Skenario a Blok 16 Tahun 2016

8/19/2019 Skenario a Blok 16 Tahun 2016

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Skenario A Blok 16 Tahun 2016

Mr Y, a 40-year old, truck driver, was aditted to hos!ital with assive heo!toe"

#e co!lained that 6 hours a$o he had a severe o% cou$hin$ with %resh &lood o%

a&out 2 $lasses" #e also said that in the !revious onths, he had !roductive cou$h

with a lot o% !hle$, ild %ever, loss o% a!!etite, ra!id loss o% &ody wei$ht '!reviouswei$ht ( )0 k$*, and shortness o% &reath" Since a week a$o, he %elt his sy!tos

were worsenin$" +ro %urther interview, Mr" Y have siilar sy!tos 6 years a$o,

he was $iven edication a%ter consultin$ with doctor at that tie" But sto! the

treatent a%ter 2 weeks &ecause he was %eelin$ &etter"

Physical examination :

eneral a!!earance ( he looked severely sick and !ale" Body hei$ht ( 1) c, Body

wei$ht ( k$ B. ( 100/)0 #$, # ( 112/inute, ( 6/inute, te! ),6 3"

there was a tattoo on the chest" n chest auscultation there was an increase o%

vesicular sound at the ri$ht a!e lun$ with oderate rales"

5a&oratoriu (

BTA '-*, #& , $7, 5eucocyte 6000, 589 12 /:a,9i; count ( 0//2/)/1/, #<

Status '-*

ont$en ( in=ltrate ri$ht a!e lun$

1" >lari=kasi stilah

?o

"

stilah >lari=kasi

1" Massive #eo!toe Batuk &erdarah le&ih dari 200-600 cc/hari2" Severe o% cou$hin$ Batuk yan$ &erat" .roductive cou$h Batuk yan$ en$hasilkan dahak atau

lendir atau s!utu@ uunya en$alai

kesulitan &erna%as dan disertai

!en$eluaran dahak4" .hle$ Su&stansi kental dan te&al yan$

disekresikan oleh ukosa saluran!erna%asan

" Mild %ever 9ea yan$ di atas noral ta!i di &awah

0 36" .ale .ucat @ !eru&ahan warna en:adi !utih)" Tattoo Suatu tanda yan$ di&uat den$an

easukkan !i$en ke dala kulit" <esicular sound Suara !aru noral, ins!irasi le&ih !an:an$



dari eks!irasi serta le&ih :elas" Moderate rales Bisin$ ter!utus-!utus yan$ terden$ar !ada

saat inhalasi

2" denti=kasi Masalah1" Mr Y, a 40-year old, truck driver, was aditted to hos!ital with assive

heo!toe" #e co!lained that 6 ears a$o he had a severe o% cou$hin$

with %resh &lood o% a&out 2 $lasses"'vvv*

2" #e also said that in the !revious onths, he had !roductive cou$h with a

lot o% !hle$, ild %ever, loss o% a!!etite, ra!id loss o% &ody wei$ht

'!revious wei$ht ( )0 k$*, and shortness o% &reath" Since a week a$o, he

%elt his sy!tos were worsenin$"

" +ro %urther interview, Mr" Y have siilar sy!tos 6 years a$o, he was

$iven edication a%ter consultin$ with doctor at that tie" But sto! the

treatent a%ter 2 weeks &ecause he was %eelin$ &etter"

4" .hysical eaination (eneral a!!earance ( he looked severely sick and !ale" Body hei$ht ( 1)

c, Body wei$ht ( k$ B. ( 100/)0 #$, # ( 112/inute, (

6/inute, te! ),6 3" There was a tattoo on the chest" n chest

auscultation there was an increase o% vesicular sound at the ri$ht a!e

lun$ with oderate rales"

" 5a&oratoriu (

BTA '-*, #& , $7, 5eucocyte 6000, 589 12 /:a, 9i; count (

0//2/)/1/, #< Status '-*

6" ont$en ( in=ltrate ri$ht a!e lun$

" Analisis Masalah1" Mr Y, a 40-year old, truck driver, was aditted to hos!ital with assive

heo!toe" #e co!lained that 6 hours a$o he had a severe o% cou$hin$

with %resh &lood o% a&out 2 $lasses"a" A!a hu&un$an usia, :enis kelain dan !eker:aan den$an kasus ' ina,

thania, nadiya*&" Ba$aiana klasi=kasi &atuk &erdarah ' dita, ican, yukel*

c" Ba$aiana ekanise &atuk &erdarah ' ira, kiki, kak ina*d" Ba$aiana da!ak dari &atuk &erdarah sa!ai 2 $elas' thania,

nadiya, dita*e" Ba$aiana tatalaksana awal !ada Mr Y 'ican, yukel, ira*

2" #e also said that in the !revious onths, he had !roductive cou$h with a

lot o% !hle$, ild %ever, loss o% a!!etite, ra!id loss o% &ody wei$ht



'!revious wei$ht ( )0 k$*, and shortness o% &reath" Since a week a$o, he

%elt his sy!tos were worsenin$"a" Ba$aiana hu&un$an dan ekanise( 'kiki, kak ina, dita, ican,

thania*- Batuk !rodukti% den$an secret- Mild %ever- >ehilan$an na%su akan- .enurunan &erat &adan yan$ drastic- Sesak na%as

&" Men$a!a $e:ala Mr Y seakin e&uruk selaa sein$$u terakhir

'nadiya, yukel, ira*

" +ro %urther interview, Mr" Y have siilar sy!tos 6 years a$o, he was

$iven edication a%ter consultin$ with doctor at that tie" But sto! the

treatent a%ter 2 weeks &ecause he was %eelin$ &etter"a" A!a da!ak !en$hentian o&at yan$ dilakukan Mr Y ' kak ina, dita,

nadia*

&" Men$a!a keluhan yan$ saa ti&ul la$i ' thania, ican, ira*

4" .hysical eaination (eneral a!!earance ( he looked severely sick and !ale" Body hei$ht ( 1)

c, Body wei$ht ( k$ B. ( 100/)0 #$, # ( 112/inute, (

6/inute, te! ),6 3" There was a tattoo on the chest" n chest

auscultation there was an increase o% vesicular sound at the ri$ht a!e

lun$ with oderate rales"a" Ba$aiana inter!retasi dari !eeriksaan !ada kasus ' yukel, kiki,

kak ina*&" Ba$aiana ekanise dari hasil !eeriksaan a&noral !ada kasus

' thania, ican, nadiya*c" A!a hu&un$an riwayat !e&uatan tato !ada kasus 'dita, yukel ira*d" a!a :enis-:enis suara ta&ahan !ada !eeriksaan auskultasi !aru

' kiki, ican, dita*e" Ba$aiana cara !eeriksaan auskultasi !ada !aru 'kak ina, ira,

thania

" 5a&oratoriu (

BTA '-*, #& , $7, 5eucocyte 6000, 589 12 /:a, 9i; count (

0//2/)/1/" Status #< '-*

a" Ba$aiana inter!retasi dari !eeriksaan !ada kasus 'kak ina,

yukel, kiki*&" Ba$aiana ekanise dari hasil !eeriksaan a&noral !ada kasus'

ira, nadiya, dita*c" Men$a!a leukosit !ada kasus noral 'ican, thania, ira*d" Men$a!a BTA ne$ati% 'nadiya, dita, ican*e" Ba$aiana cara !eeriksaan BTA 'kak ina, kiki, yukel*%" Ba$aiana hu&un$an status #< den$an kasus



6" ont$en ( in=ltrate ri$ht a!e lun$a" Ba$aiana inter!retasi dari !eeriksaan !ada kasus 'yukel, kak

ina*&" Ba$aiana ekanise dari hasil !eeriksaan a&noral !ada kasus

'ican, dita, nadiya*c" Ba$aiana $a&aran ront$en noral dan ront$en !ada kasus' kiki,

thania, ira*

)" Te!late ( 3A S8MCA DDDa" 99&" 9> c" 8!ideiolo$id" 8tiolo$ie" .ato=siolo$i%" Mani%estasi >linis$" .eeriksaan old standar

h" .eeriksaan !enun:an$i" +aktor resiko :" 3ara !ene$akkan dia$nosisk" >o!likasil" Tatalaksana" .ence$ahann" .ro$nosiso" S>9

4" 5earnin$ ssue1" Anatoi dan =siolo$i !aru 3A S8MCAAAADDDDDDDDDDDD

" #i!otesis Tuan Y 40 tahun didu$a enderita TB .aru den$an $e:ala klinis 'E* den$an

BTA '-* dan status #< '-*

.edoan ?asional .enan$$ulan$an Tu&erkulosis 2014 di !oin dia$nosis

tatalaksana

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Skenario a Blok 16 Tahun 2016