1. Step 4
1.1. Hypothesis organization (tentative solution)
1.1.1. demylination
1.1.1.1. MS
1.1.1.2. vit B12 def. ??
1.2. 20 minutes
2. Step 1
2.1. Identify terms and cues
2.2. New terms
2.2.1. urge
2.2.1.1. compulsive .. need immediate attention
2.2.2. incontinence
2.2.2.1. no control of the urination
2.3. cues
2.3.1. 26 yo female
2.3.2. wearing glasses
2.3.3. abnormal vision in left side while going down stairs
2.3.4. mild urinary urge incontinance a year ago
2.3.5. difficulty walking
2.3.6. urinary sym and difficulty walking treated with antibiotics and resolved after 2-3 wks
2.4. 10 minutes
3. Step 5
3.1. Formulate learning objectives
3.1.1. mylien sheath
3.1.1.1. physiology
3.1.1.2. pathophysiology
3.1.2. MS
3.1.2.1. causes
3.1.2.2. symptoms and sign
3.1.2.3. diagnosis
3.1.2.4. epidemiology
3.2. 10 minutes
4. Step 2
4.1. Problem formulation (put it in a senates)
4.1.1. 26 yo female complaining of left visual field defect, with a history of urinary incontinence and difficulty walking
4.2. 10 minutes
5. Step 3
5.1. Hypothesis generation (brainstorming)
5.1.1. left visual feild defect
5.1.1.1. localization
5.1.1.1.1. eyes problem
5.1.1.1.2. visual feild problems
5.1.1.1.3. visual center problem
5.1.1.2. pathophysiology
5.1.1.2.1. vascular ischemia
5.1.1.2.2. space occupying lesion
5.1.1.2.3. lateral abduscent lesion ??
5.1.1.2.4. demylination of the optic verve
5.1.1.2.5. area 17 in the occipital
5.1.1.2.6. infection that follows the nerve
5.1.1.2.7. toxic or metabolic causes ??
5.1.1.2.8. reticlospinal tract problem ??
5.1.1.2.9. central infection treated by antibiotics
5.1.1.2.10. connective tissue disease
5.1.1.2.11. devex syndrome
5.1.2. previous symptoms
5.1.2.1. difficulty walking
5.1.2.1.1. somatic control
5.1.2.2. urinary incontinence
5.1.2.2.1. autonomic control by SNS
5.1.2.2.2. upper motor neuron lesion
5.1.2.3. pathophysiology
5.1.2.3.1. MS is an autoimmune disease that leads to demylination
5.1.2.3.2. alcohol
5.1.2.3.3. B12 deficinacy
5.1.2.3.4. diabetic changes ???
5.1.2.3.5. inhereted disease leads to demylination