GERIATRY & GROWTH DEVELOPMENT SYSTEM

MEDICAL FACULTY
HASANUDDIN UNIVERSITY

STUDENTS MODULE

Given to 6th Semester Medical Students Of

Hasanuddin University
Created By
dr. Femi Syahriani, SpPD.
dr. Wasis Udaya, SpPD.

GERIATRY & GROWTH DEVELOPMENT SYSTEM

MEDICAL FACULTY
HASANUDDIN UNIVERSITY
2011

INTRODUCTION
These modules are designed for the sixth semester students of Medical Faculty, as part
of the Geriatry and Growt Development System Curriculum. The module is completed
with scenarios that represent the signs and symptoms, as well as the risk factors which
frequently found in certain diseases among elderly people. The students are expected
to discuss not only the chief complain (as the main problem) of the scenario, but also
everything that considered asscociated to it, e.g. diseases pathomechanism in which
the students must discuss about the related anotomy, physiology and biochemical
process. The ultimate goal is directed more to the problem solving process rather than
the diagnosis.

The students are expected to be able to explain all aspects about normal diuresis
control, the changing process in the urinary tract due to aging process, the causative
factors and its cathegorization, and the treatment of urine incontinence for elderly
people.

Prior to the PBL process, both students and turors must read the goals and objectives
of the module to assure the prosess is accomplished according to the designated
objectives, as well as to achieve the desired competition. Discussion materials can be
obtained either from lecture handouts or other references provided by the lecturers or
tutors.

We strongly hope that this module can be very useful in helping the students in solving
the problem of urine incontinence and fall; able to confirm the dignosis and becoming
well knowledgable for the treatment and prevention.
Makassar , February 2011

Creative Team,
Geriatry & Growth Development System

STUDENTS TASKS
1.

2.
3.
4.
5.

After reading the above scenarios thoroughly, the students must discuss the
cases in a leader-led group discussion. Both the leader and the secretary are
chosen by the students themselves.
Conducting a self study by providing data/information that will support the
discussion
Conducting a self-coached group discussion (without tutor)
Consulting the problems revealed during the PBL to the experts for a better
understanding
Attending provided experts lecture for unsolved problems

PROBLEM SOLVING PROCESS

In a leader-led group discussion, the students are expected to solve the problems in the
scenarios by conducting these following 7 jumps of problem solving process:
1. Clarifying the un-clear terms stated in the scenario, then defining the
keywords/key statement(s)
2. Identifying the basic problem of the scenario, by creating some leading
important questions
3. Analizing the problems by answering the above questions
4. Classifying the answers
5. Developing study objectives that must be achieved by the students during the
case discussion
6. Looking for other supporting information related to the above cases
7. Reporting the result of discussion and synthesizing the other identified
information
Important Notes:
Step 1 to 5 are conducted during the first coached-tutorial with the tutor
Step 6 is a self study; performed out of the class either by a group discussion or
by student solely, which will then be discussed together in an un-coached
group
Step 7 is conducted during the second coached-tutorial with the tutor

ACTIVITIES SCHEDULE
1.

First meeting in a general class lecture; the lecture delivers a one way
communication of lecturing followed with asking question session
Objective:
explaining the module and how to complete the provided tasks
developing several discussion groups. During this first meeting, the modules
will also be distributed to the students.

2.

Second meeting: self-study. Objectives:

choosing a group leader and secretary

brain storming for step 1 to 3

distributing tasks for members of the group
3.

Third meeting: a leader-led group discussion, facilitated by a tutor. Objective: to

report the self-study result and accomplish the PBL process to the fifth step

4.

Self-study, either together with other students in a group discussion or solely.

Objective: Collecting other new necessary information

5.

Fourth meeting: a leader-led group discussion, facilitated by a tutor. Objective:

reporting the last discussion result as well as for synthesizing the recently identified
information

6.

Fifth meeting (last one): conducted in a general class, applying a panel discussion
form, in which students report the final results of each groups discussion, and
clarifying things that remain unsolved by the groups.

TIME-TABLE
PERTEMUAN
I

II

III

IV

1st Meeting

2nd

1st Tutorial

Self

Explanatio

Meeting;

Collecting

Study

self study

information

(Brain

,analyzing

Practica

Storming)

and

l Work,

synthesizin

CSL

VI

VII

Lecture,

2ndTutorial

Last

Consultatio

(Reporting

Meeting

and

(Reporting)

discussing)

g data

STUDY STRATEGIES
1.
2.
3.
4.
5.
6.

A leader-led group discussion, facilitated by a tutor

A leader-led group discussion, without a tutor
Experts consultation
Experts lecture in a general class
Self-study activities in the library with books, magazines, slides, tape
recorder, video or the internet.
Conducting practical work of Anatomy, Physiology, Biochemistry, Histology,
Pathology Anatomy, Microbiology, Clinical Pathology and Nutrition

OTHER SOURCES OF INFORMATION AND REFERENCE

LIST
A. Hand outs and Journals
Anatomy
Histology
Biochemistry
Pathology Anatomy
Microbiology
1. Baron, JD; Peterson, LR; Finegold, SM: Bailey & Scotts Diagnostic
Microbioloy, 9th edition, Mosby, Sydney, 1994.
2. Brooks, GF; Butel, JS; Morse, SA: Jawezt, Melnick, & Adelbergs Medical
Microbiology, 23rd Edition, International Edition, McGraw-Hill, Kuala Lumpur,
2004.
3. Cohen, J., et all: Infectious Diseases, Volume 1, 2nd Edition, Mosby, Sydney,
2004.
4. Ryan, KJ; Ray CG: Sherris Medical Microbiology, an Introduction to Infectious
Diseases, 4th Edition, McGraw-Hill, Singapore, 2004.
5. Joklik, WK; Willett, HP; Amos, DB; Wilfret, CM: Zinsser Microbiology, 20th
Edition, Appleton & Lange, Connecticut, 1992.
6. Virella, G.: Microbiology and Infectious Diseases, 3rd Edition, Wlliams &
Wilkins, Tokyo, 1997.
Geriatry
1. Brocklehurst JC, Allen SC. Urinary Incontinence. Geriatric Medicine for
Student. 3rd ed. Churchill Livingstone; 1987. 73-91.
2. Boedhi-Darmojo R. Teori Proses Menua. Dalam : Buku Ajar Geriatri. Ed 2,
Edit oleh R.Boedhi-Darmojo & Hadi Martono. Balai Penerbit Fakultas
Kedokteran Universitas Indonesia, 2000; 3-12.
3. Cordts GA. Urinary Incontinence. In: Forciea MA, et al. Editors. Geriatric
Secrets. Philadelphia: Hanley & Belfus Inc; 1996. 185-93.
4. Fonda D. Management of The Incontinent Elderly Patient. In: Update in
Geriatric Medicine
5. Kane RL, Ouslander JG, Abrass IB. Essential of Clinical Geriatrics. New York.
McGraw-Hill; 1994. 145-96.
6. Konety B, Tewari Pasien, Narayan P : Urinary Incontinence. In: Lonergan ET.
Editor. Geriatrics. Stamford Conecticut: Appleton & Lange. 1996. 489-96.
7. Lapitan MCM. The Role of The Pelvic Floor in Urinary Incontonence and
Other Urological Conditions. Medical Progress. 1999; 26 : 27-32.
8. Lim PHC. Overactive Bladder. Medical Progress. 2000; 27: 17-23.
9. Setiati S. Pedoman Pelaksanaan Inkontinensia Urin Pada Pasien Geriatri.
Dalam: Pedoman Pengelolaan Kesehatan Pasien Geriatri. Editor Soejono
CH, Setiati S, Wiwie MSN, Silaswati S. Pusat Informasi da Penerbitan Bagian
Ilmu Penyakit Dalam Fakultas Kedokteran Universitas Indonesia. 2000: 85102.
10.Pranarka K. Inkontinensia. Dalam : Buku Ajar Geriatri. Ed 2, Edit oleh
R.Boedhi-Darmojo & Hadi Martono. Balai Penerbit Fakultas Kedokteran
Universitas Indonesia. 2000; 177-188.

Paediatrics
1. Soetjihningsih. Tumbuh kembang anak. Ranuh G Ed. Jakarta :EGC, 1995.
2. Sularyo TS. Pertumbuhan linier anak dan upaya pemantauanya dengan
minat
perawakan pendek/terlalu pendek. Dalam: Rukman Y, Batubara
Yose, Tridjaja B, Eds. Masalah penyimpangan pertumnbuhan somatik pada
anak dan remaja. PKB ilmu kesehatan anak XXVIII, Jakarta 1993.
3. Tanuwidjaya S. Konsep tumbuh dan kembang. Dalam : Narendra MB,
Sularyo TS, Soetjiningsih, Suyitno H, Ranuh IG. Eds. Tumbuh kembang anak
dan remaja. Jakarta. Sagung Seto, 2002,1-13.
4. Needlmn RD. Growth and development. Dalam : Behrman RE, Kliegman
RM, Jenson HB, Eds. Nelson textbook pediatrics 17 th, Philadelphia,WB
Saunders 2004:23-65
5. Pedoman pelaksanaan stimulasi, deteksi dan intervensi dini Tumbuh
Kembang Anak di tingkat pelayanan dasar. Depkes RI 2005
6. Tumbuh kembang-pedsos. Dalam : Pusponegoro HD, Hadinegoro SR,
Firmanda D, Tridjaja B, Eds.Standar Pelayanan Medis kesehatan anak
Edisi1: IDAI; 2004. 367-369.
7. Levine DA. Growth and development. Dalam : Behrman RE, Kliegman RM,
Jenson HB, Eds. Nelson textbook pediatrics 5 th, Philadelphia: Saunders
2004;23-65
8. Soedjatmiko. Stimulasi dini untuk bayi dan balita. Dalam : Pulungan AB,
Hendarto A, Hegar B, Oswari H. Eds. Continuing Profesional Development
Nutrition Growth-development. IDAI Jaya 2006, 27-46.
B. Lecture Handout
C. Other source : VCD, Film, Internet, Slide, Tape
D. Lecturers
No.
01.

NAMA DOSEN
Prof.Dr.dr.Edu S.Tehupeiory, SpPD-KR

BAGIAN
Penyakit Dalam / Reumatologi

02.

Prof.dr.H.Junus Alkatiri, SpPD-KKV, SpJP(K), FIHA

Kardiologi / Penakit Dalam

03.

Prof.dr. H.A.M. Akil, SpPD-KGEH

04.

Prof.dr.H.Achmad M.P, SpB,SpBU(K)

Penyakit Dalam /
Gastroenterohepatologi
Bedah Urologi

05.

Prof.dr.H.Harsinen Sanusi, SpPD-KEMD

06.

Prof.Dr.dr.H.Syakib Bakri, SpPD-KGH

07.

Prof.dr. Piter Kabo, PhD, SpFK, SpJP

Penyakit Dalam / EndokrinMetabolik

Penyakit Dalam / GinjalHipertensi
Farmakologi dan Kardiologi

08.

Dr. H.M.Junus Patau, SpP, SpPD-KP

Penyakit Dalam / Pulmonologi

09.

Dr. H.A.Fachruddin Benyamin, SpPD-KHOM

10.

dr. H.Wasis Udaya, SpPD

Penyakit Dalam / HematologiOnkologi

Penyakit Dalam / Geriatri

11.

Dr.dr. Hj.Nurpudji Astuti Taslim, MS

Gizi Klinik

HP / FLEXI
081524187006 /
5020948
08124151234 /
0816250816

0811440252 /
081342945932
08159912601 /
5766036
0811443856

12.

Dr.dr. A.Wardihan Sinrang, MS, SpAnd

Fisiologi

13.

Prof. dr. Rosdiana Natsir, PhD

Biokimia

14.

dr. H.Tahir Abdullah, MSc

IKM / IKP

15.

dr.H.A.Jayalangkara Tanra, PhD, SpKJ

Psikiatri

16.

dr. Asmaun Nadjamuddin, SpRM

Rehabilitasi Medik

081342585728

17.

dr. Muhammad Akbar, PhD, SpS

Neurologi

0811415252

18.

dr. A. D a r w i s, SpRad

Radiologi

19.

dr. Henry Yurianto, SpOT

Bedah Orthopedi

20.

dr. Hj.Habibah S. Muhiddin, SpM

Ilmu Penyakit Mata

21.

dr. H. H a m z a h , SpM

Ilmu Penyakit Mata

22.

dr. Hj. Farida Tabri, SpKK

Ilmu Penyakit Kulit & Kelamin

23.

Prof. Dr.dr. Syarifuddin Rauf, SpA(K)

Ilmu Kesehatan Anak

0811411109

24.

dr. J. S. Lisal, SpA(K)

Ilmu Kesehatan Anak

0811418053

25.

dr. Ny. Djuahariah A. Madjid, SpA(K)

Ilmu Kesehatan Anak

0811446616

26.

dr. Martira Maddeppungeng, SpA

Ilmu Kesehatan Anak

081342903666

E. REFERENCES
Boedhi-Darmojo R. Teori Proses Menua. Dalam : Buku Ajar Geriatri. Ed 2, Edit oleh
R.Boedhi-Darmojo & Hadi Martono. Balai Penerbit Fakultas Kedokteran Universitas
Indonesia, 2000; 3-12.
Campbell JA, Borrie MJ, Spears GF. Risk Factor for Falls in A Community Based
Prospective Study of People 70 years and Older. J Gerontology Medical Sciences,
44:M112-117, 1987.
Isbagio H. Perbedaan antara osteoporosis dengan gangguan muskuloskeletal lainnya.
Dalam : Naskah Lengkap Simposium Diagnostik dan Penatalaksanaan Terpadu
Osteoporosis. FKUI, Jakarta, 1994.
Kane RL, Ouslander JG, Abrass IB. Instability and Falls. In : Kane RL ed; Essentials of
Clinical Geriatrics. 3rd ed. Mc Graww-Hill Inc, New York, 1994; 197-219.
Kane RL, Ouslander JG, Abrass IB. Clinical Implications of The Aging Process. In : Kane
RL, Ouslander JG, Abrass IB (eds). Essentials of Clinical Geriatrics. New York. Mc GrawHill, 1994 ; 3-17.
Setiati S. Proses Menua dan Implikasi Kliniknya. Dalam : Pedoman Pengelolaan Kesehatan
Pasien Geriatri. Ed 1. Edit : Soejono CH, Setiati S, Wiwie MS, Silaswati S. Pusat Informasi
dan Penerbitan Bagian Ilmu Penyakit Dalam FKUI, 2000 ; 6-15.

Soejono CH. Instabilitas dan Jatuh. Dalam : Pedoman Pengelolaan Kesehatan Pasien
Geriatri. Ed 1. Edit : Soejono CH, Setiati S, Wiwie MS, Silaswati S. Pusat Informasi dan
Penerbitan Bagian Ilmu Penyakit Dalam FKUI, 2000 ; 109-114.
Tinetti MR. Falls. In : Hazzard WR, Andres R, Bierman EL, Blass JP ed ; Principles of
Geriatric Medicine and Gerontology, 2nd ed. Mc Graww-Hill Inc, New York, 1992; 1192-1199.
Van der Cammen TJM, Rai GS, Extonsmith AN. Instability and Falls. In : Manual of
Geriatrics Care. Churchill-Livingstone, Edinburg, 1991.
Williams ME. Approach to Managing the Elderly Patient. In : Hazzard WR, Bierman EL,
Blass JP, et al (eds). Principles of Geriatric Medicine and Gerotology. New York. Mc GrawHill Inc, 1999 ; 249-253.

GERIATRY & GROWTH DEVELOPMENT SYSTEM

MEDICAL FACULTY
HASANUDDIN UNIVERSITY

STUDENTS MODULE
FALLS & URINE INCONTINENTIA

Given to 6th Semester Medical Students Of

Hasanuddin University
Created By
dr. Femi Syahriani, SpPD.
dr. Wasis Udaya, SpPD.

GERIATRY SYSTEM
MEDICAL FACULTY
HASANUDDIN UNIVERSITY
2011

MODULE
FALLS
STUDY GOALS
After learning the module, the students are expected to have the ability in explaining the
principal concept of knowledge related to the process that might develop fall among the
elderly, as well as the possible risk factors both intrinsic and extrinsic factors.

CASES
SCENARIO I

A 73 year old woman was hospitalized due to pain at her right hip, leading to pain
sensation whenever she walked. She has been having the problem since 3 days ago,
it started when she fell in sitting position in the toilet. She had the back bending
posture since last year. She was in medication for diabetes, hypertention, heart
disease and rheumatic. Four years ago, she had stroke attack.
.
SCENARIO II

A 69 year old man came to a hospital because he can not move both of his legs. Prior
to this, he was sliped and landed on a sitting position. He claimed that he did not see
the spilled water ahead of him. It has been a week since he has been coughing and
difficult in breathing. He lost his appetite, but having no fever. All this time he was in
medication for diabetes and hypertention.

MODULE

URINE INCONTINENTIA

STUDY GOALS
After learning the module, the students are expected to have the ability in in solving the
problem of urine incontinensia; able to confirm the dignosis and become well
knowledgable for the treatment and prevention.

CASES
Scenario 1
A 79 year old man was taken to PUSKESMAS with frequent urinate but less in
quantity. Eventough the prosess took a long time, most of the time he felt unsatisfied.
This condition started 7 days ago. He also complained about knee pain that he had
been having for some times.
According to the family, the man was always in a bad temper, easy forgetting lots of
things which he just did. He was in medication for diabetes,

hypertention, heart

disease and rheumatic for about 7 years now. Three years ago, he had stroke attack.

Scenario 2
A 68 year old woman was taken to PUSKESMAS by her family. According to the
family, she frequently went to the toilet for peeing. She did not complain of any pain
during urinate. It had been a week since she started to cough and bit hard in cathing
up her breath, her appetite lost significantly, no fever.
She had diabetes and hypertention, and she was in medication for both.

GERIATRY & GROWTH DEVELOPMENT SYSTEM

MEDICAL FACULTY
HASANUDDIN UNIVERSITY

STUDENTS MODULE
IMPAIRMENT IN CHILDREN GROWTH &
DEVELOPMENT

Given to 6th Semester Medical Students Of

Hasanuddin University
Created By :
Prof.dr.Ny Djauhariah A Madjid SpA(K)
dr.Martira M Maddeppungeng SpA

GERIATRY SYSTEM
MEDICAL FACULTY
HASANUDDIN UNIVERSITY
2011

INTRODUCTION

These modules of Impairment in Children Growth and Development & Energy

Protein Malnutrition are designed for the sixth semester students of UNHAS Medical
Faculty, as part of the Geriatry and Growth Development System Curriculum.

By using the module of Impairment in Children Growth and Development, the

students are expected to comprehend the children growth and develoment process from
the newborn until adoloscent, factors thet intervene the process, as well as
understanding the importance of monitoring the process for early impairment detection.

PBL process includes activities like tutorial meetings, self study for information
gathering from the experts, text books, journals in the library or through the internet,
writing and presenting final report as the result of the PBL discussion process.

We strongly hope that through this PBL the students will be more active to search for
solutions to overcome the challenges presented in the scenarios that are most likely be
found in the community.

Makassar , February 2011

Creative Team,
Geriatry & Growth Development System

MODULE

IMPAIRMENT IN CHILDREN GROWTH AND

DEVELOPMENT
GENERAL INSTRUCTIONAL OBJECTIVES
After learning the module, the students are expected to have the ability in explaining the
growth and development process, defining normal children growth and development,
defining children nutritional status, planning children vaccination and identifying any
impairment in growth and development in children.

SCENARIO :
A, a boy was taken to Puskesmas in Desember 5th 2009 due to overnight fever. He
born in February the 25th, 2009; supported by a midwife, hardly breathing when he was
first delivered, with weak muscle tonus, birth weight (BW) 3000 grams, birth length (BL)
49 cm, head circumference (HC) 35 cm. The last 2 months consequtive weighin
records: 6100 grams dan 6300 grams, with HC 44 cms. For daily meal the baby was
fed with rice and vegetables, tofu, tempe, and sometimes egg. Starting from the age of
3 months, he consumed formula milk, bananas and baby porridge because he cried
most of the time.
He got BCG immunization when he was 2 months old; 4 times polio vaccine; B Hepatitis
vaccine twice, in the age of 40 days and 3 months; DPT when he was 2 and 6 months
old.
The baby was able to crawl, but not yet sit and stand by him self. Sometimes mumbled,
not able to hold jingling toys with his hands. He responded to sound, and able to show
the direction of the sound source, can not feed him self with biscuits, and do not know
how to play peek-a-boo. His mother was elementary school graduate only. Toys
available at home: jingling toys, dolls, a three wheel bicycle. The mother never talked
much.

MODULE
MALNUTRISI ENERGI PROTEIN

GENERAL INSTRUCTIONAL OBJECTIVES

After learning the module, the students are expected to have the ability in explaining the
definition, etiology, pathogenesis, clinical features, required laboratory tests and other
supporting

examinations,

diagnosis

and

complication,

other

accompanying

diseases/conditions, management, and prevention of Malnutrition condition in general

and Protein and Energy Malnutrition condition in particular.

SCENARIO:

A 1 year old and 11 month boy was hospitalized due to fever and recurrent cough
during the last 6 months, and now showing shortness of breathing. He also showed
less apetite, and swelling of lower legs and stomach for the last 1 month. He had
frequent diarrhea, sometimes accompanied with bloody and mucoid stool. The parents
were economically struggle. Contact history with TB patient was not clear.

Physical examination findings: The child looked very sick with very bad nutritional
status, apthy, body weight 8.1 kgs, body height 76 cms, looked dyspnoeic, nose tip
breathing, tachypnoe, cyanosis. Lung: wet ronchy, but not clear; Heart: normal; face,
palm and feet looked pale; Liver: 3 cms below ribs curve; Spleen: S1, edema dorsum
pedis, pretibial and upper legs, ascites. Dehydration score: 10.