Consedaring ulternatives Session 2

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Consedaring ulternatives Session 2 by Mind Map: Consedaring ulternatives Session 2

1. Step 6

1.1. Review session 1

1.1.1. chronic fatque

1.1.1.1. causes

1.1.1.2. risk factors

1.1.1.3. mechanisim

1.1.2. fainting

1.1.2.1. mechanisim

1.1.2.2. causes

1.1.2.2.1. stress???

1.1.2.3. posteral hypotension

1.1.2.3.1. risk factors

1.1.2.3.2. mechanisim

1.2. Report new knowledge

1.3. 30 minutes

1.3.1. The scribe does not have to write in this step!

2. Step 8

2.1. Diagnostic decision

2.1.1. depression disorder

2.1.1.1. with fatgue

2.2. Mechanism

2.2.1. stressors

2.2.1.1. daughter

2.2.1.2. work

2.2.1.3. family history

2.3. Presentation

2.3.1. depressed and fatgue

2.3.2. history of syncopy

2.3.3. chronic fatgue

2.4. Supporting data

2.4.1. exclusion other medical condition

2.4.2. history and physical examination

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. no palpitation , no dizznea

3.1.1.2. no ora

3.1.1.3. genrally wake up stressed

3.1.1.4. no infection

3.1.1.5. one fainting 20 years ago

3.1.1.6. consider soicide

3.1.1.7. waking regularly at 3,4 in the morning

3.1.1.8. fatgue six months ago

3.1.1.9. lipido down

3.1.1.10. decreased interest

3.1.1.11. feels hopless , helpless

3.1.1.12. cant concentrate

3.1.1.13. poor apetite , lost 4kilos in two moths

3.1.1.14. no infection

3.1.2. Previous medical / surgical history

3.1.2.1. allergic rhinitis

3.1.3. Drug history / allergy

3.1.3.1. aspirin 4-6 per day

3.1.3.1.1. not useful

3.1.4. Family history

3.1.4.1. father episode of depression

3.1.4.2. brother had anxity and depression from time to time

3.1.4.3. parents alife

3.1.4.4. brother drinking problem

3.1.4.5. mother episodes of fainting since young

3.1.5. Social / occupational history

3.1.5.1. non smoker

3.1.5.2. non drinker

3.1.5.3. manger

3.1.5.4. golf in SAT but recently stopped

3.1.5.5. no fainancial

3.1.6. Systemic review

3.1.6.1. no headaches

3.1.6.2. no chest pain

3.1.7. Physical examination

3.1.7.1. H 180

3.1.7.2. W 86

3.1.7.3. P 80

3.1.7.3.1. sinus rhythem

3.1.7.4. BP 130/85

3.1.7.4.1. no posterial drop

3.1.7.5. RR 18

3.1.7.6. T 36.8

3.1.7.7. inspection

3.1.7.7.1. depressed

3.1.7.7.2. mo wasisting

3.1.7.7.3. pale on the episode

3.1.7.8. palpation

3.1.7.8.1. apex beat normal

3.1.7.8.2. JVP

3.1.7.9. ausciltation

3.1.7.9.1. normal

3.1.8. tests results

3.1.8.1. CBC

3.1.8.1.1. normal

3.1.8.2. ECG

3.1.8.2.1. normal

3.1.8.3. electrolyte

3.1.8.3.1. normal

3.2. 50 minutes