1. Step 6
1.1. Review session 1
1.1.1. Summary of step 5
1.1.1.1. Anatomy
1.1.1.1.1. Respiratory system (nerves, blood vessels, lymph vessels)
1.1.1.2. physiology
1.1.1.2.1. Respiratory system
1.1.1.3. pathology
1.1.1.3.1. Infection of respiratory system (Airborne)
1.1.1.3.2. Immune deficiencies in relation with lungs
1.1.1.4. pathophysiology
1.1.1.4.1. Relate the symptoms together to one disease
1.1.1.4.2. What causes chest pain in the right area?
1.2. Report new knowledge
1.2.1. Anatomy
1.2.2. Physiology
1.2.3. Patholog
1.2.3.1. pneumonia
1.2.3.1.1. epidemiology
1.2.3.1.2. pathophysiology
1.2.3.1.3. symptoms
1.2.3.1.4. people at higher risk
1.2.3.1.5. Types
1.2.3.1.6. diagnosis
1.2.3.2. Pulmonary TB
1.2.3.2.1. Mycobacterium tuberculosis
1.2.3.2.2. tuberculosis pneumonia
1.2.3.3. acute bronchitis
2. Step 7
2.1. Inquiry plan and info gathering
2.1.1. history
2.1.1.1. what did they treat for in the first visits?
2.1.1.1.1. They thought it was flu
2.1.1.1.2. No antibiotics described
2.1.1.2. risk factors?
2.1.1.2.1. Type 1 diabetic
2.1.2. vital signs
2.1.2.1. wight 68
2.1.2.2. hight 150
2.1.2.3. temperature 39 c
2.1.2.4. pulse 80
2.1.2.5. blood pressure 110/60
2.1.2.6. looks sick
2.1.3. stethoscope
2.1.3.1. crackling sounds
2.1.4. tests results
2.1.4.1. o2 saturation 88%
2.1.4.2. hemoglobin is OK
2.1.4.3. high WBC count
2.1.4.3.1. High neutrophils
2.1.4.4. ESR: high
2.1.4.5. LDH: high
2.1.4.6. phlegm culture
2.1.4.6.1. no results yet
2.1.4.7. C reacting protein: high
2.1.4.8. Electrolytes are good
2.1.4.9. Glucose 220
2.1.4.10. x ray
2.1.4.10.1. showing pneumonia
3. Step 8
3.1. Diagnostic decision
3.1.1. Community acquired pneumonia (typical)
3.1.2. probably streptococcus pneumoniae
3.2. Mechanism
3.2.1. Inhalation of pathogen
3.2.2. passed to the right upper lobe
3.2.3. immune response causing inflammation
3.2.4. alveoli filled with fluid
3.2.5. decreased O2 passage to blood
3.3. Presentation
3.3.1. productive cough
3.3.2. fever and chills
3.3.3. chest pain in the right upper area
3.4. Supporting data
3.4.1. low O2 in blood
3.4.2. chest x-ray
3.4.3. high WBC count
3.4.4. ESR confirms inflammation
3.4.5. LDH proves hemolysis
3.4.6. elevated c reactive protein confirms inflammation
3.5. Objectives for next session
3.5.1. Management
3.5.1.1. keep in mind he is diabetic type 1
3.5.2. prevention
3.5.3. intervention and treatment