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Pasien Gangguan Alergi

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Pendahuluan
Kelainan

hipersensitivitas (alergi) merupakan keadaan dimana tubuh menghasilkan respons yang tidak tetap atau yang berlebihan terhadap antigen spesifik. Alergi merupakan respon sistem imun yg tidak tepat dan kerapkali membahayakan thd substansi yg biasanya tidak berbahaya.
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Reaksi

alergi merupkan manifestasi cedera jaringan yg terjadi akibat interaksi antara antigen dan antibodi. Reaksi alergi umum akan terjadi ketika sistem imun pada seseorang yg rentan bereaksi secra agresif thd suatu substansi yg normalnya tidak berbahaya (mis: debu, tepung sari, gulma)

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Lanjutan..
Misal:

kadar Ig E meninggi pada gangguan alergik dan sebagian infeksi parasit. Dua tau lebih molekul Ig E akan mengikatkan dirinya dengan alergen dan memicu sel-sel mast atau basofil untuk melepaskan histamin, serotonin, kinin, SRS-A (slow-reacting substance of anaphylaxis) dan faktor neutrofil. Semua mediator ini menimbulkan reaksi alergi kulit, asma, dl
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Mediator reaksi hipersensitivitas


Histamin,

efek fisiologik histamin : kontraksi otot polos bronkusmengi, dilatasi venula dan kontriksi pembuluh darah besar eritema, peningkatan sekresi lambung serta sel-sel mukosa diare. Leukotren, merupakan mediator kimia yg memulai respons inflamasi
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Bradikinin,

menyebabkan kontraksi otot polos bronkus dan pembuluh darah. Bradikinin menstimulasi serabut saraf dan menimbulkan nyeri Serotonin, serotonin dilepas saat terjadi agregasi trombosit dan menyebabkan kontraksi otot polos bronkus.

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Tipe-tipe Hipersensitivitas
1. Hipersensitivitas Anafilaktik (Tipe I) merupakan hipersensitivitas anafilaktik seketika dg reaksi dimulai beberapa menit sesudah terjd kontak dg alergen
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Lanjutan..
- Reaksi ini diantarai oleh Ig E dan bukan oleh antibodi Ig G atau Ig M. - Proses ini terjadi di dalam kelenjar limfe. - Pada saat terjadi kontak ulang, antigen akan terikat dg antibodi Ig E didekatnya dan pengikatan ini mengaktifkan reaksi seluler yg memicu proses pelepasan mediator kimia ( histamin, leukotrin, dll.) - Penykt yg timbul: asma bronkial, urtikaria
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2. Hipersensitivitas Sitotoksik (Tipe II)


Hipersensitivitas

yg terjadi jika sistem kekebalan tubuh secara keliru mengenali konstituen tubuh yg normal sbg benda asing. Tipe ini meliputi pengikatan antibodi Ig G dan Ig M. ontoh reaksi tipe II ini adalah distruksi sel darah merah akibat reaksi transfusi, penyakit anemia hemolitik, kerusakan jaringan pada penyakit autoimun.

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3. Hipersensitivitas Kompleks Imun (Tipe III)


Yaitu

kompleks imun terbentuk ketika antigen terikat dengan antibodi dan dibersihkan dari dalam sirkulasi darah lewat kerja fagositik. Antigen pada reaksi tipe III ini dapat berasal dari infeksi kuman patogen yang persisten (malaria), bahan yang terhirup (spora jamur yang menimbulkan alveolitis alergik ekstrinsik) atau dari jaringan sendiri (penyakit autoimun).
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4. Hipersensitivitas Tipe-Lambat (Tipe IV)


Reaksi

ini, juga dikenal sbg hipesensitivitas seluler, terjadi 24 hingga 72 jam sesudah kontak dengan alergen. Reaksi ini diantarai oleh makrofag dan selsel T yg sudah tersensitisasi. Contoh: efek penyuntikan intradermal antigen tuberkulin.
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Tes diagnostik
Pemeriksaan darah (hitung darah lengkap) Tes kulit (mencakup penyuntikan intradermal yg dilakukan secara bersamaan pada tempat-tempat terpisah dengan beberapa jenis larutan yg mengandung antigen. Makna klinis reaksi positif : bidur dan eritema

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Body,

fundus pylorus rugae pyloric sphincter

Fundus

Body

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Small Intestine
small

bowel enter/o - small intestine villi Parts


duodenum jejunum ileum
ileocecal

valve
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Large Intestine
Large

Bowel col/o or colon/o cecum vermiform appendix

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Colon

ascending hepatic flexure transverse splenic flexure descending

Sigmoid

Rectum
Anus
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Liver - hepat/o
Functions

production of bile glucose - glycogen storage of vitamins, B12, A, D, E, K erythrocytolysis (pigment released eliminated in bile called bilirubin) bilirubin gives stool its characteristic dark color removes toxins from blood manufactures blood proteins
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Pancreas
internal

- endocrine function

insulin glucogon
external

- exocrine function

amylase - carbohydrates trypsin, chymotrypsin - proteins lipase - fats


enzymes

inactive until reach duodenum


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Gallbladder
pear-shaped

sac under the liver chol/e means bile or gall cyst/o means cyst or sac gallbladder contracts forcing bile out cystic duct into common bile duct.

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Bile
is a digestive juice- emulsifier acts on fat in a way that lipid enzymes can digest fat travels via hepatic duct to cystic duct to gall bladder, where stored bile consists of water, bile salts, cholesterol, and bilirubin (a colored substance resulting from breakdown of hemoglobin) bilirubin gives bile yellow or orange color Health Sciences Department, Rogers State University
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bile

Stomach during Digestion


Gastric

juices

HCL - activates enzymes protease pepsin lipase


Chyme

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Small Intestine during Digestion


digestion

completed in small intestine chyme mixed with bile and pancreatic juices emulsification absorption

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Large Intestine
receive

fluid waste products and store until released from body. excess water absorbed feces, stools defecation, or bowel movement
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Pathology - Ulcers
Gastric

ulcers Peptic ulcers Ulcerative Colitis

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Pathology - Hernias
Diaphragmatic
Hiatal,

Gastroesophageal Inguinal Umbilical

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Bowel Obstructions
Volvulus

Ischemia Necrosis Peritonitis


Intussusception

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Hemorrhoids
Internal
External Hemorrhoidectomy

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Liver Disorders
Yellow

skin - jaundice, icterus Hepatitis


Type A - fecal, oral Type B - parenteral, sexual, perinatal Type C - parenteral to blood, blood products

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Diverticulosis
Diverticulitis
obstipation diverticulectomy

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Oncology
Neoplasn

from epithelial lining

gastric adenocarcinoma esophageal carcinomas hepatocellular carcinomas pancreatic carcinomas

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Diagnostic, Symptomatic, Therapeutic Terms


Aerophagia
anorexia appendicitis ascites borborygmus

bulimia

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Diagnostic, Symptomatic, Therapeutic Terms


cachexia
cholelithiasis cleft

palate Crohns disease cirrhosis colic


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Diagnostic, Symptomatic, Therapeutic Terms


deglutition
dysentery dysphagia eructation fecalith

flatus
gastroesophageal

reflux disease
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Diagnostic, Symptomatic, Therapeutic Terms


Halitosis
hematemesis irritable

bowel syndrome leukoplakia malabsorption syndrome melena obstipation


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Diagnostic, Symptomatic, Therapeutic Terms


Peristalsis
pyloric

stenosis regurgitation steatorrhea visceroptosis

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