1. Step 4
1.1. Hypothesis organization (tentative solution)
1.1.1. central
1.1.1.1. vascular lesion
1.1.1.1.1. ischemic stroke
1.1.2. syncope and fainting
1.1.3. keep im mind
1.1.3.1. epilepsy?
1.1.3.2. drug toxicity?
1.2. 20 minutes
2. Step 1
2.1. Identify terms and cues
2.2. New terms
2.2.1. propped up
2.2.1.1. supported
2.2.2. hoarse
2.2.3. right out to it
2.2.3.1. out of consious
2.2.4. hospital strecher
2.2.4.1. moving bed
2.3. cues
2.3.1. women brought to ED after collapse
2.3.2. difficult communication because of her speech
2.3.3. nausea, vomiting, then collapsed for a minute
2.3.4. stroke her left hip on the road
2.3.5. the right side of body feels different
2.3.6. hoarse voice after the accident
2.3.7. she was with the husband
2.3.8. in ED wearing oxygen mask and propped up on pillows
2.3.9. her husband holding her hands
2.4. 10 minutes
3. Step 5
3.1. Formulate learning objectives
3.1.1. anatomy of the brain blood supply
3.1.2. centers in the brain
3.1.2.1. consiousness
3.1.2.2. vomiting
3.1.2.3. nausea
3.1.2.4. speech
3.1.3. ischemic stroke
3.1.3.1. pathogenisis
3.1.3.2. etiology
3.1.3.3. epidemiology
3.1.3.4. diagnosis
3.2. 10 minutes
4. Step 2
4.1. Problem formulation (put it in a senates)
4.1.1. a female brought to ED after she collapsed for a minute and striking her left hip on the road followed by voice hoarseness, difficulty communicating, and "different" feeling in the right side.
4.2. 10 minutes
5. Step 3
5.1. Hypothesis generation (brainstorming)
5.1.1. nausea and vomiting
5.1.1.1. domination of the parasympathetic system
5.1.1.1.1. through vagal stimulation
5.1.1.2. body response to internal event
5.1.1.3. hyperventilation
5.1.1.4. exogenic factor that might be eaten
5.1.2. collapse
5.1.2.1. cardiac
5.1.2.2. non cardiac
5.1.2.2.1. neurogenic
5.1.2.2.2. vascular
5.1.2.3. metabolic
5.1.2.3.1. hypoxia
5.1.2.3.2. hypoglycemia
5.1.2.3.3. dehydration and exhaustion
5.1.2.4. transient
5.1.2.4.1. postural HTN
5.1.2.4.2. Cerebrovascular lesion
5.1.3. voice hoarseness and difficult communication
5.1.3.1. tumor pressing on recurrent laryngeal nerve
5.1.3.2. vocal cords paralysis
5.1.3.3. difficult articulation
5.1.4. different feeling in the right side
5.1.4.1. permanent damage to brain tissue
5.1.4.2. spinal cord
5.1.5. striking her left hip
5.1.5.1. tone loss in the left side