What Can I Do?

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What Can I Do? by Mind Map: What Can I Do?

1. Third Session

1.1. Step (9): Review of Learning Objectives

1.2. Step (10): Management

1.2.1. Non-small cell

1.2.1.1. Stage one & two: surgical

1.2.1.1.1. Exceptions ( Refusal, affecting the bronchi and esophagus, co-morbidity )

1.2.1.2. Stage 3?

1.2.1.2.1. Chemi + radio

1.2.1.3. Stage 4:

1.2.1.3.1. Surigcal intevention ( has to be have a solitary metastatic leison + confined to one area )

1.2.2. Small cell

1.2.2.1. Chemotherapy

1.2.2.1.1. Cisplatin or carboplatine + etoposide

1.2.2.2. Surgical if the tumor is not Met

1.2.2.2.1. Because by the time of the diagnosis the cancer has spread( Only done to get a biopsy )

1.2.2.3. Radiotherapy ( Rarely used )

1.2.3. For the prevention of the nausea and vomiting associated with chemo >> Ondasterone

1.2.4. If brain met is suggested > prophylactic radiation BUT if sure >> radiation and chemo

1.2.5. Prevention

1.2.5.1. Cutting off smoking

1.2.5.2. Awareness of the risk of smoking

1.2.5.3. Asbestos as a risk

1.3. Step (11): Feedback & Resources

2. Second Session

2.1. Step (6): Review of Learning Objectives

2.1.1. Mass in the lung:

2.1.1.1. Neoplasia

2.1.1.2. Inflammatory

2.1.1.2.1. Infectious

2.1.1.2.2. Non-infectious

2.1.1.3. Benign lesion

2.1.1.3.1. Hamartoma

2.1.1.4. Difference between malignant and benign lesions

2.1.1.4.1. Malignant: can have corona radiata, irrigular ridge, Above 3 cm

2.1.2. Lung cancer

2.1.2.1. Types

2.1.2.1.1. Adenocarcinoma

2.1.2.1.2. Small cell

2.1.2.1.3. Squamous

2.1.2.1.4. Large cell

2.1.2.2. 10% of heavy smoker develop cancer ( But 80% of those who developed lung cancer used to be tobacco smokers )

2.1.2.3. Risks: smoking, age, asbestos, air pollution

2.1.2.4. Sings and symptoms:

2.1.2.4.1. Cough, wheezing, hemoptysis,

2.1.2.4.2. Systemic: fever, weight loss

2.1.2.4.3. Met: bone pain

2.1.2.4.4. Para-neoplastic syndrome: SIADH( hyponatriemia + euvolmic ) .. ACTH production .. Lambert-eaton syndrome and other neurological syndromes

2.1.2.4.5. Pancost tumor: Ptosis, miosis, anhydrosis, enophthalmos

2.1.2.4.6. SVC obstruction

2.1.2.4.7. Clubbing & PHOA

2.1.2.4.8. Airways obstruction

2.2. Step (7): Gathering Information & Inquiry Plan

2.2.1. History

2.2.2. Physical Examination

2.2.2.1. Vitals:

2.2.2.1.1. BP: 110/65

2.2.2.1.2. pulse: 90 per min

2.2.2.1.3. Wight : 50 Kg .. height: 150 cm

2.2.2.1.4. Not jaundiced

2.2.2.1.5. TEMP: 37.4

2.2.2.2. General appearance: emaciated

2.2.3. Investigation

2.3. Step (8): Diagnostic Decision

2.3.1. Mechanism

2.3.2. Presentation

2.3.3. Supporting Data

2.4. OBJECTIVES

2.4.1. Management and prevention

3. First Session

3.1. Step (1): Identifying Difficult Words & Cues

3.1.1. Difficult Words

3.1.1.1. Naturopath

3.1.2. Cues

3.1.2.1. 50 M

3.1.2.2. Worsening cough

3.1.2.3. Shortness of breath

3.1.2.4. Pain; left rib, pelvic pain, RUQ

3.1.2.5. MASS IN THE RIGHT LUNG

3.1.2.6. need for further investigation

3.1.2.7. Pain worsening at night

3.1.2.8. Worsen with bending

3.2. Step (2): Problem Formulation

3.2.1. 50 y old Male complaining of RUQ pain, and in the left rib & left pelvic region with shortness of breath and cough. 2 y ago X-ray showed right lung mass lesion.

3.3. Step (3): Hypotheses Generation

3.3.1. Lung cancer

3.3.2. what about the mass in the x-ray?

3.3.3. Liver cancer > Lung ( Met ) to the bone as well

3.3.4. TB

3.3.5. Pelvic trauma

3.3.6. Alcoholic pt; multiple rib fractures

3.4. Step (4): Hypotheses Organization

3.4.1. Neoplastic ( of the lung mass ) & Non-neoplastic

3.5. Step (5): Learning Objectives

3.5.1. 1- To list the DDx of mass in the lung upon X-ray

3.5.2. 2- Lung cancer definition, pathogenesis, risk factors, presentation, investigations and pattern of metastasis