PBL 10 session 2

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PBL 10 session 2 by Mind Map: PBL 10 session 2

1. Step 6

1.1. Review session 1

1.2. Report new knowledge

1.3. 30 minutes

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

2. Step 8

2.1. Diagnostic decision

2.1.1. Schizophrenia

2.2. Mechanism

2.2.1. Multifactorial

2.2.1.1. Genetics, stress, delivery, head trauma

2.3. Presentation

2.3.1. psychosis

2.4. Supporting data

2.4.1. Mental status examination + Brain MRI

2.5. 10 minutes

3. Step 7

3.1. Inquiry plan and info gathering

3.1.1. History of presenting complaint

3.1.1.1. symptoms started 6 months ago, began hearing voices when she was studying for her midterm

3.1.1.2. she jumped off balcony because she was with her friend and she became extremely paranoid, she thought that her friends are going to kill her

3.1.1.3. her friends think that she may have taken some drugs

3.1.1.4. Alia: fatima stopped doing thing 6 months ago

3.1.1.4.1. Alia thought that fatima is busy because of medical school

3.1.1.4.2. Alia stopped taking care of her appearance

3.1.1.4.3. she was doing well in school

3.1.1.5. she tried shisha to chill out

3.1.1.6. after shisha she felt paranoid, and her friends trying to kill her

3.1.1.7. she has not being doing well at school for the past 12 months

3.1.1.8. she is anxious, she is feeling someone is commenting on everything she does

3.1.1.9. it became occasionally at night

3.1.1.10. by time of exam, when she was watching TV, she felt like someone is stalking to her

3.1.1.11. she doesn't feel happy when she smokes shisha

3.1.1.12. she has been poor with her sleep

3.1.1.13. her appetite was down

3.1.1.14. History from family

3.1.1.14.1. they said that fatima was irritable and keeping to her self for the past 6 months

3.1.2. Previous medical / surgical history

3.1.2.1. Appendectomy when she was 9

3.1.2.2. she saw a counsler when she was distressed about exam

3.1.2.3. after that she was GP, diagnosed her with depression for sleep problems

3.1.2.4. she was given SSRI, she stopped after 1 month because she said she got better

3.1.2.5. never saw a psychiatrist

3.1.2.6. one minor injury when she was 7

3.1.3. Drug history / allergy

3.1.4. Family history

3.1.4.1. her mother has a monozygote twin w/ schizophrenia

3.1.4.1.1. from age of 23

3.1.4.1.2. she tried on many occasions to kill herself

3.1.4.2. her parents both well, her older brother mohammed is an medical student

3.1.5. Social / occupational history

3.1.5.1. she lived with her parent and brother in dammam

3.1.6. Systemic review

3.1.7. Physical examination

3.1.7.1. distressed

3.1.7.2. uncooperative

3.1.7.3. distracted

3.1.7.4. difficulty to assess

3.1.7.5. frightened

3.1.7.6. did not appear to be elevated

3.1.7.7. paranoid delusions

3.1.7.8. she thinks of killing herself

3.1.7.9. Good Minimental status examination

3.1.7.10. Sweaty

3.1.8. tests results

3.1.8.1. Brain MRI

3.2. 50 minutes