step 4
2.1. Hypothesis organization (tentative solution)
2.1.1. hypertension
2.1.1.1. Side effects from drugs or medications
2.1.1.2. obesity and weight gain
2.1.1.3. may be uncontrolled
2.1.1.3.1. organ damage(possible)
2.1.2. Effect of occupation
2.1.2.1. Drugs
2.1.2.1.1. effect on loss of interest and fatigue
2.1.2.2. Oil tankers(environmental)
2.1.2.3. medication
2.1.3. OSA and obesity
2.1.3.1. effect on loss of interest and fatigue
2.2. 20 minutes
3. Step 5
3.1. Formulate learning objectives
3.1.1. Hypertension
3.1.1.1. Mechanism
3.1.1.2. Risk factors
3.1.1.3. Complications
3.1.1.4. Association with Obesity and OSA
3.1.1.5. Diagnosis
3.1.1.5.1. Signs and symptoms
3.1.2. Complications of anti-hypertensives and ilicit drugs
3.2. 10 minutes
4. Step 2
4.1. Problem formulation (put it in a senates)
4.2. 58 y/o male truck driver hypertensive complaining of snoring and general lack of energy with history of weight gain, and loss of interest. (5 years ago)
4.3. 10 minutes
5. Step 3
5.1. Hypothesis generation (brainstorming)
5.1.1. Hypertension
5.1.1.1. OSA
5.1.1.2. Symptoms:
5.1.1.2.1. Headache
5.1.1.2.2. Tired
5.1.1.3. Not enough blood reaching pharyngeal muscles->OSA
5.1.1.4. Idiopathic
5.1.1.5. Decreased Blood flow to the renal arteries
5.1.1.6. Aldosterone->Na retention, K waste
5.1.2. Weight gain
5.1.2.1. Involved in OSA, and hypertension formation
5.1.2.2. caused by fluid retention
5.1.2.3. It happened after changing the job
5.1.3. loss of interest
5.1.3.1. OSA
5.1.3.2. Hypothyroidism
5.1.3.3. Consequence of hypertension and OSA
5.1.3.4. From the mechainsm of ACE inhibitors
5.1.3.4.1. Hypotension
5.1.3.5. brain tumor
5.1.3.6. caused by drugs intake
5.1.3.6.1. CNS stimulants
5.1.3.7. alcohol intake
5.1.4. lack of energy
5.1.4.1. OSA
5.1.4.2. Caused by hypertension
5.1.4.3. Syncope caused by medications
5.1.4.4. decreased CO
5.1.4.5. Depression because of job change
5.1.4.6. OIL TANKERS MAY BE RELATED
5.1.5. snoring
5.1.5.1. OSA
5.1.5.1.1. Can be caused by hypertension
5.1.5.1.2. phases
5.1.5.1.3. Hypertension and Obesity are risk factors
5.1.5.2. Lifestyle changes
5.1.5.3. Narrow in the upper airway