"Pathophysiologic Hypothesis" Format

You will electronically submit at Turnitin.com a hypothesis consisting of a textual interpretative case summary and an accompanying diagram. Put your six-digit ID number on your hypothesis (but not your name) so that grading of hypotheses can be anonymous. Be sure to include the ID numbers of fellow students that collaborated with you in generating the hypothesis under your own ID number at the top of your submission (e.g. I worked with: ...).

The free concept map program, Cmap, is recommended for creating your diagrams on both Macintosh and Windows platforms. Click here for instructions for using the program (most frequently asked tip: hold down the "Shift" key while drawing lines/arrows to eliminate the text box between phrases ).

Submit your text and diagram as ONE document in either MS Word (.doc) or Adobe Acrobat (.pdf) format.
Utilize ½ inch margins for your Word document to facilitate maximum readability of your diagrams. Enlarge your diagram to fill the page.
Scan/import your diagram in a VERTICAL orientation (portrait view) for readability.

Problem List

Generate a problem list from the clinical description of the case. The problem list ultimately sets the stage as to what needs to be explained in the diagram (described below).

Diagram

Create a diagram that explains (via established pathophysiologic mechanisms of disease) each of the clinical findings on your problem list given the known underlying diagnosis. The style for the diagram should be consistent to insure getting credit for your work. Use the following format:

Make it readable. An overcrowded page tends to be uninterpretable and will not likely be graded positively.
The diagram consists of nodes linked together in meaningful ways thus providing an explanation as to how the disease manifestations occurred and how they relate to each other and to the underlying disease process (not a rehash of the timeline of what occurred). Unless otherwise specifically instructed, the hypothesis is about the patient in the case report, not the disease in general.
Nodes represent findings, processes or diseases (try to keep them to 1 to 3 words). Nodes representing the clinical findings on the problem list should be designated by BOLDED text. The best arrangement is to have the bolded items from your problem list as endpoints around the periphery of the diagram with the disease mechanisms explaining them radiating out from the center.
Links are of various types. Solid arrows indicate probable causal relationships; broken arrows indicate inhibitory influences; solid lines indicate other types of relationships such as one of the items being a feature of or supporting evidence for the other item. Students should strive for “global coherence” meaning that all findings are ultimately related to each other in the diagram. Thus, although most aspects of the hypothesis should reflect established relationships, some will necessarily be speculative. Reasonable but unproven hypotheses are encouraged but hypotheses that violate established medical knowledge will be penalized.

Quick reference - utilize the following standard designations for your diagrams:

All of the patient findings (from your problem list) should be BOLDED. The point of the diagram and hypothesis is to EXPLAIN these findings now that you know what the final diagnosis is.
The diagram is NOT a chronology of events and is NOT about the differential diagnosis process.
An ARROW should be utilized for causal relationships (i.e., A leads to B).
Therapeutic interventions that cause part of the disease manifestation should be indicated in RED. Therapy that is not part of the pathogenesis of disease should be omitted from the hypothesis.
A DASHED ARROW should be utilized for inhibitory relationships.
A LINE should be utilized for associated relationships in which causality has not been established.

Text

Write a concise interpretative summary to describe and explain what happened in the case. This summary should be less than 250 words.

A coherent description of what happened to the patient should be designed to help a reader follow the logic of your diagram (see example provided). Make sure to spell out any abbreviations used in your diagram. A well-written piece will more likely be graded favorably than one where it is a struggle to decipher what you are postulating. We will take the position that it is no more useful to know what is going on and not be able to communicate it than to not know what is going on at all.
Be sure to focus some attention on both the unresolved issues in the case and those findings with multiple possible causes.