OEDEMA

NET FILTRATION Water Movement Between

Plasma and Interstitial Fluid
 Capillary hydrostatic pressure (blood pressure)
Movement of water from the capillary to the interstitial space.

 Capillary (plasma) oncotic pressure

osmotically attracts water from the interstitial space back into the capillary.

 Interstitial hydrostatic pressure

Inward movement of water from the interstitial space into the capillary.

 Interstitial oncotic pressure

osmotically attracts water from the capillary into the interstitial space.
MANIFESTASI KLINIS
 GENERAL
 MENYELURUH ....ADA DI BAG TERTENTU SPT
KAKI KRN GRAVITASI
 LOKAL:
 EFUSI PLEIRA
 OEDEMA PULMONUM
 OEDEMA CEREBRAL
 ASCITES
MANIFESTASI KLINIK OEDEMA

 BERAT BADAN BER +

 BENGKAK
 ELASTISITAS KULIT/JARINGAN JELEK
 GERAKAN SENDI TERBATAS/MENURUN
TREATMENT
 TANGANI PENYEBAB
 TERAPI SIMPTOMATIS
 DIURETIC
 ALBUMIN
 BERBARING KAKI SEDIKIT DIATAS
 COMPRESI DG STOCKING
 HINDARI BERDIRI LAMA
 KURANGI INTAKE NATRIUM
HEMORRHAGE
 PLATELET (PLT)
 PRODUKSI TURUN
 PENINGKATAN DESTRUKSI
 MALFUNGSI PLT
 FAKTOR PEMBEKUAN DARAH....DEFISENSI/MALFUNGSI
 DEFISIENSI
 PERDARAHAN SETELAH TRAUMA
 LARGAE BRUISES
 HEMATOMA
 PROLONG BLEEDING
 GANGGUAN FUNGSI
 HEMOPHILIA , vWF (inherited)

 FAKTOR PEMBULUH DARAH

 NONTROMBOCYTOPENIC PURPURA
HEMORRHAGE
KARENA PLATELET
 PERDARAHAN SPONTAN PD PEMB DARAH KECIL
 MEMBRAN MUKOSA HIDING, MULUT, GAST INTESTINAL, UTERUS
 PERDRHAN SUBKUTAN: PTECHIE, BRUISHING
 JUMLAH PLT MENURUN T(ROMBOSITOPENIA)
 PRODUKSI MENURUN PLT
 RUSAK SUMSUM TL
 KANKER SUMSUM TULANG
 X-RAY, CEMOTHERAPY
 INFEKSI VIRUS (HIV)
 TERTAHAN DI LIMPA (SPLEENOMEGALI)
 MASA HIDUP PLT TURUN
 IMUN MEDIATED: AB PLT
 NON IMUN: KLEP BUATAN..PEMB DARAH SEMPIT HYOERTENSI
 PENINGKATAN DESTRUKSI PLT
 GANGGUAN FUNGSI PLT
DRUGS INDUCED TROMBOCYTOPENIA
o ASPIRIN
o ATORVASTATIN
o AB
 FORMASI ANTIGEN ANTIBODI KOMP .................> PLT DESTRUCTION

HEPARIN INDUCED TROMBOCYTOPENIA

 IMMUNE REACTION AB+PLT FACTOR 4

IMMUNE TROMBOCYTOPENIC PURPUREA

 FORMATION AB PLT......> PLT DESTRUCTION
 TREATMENT CORTICOSTEROID
 GANTI PLASMA
TROMBOCYTOPATHIE
 GANGGUAN FUNGSI PLT
 INHERETED.....GANGGUAN ADESI PLT
 DAPATAN KRN OBAT2AN
OBAT YG BERPENGARUH THD PLT
 Acetazolamide
 Antimetabolite and anticancer drugs
 Antibiotics such as penicillin and the cephalosporins
 Aspirin and salicylates
 Carbamazepine
 Clofibrate
 Colchicine
 Dipyridamole
 Diuretics
 Heparin ,NSAIDs, Quinine derivatives (quinidine and hydroxychloroquine) Sulfonamides
PERDARAHAN KRN FAKTOR BEKUAN DARAH
 DEFISIENSI / GANGGUAN FUNSI FAKTOR BEKUAN DARAH
 HEMOPHILA A(FAKTOR VIII DEF)
 HEMOPHILIA B (FAKTOR IX DEF)
 Px vWF
MANIFESTASI KLINIS
 PERDARAHAN SPONTAN DARI HIDUNG MULUT ATAU GI
 PROLONG BLEEDING TIME
 KADAR PLT NORMAL
TREATMENT
FACTOR VII REPLACEMENT
HINDARI ASPIRIN DAN NSAIDs
PERDARAHAN KARENA PEMBULUH DARAH
 = NONTROMBOCYTOPENIC PURPUREA
 WEAK VESSEL....INFLAMASI / IMMUNE RESPONE
 SPONTAN PTECHIE, PURPUREA, SKIN, MUKUS MEM, SUBKUTAN
 HEMORAGI TALANGIEKTASI...TIPIS LEBAR KAPILER-ARTERIOLE
 DEF VIT C....dinding pemb drh lemah mudah pecah
 CUSHING DISEASE...prot wasting, loss vessel tissue support
 DIC: DESSIMINATED INTRAVASCULAR COAGLOPATION
 KOAGULASI DAN PERDARAHAN MENYELEURUH
 massive activation of the coagulation
 systemic formation of fibrin
 all the major anticoagulants are reduced
 vessel occlusion and tissue ischemia
 Clot formation consumes all available coagulation proteins and platelets,
and severe hemorrhage results.
PATOPHYSIOLOGY OF DIC