SKENARIO C BLOK 17 TAHUN 2017 Amir, a boy, boy, 13 month, a! ho!"ita#i$%& &'% to &iarrh%a( )o'r &ay! b%*or% a&mi!!ion, a& mi!!ion, th% "ati%nt ha& non "ro+%ti#% -omitin. / tim%! a &ay( H% -omit%& hat h% at%( Thr%% &ay! b%*or% a&mi!!ion th% "ati%nt .ot &iarrh%a 10 tim%! a &ay aro'n& ha#* .#a!! in %-%ry &%*%ation, th%r% a! no b#oo& an& m'o'!"'! in it( Th% *r%'%ny o* -omitin. &%r%a!%&( A#on. tho!% &ay!, h% &ran %a.%r#y an& a! .i-%n "#ain at%r( H% a#!o .ot mi#& *%-%r( 4%!t%r&ay 4%!t%r&ay,, h% #oo%& or!%nin., #%thar.y, #%thar.y, &i&n5t ant to &rin, !ti## ha& &iarrh%a b't n o -omitin.( Th% amo'nt o* 'rination in 6 ho'r! a.o a! #%!! than '!'a#( Amir5! *ami#y #i-%! in !#'m ar%a( hy!ia# %8amination ati%nt #oo! !%-%r#y i##, om"o! m%nti! b't %a 9#%thar.i:, B 70;0 mmH., RR 36 8m, HR 1 8m r%.'#ar b't %a, bo&y t%m"%rat'r% 36,7 oC, B< 10 ., BH 7; m H%a& = !'n%n *rontan%##a, !'n%n %y%, no t%ar! &ro", an& &ry mo'th( Thora8 = !imi#ar mo-%m%nt on both !i&%, r%tration 9>>:, -%!i'#ar br%ath !o'n&, norma# h%art !o'n&( Ab&om%n = *#at, !h'**#%, bo%# !o'n& inr%a!%!( Li-%r i! "a#"ab#% 1 m b%#o ar'! o!ta an& 8i"hoi& "ro%!!'!, !"#%%n 'n"a#"ab#%( inh th% !in o* th% ab&om%n = -%ry !#o#y 9#on.%r than 2 !%on&!:( R%&n%!! !in !'rro'n&in. ana# ori*i%( E8tr%miti%! = o#& han& an& *%%t Laboratory %8amination Hb 12,6 .&#, :, RBC 9>:, "rot%in 9>:, %ton bo&i%! 9@: )%a%! ro'tin% ?aro!o"i = at%r mor% than a!t% mat%ria#, b#oo& 9>:, m'o'! 9>: / H), RBC 0>1 H), bat%ria 9@@:, E( o#i 9@:, *at 9@: I(
K#ari*ia!i I! I!ti#ah a: iarrh%a b: Non "ro+%ti#% -omitin. : omit &: %*%ation %: ?i#& *%-%r *: L%thar.i m%n.ant', &an a"ati!(
= "%n.%#'aran tin+a b%rair b%ra#i a#i yan. ti&a norma#( = m'ntah yan. &itan&ai &%n.an ti&a a&anya !%mb'ran( = "%n.%#'aran i!i #amb'n. m%#a#'i m'#'t( = "%mb'an.an tin+a &ari r%t'm( = "%nin.atan t%m"%rat'r% &i ata! norma#( = "%n'r'nan tin.at %!a&aran &itan&ai &%n.an #%!',
.: S'n%n *rontan%##a h: S'n%n %y%
II(
= 'b'n>'b'n yan. %'n.( = mata yan. t%r#ihat %'n. yan. m%nan&aan !%!%oran.
m%n.a#ami &%hi&ra!i( i: Sh'**#% ab&om%n = &%*an! m'!'#ar 9>: +: Ana# ori*i% = #'ban. an'!( I&%nti*ia!i ?a!a#ah a: Amir, a boy, 13 month, a! ho!"ita#i$%& &'% to &iarrh%a( Th% amo'nt o* 'rination in 6 ho'r! a.o a! #%!! than '!'a#( 9: b: )o'r &ay! b%*or% a&mi!!ion, th% "ati%nt ha& non "ro+%ti#% -omitin. / tim%! a &ay( H% -omit%& hat h% at%( : Thr%% &ay! b%*or% a&mi!!ion th% "ati%nt .ot &iarrh%a 10 tim%! a &ay aro'n& ha#* .#a!! in %-%ry &%*%ation, th%r% a! no b#oo& an& m'o'!"'! in it( Th% *r%'%ny o* -omitin. &%r%a!%&( &: A#on. tho!% &ay!, h% &ran %a.%r#y an& a! .i-%n "#ain at%r( H% a#!o .ot mi#& *%-%r( %: 4%!t%r&ay, h% #oo%& or!%nin., #%thar.y, &i&n5t ant to &rin, !ti## ha& &iarrh%a b't no -omitin.( *: Amir5! *ami#y #i-%! in !#'m ar%a( .: hy!ia# %8amination ati%nt #oo! !%-%r#y i##, om"o! m%nti! b't %a 9#%thar.i:, B 70;0 mmH., RR 36 8m, HR 1 8m r%.'#ar b't %a, bo&y t%m"%rat'r% 36,7 oC, B< 10 ., BH 7; m H%a& = !'n%n *rontan%##a, !'n%n %y%, no t%ar! &ro", an& &ry mo'th( Thora8 = !imi#ar mo-%m%nt on both !i&%, r%tration 9>>:, -%!i'#ar br%ath !o'n&, norma# h%art !o'n&( Ab&om%n = *#at, !h'**#%, bo%# !o'n& inr%a!%!( Li-%r i! "a#"ab#% 1 m b%#o ar'! o!ta an& 8i"hoi& "ro%!!'!, !"#%%n 'n"a#"ab#%( inh th% !in o* th% ab&om%n = -%ry !#o#y 9#on.%r than 2 !%on&!:( R%&n%!! !in !'rro'n&in. ana# ori*i%( E8tr%miti%! = o#& han& an& *%%t h: Laboratory %8amination Hb 12,6 .&#,
Urin% ro'tin% ?aro!o"i = y%##oi!h o#o'r, ?iro!o"i = :, RBC 9>:, "rot%in 9>:, %ton bo&i%! 9@: )%a%! ro'tin% ?aro!o"i = at%r mor% than a!t% mat%ria#, b#oo& 9>:, m'o'! 9>: / H), RBC 0>1 H), bat%ria 9@@:, E( o#i 9@:, *at 9@: I(
Ana#i!i! ?a!a#ah a: Amir, a boy, 13 month, a! ho!"ita#i$%& &'% to &iarrh%a( Th% amo'nt o* 'rination in 6 ho'r! a.o a! #%!! than '!'a#( 9: 1( A"a h'b'n.an '!ia, +%ni! %#amin &%n.an a!'! 1 2( Ba.aimana *r%'%n!i &an on!i!t%n!i BAB norma# bayi 13 b'#an 1 3( A"a in&ia!i raat ina" "a&a a!'! &iar% ana 1 ( Ba.aimana #a!i*ia!i &ari &iar% 1 ;( Ba.aimana "ato*i!io#o.i &ari &iar% 1 /( Ba.aimana tata #a!ana aa# &iar% "a&a ana 1 7( ?%n.a"a 'rin% 6 +am yan. #a#' !%&iit &ari"a&a bia!anya 2 6( A"a "%ny%bab &iar% t%r!%rin. "a&a ana 13 b'#an 1 D( A"a !a+a or.an yan. t%r#ibat "a&a a!'! 1 10( B%ra"a -o#'m% &an *r%'%n!i norma# 'rin% bayi 13 b'#an 2 b: )o'r &ay! b%*or% a&mi!!ion, th% "ati%nt ha& non "ro+%ti#% -omitin. / tim%! a &ay( H% -omit%& hat h% at%( 1( Ba.aimana m%ani!m% m'ntah "a&a a!'! 7 2( Ba.aimana #a!i*ia!i m'ntah 7 3( A"a !a+a yan. m%ny%baban m'ntah non "ro+%ti#% 7 ( Ba.aimana h'b'n.an m'ntah &an &iar% "a&a a!'! 7 ;( A"a &am"a &ari m'ntah / a#i !%hari 7 /( A"a !a+a maanan !i!i"an yan. #aya 'nt' bayi 13 b'#an 7 7( A"a mana baha ia m%m'ntahan a"a"'n yan. ia maan 7 6( Ba.aimana "%rb%&aan m'ntah "ro+%ti#% &an non "ro+%ti#% 7 D( A"a !a+a yan. maanan yan. &a"at m%mi' m'ntah "a&a bayi 13 b'#an 7 : Thr%% &ay! b%*or% a&mi!!ion th% "ati%nt .ot &iarrh%a 10 tim%! a &ay aro'n& ha#* .#a!! in %-%ry &%*%ation, th%r% a! no b#oo& an& m'o'!"'! in it( Th% *r%'%ny o* -omitin. &%r%a!%&( 1( A"a mana &ari &iar% 10 a#i !%hari !%banya !%t%n.ah .%#a! 1 2( ?%n.a"a *r%'%n!i m'ntah m%n'r'n 1 3( A"a mana ti&a &it%m'annya &arah &an m''! 1
( A"aah a&a h'b'n.an *r%'%n!i &iar% &%n.an tin.at %"arahan &%hi&ra!i 1 2 &: A#on. tho!% &ay!, h% &ran %a.%r#y an& a! .i-%n "#ain at%r( H% a#!o .ot mi#& *%-%r( 1( Ba.aimana m%ani!m% &%mam "a&a a!'! 7 2( Ba.aimana h'b'n.an min'm yan. #aha" &%n.an tin.at %"arahan &%hi&ra!i 2 7 3( Cairan a"a yan. !%bainya &ib%rian %"a&a "a!i%n "a&a a!'! 1 2 ( Ba.aimana h'b'n.an &%mam &%n.an m'ntah &an &iar% "aa a!'! 1 2 7 %: 4%!t%r&ay, h% #oo%& or!%nin., #%thar.y, &i&n5t ant to &rin, !ti## ha& &iarrh%a b't no -omitin.( 1( Ba.aimana m%ani!m% t%r+a&inya #%thar.i 2( Ba.aimana %a&aan amir !%aran. &%n.an #a!i*ia!i &%hi&ra!i 2 3( A"a mana #ini! &ari #%thar.i, ti&a ma' min'm "a&a a!'! 2 *: Amir5! *ami#y #i-%! in !#'m ar%a( 1( Ba.aimana h'b'n.an #in.'n.an &%n.an &iar% "a&a a!'! 1 .: hy!ia# %8amination ati%nt #oo! !%-%r#y i##, om"o! m%nti! b't %a 9#%thar.i:, B 70;0 mmH., RR 36 8m, HR 1 8m r%.'#ar b't %a, bo&y t%m"%rat'r% 36,7 oC, B< 10 ., BH 7; m H%a& = !'n%n *rontan%##a, !'n%n %y%, no t%ar! &ro", an& &ry mo'th( Thora8 = !imi#ar mo-%m%nt on both !i&%, r%tration 9>>:, -%!i'#ar br%ath !o'n&, norma# h%art !o'n&( Ab&om%n = *#at, !h'**#%, bo%# !o'n& inr%a!%!( Li-%r i! "a#"ab#% 1 m b%#o ar'! o!ta an& 8i"hoi& "ro%!!'!, !"#%%n 'n"a#"ab#%( inh th% !in o* th% ab&om%n = -%ry !#o#y 9#on.%r than 2 !%on&!:( R%&n%!! !in !'rro'n&in. ana# ori*i%( E8tr%miti%! = o#& han& an& *%%t 1( 2( 3( ( ;( /(
Ba.aimana int%r"r%ta!i &ari "%m%ri!aan *i!i "a&a a!'! Ba.aimana m%ani!m% abnorma# Ba.aimana ara m%n%nt'an &%ra+at &%hi&ra!i 2 Ba.aimana .ra*i "%rt'mb'han ana '!ia 13 b'#an A"a yan. &ima!'& &%n.an om"o! m%nti! b't %a 9#%thar.i: Ba.aimana .ambaran &ari !'n%n *ontan%##a, !'n%n %y%, &ry mo'th "a&a a!'!
7( imana &an ba.aimana ara "%m%ri!aan t'r.or '#it 6( Ba.aimana ara "%mri!aan *i!i ab&om%n "a&a ana h: Laboratory %8amination Hb 12,6 .&#, :, RBC 9>:, "rot%in 9>:, %ton bo&i%! 9@: )%%! ro'tin% ?aro!o"i = at%r mor% than a!t% mat%ria#, b#oo& 9>:, m'o'! 9>: / H), RBC 0>1 H), bat%ria 9@@:, E( o#i 9@:, *at 9@:
II(
III(
1( Ba.aimana int%r"r%ta!i &ari "%m%ri!aan #aboratori'm "a&a a!'! ; 2( Ba.aimana m%ani!m% abnorma# ; 3( Ba.aimana ara "%m%ri!aan #ab 'rin% ro'tin% ; ( Ba.aimana ara "%m%ri!aan #ab *%%! ro'tin% ; ;( Ba.aimana !orin. &a#am "%m%ri!aan bat%ri "a&a *%%! ; Hi"ot%!i! Amir, 13 b'#an, m%n&%rita &iar% a't &%n.an &%hi&ra!i b%rat %m'n.inan ar%na rota -ir'!( a: b: : &: %: *: .: h: i: +: : #: m: n: o: ": : LI
%*ini!i ia.no!i! K%r+a A#.oritma %n%.aan ia.no!i! K#a!i*ia!i Etio#o.i E"i&%mio#o.i )ator ri!io ato*i!io#o.i ato.%n%!i! %m "%n'n+an. ?ani*%!ta!i #ini! Kom"#ia!i Tata #a!ana ro.no!i! %n%.ahan &an %&'a!i SKI
1( 2( 3( ( ;( /( 7(
iar% 13 / 7 ; 1 %hi&ra!i 12 ; 6 3 Anatomi, hi!to"ato#o.i '!'! 11 10 %m*i! 10 3 D 2 %m#ab D 2 11 )i!io#o.i '!'! 6 1 12 ?%ani!m% .%+a#a 7 13 /
riani%rnaymai#(om LI AN AN?AL KIRI?FF
