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7/25/2019 pleno sken 4HI

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PLENO KELOMPOK 1


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Mala Needs Injection

Mrs.Mala, 30 years old, come to the doctorcomplaining about her oint discom!ort. "he !eels ite#ery morning in her $nees. "he also !eels that her

$nee is s%elling. &eside that, Maya also !eel ache inher arm. '!ter !ollo%ing the historical diseases, Malasaid that she o!ten had cough, (u, and sorethroat.

&ecause she)s already bored !or consuming drugs,Mala %ants to be inected by analgetic. '!ter the

doctor as$s about the history o! drug allergic andshe hasn)t ha#e it, Mala is inected %ith ananalgetic. *e% times later, Mala !eels di++y, blurringeyes and hard to breath. hat is actually happenedto Mala.


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"-EP 1

-here is no un!amiliar terminology


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"-EP

1. hat is the diagnose and dierentialdiagnose !rom mrs Mala disease

. hat is supporti! e2amination !or Mrs Mala

3. hat is the etiology and ris$ !actor !rom MrsMala disease

. hy Mrs Mala got di++y, blurring eyes andhard to breath a!ter she got inected an

analgetic4. hat is the treatment !or Mrs Mala

5. hat is the complication !rom Mrs Mala

disease


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"-EP 3

1. &ased on scenario %e suspect thatMrs Mala 6ot Reumathoid ArthritisandHipersensitivity Reaction (Anaflaktik)

'nd the dierential diagnose !or Mrsmala disease is 7 "LE, Osteoarthritis,'rthritis 6out

'nd other hypersensiti#ity reaction


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. Laboratory e2amination and othere2amination %e can do are 7

89P

Led

Leu$ocyte count

3. -he etiology o! Mrs Mala disease is 7

'utoimun 6enetic


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'nd !or the ris$ !actor o! Mrs Maladisease is 7

6ender

'ge

9adiation

. Mrs Mala !elt the Mani!estation clinic

o! 'na:lactic reaction


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4. -reatment !or Mrs Mala are7

*armacology and Non;*ramacology treatment

5. -he complication o! Mrs Mala diseaseare7

anemia

8arpal tunnel syndrome


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"tep

1. ' chronic disease characteri+ed bythe in(ammation o! the lining o! the

oints, %hich is called the syno#ium.

More common in %omen than men.-he e2act cause o! 9' is un$no%n.

"uspected causes are7&acterial ?iral "tress


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8linical mani!estation o! 9' patients are7

*atigue.

"tiness, especially in early morningand a!ter sitting a long period o! time.

Lo% 6rade *e#er, ea$ness.

Muscle pain and pain %ith prolongedsitting.

"ymetrical, aects oints on bothsides o! the body.

9heumatoid nodules.

=e!ormity o! your oints o#er time.


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=iagnose 8riteria o! 9eumathoid'rthritis

Morning stiness

'rthritis o! 3 or more oints 'rthritis o! hand oints

"ymmetric arthritis

9heumatoid nodules

"erum rheumatoid !actor

9adiographic changes

' person shall be said to ha#e

rheumatoid arthritis i! he or she hassatis:ed o! @ criteria, %ith criteria


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-he dierential diagnose !or 9' are7

"LE, Osteoarthritis,

'rthritis 6out


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. Laboratory e2amination89P 7 increase until A 0,@ pgBml

LE= 7 increase until A 30 mmBhour

Cb 7 decrease, until 10gBdl

Leu$ocyte count 7 usually increase

-rombocyte count 7 increase

9* 7 positi#e in D0 9')s patient


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9adiology 9adiology 7 normalB there is

osteopeni or erosion

"ymmetrical

Early7 no sig changes

Late7

Fu2ta;articular osteoporosis %Bdecr bone density

Gni!orm t narro%ing

Marginal erosions


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3. -he etiology o! Mrs Mala disease isH9'I is un$no%n. "uspected causes

are7

&acterial


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'nd !or the ris$ !actor o! Mrs Maladisease is 7

6ender

'ge

*amilial history

"mo$ing

9adiation


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. 'naphyla2is may be an allergic response

that is immunologically mediated, or anon;immunologically mediated response,or idiopathic. 8ertain !oods, insect#enoms, some drugs and late2 are

common precipitants o! immunoglobulinE H


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4. -reament !or Mrs Mala are7

pharmacology HsymptomaticI7

'nlagetic O'


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Non;pharmaclogy7 -a$e a rest *asting

E2ercise

8od li#er oil suplement HN"'


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5. -he complication o! Mrs Maladisease are7

'nemia

8ancer

8ardiac complication


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"tep 4

1. Nutrition !or management !or 9'patients

. 'nother autoimmune disease that can

damage the untional3. 'nother medicine than can cause

allergy

. 9eumathoid Non;in(amation4. -reatment !or ana:la$sis


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"tep 5


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"tep @

1. Nutritonal or 9' patein is moreconsumption7

. ?it =

. ?it E Hantio$sidanI

. Omega 3 Hantural analgeticI

. 8od li#er oil HN"'


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. "LE H"ystemic Lupus EritematousI

Systemic lupus erythematosusHalso calledSLE, or lupusI is an autoimmune disease o!the bodyJs connecti#e tissues.Autoimmunemeans that the immune system attac$s thetissues o! the body.


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8linical mani!estation 7

*atigue

eight loss

Musculosceletal mani!est

"$in mani!est Hmalar rashI Lung mai!est HpneumonitisI

Ceart mani!est HpericarditisI

9ena mani!est


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8riteria diagnose !or "LE7

-here is positi#e i! %e can !ound ormore sign


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-reatment !or "LE patient7

Pharmacology7

N"'


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3. -he medicine that can cause alergy7

'ntibiotics >'nalgesics Penicilline ; 8odein

HN"'


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. 'rthritis non;in(amatory7

Osteorthritis7'ge o! Onset A 0 years

8ommonly 'ected Foints

8er#ical and lumbar spine

*irst carpometacarpal oint

Pro2imal interphalangeal oint

=istal interphalangeal oint

Cip

Knee

"ubtalar oint *irst metarsophalangeal oint


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=iagnose 7 "ymptoms

Pain

"tiness 6elling

Physical e2amination 8repitus &ony enlargement =ecreased range o! motion Malalignment-enderness to palpation

-he more !eatures, the more li$ely the diagnosis


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-reatment7

Non;pharmacology7 pharmacology7

eight loss > 'nalgetic

Physicology > N"' 8orticosteroid E2ercise > operation


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-reatment !or 'naphylactic


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-C'NK OG

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