PBL 5 session 2

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PBL 5 session 2 by Mind Map: PBL 5 session 2

1. Step 8

1.1. Diagnostic decision

1.1.1. hemipligic migraine

1.2. Mechanism

1.2.1. multifactorial with possible genatic influence and life stresses

1.3. Presentation

1.3.1. 3 episods of throbing left side headache with aura( zig-zag visual pattern), sensory and motor abnormalities

1.4. Supporting data

1.4.1. HISTORY

1.4.2. and exclusion of other possibilities

1.5. 10 minutes

2. Step 6

2.1. Review session 1

2.2. Report new knowledge

2.2.1. headache types migraine pathophysiology etiology clinical presentation

2.2.2. aura types why does it happen

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 left side headache headache started from the past 2 weeks as episode 3 episods headache last for four hours moderitly to sever throbing pain there is nousia vomiting and photophobia ZIG-ZAG pattern in the left side the pain come after the aura she take 900 mg of aspirin to reileve pain

3.1.2. Previous medical / surgical history she have a history of migraine stress was the main trigger frequently she has been migraine free for several years she had aura ( in the past ) visual symptoms in both visual field which last for 30 min

3.1.3. Drug history / allergy she take 900 mg of aspirin to reileve pain triphasic oral contrasiptive pills for the last 15 years

3.1.4. Family history the mother has history of headache with photophobia

3.1.5. Social / occupational history teacher / musician non-smoker no children stress at work last 2 month missed couple of classes because of headache

3.1.6. Systemic review

3.1.7. Physical examination vitals BP 110/70 PULSE 76 right handed cranial nerve examination visual acuity 6/5 in both eyes with her glasses neurological limp examination normal deep tendon reflex are normal with downgoing planter responses

3.1.8. tests results FBC NORMAL electrolight normal lupos anticogulant is normal

3.2. 50 minutes