1. Step 8
1.1. Diagnostic decision
1.1.1. idopatheic parkinson
1.2. Mechanism
1.2.1. interaction of multiple causes leading to dupmin depletion
1.3. Presentation
1.3.1. rigidity
1.3.2. stooped postrue
1.3.3. fine motor abormality
1.3.4. micographia
1.3.5. shuffling gait
1.3.6. akinesia / bradykinesia
1.3.7. mask facial expression
1.4. Supporting data
1.4.1. exclusion of secondry parkinosim
1.4.2. history and physical examination
1.5. 10 minutes
2. Step 6
2.1. Review session 1
2.2. Report new knowledge
2.2.1. dopamin physiology
2.2.2. parkinson
2.2.2.1. etiology
2.2.2.2. phathophysiology
2.2.2.3. presentation
2.2.2.4. diagnosis
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. slowing down when getting dressed
3.1.1.1.1. sometimes cant
3.1.1.2. stooped and seemes aged
3.1.1.2.1. difficult to balance on one leg
3.1.1.3. no signs of tremor
3.1.1.4. no dpression
3.1.1.5. less animated
3.1.1.6. tirdness and stifness and climness in his right hand
3.1.1.7. no memory loss
3.1.1.7.1. gave full history
3.1.1.8. micrographia
3.1.1.9. cant manage tooth brushing
3.1.1.10. cant control his hands
3.1.1.11. difficulty picking up cards
3.1.2. Previous medical / surgical history
3.1.3. Drug history / allergy
3.1.4. Social / occupational history
3.1.4.1. retiered solider at national guard
3.1.4.2. not smoking
3.1.4.3. three children
3.1.4.4. po
3.1.5. Family history
3.1.5.1. negative
3.1.6. Systemic review
3.1.7. physical examination
3.1.7.1. vital
3.1.7.1.1. T 36.8
3.1.7.1.2. rr 16
3.1.7.1.3. p 60
3.1.7.1.4. bp 130/80
3.1.7.1.5. weight 57
3.1.7.2. looks old
3.1.7.3. he doesnt swing his arm
3.1.7.4. stooped
3.1.7.5. slowing movment
3.1.7.6. strength of tha hand is normal
3.1.7.7. cogwheel rigidty
3.1.7.8. no tremor
3.1.7.9. micrographia
3.1.7.10. difficulty looking upward