Scenario D Blok 20 Batch 2018

” Unbearable Sadness”
Rina, a 24-year-old student, was brought by her parents to the ER RSMP in an unconscious state
because she tried to commit suicide by drinking Baygon 2 hours ago. She looked shortness of breath.
There are a trace of vomit and a smell of insect poison from her mouth. According to her parents, after
drinking Baygon, she groaned in pain in her stomach accompanied by vomiting, peeing in her pants
and having seizures 3 times. It was estimated that Rina had drunk half a large bottle of Baygon.

Physical Examination:
General Appearance: GCS: E2 M5 V2, looks very sick
Vital Sign: BP : 120/80 mmHg, HR : 58 x/m, regular, RR : 28x/m, T : 37,40C
Specific Examination :
Head:
Eye: pin point pupil (+/+), ligh reflex (-/-), anemic conjungtive (-/-), sunken eyelids (-/-),
tremor eyeball (+/+).
Mouth: tremor tongue (+), a lot of saliva coming out of the corner of the mouth
Thoraks: symmetrical movement, normal vesicular, smooth wet rhonchi (+/+), wheezing (-), normal
heart sound, murmur (-).
Abdomen:
Inspection: flat
Palpation: tenderness can not be assessed
Percussion: tympani
Auscultation: increased bowel sounds
Ekstremities: cyanosis in fingertips.

Laboratory:
Blood test: Hb 13,4 g/dl; leucocyte: 9900 /mm3, Trombocyte: 225.000 mm3, LED: 13 mm/jam
Blood chemistry: Ureum 25 mg/dl, Creatinin 0,8 mg/dl, Sodium 130 mmol/l, Potassium 3,1 mmol/l