PBL 3 session 2

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PBL 3 session 2 by Mind Map: PBL 3 session 2

1. Step 8

1.1. Diagnostic decision

1.1.1. cervical sqeuamous cell carcinoma stage 2b

1.2. Mechanism

1.2.1. prolonged infection with HPV

1.2.2. risk factors

1.3. Presentation

1.3.1. lower back pain

1.3.2. R loin pain

1.3.3. microscopic hematouria

1.4. Supporting data

1.4.1. history and physical exam

1.4.2. colposcopy

1.4.3. CT scan

1.4.4. biopsy

1.5. 10 minutes

2. Step 7

2.1. Inquiry plan and info gathering

2.1.1. History of presenting complaint worsening discahrge and pain lower back pain and pelvis worsned over 2 m no radiation like perioed pain but continuos dull dragging with R loin pain not relieved by pain killers no pain with urination diacharge

2.1.2. Previous medical / surgical history cholecysteectomy for gallstones

2.1.3. GYn history regular period 28 days one sexuall partner five normal pregnancy with normal vaginal delivery intermenstural postcoital bleeding two times in the last few months two pap smears the last one two and half ago tubal ligation

2.1.4. Drug history / allergy

2.1.5. Family history no malignancy in family father died of heart attck at 72 mother a life and well 78y

2.1.6. Social / occupational history stopped smoking three y ago 20 ciggirate per day perviously not a drinker recreational activiter

2.1.7. Systemic review

2.1.8. Physical examination vitals rr 18 per min P 76 BP 130/70 T 36.8 weight 67 hight 163 general appearance looks well abdominal scar liver and spleen are not palpable genital normal vulva cervix irregular mass tumor 6 CM extened to anterior and posterior vaginal vornizes DRE early parametrial involvment syaged 2b cystoscopy no tumor in bladder are of bollus edema scolscoospy invasive carcinoma in cervixs

2.1.9. tests results

2.2. 50 minutes

3. Step 6

3.1. Review session 1

3.2. Report new knowledge

3.2.1. cervical cancer definition epidemiology etiology HPV risk factors pathophysiology presentation diagnosis

3.3. 30 minutes

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