PR UJIAN KASUS II

08 Mei 2020
Tiara Mahza W./G992003146
Diabetes Test

American Diabetes Association (2020). Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes 2020. Diabetes Care 2020 Jan; 43(Supplement 1): S14-S31.
Daftar Pustaka EKG T inverted, T biphasic, T
Flat
• Burns, Ed. (2020). T Waves. Life
In The Fast Line.
• Rawshani, Araz. (2018). The T
Waves: Physiology, variant EKG
Features. ekgwaves.com
 Perbedaan Foto Thorax AP dan PA
AP PA

Arah sinar Dari depan ke belakang Dari belakang ke depan

Ukuran jantung Terlihat lebih besar normal

Lebar mediastinum Terlihat lebih lebar normal

Costae normal Costae depan jelas, costae belakang agak kabur

Lapang pandang paru Lebih sempit lebar

Lengkung costae Sempit/pendek karena tubuh bagian depan lurus Lebar karena tubuh bagian belakang melengkung
sehingga costae relatif tertarik

Posisi Supinasi, fundus gaster tidak terlihat karena terisi Berdiri, pada fundus gaster tampak adanya udara
makanan

Skapula Tampak menutupi Tampak di samping

Klavikula Sudut klavikula mendatar, bagian medialnya mengarah Klavikula tajam, lancip, bagian tengah mengarah ke
ke kranial kaudal

Fatmawati, Heni, et al. (2019). Perangkat Pembelajara Audiovisual Pembacaan Rontgen Thorax. Digital Repository Universitas Jember
Perbedaan Foto Thorax AP dan PA

Fatmawati, Heni, et al. (2019). Perangkat Pembelajara Audiovisual Pembacaan Rontgen Thorax. Digital Repository Universitas Jember
 Anemia Hemolitik pada Hipertensi
Emergensi
• Prior history of hypertension, high mean arterial • Both TTP and malignant hypertension-induced TMA
pressure, significant renal impairment but mostly present with neurological and gastrointestinal
symptoms. In malignant hypertension-induced TMA,
relatively modest thrombocytopenia and lack of however, patients do not have fever. Prior history of
severe ADAMTS-13 deficiency are clues to hypertension and higher mean arterial pressure at
diagnose malignant hypertension-induced TMA presentation are possible clues to a diagnosis of malignant
(Thrombotic microangiopaty) or microangipathic hypertension. The greater degree of renal impairment at
hemolytic anemia. diagnosis, relatively modest thrombocytopenia and lack of
severe ADAMTS-13 deficiency (activity <10%) can further
• In malignant hypertension, the autoregulatory differentiate malignant hypertension from TTP.
mechanism fails, resulting in damage to the • Unlike TTP, patients with malignant hypertension respond
vascular wall. Disruption of the vascular well to antihypertensive agents, do not require plasma
endothelium causes plasma constituents exchange and have favorable nonrenal outcomes;
(including fibrinoid material) to enter the vascular however, patients frequently end up with persistent renal
wall and obliterate the vascular lumen. This failure. Aggressive management of blood pressure in
luminal narrowing is believed to fragment malignant hypertension-induced TMA has been previously
shown to result in resolution of TMA and gradual return of
erythrocytes and consume platelets leading to renal function
TMA

Khanal, N., Dahal, S., Upadhyay, S., Bhatt, V. R., & Bierman, P. J. (2015). Differentiating malignant hypertension-induced thrombotic microangiopathy from thrombotic thrombocytopenic purpura. Therapeutic Advances in Hematology, 6(3), 97–102.