1. Step 4
1.1. Hypothesis organization (tentative solution)
1.1.1. pancreas
1.1.1.1. chronic pancreatic
1.1.1.2. jaundice can be associated
1.1.2. gall bladder
1.1.2.1. cholicystitis
1.1.2.2. obstruction
1.1.2.2.1. MALIGNANCY
1.1.2.2.2. stones
1.2. 20 minutes
2. Step 1
2.1. Identify terms and cues
2.2. New terms
2.2.1. plumpish
2.2.1.1. a bit overweight
2.2.2. put up with it
2.2.2.1. tolerate
2.2.3. incapacitated
2.2.3.1. dependant
2.2.4. peering
2.2.4.1. looking
2.3. cues
2.3.1. 82 YO female
2.3.2. having pain on her top stomach in the last 2 weeks
2.3.2.1. pain radiate to chest and back
2.3.2.2. pain is occasionally present for few years
2.3.2.3. pain is an hour or 2 after meal
2.3.3. having recent yellowish eys
2.3.4. plumpish
2.3.5. worried that she cannot take care of her husband
2.4. 10 minutes
3. Step 5
3.1. Formulate learning objectives
3.1.1. billiary tract obstruction
3.1.1.1. signs and symptoms
3.1.1.2. pathophysiology
3.1.1.3. causes
3.1.1.3.1. malignancy
3.1.1.4. diagnosis
3.1.1.5. complications
3.1.2. pancreatitis
3.1.2.1. signs and symptoms
3.1.2.2. pathophysiology
3.1.2.3. causes
3.1.2.4. diagnosis
3.2. 10 minutes
4. Step 2
4.1. Problem formulation (put it in a senates)
4.2. 82 YO female complaining of intermittent pain in top of her stomach occurring after meals , the pain radiate to her chest and back with recent yellowish eyes discoloration
4.3. 10 minutes
5. Step 3
5.1. Hypothesis generation (brainstorming)
5.2. upper epigastric pain
5.2.1. radiating to chest and back
5.2.1.1. pancriase
5.2.1.2. related to vague innervation
5.2.1.2.1. nerve compression
5.2.1.3. accessory organs
5.2.1.3.1. billary tract
5.2.1.3.2. low blood supply
5.2.1.3.3. gallblader
5.2.1.4. complication of stomach problem
5.2.1.5. sympathatic or para sympathatic
5.2.2. GERD
5.2.3. MI can cause the same pain radiation
5.2.4. post meals pain
5.2.4.1. pain is related to digestive tract
5.3. jaundice
5.3.1. increase in billirobin level
5.3.1.1. conjigated
5.3.1.1.1. post hepatic causes
5.3.1.2. non-conjigated
5.3.1.2.1. liver problems