PBL 2 session 2

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PBL 2 session 2 by Mind Map: PBL 2 session 2

1. Step 8

1.1. Diagnostic decision

1.1.1. khaled

1.1.1.1. mylomengiocele and hydrocephalus

1.1.2. noura

1.1.2.1. epilepsy (juvenile myclonic epilepsy)

1.2. Mechanism

1.2.1. khaled

1.2.1.1. mothers medication induced mylo.

1.2.2. noura

1.2.2.1. idiopathic

1.3. Presentation

1.3.1. khaled

1.3.1.1. came with mother with motor impairment and incontenince

1.3.2. noura

1.3.2.1. presented with a concern of epilepsy episode

1.4. Supporting data

1.4.1. physical and history and low serum thereputic level for noura plus the EEG

1.5. 10 minutes

2. Step 6

2.1. Review session 1

2.2. Report new knowledge

2.2.1. understanding CNS development

2.2.2. spinal bifida (mylomeningiocele)

2.2.2.1. cause

2.2.2.2. manifestations

2.2.2.3. complications (hydrocephalus?)

2.2.3. epilepsy

2.2.3.1. does medications completly prevent seizures?

2.2.3.2. effects on pregnancy

2.2.3.3. effects of epilepsy drugs on pregnancy

2.2.4. CSF circulation physiology and hyrocephalus

2.2.5. pictures

2.2.5.1. 1

2.2.5.2. Early development

2.2.5.3. manifestations

2.2.5.3.1. mylomeningiocele

2.2.5.4. CSF circulation physiology and hyrocephalus

2.2.5.5. Primary vesicles

2.3. 30 minutes

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

3. Step 7

3.1. Inquiry plan and info gathering

3.1.1. History of presenting complain

3.1.1.1. khaled

3.1.1.1.1. vaginal delivery at 38 w getation

3.1.1.1.2. normal weight

3.1.1.1.3. required bag mask (relived in ten minutes)

3.1.1.1.4. head circumfrence 33 increased to 37 on day 14

3.1.1.1.5. dialated ventricles on CT in day 2

3.1.1.1.6. was put on antibiotic

3.1.1.1.7. day 3 went to surgery

3.1.1.1.8. suture line seperated

3.1.1.1.9. increased intracranial presure

3.1.1.2. noura

3.1.2. Previous medical / surgical history

3.1.2.1. had seizure since ten

3.1.2.2. juvineile myocloinic epilepsy

3.1.2.3. wasnt compliant due to side effects

3.1.2.4. ob history

3.1.2.4.1. vaginal bleeding

3.1.3. Drug history / allergy

3.1.3.1. was

3.1.4. Family history

3.1.4.1. maternal uncle had abcense seizures

3.1.5. Social / occupational history

3.1.5.1. non smoker

3.1.6. Systemic review

3.1.6.1. normal

3.1.7. Physical examination

3.1.7.1. KHALED ay birth

3.1.7.1.1. MYLOMENGIOCELE

3.1.7.1.2. afebrile

3.1.7.1.3. head circumfrence 33

3.1.7.1.4. normal neurological exam in upper limbs but abnorlam in lower with incontinence

3.1.7.1.5. meconium illeius

3.1.7.2. khaled present

3.1.7.2.1. head cir. 37

3.1.7.2.2. normal movment in lower limbs with decreased tone

3.1.7.3. noura

3.1.7.3.1. normal

3.1.8. tests results

3.1.8.1. serum valprate low

3.1.8.2. EEG had epileptic charges indicating sezure last night

3.2. 50 minutes