CASE DR.CUT ppt

7/23/2019 CASE DR.CUT ppt

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TUBERCULOSIS PARUDEVI KHARISMA

AINUN ZAMIRA

INTAN CANTIKALUTHFITA RAHMAWATI

PEMBIMBING:

Dr. Cut Yuli ! S".P


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IDENTITAS PASIEN

N# : T$. I$%r

U#ur : &' t(u$

)*$i+ ,*l#i$ : L,i-l,i

Al#t : C*#", Puti( Brt IV

T$l MRS : /' S*"t*#0*r &/12


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ANAMNESIS

K*lu($ Ut#

N3*ri %% ,$$ +*4, 5 (ri SMRS

K*lu($ T#0($

S*+,! 0tu,! %*##! "*$uru$$ 0*rt 0%$!

$6+u #,$ #*$uru$! l*#+


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Ri73t P*$3,it S*,r$

P+i*$ #+u, RSI)CP %*$$ ,*lu($ $3*ri "% %% ,$$ 3$

(*0t %$ %i+*rti %*$$ +*+, $6+. N3*ri %% %ir+,$+*#,i$ 0*rt#0( ,*ti, 0*r$6+. N3*ri %ir+,$ "% %%

,$$ %$ ti%, #*$4lr. N3*ri %ir+,$ +*4, 5 (ri SMRS.

S*0*lu#$3 "+i*$ 0*lu# "*r$( #*$*lu( $3*ri %% %i+*rti

+*+, $6+. P+i*$ 4u #*$*lu( 0tu, 0*r%(, +*4, 1 #i$u

SMRS! 0tu, 0*r%(, 0*r7r$ ,u$i$! ,*$tl. P+*i$ 4u #*r+

%*## +*4, 5 (ri SMRS! %*## %ir+,$ $i, turu$! #*$iil

ti%, %. Flu %i+$,l! #ul %$ #u$t( ti%, %. P+i*$ 4u#*r+ 0*rt 0%$ +*#,i$ #*$uru$ %$ ,(ir-,(ir i$i "+i*$

4r$ #,$ %$ #u%( #*r+ l*#+


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Ri73t P*$3,it D(ulu P+i*$ 0*lu# "*r$( #*$l#i ,*lu($ $3*ri %%

+*0*lu#$3

P+i*$ "*r$( #*$l#i Tu0*r8ul9+i+ & t(u$ 3$ llu %$"*$90t$ tu$t+

Ri73t Di0*t*+ M*litu+ %i+$,l

Ri73t Hi"*rt*$+i %i+$,l

Ri73t P*$3,it K*lur K*lur ti%, "*r$( #*$l#i ,*lu($ 3$ +#

%*$$ "+i*$

P#$ "+i*$ "*r$( #*$l#i ,*lu($ 0tu, 0*r%(,+*4, ,ur$ l*0i( & #i$u 3$ llu.

K*lur "+i*$ ti%, #*#ili,i "*$3,it Hi"*rt*$+i! Di0*t*+M*litu+.

Ri73t Al*ri

Al*ri #,$$! 90t-90t$ %$ 8u8 %i +$,l


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Ri73t P*$90t$

P+i*$ "*r$( #*$,9$+u#+i 90t TB & t(u$ 3$ llu

+*8r tu$t+

Ri73t P+i,9+9+il

P+i*$ #,$ ti%, t*rtur

P+i*$ +*ri$ #*r9,9, 1 0u$,u+ "*r(ri +*l# t(u$


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PEMERIKSAAN FISIK

K*%$ u#u# : T#", S,it S*%$

K*+%r$ : C9#"9+ M*$ti+ GCS 12

Sttu+ i;i

BB +*0*lu# +,it : < ,

BB ,*ti, +,it : 2 ,

TB : 1=5 8# K*+i#"ul$ : 1=!> ?u$%*r7*i(t@

T$% itl

T*,$$ %r( : 1&/


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Sttu+ G*$*rli+ K*"l : $9r#98*"(l

Mt : ,9$4u$ti $*#i+ --! +,*lr i,t*ri, --

Hi%u$ : $9r#9$i

T*li$ : $9r#9ti! +*ru#$ ?-@

Mulut : 6ri$ (i"*r*#i+ ?-@! #u,9+ 0i0ir ,*ri$

T(9r

Pru-"ru

I$+"*,+i : "*r*r,$ %% ti%, +i#*tri+! *r,$ %% t*rti$l "% %%

,$$

Pl"+i: 98l 6r*#itu+ ti%, t*r0 +#! l*0i( ,ut "% %% ,iri!

t*r0 #+ "% li$* ilri+ "9+t*ri9r ICS =-' %*$$ %i#*t*r 8#!

,9$+i+t*$+i ,*$3l! "*r#u,$ rt! #90il*! t*r0 $3*ri.

P*r,u+i : +9$9r "% "ru ,iri! %$ "*ru0($ +9$9r ,* r*%u" "% li$*

#i%,li,ulri+ ,$$ ICS -2 %$ "% li$* ilri+ ,$$ $t*ri9r ICS

-2

Au+,ult+i : *+i,ulr #*$uru$ "% l"$ 07( "ru! r9$,(i ,+r "%l"$

t+ ?@


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T(9r

)$tu$

I$+"*,+i : I8tu+ 89r%i+ ti%, t*rli(t

Pl"+i : I8tu+ 89r%i+ ti%, t*r0

P*r,u+i

Bt+ t+: li$* "r+t*r$li+ %*tr ICS II

Bt+ ,$$ : li$* "r+t*r$li+ %*tr ICS V

Bt+ ,iri : li$* #i%,li,ul +i$i+tr ICS V

Au+,ult+i : Bu$3i 4$tu$ 1 %$ & r*ulr! ll9" ?-@!#ur#ur ?-@


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A0%9#*$

I$+"*,+i : %tr! +8r ?-@

Au+,ult+i : 0i+i$ u+u+ ?@ 1/#*$it! $9r#l

Pl"+i: #++ ?-@! $3*ri t*,$ "% (i"989$%ri8 ,$$

P*r,u+i: ti#"$i %i +*luru( ,u%r$ 0%9#*$

E,+tr*#it+

Su"*ri9r : A,rl ($t! *%*# ?-@! +i$9+i+ ?-@! RCT &

%*ti,

I$6*ri9r : A,rl ($t! *%*# ?-@! +i$9+i+ ?-@! RCT &

%*ti,


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PEMERIKSAAN PENUN)ANG


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-RAY THORA PA LATERAL


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RESUME


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DAFTAR MASALAH

E6u+i "l*ur *.8 TB Pru R*8urr*$t


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ASSESMENT E6u+i "l*ur *.8 TB Pru R*8urr*$t

S: P+i*$ #+u, RSI)CP %*$$ ,*lu($ $3*ri "% %%

,$$ 3$ (*0t %$ %i+*rti %*$$ +*+, $6+.N3*ri %% %ir+,$ +*#,i$ 0*rt#0( ,*ti,0*r$6+. N3*ri %ir+,$ +*4, 5 (ri SMRS. P+i*$ 4u#*$*lu( 0tu, 0*r%(, +*4, 1 #i$u SMRS! 0tu,0*r%(, 0*r7r$ ,u$i$! ,*$tl. P+*i$ 4u #*r+%*## +*4, 5 (ri SMRS! %*## %ir+,$ $i, turu$.P+i*$ 4u #*r+ 0*rt 0%$ +*#,i$ #*$uru$ %$,(ir-,(ir i$i "+i*$ 4r$ #,$ %$ #u%( #*r+l*#+. P+i*$ "*r$( #*$l#i Tu0*r8ul9+i+ & t(u$

3$ llu. P#$ "+i*$ "*r$( #*$l#i ,*lu($0tu, 0*r%(, +*4, ,ur$ l*0i( & #i$u 3$ llu.P+i*$ "*r$( #*$,9$+u#+i 90t TB & t(u$ 3$ llu+*8r tu$t+. P+i*$ +*ri$ #*r9,9, 1 0u$,u+ "*r(ri+*l# t(u$.


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O : ,*%$ u#u# t#", +,it +*%$! +ttu+ i;iu$%*r7*i(t ?1=!>@. Pru-"ru : I$+"*,+i : "*r*r,$

%% ti%, +i#*tri+! *r,$ %% t*rti$l "% %%,$$. Pl"+i: 98l 6r*#itu+ ti%, t*r0 +#! l*0i(,ut "% %% ,iri! t*r0 #+ "% li$* ilri+"9+t*ri9r ICS =-' %*$$ %i#*t*r 8#! ,9$+i+t*$+i,*$3l! "*r#u,$ rt! #90il*! t*r0 $3*ri. P*r,u+i :

+9$9r "% "ru ,iri! %$ "*ru0($ +9$9r ,* r*%u" "%li$* #i%,li,ulri+ ,$$ ICS -2 %$ "% li$*ilri+ ,$$ $t*ri9r ICS -2. Au+,ult+i : *+i,ulr#*$uru$ "% l"$ 07( ,*%u "ru! r9$,(i ,+r"% l"$ t+ ,*%u "ru ?@. P% "*#*ri,+$

0%9#*$ %i%"t,$ $3*ri t*,$ "% (i"98r%i8%*tr


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A: E6u+i "l*ur DD P*$*0l$ "l*ur *.8 +u+"*,TB Pru R*8urr*$t

Pl$$i$

P*#*ri,+$ USG T(9r! +r$ "*#*ri,+$CT S8$ t(9r %*$$ ,9$tr+

DOTS ?9rl@ 1 & t0 G+tri%i$ ?9rl@ &1

A+# M*6*$#t ?9rl@ 51

Str*"t9#38i$ IM %9+i+ 12#,BB(ri

122, ='2 #(ri

Cir$ : A+*ri$ 1& 4#


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TUBERCULOSIS PARU


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DEFINISI

TB Paru adalah penyakit menular langsung yang

disebabkan oleh Mycobacterium tuberculosis yangmenyerang jaringan (parenkim) paru, tidak termasuk

pleura (selaput paru). (DepKes, !"").

Tuberkulosis adalah penyakit menular langsung yang

disebabkan oleh kuman TB (Mycobacterium

tuberculosis). (DepKes, !"")


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EPIDEMIOLOGI

Gambar . Insidens TB didunia (WHO, 2004)


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ETIOLOGI

P*$3*00 tu0*r8ul9+i+ %l(Mycobacterium tuberculosis, +*4*$i+ ,u#$0*r0*$tu, 0t$ %*$$ u,ur$ "$4$ 1-u# %$ t*0l /!5-/!=u#

Si6t ,(u+u+ 3itu t($ t*r(%" +# "%"*7r$$! 9l*( ,r*$ itu %i+*0ut "ul+*0i B+il T($ A+# ?BTA@

Ku#$ TB 8*"t #ti %*$$ +i$r #t(ril$+u$

D t 0*rt($ (i%u 0*0*r #


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PATOGENESISKuman

TB Droplet l!eolus

"a#ro$a%

Di&an'ur#an

Ber#emban%Bia#

"atio#usrimerGo&n

*al. +im$e

+im$an%itis

+im$adenitis

Komple#srimer


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Gambar 3.1. Patogenesis tuberkulosis3


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"I-*T*I K+IIK

G*4lr*+"irt9ri,

Btu, i$u

Btu, %r(

S*+, $"+ N3*ri %%

G*4l +i+t*#i,

%*## #li+* K*ri$t

#l# $9r*,+i BB


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PEMERIKSAAN FISIK

K9$4u$ti $*#i+ %$ ,ulit "u8t

Su(u %*## ?+u06*0ri+@

B%$ ,uru+

P*r,u+i : r*%u"

Au+,ult+i : +ur 0r9$,il

Sur $"+ t#0($ : r9$,i 0+(! ,+r! $3ri$

P*$*0l$ "l*ur : *+i,ul*r #*l*#(


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P*#*ri,+$ R%i9l9i, P*#*ri,+$ %r( : LED P*#*ri,+$ +"utu# : %i$9+i+

"+ti BTA ?@ P*#*ri,+$ u4i Tu0*r,uli$ ?#$t9u

t*+@

P*#*ri,+$ "*$u$4$


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ALUR DIAGNOSIS


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PENATALAKSANAAN

P*$90t$ TB 0*rtu4u$ :

1. M*$3*#0u(,$ "+i*$&. M*$8*( ,*#ti$

5. M*$8*( ,*,#0u($

. M*#utu+,$ r$ti "*$ulr$ %$#*$8*(

t*r4%i$3 r*+i+t*$+i ,u#$ t*r(%"OAT


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PADUAN OAT YANG DIGUNAKAN DI

INDONESIA

Kt*9ri 1 : &?HRZE@?HR@5.

Kt*9ri & : &?HRZE@S?HRZE@2?HR@5E5

Di+#"i$ ,*%u ,t*9ri i$i! %i+*%i,$ "%u$90t +i+i"$ ?HRZE@

O0t 3$ %iu$,$ %l# ttl,+$ "+i*$ TBr*+i+t$ 90t %i I$%9$*+i t*r%iri %ri OAT li$i ,*-&3itu K$#38i$! C"r*9#i+i$! L*9J9,++i$!Et(i9$#i%*! +i,l9+*ri$ %$ PAS! +*rt OAT li$i-1!3itu "ir;i$#i% $% *t#0ut9l.


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P%u$ OAT ,t*9ri-1 %$ ,t*9ri-& %i+*%i,$%l# 0*$tu, ",*t 0*ru" 90t ,9#0i$+i %9+i+ t*t"?OAT-KDT@. T0l*t OAT KDT i$i t*r%iri %ri ,9#0i$+i &

tu 4*$i+ 90t %l# +tu t0l*t. D9+i+$3%i+*+ui,$ %*$$ 0*rt 0%$ "+i*$. P%u$ i$i%i,*#+ %l# +tu ",*t u$tu, +tu "+i*$.

P,*t K9#0i",. A%l( ",*t 90t l*"+ 3$ t*r%iri%ri I+9$i+i%! Ri6#"i+i$! Pir;i$#i% %$ Et#0ut9l3$ %i,*#+ %l# 0*$tu, 0li+t*r. P%u$ OAT i$i%i+*%i,$ "r9r# u$tu, %iu$,$ %l#"*$90t$ "+i*$ 3$ #*$l#i *6*, +#"i$ OAT

KDT.


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TATALAKSANA


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TERIMA KASIH

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CASE DR.CUT ppt

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