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A 35-year-old man came with a complaint of fever for 10 days. The patient also complained of nausea,
vomiting, calf pain and urinating like tea. On examination of vital signs, blood pressure was 100/60
mmHg, pulse was 100 beats per minute, and axillary temperature was 38 C. On physical examination,
jaundice and scleral injection were found. One week earlier the patient's house was flooded.
KEY WORDS
DIFFICULT WORDS
1. Jaundice : A yellow discoloration of the sclera, mucous membranes and skin due to
accumulation of bilirubin in the tissues or interstitial fluid
2. Scleral injection : A popular term for eyes that appear red due to dilation of the conjunctival
vessels overlying the sclera
QUESTIONS
THE ANSWERS
3. Explain the complaint pathomecanism related to the scenario ( fever, vomiting, urine like tea )
FEVER : it start from pyrogen eksogen
Vomiting : increased intracranial pressure, stimulates intracranial pressure receptors, stimulates
the vomiting center in the dorsolateral reticularis, contracts in the duodenum and stomach
antrum, increases intra-abdominal pressure, retrograde peristalsis, stomach feels full and
diaphragm rises, intrathoracic pressure increases, then the esophageal sphincter opens, and
vomiting occurs.
Urine like tea : the colour of urine. Sometimes called hemolitic jaundice. Conjugated bilirubin
dalam darah meningkat, konjugasi bilirubin tidak larut dalam air makanya tidak bisa larut dalam
kemih. Meningkat karena peningkatan beban bilirubin yang load of the liver
LEPTOSPIROS
Demam, icterus, kerusakan ginjal
Etiology : penyakit infeksi yang disebabkan oleh leptospirosis
Epidemiologi : Penyakin zonosis dengan distribusi luas
Patogenesis : Masuk ke manusia terutama lewat air dan tanah
Diagnosis : Mikroskopis, kultur
MALARIA
A serious injures desease. Through mosquito bites. Plasmodium falciparum
TETANUS
7. What are the complications that can occur regarding the scenario?
Leptospirosis can cause serious complications : kidney or liver failure, meningitis, difficulty
breathing, and bleeding
8. Perspective islam based on scenario
“ Janganlah kamu mencaci maki penyakit demam, karena sesungguhnya Allah akan
menghapuskan dosa dosa anak Adam sebagaimana tungku api menghilangkan kotoran kotoran
besi “