Skenario A Blok

16 Tahun 2015
Tutor :
dr. Aida Farida, Sp.PA

Nama Kelompok
Tri Kurniawan

04011281320019
RA Deta Hanifah 04011281320023
Rofaqo Hakki 04011281320049
Revana Pramudita K 04011381320001
Nina VellaRizky
04011181320051
Abdiaman Putra Dawolo 04011181320075
Iqbal Fahmi 04011181320031
Bella Bonita04011181320043
M. Mardian Safitra 04011181320059
Yeni Meita 04011181320087
Rani Juliantika 04011181320089
Dwi Nopianti 04011181320101

Outline
Judul
Nama Kelompok
Outline
Skenario
Klarifikasi Istilah
Identifikasi Masalah
Anilisis Masalah
Learning Issue
Keranngka Konsep
Kesimpulan

Skenario
Mr. Y, a 40-year old, sailor, was admitted to hospital with hemoptoe. He
complained that 6 hours ago he had a severe bout of coughing with fresh
blood of about 2 glasses. He also said that in the previous month he had had
productive cough with a lot of phlegm, mild fever, loss of appetite, rapid loss
of body weight (previous weight: 70 kg), and shortness of breath. Since a
week ago, he felt his symptoms were worsening.
Physical examination :
General appearance : he looked severely sick and pale. Body height : 175 cm.
Body weight: 55 kg BP: 100/70 mmHg, HR: 112x/minute, RR: 36x/minute,
temp 37,6 C.
There was a tattoo on the chest and lymphadenopaty of the right neck, and
stomatitis.
In chest auscultation the was increase of vesicular sound at the right upper
lung with moderate rales.
Additional information:
Laboratory :
Hb : 8,5 g%, WBC : 6.000/L, ESR 65 mm/hr, Diff Count : 0/3/2/75/15/5, Acid
Fast Bacili : (-), HIV test (+), CD4 120/L,
Radiology :
Chest radiograph showed infiltrate at right lower lung.

Klarifikasi Istilah
Hemoptoe
Batuk Produktif
Phlegm
Demam Ringan
Sesak Nafas
Sakit Berat
Lymphadenopaty
Stomatitis
Suara vesikuler
Ronki Sedang

Identifikasi Masalah
Mr. Y, a 40-year old, sailor, was admitted to

hospital with hemoptoe. He complained that 6

hours ago he had a severe bout of coughing
with fresh blood of about 2 glasses.
He also said that in the previous month he
had had productive cough with a lot of
phlegm, mild fever, loss of appetite, rapid loss
of body weight (previous weight: 70 kg), and
shortness of breath. Since a week ago, he felt
his symptoms were worsening.

Physical examination :

General appearance : he looked severely

sick and pale. Body height : 175 cm. Body
weight: 55 kg BP: 100/70 mmHg, HR:
112x/minute, RR: 36x/minute, temp 37,6 C.
There was a tattoo on the chest and
lymphadenopaty of the right neck, and
stomatitis.
In chest auscultation the was increase of
vesicular sound at the right upper lung with
moderate rales.

Additional information:
Laboratory :

Hb : 8,5 g%, WBC : 6.000/L, ESR 65

mm/hr, Diff Count : 0/3/2/75/15/5, Acid Fast
Bacili : (-), HIV test (+), CD4 120/L,
Radiology :
Chest radiograph showed infiltrate at right
lower lung.

Analisis Masalah
Mr. Y, a 40-year old, sailor, was admitted to

hospital with hemoptoe. He complained that 6

hours ago he had a severe bout of coughing
with fresh blood of about 2 glasses.
a. Bagaimana anatomi dan fisiologi saluran pernafasan?
b. Apa hubungan umur,jenis kelamin, dan pekerjaan
dengan keluhan?
c. penyakit/gangguan apa yang disertai batuk darah?
d. bagaimana patofisiologi batuk darah?
e. apa dampak batuk darah sekitar 2 gelas selama 6
jam?

f. apa saja kemungkinan penyebab batuk

darah?
g. apa saja factor resiko terjadinya batuk darah?
h. Bagaimana klasifikasi dan kriteria batuk
darah?

He also said that in the previous month he

had had productive cough with a lot of

phlegm, mild fever, loss of appetite, rapid
loss of body weight (previous weight: 70
kg), and shortness of breath. Since a week
ago, he felt his symptoms were worsening.
a. Bagaimana patofisiologi dari :
- batuk produktif dengan banyak dahak
- demam ringan
- hilang nafsu makan
-kehilangan berat badan
-sesak nafas

b. mengapa batuk berdarah pada tn. Y dapat

menjadi batuk berdarah dalam 1 bulan?
c. bagaimana perbedaan batuk produktif dan
non produktif?
d. bagaimana mekanisme terbentuknya dahak
dihubungkan dengan pertahanan tubuh?
e. bagaimana klasifikasi dan tipe demam?
f. bagaimana klasifikasi dahak?
g. apa saja jenis-jenis sesak nafas?
h. Bagaimana korelasi antar hubungan?

Physical examination :

General appearance : he looked severely

sick and pale. Body height : 175 cm. Body
weight: 55 kg BP: 100/70 mmHg, HR:
112x/minute, RR: 36x/minute, temp 37,6 C.
There was a tattoo on the chest and
lymphadenopaty of the right neck, and
stomatitis.
In chest auscultation the was increase of
vesicular sound at the right upper lung with
moderate rales.

a. bagaimana interpretasi dan mekanisme

abnormal?
b. bagaimana hubungan tattoo dengan kasus?
c. bagaimana membedakan lympadenopati dengan
benjolan lain di region leher? rani
d. mengapa bunyi vesikuler pada kasus meningkat?
e. bagaimana jenis-jenis suara paru?
f. bagaimana gambaran histopatologi
lympadenopaty?
g. kemungkinan penyakit dari rales sedang
terdengar di paru kanan bagian apex?

Additional information:
Laboratory :

Hb : 8,5 g%, WBC : 6.000/L, ESR 65 mm/hr, Diff

Count : 0/3/2/75/15/5, Acid Fast Bacili : (-), HIV
test (+), CD4 120/L,
Radiology :
Chest radiograph showed infiltrate at right lower
lung.
a. bagaimana interpretasi dan mekanisme
abnormal?
b. bagaimana cara pemeriksaan BTA?

c. Apa saja DD dari infiltrate di paru kanan bagian

bawah?
d. apa saja pemeriksaan penunjang yang akan
dilakukan untuk menentukan diagnosis?
e. apa diagnosis kerja?
f. apa definisi dari diagnosis?belbon
g. apa epidemiologi dari diagnosis?
h. apa etiologi dari diagnosis?
i. apa factor resiko dari diagnosis?
j. bagaimana patofisiologi dari diagnosis?
k. bagaimana pathogenesis dari diagnosis?

l. apa saja gejala klinis dari diagnosis?

m. apa saja terapi yang harus diberikan?
n. bagaimana cara pencegahannya?
o. apa komplikasi dari diagnosis?
p. bagaimana prognosis dari diagnosis?
q. jelaskan skdi dari diagnosis?

Learning Issue
a. anatomi dan fisiologi system pernafasan
b. TB paru
c. imunologi sist respirasi

Keranngka Konsep

Kesimpulan
Tn. Y, 40 tahun seorang pelaut menderita TB

paru dengan BTA negativ dan HIV positif

dengan keluhan batuk darah, hilang nafsu
makan, penurunan berat badan, demam
ringan dan sesak nafas yang semakin lama
semakin memburuk

Terima kasih