1. step 6
1.1. REVIEW SESSION 1
1.1.1. alcoholic liver disease
2. STEP 8
2.1. Diagnostic decision
2.1.1. coeliac disease
2.1.2. presentation
2.1.2.1. abdominal bloating
2.1.2.2. gradual tirdness
2.1.2.3. chronic diarrhea
2.1.3. mechanism
2.1.3.1. immune mediated villi distraction
2.1.4. supporting data
2.1.4.1. history and physical examination
2.1.4.1.1. family history
2.1.4.2. CBC
2.1.4.2.1. iron deficiency anemia
2.1.4.2.2. folate deficiency
2.1.4.3. biochem
2.1.4.3.1. liver
2.1.4.3.2. hematology
2.1.4.4. histopathology
2.1.4.4.1. biopsy showed flat villi and hypercellular
2.2. objectives
2.2.1. celiac disease
2.2.1.1. what to see in the blood test
3. STEP 7
3.1. inquiry plan and information gathering
3.1.1. history taking
3.1.1.1. HPC
3.1.1.1.1. malaise for 3 months
3.1.1.1.2. hx of diarrhea
3.1.1.1.3. abdominal bloating
3.1.1.1.4. symptoms are aggravated by milk
3.1.1.1.5. slight weight lost 2 kg
3.1.1.1.6. monthly menstrual period .. light blood loss .. lasts for 2 days
3.1.1.2. PH
3.1.1.2.1. intermittent mouth ulcer since childhood
3.1.1.2.2. menerache at age of 15
3.1.1.3. FH
3.1.1.3.1. no
3.1.1.4. SH
3.1.1.4.1. no smoking no alcohol
3.1.1.4.2. no travel
3.1.1.4.3. born in reiyadh
3.1.1.4.4. normal diet .. having meets 3 times?week
3.1.1.4.5. her father doesn't drink milk
3.1.1.5. medication history
3.1.1.6. occupitional history
3.1.1.6.1. school teacher
3.1.2. physical examination
3.1.2.1. Vital signs
3.1.2.1.1. pulse is 68
3.1.2.1.2. BP 110/70
3.1.2.1.3. h: 158 .. w: 48
3.1.2.2. inspection
3.1.2.2.1. looks pale
3.1.2.3. abdominal examination
3.1.2.3.1. inspection
3.1.2.3.2. auscultation
3.1.2.3.3. normal anal
3.1.2.4. chest
3.1.2.4.1. normal
3.1.2.4.2. CVS
3.1.3. investigations
3.1.3.1. CBC
3.1.3.1.1. iron deficiency anemia
3.1.3.1.2. folate deficiency
3.1.3.2. biochem
3.1.3.2.1. liver
3.1.3.2.2. hematology
3.1.3.3. histopathology
3.1.3.3.1. biopsy showed flat villi and hypercellular