Skenario G Blok 23 Tahun 2015 Sekmej

I.
Skenario
Mrs. Lina, 29 years old, attend the primary health centre with her husband. They have been
trying to get pregnant for 3 years but failed. She has regular menstrual cycles, every 28 days.
There was no history of intermenstrual or postcoital bleeding. There was no pain during
her period, no contraception used, no history of drug consumption (including alcohol and
tobacco). She didnt have previous abdominal surgery, no history of allergies, no pelvic
infection and no chronic disease. Her husband (32 years old) is a bank employee. He had no
history of mumps and medication for any disease. He was not smoking and no alcohol
consumption. He also didnt have any allergies. This couple enjoyed regular intercourse.
You act as the doctor in the clinic and be pleased to analyse this case.
In the examination finding:
Wife
Height = 160 cm; Weight 55 kg; BMI= 21 kg/m2; Blood pressure = 110/70 mmHg; Pulse =
80 x/m; RR = 18 x/m.
Palpebral conjunctiva looked normal, no exophthalamus, no sign of hirsutism, no thyroid
enlargement, no galactorrhoea, secondary sexual characteristics are normal.
External examination: abdomen flat and souffle, symmetric, uterine fundal not palpable, there
are no mass, pain tenderness and free fluid sign.
Internal examination:
Speculum examination: portio not livide, external os closed, no fluor, no fluxus, there are no
cervical erotion, laceration or polyp.
Bimanual examination: cervix is firm, the external os closed, uterine size normal, both
adnexa and parametrium within normal limit.
Laboratory examination:
Hb 12 g/dL; WBC 8.000/mm3; RBC 4,3x106/mm3; Ht 36 vol%; platelets 250.000/mm3; ESR
15 mm/hour; blood type A Rh (+); blood film: Normal.
Urine : Normal
* Ultrasound: normal internal genitalia; sonohysterography : normal uterine and both tubal
patency.
Postcoital test : normal
Husband
1
Height= 176 cm; Weight = 72 kg; BMI = 23 kg/m 2; Blood pressure = 120/80 mmHg; Pulse =
76 x/m; RR = 20 x/m.
Palpebra conjuctiva looked normal, no exopthalmus, no thyroid enlargement, no
gynecomastia, secondary sexual characteristics are normal
External examination: abdomen flat and tender, symmetric, no sign of hepatomegaly and
inguinal hernia
Genital examination:
Penis: normal, testes: normal size and volume; scrotum: no varicocele
Lab examination:
Hb 14 g/dL; WBC 8.000/L ; RBC 4,3x106/L ; Ht 42 vol%, Platelets 350.000/L; ESR 6
mm/hour; Blood type O Rh (+); Blood film: Normal, blood chemistry: Normal. Hormonal :
FSH, LH, and testosterone level: Normal.
Urine: Normal
Semen analysis: volume 4.5 ml; sperm concentration 0.1x106/ml; motility 22% forward
progression, 15 % rapid forward progression; morphology 5 %with normal forms.
II.
Klarifikasi Istilah
1. Galactorrhoea : Pembentukan air susu pada pria atau wanita yang tidak sedang dalam masa
menyusui
2. Varicocele : Varikositas pleksus pampiniformis pada funiculus spermatikus yang
membentuk benjolan skrotum dan terasa seperti kantung cacing
3. Hirsutism : Pertumbuhan rambut berlebihan pada wanita dibagian tubuh yang tidak
seharusnya
4. Gynecomastia : Perkembangan kelenjar susu laki-laki yang berlebihan bahkan sampai
tingkat fungsional
5. Intramenstrual bleeding : Perdarahan vagina yang terjadi di antara periode menstruasi
6. Postcoital bleeding : Perdarahan pada vagina setelah melakukan hubungan seksual
7. Sonohysterography : pemeriksaan untuk mendeteksi adanya kelainan pada rongga rahim
dan saluran telur menggunakan USG dan memasukkan cairan saline steril ke dalam rongga
rahim
III.
Identifikasi Masalah
1. Mrs. Lina, 29 years old, attend the primary health centre with her husband (32 years).
This couple enjoyed regular intercourse. They have been trying to get pregnant for 3
years but failed.
2. She has regular menstrual cycles, every 28 days. There was no history of
intermenstrual or postcoital bleeding. There was no pain during her period, no
contraception used, no history of drug consumption (including alcohol and tobacco). She
didnt have previous abdominal surgery, no history of allergies, no pelvic infection and no
chronic disease.
3. Her husband (32 years old) is a bank employee. He had no history of mumps and
medication for any disease. He was not smoking and no alcohol consumption. He also
didnt have any allergies.
4. In the examination finding:

Wife
80 x/m; RR = 18 x/m.
Urine : Normal
patency.
5. Husband
76 x/m; RR = 20 x/m.
inguinal hernia
Lab examination:
Urine: Normal
IV.
Analisis Masalah
1. Mrs. Lina, 29 years old, attend the primary health centre with her husband (32 years). This
couple enjoyed regular intercourse. They have been trying to get pregnant for 3 years but
failed.
a)
Apa makna klinis dari Mrs.Lina sudah mencoba hamil selama 3 tahun tapi gagal?
Balqis,Ayu
b) Bagaimana kriteria pasutri yang dikatakan infertil? Reska, Shabrin

c)
Apa hubungan usia, pekerjaan, sosial ekonomi pasutri dengan infertilitas? Jojo, Adinda
d) Berapa frekuensi coitus yang dianjurkan agar dapat terjadi kehamilan? Niken, Widya
2. She has regular menstrual cycles, every 28 days. There was no history of intermenstrual
or postcoital bleeding. There was no pain during her period, no contraception used, no
4
history of drug consumption (including alcohol and tobacco). She didnt have previous
abdominal surgery, no history of allergies, no pelvic infection and no chronic disease.
a)
Bagaimana makna klinis riwayat Mrs.Lina? Tika, Aqil
b) Bagaimana siklus menstruasi yang normal? Rani, Christian
3. Her husband (32 years old) is a bank employee. He had no history of mumps and
medication for any disease. He was not smoking and no alcohol consumption. He also didnt
have any allergies.
a)
Makna klinis dari riwayat suami? Jojo, Talita
4. In the examination finding:

Wife
80 x/m; RR = 18 x/m.
Urine : Normal
patency.
a)
Interpretasi dan mekanisme abnormal? Zahro Talita

5
b) Bagaimana cara pemeriksaan internal examination (spekulum, bimanual)? Tika, Niken

c)
Bagaimana cara melakukan postcoital test? Edo, Zahro
5. Husband
76 x/m; RR = 20 x/m.
inguinal hernia
Lab examination:
Urine: Normal
a)
b)
c)
d)
Bagaimana interpretasi dan mekanisme abnormal? Ayu, Rani

Bagaimana cara melakukan semen analysis? Christian, Reska
Bagaimana kriteria normal semen analysis? Shabrin, Adinda
Apa indikasi melakukan semen analysis? Edo, Aqil
V. Hipotesis
Pasutri Mrs.Lina (29 yo) dan suaminya (32 yo) mengalami infertilitas primer akibat
faktor suami (oligoastenozoospermia).
a) DD Balqis, Ayu,
b) WDZahro, Widya,
c) Definisi Christian, Adinda,
d) Epidemiologi Reska, Edo,
e) Faktor Resiko Sabrin Aqil
f) Etiologi Tika, Niken,
g) Patofisiologi Jojo, Talita
h) Manifestasi Klinis Rani, Niken
i) Tatalaksana Talita, Zahro
j) Pencegahan Christian, Adinda
k) Komplikasi Reska. Aqil
l) Prognosis Edo, Tika
m) SKDI Shabrin, Ayu
6
VI. Learning Issue

A. Infertilitas (Prioritas utama: Pria) (Balqis, Ayu, Zahro, Widya, Jojo, Talita)
B. Pemeriksaan Lab Penunjang Diagnosis Infertilitas (Christian, Adinda, Reska, Edo,
Sabrin)
C. Ginekologi Examination Test (Tika, Niken, Rani, Aqil)

Skenario G Blok 23 Tahun 2015 Sekmej

Încărcat de

Informații document

Drepturi de autor

Formate disponibile

Partajați acest document

Partajați sau inserați document

Opțiuni de partajare

Vi se pare util acest document?

Este necorespunzător acest conținut?

Drepturi de autor:

Formate disponibile

Skenario G Blok 23 Tahun 2015 Sekmej

Încărcat de

Drepturi de autor:

Formate disponibile

I.

4. In the examination finding:

b) Bagaimana kriteria pasutri yang dikatakan infertil? Reska, Shabrin

Bagaimana makna klinis riwayat Mrs.Lina? Tika, Aqil

b) Bagaimana siklus menstruasi yang normal? Rani, Christian

Makna klinis dari riwayat suami? Jojo, Talita

4. In the examination finding:

Interpretasi dan mekanisme abnormal? Zahro Talita

b) Bagaimana cara pemeriksaan internal examination (spekulum, bimanual)? Tika, Niken

Bagaimana cara melakukan postcoital test? Edo, Zahro

Bagaimana interpretasi dan mekanisme abnormal? Ayu, Rani

VI. Learning Issue

C. Ginekologi Examination Test (Tika, Niken, Rani, Aqil)

S-ar putea să vă placă și