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Tutorial A Blok 16 TB
Tutorial A Blok 16 TB
Tutorial A Blok 16 TB
KELOMPOK 8
ANGGOTA
Erika Sandra
(04011181419014)
Abdurrahman Akib
(04011181419020)
(04011181419004)
Aprita Nurkarima
(04011181419216)
(04011281419080)
Elisabeth Stefanny
(04011281419114)
Fitria Masturah
(04011281419116)
(04011281419128)
Syah Fitri
Nyimas Shafira
(040112814191)
(04011281419138)
OUTLINE
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SKENARIO
Mr. Y, a 40-year old, truck driver, was admitted to hospital with massive hemoptoe. He complained that 6
hours ago he had a severe of coughing with fresh blood of about 2 glasses. He also said that in the
previous months, he had productive cough with a lot phlegm, mild fever, loss of appetite, rapid loss
of body weight (previous weight: 70 kg), and shortness of breath. Since a week ago, he felt his
symptoms were worsening. From further interview, Mr. Y have similar symptoms 6 years ago, he was given
medication after consulting with doctor at that time. But stop the treatment after 2 weeks because he was
feeling better.
Physical Examination :
General appearance : he looked severely sick and pale. Body height : 175 cm, body weight : 55 kg, BP :
100/70 mmHg, HR:112 x/minute, RR: 36 x/minute, temperature: 37.6 oC. There was a tatto on the chest. In
chest auscultation there was an increase of vesicular sound at the right apex lung with moderete rales.
TUBERCULOSIS
TUBERCULOSIS
TUBERCULOSIS
PENULARAN
TUBERCULOSE
Panjang 1-4/um
Lebar 0.3-0,6/um
Dinding sel,
asam lemak
peptidoglikan
Arabinomann
Sitoplasma makrofag
aerob
PATOGENESIS
Tuberculosis primer
Tuberculosis pasca primer
PEMERIKSAAN
Pemeriksaan fisik
konjungtiva pucat
subfebris
perkusi redup, auskultasi nafas bronkial
ronki basah,kasar, nyaring
PEMERIKSAAN
Pemeriksaan laboratorium
TB baru
-> Leukosit sedikit meninggi
limfosit masih dibawah normal
LED meningkat
TB mulai sembuh -> Leukosit kembali normal
limfosit masih tinggi
LED turun ke normal
PEMERIKSAAN
- Sputum
diagnosis
-> ditemukan kuman BTA
kuman BTA ditemukan bila bronkus yg terlibat
proses penyakit terbuka keluar
pemeriksaan -> dianjurkan minum air + 2 liter, refleks
batuk
obat mukolitik eks-pektoran
inhalasi larutan garam hipertonik selama 20-30 mnt
bronkoskopi
PEMERIKSAAN
Tes Tuberculin
- Tes Mantoux,
menyuntukkan 0,1 cc
tuberkulin P.P.D. (purified
protein derivative)
intrakutan berkekuatan 5
TATALAKSANA
TATALAKSANA
Kategori 3
Sputun BTA negatif
Kelainan paru tidak luas
Kasus ekstra pulmonal
------------------ ke Katagori 1
Kategori 4
Tuberkulosis kronik
Resistensi ganda
Sputum harus dikultur menurut uji kepekaan obat
WHO-> seumur hidup diberi H saja
KERANGKA KONSEP
Tn. Y, 40 tahun
terinfeksi M. tuberculosis
infiltrasi sel
radang di alveolus
Pelepasan angiogenesis
growth factor
kerusakan membran
mukosa saluran
napas
sekresi sputum
pirogen endogen
set point di
hipotalamus
sekresi
hormon leptin
demam ringan
nafsu makan
asupan nutrisi
kurang
berat badan
refleks batuk
ruptur pembuluh darah
Hb
takikardi
BP sedikit menurun
hemoptoe
saluran napas
terhalang
suara vesikular
akumulasi cairan
di alveoulus
moderate rales
gangguan difusi
O2 dan CO2
takipneu
TERIMA KASIH