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IPD Flashcards

1
Q

Gejala klasik DM?

A

Poliuria, polidipsi, polifagi, penurunan bb

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2
Q
A
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3
Q

Kriteria diagnosis DM?

A

HbA1C ≥ 6,5
GDP ≥ 126
G2PP ≥ 200
GDS ≥ 200 + GEJALA KLASIK DM
TTGO ≥ 200

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4
Q

Kriteria diagnosis prediabetes?

A

HbA1C = 5,7 - 6,4
GDP = 100-125
G2PP = 140-199

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5
Q

Kriteria GDPT?

A

GDP 100-125
TTGO < 140

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6
Q

Kriteria TGT (Toleransi Glukosa Terganggu)

A

GDP <100
TTGO 140-199

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7
Q

Nilai normal berapa?
Hba1c :
GDP :
GD2PP :

A

Hba1 c: <5,7
GDP : 70-99
GD2PP : 70-139

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8
Q

Empat pilar tatalaksana DM?
1.
2.
3.
4.

A
  1. Edukasi
  2. Diet
  3. Aktivitas fisik
  4. Obat (OHO dan insulin)
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9
Q

golongan Obat DM apa saja ? contoh obatnya?

A
  1. insulin sensitizer = metformin, thiazolidinedione
  2. insulin secretagogue = sulfonilurea, glinid
  3. DPP-4 inhibitor = alogliptin, linagliptin, dll
  4. alfa-glukosidase inhibitor = acarbose
  5. SGLT-2 inhibitor = empagliflozin, dll
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10
Q

Pasien DM, Hba1c <7.5%
Apa tatalaksananya?

A

Monoterapi:
Metformin
Sulfonilurea/glinid
Alfa glukosidase inhibitor
Tiazolidinedion
DPP4 inhibitor
SGLT 2 inhibitor
Agonis GLP-1

*Bila Hba1c belum mencapai <7% dalam 3 bulan, maka kombinasi 2 obat

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11
Q

Pasien DM, Hba1c nya ≥ 7.5%
Apa tatalaksananya?

A

Kombinasi 2 obat dengan mekanisme yang berbeda:
Metformin
Sulfonilurea/glinid
Alfa glukosidase inhibitor
Tiazolidinedion
DPP4 inhibitor
SGLT 2 inhibitor
Agonis GLP-1

*Bila Hba1c belum mencapai <7% dalam 3 bulan, maka kombinasi 3 obat

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12
Q

Pasien DM, Hba1c >9%, gejala klinis (-)
apa tatalaksananya?

A

Kombinasi 2 obat atau kombinasi 3 obat

Metformin
Sulfonilurea/glinid
Alfa glukosidase inhibitor
Tiazolidinedion
DPP4 inhibitor
SGLT 2 inhibitor
Agonis GLP-1

*Bila Hba1c belum mencapai <7% dalam 3 bulan, maka ikuti alur nya

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13
Q

Pasien DM, Hba1c >9%, gejala klinis (+)
apa tatalaksananya?

A

Insulin ± obat lain

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14
Q

Target t

A
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15
Q

Target terapi DM?
IMT:
TD Sistol :
TD Diastol :
HbA1C:

A

IMT: 18,5 - 22,9
TD Sistol : <140
TD Diastol : <90
HbA1C: <7

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16
Q

Target terapi DM?
gula darah pre prandial :
gd2pp :
LDL :
Trigliserida :
HDL :
Apo-B :

A

gula darah pre prandial : 80-130
gd2pp : <180
LDL : <100, <70 bila risiko KV sangat tinggi
Trigliserida : <150
HDL : >40 (laki), >50 (perempuan)
Apo-B : <90

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17
Q

GD2PP≥200 + gejala klasik dm
GDS≥ 200 + gejala klasik dm
C-peptide rendah
Dx?

A

DM Tipe 1

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18
Q

Hiperglikemia (300-600)
tanda dan gejala asidosis
plasma keton (+)
dx?

A

KAD

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19
Q

hiperglikemia berat (600-1200)
tanpa tanda da gejala asidosis
osmolaritas plasma meningkat (330-380)
plasma keton (+/-)

dx?

A

HHS

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20
Q

Tatalaksana krisis hiperglikemia?

A
  1. Cairan isotonik
    - 1 L/jam Nacl 0.9%
  2. KCL jika hipo/normokalemia
  3. insulin bolus 0,05-0,1U/kgBB lanjut 0,1 U/kgBB/jam IV drip
  4. Koreksi HCO3

*pemberian cairan harus melihat status dehidrasinya
- kalo sever hipovolemia= nacl 0,9% 1L/jam
- mild dehydration= evaluasi Na Corrected.
normal atau high Na: pakai 0,45% NacL 250-500ml/jam
low Na = nacl 0.9% (250-500ml/jam)

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21
Q

Whipple’s triad hipoglikemia?
1.
2.
3.

A
  1. Terdapat gejala hipoglikemia
  2. GDS< 70 mg
  3. gejala berkurang dengan pengobatan
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22
Q

Pasien tidak memerlukan bantuan orang lain untuk memberika glukosa oral
Derajat hipoglikemia?

A

Hipoglikemia ringan

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23
Q

Pasien membutuhkan bantuan orang lain untuk memberika glukosa iv, glukagon, dll.
Derajat hipoglikemia?

A

Hipoglikemia berat

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24
Q

Tatalaksana Hipoglikemia Ringan?

A

Glukos 15-20gr (2-3 sendok makan gula pasir) dilarutkan dalam air

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25
Q

Tatalaksana hipoglikemia berat?

A

D10% 150 ml dalam 15 menit
or
D40% 25 ml dalam 15 menit

Maintanance D10% 100ml/jam jika GD sudah mencapai target

Target ≥ 70

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26
Q

Klinis: poliuria, polidipsi
Penunjang:
urinalisa berat jenis urin rendah (<1.005 mOSm)
water deprivation test-> osmolalitas urin tidak berubah
uji desmopressin-> peningkatan osmolalitas urin
Dx?

A

Central diabetes insipidus

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27
Q

Klinis: poliuria, polidipsi
Penunjang:
urinalisa berat jenis urin rendah (<1.005 mOSm)
water deprivation test -> osmolalitas urin tidak berubah
uji desmopressin-> tidak ada perubahan osmolalitas urin
Dx?

A

Nephrogenic diabetes insipidus

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28
Q

Klinis: poliuria, polidipsi
Penunjang :
Berat jenis urin rendah (<1.005 mOSm)
water deprivation test -> osmolalitas urin meningkat sampai 500 mOsm/L
Dx?

A

Psychogenic polydipsia

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29
Q

Klinis:
pembesaran tiroid, palpitasi, tremor, iritabilitas, mudah lelah, keringat berlebih, nafsu makan meningkat, penurunan berat badan
DX?

A

Hipertiroid

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30
Q

Klinis hipertiroid
Pembesaran kelenjar tiroid tanpa nodul
TSH rendah
FT4 dan T3 tinggi
TrAb or TSI (+)
High radioiodine uptake: diffuse
DX?

A

grave’s disease

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31
Q

Klinis hipertiroid
TSH rendah
FT4 dan T3 tinggi
High radioactive uptake: focal in solitary nodule asymetrical
USG tiroid :nodular goiter
Dx?

A

Toxic multinodular goiter
or
Toxic solitary adenoma

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32
Q

Tatalaksana hipertiroid?

A

Propanolol 40-80 mg terbagi 2-4 dosis
Obat anti tiroid:
- Propylthiouracil (PTU) 3x 100-200 mg/hari (dipilih pada kehamilan TM1)
- Metimazole 10-20 mg/hari (dipilih pada pasien dewasa, anak, kehamilam TM2-3)

*ES: agranulositosis
*Evaluasi klinis dan fungsi tiroid setiap 1 bulan sampai eutiroid

Tatalaksana lain:
Radioactive iodine I 131
Tiroidektomi

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33
Q

Klinis:
bradikardi, gangguan memori dan konsentrasi, mudah lelah, kulit kering, akral dingin, nafsu makan menurun, BB meningkat
FT4 dan T3 turun
DX?
Tatalaksana?

A

Hipotiroid
Levotiroksin

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34
Q

Klinis hipotiroid
riwayat tinggal di pegunungan

A

Goiter endemik

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35
Q

Klinis hipotiroid
Anti TPO (+)
PA: infiltrat limfosit
Dx?

A

Hashimoto tiroiditis

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36
Q

klinis hipotiroid
gejala obstruksi (+)
Anti-TPO (+)
PA: jaringan fibrosa
dx?

A

Riedel’s thyroiditis

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37
Q

klinis hipotiroid
benjolan ireguler
gejala obstruksi (+)
dx?

A

tumor tiroid

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38
Q

klinis hipertiroid
nyeri (+)
infeksi bakteri (+)
dx?

A

Tiroiditis akut

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39
Q

klinis hipertiroid
nyeri (+)
infeksi virus
transient tirotoksikosis diikuti dengan hipotiroid
dx?

A

deQuervain’s thryroiditis

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40
Q

klinis hipertiroid
nyeri (_)
Radioiodine uptake diffuse
TRab (+)
dx?

A

Autoimune (Grave’s disease)

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41
Q

klinis hipertiroid
nyeri (-)
radioiodine uptake (-)
TRAb (-)
dx?

A

Subacute lymphocytic thyroiditis

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42
Q

klinis hipertiroid
nyeri (-)
radioiodine uptake nodular
TRAb (-)
dx?

A

tumor tiroid

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43
Q

Pasien post operasi struma
klinis: kejang, laringospasme, bronkospasme, chovstek sign, trousseau sign
dx?

A

Hipoparatiroid

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44
Q

klinis:
nefrolithiasis, miopati, ulkus peptikum, osteitis fibrosa cystika (salt and pepper appearance di cranium)
Hormon PTH meningkat, kalsium serum meningkat
EKG QT Interval memendek
dx?

A

Hiperkalsemia

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45
Q

Klinis :
moon face, striae rubra, facies plethorik (wajah bengkak dan merah), obesitas sentral, buffalo hump
dx?

A

Hiperkortikolism

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46
Q

Klinis :
moon face, striae rubra, facies plethorik (wajah bengkak dan merah), obesitas sentral, buffalo hump
Penunjang:
Low dose dexa suppresion test
DX?

A

Cushing syndrome

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47
Q

Cushing Syndrome + ACTH Rendah
DX?

A

ACTH independent cushing syndrome
ec:
tumor adrenal or paparan kortikosteroid eksogen

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48
Q

Cushing syndrome + ACTH meningkat
dx?

A

ACTH dependent cushing syndrome

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49
Q

Cushing syndrome + ACTH meningkat
DX: ACTH dependent cushing syndrome
Kemudian dilakukan high dose dexa suppression test = kortisol turun
DX?

A

Cushing disease

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50
Q

Cushing syndrome + ACTH meningkat
DX: ACTH dependent cushing syndrome
Kemudian dilakukan high dose dexa suppression test = kortisol tetap tinggi
DX?

A

Ectopic ACTH secretion

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51
Q

Klinis:
hipotensi, salt craving, hiponatremia, hiperkalemia, asidosis metabolik
Dx?

A

Hipoaldosteron

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52
Q

klinis:
penurunan bb, anoreksia, lemas, depresi, kram otot, mual, muntah, diare, hipotensi, sugar craving, hiponatremia
dx?

A

Hipokortikolisme

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53
Q

Krisis adrenal :
menurunnya hormon adrenal
hipotensi
hiponatremia
hiperkalemia
hipoglikemia

Tx?

A
  • Hidrokortison 100mg bolus IV/IM diikuti drip 10mg/jam
  • Rehidrasi dengan 1 L nacl dalam 1 jam
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54
Q

Kriteria AKI namanya apa?

A

RIFLE

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55
Q

Cara membedakan AKI pre renal dan renal?

A

rasio BUN:SC >20 = Prerenal
rasio BUN:SC<20 = Renal

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56
Q

STAGE AKI?
1.
2.
3.

A
  1. Urine output <0,5 mg/kg/jam selama 6-12 jam
  2. <0,5 ml/kg/jam selama ≥ 12 jam
  3. <0,3 ml/kg/jam selama ≥ 24 jam
    atau anuria ≥ 12 jam
57
Q

kerusakan ginjal > 3 bulan, berupa kelainan struktural/fungsional, dengan atau tanpa penurunan GFR
DX?

A

CKD

58
Q

STAGE CKD?
1.
2.
3.
4.
5.

A
  1. GFR ≥ 90
  2. GFR 60-89
  3. GFR 30-59
  4. GFR 15-29
  5. GFR < 15
59
Q
A
59
Q

edema anasarka
proteinuria masif >3,5 g/hari
hipoalbuminemia <3,5
hiperkolesterolemia
lipiduria (oval fat bodies)
dx?

A

sindrom nefrotik

60
Q

Klinis:
disuria, frekuensi, urgensi, nyeri perut bawah, demam (-)
nyeri tekan suprapubik
dx? tx?

A

ISK Bawah (Sistitis Non-Kom
tx:
- Nitrofurantoin 2x100 mg selama 5 hari
- Kotrimoksazole 2x960 mg selama 3 hari
- Ciprofloksasin 2x250 mg selama 3 hari

61
Q

klinis:
demam, menggigil, nyeri pinggang, mual, muntah, nyeri ketok cva +
dx? tx?

A

ISK ATAS (pielonefritis non komplikata)
tx:
Ciprofloksasin 2x500 mg selama 7 hari

62
Q

Wanita tidak hamil, tidak ada kelainan anatomis atau fungsional saluran kemih.
isk komplikata or non komplikata?

A

isk non komplikata

63
Q

laki-laki, wanita hamil, kelainan anatomis atau fungsional saluran kemih, penggunaan kateter urin, imokompromised.
ISK Komplikata or Non Komplikata?

A

ISK Komplikata

64
Q

Kinis:
nyeri sendi diperberat dengan aktivita fisik dan membaik saat istirahat (Gelling Phenomenon)
Morning stiffness <30 menit
krepitasi
deformitas
perubahan gaya berjalan
dx?

A

Osteoarthritis

65
Q

Grading Kellgren-Lawrence Osteoarthritis
grade 0:
grade 1:
grade 2:
grade 3:
grade 4:

A

grade 0:
tidak ada penyempitan celah sendi
grade 1:
terdapat penyempitan celah sendi tpi masih diragukan, mungkin terdapat osteofit
grade 2:
terdapat osteofit definitif, mungkin ada penyempitan celah sendi
grade 3:
osteofit ukuran sedang, penyempitan celah sendi definit, sklerosis, mungkin terdapat deformitas tulang
grade 4:
osteofit ukuran besar, penyempitan celah sendi definit, sklerosis berat, deformitas tulang definit

66
Q

Klinis:
morning stiffness>1 jam pada sendi
poliartritis simetris dan bilateral (sendi MCP, PIP)
swan neck deformity
rheumatoid factor (+)
dx? tx?

A

Rheumatoid Arhtritis
TX:
DMARD : metrotreksat, sulfasalazine, dll

67
Q

Klinis anemia:
MCV<80
SI ⬇
TIBC ⬆
Ferritin ⬇
morfologi eritrosit : pencil cell/ cigar cell
dx?

A

ADB

68
Q

Klinis anemia
MCV<80
SI ⬇
TIBC ⬇
Ferritin⬆
DX?

A

anemia ec penyakit kronik

69
Q

Klinis anemia
MCV<80
SI ⬆
TIBC ⬇
Ferritin⬆
morfologi : ring sideroblast
dx?

A

Anemia sideroblastik

70
Q

Trias: anemia, ikterus, organomegali
gejala anemia
urin berwarna gelap
penunjang: Coombs test (+)
apusan darah tepi: sferosit, skistosit (helmet cell), retikulosit, heinz bodies, bite cell
dx?

A

Anemia Hemolitik Auto Imun (AIHA)

71
Q

Klinis:
gejala anemia
gejala leukopenia rentan infeksi
gejala trombositopenia (petekie, ekimosis, dll)
organomegali (-)
biopsi: hiposelularitas, didominasi sel adiposit
dx?

A

Anemia Aplastik

72
Q

klinis:
gejala anemia,
diet rendah daging
abis operasi bypass gastric/ileum
gangguan neurologis (parestesia, ataksia, demensia)
glossitis, angularis cheilosis, hipertrofi gingiva
Penunjang :
MCV>100
DX? TX?

A

Anemia Megaloblastik ec Vit B12 Defisiensi
Tx:
injeksi vit B12 100-1000 mikrogram IM

73
Q

Klinis:
gejala anemia
diet rendah sayur
alkoholism, drug
glossitis, angular cheilosis, hipertrofi gingiva
neural tube defect
penunjang:
low serum folate
high homosistein
dx? tx?

A

Anemia megaloblastik ec Asam Folat Deficiency
tx:
asam folat 1 mg/hari

74
Q

predileksi usia: anak anak»
klinis: demam, lemas, nyeri tulang dan sendi, perdarahan, hepatosplenomegali,limfadenopati
lab:
BLAST>20%
DX?

A

Acute Lymphoblastic Leukimia (ALL)

75
Q

Predileksi: dewasa, anak”
Klinis: demam, lemas, penurunan BB, perdarahan, hepatosplenomegali
Lab:
anemia, leukositosis, trombositopenua
Auer rod (+)
Blast>20%
DX?

A

Acute Myeloid Leukomia (AML)

76
Q

predileksi: dewasa (>65 th)
50% asimtomatik, hepatosplenomegali, limfadenopati
lab:
anemia, leukositosis, trombositopenia
BNP: Smudge cell/ Basket cell (+)
dx?

A

Chroic Lymphocytic Leukimia (CLL)

77
Q

predileksi: dewasa, kromosom philadelphia
20% asimtomatik, lemas, penurunan bb, splenomegali
lab:
anemia, leukositosis, trombositopenia
MIELOSIT»
DX?

A

Chronic Myeloid Leukimia (CML)

78
Q

Klinis: OLD CRAB
Old age
Calcium elevated (hiperkalsemia)
Renal failure
Anemia
Bone Lytic Lesions
Penunjang:
x ray= lesi litik
Elektroforesis urin: Bence Jones Protein
DX?

A

Multiple Myeloma

79
Q

Reed-Sternberg cell (+). Temuan biopsi pada penyakit?

A

Limfoma Hodgkin

KLINIS:
Limfadenopati lokalisata dengan konsistensi kenyal tidak nyeri
demam tipe pel-ebstein, keringat malam, penurunan berat badan
neuropati

80
Q

Klinis:
limfadenopati generalisata, kenyal, tidak nyeri
Reed-sternberg cell (-)
dx?

A

limfoma non hodgkin

81
Q

Tatalaksana syok anafilaktik?

A

Primary Survey
Adrenaline 1:1000 -> 0,3-0,5 ml IM

82
Q

Skor qSOFA apa saja?
1.
2.
3.

A
  1. RR≥ 22x/menit
  2. Perubahan status mental
  3. TD Sistol ≤ 100 MMhG
83
Q

Tatalaksana Syok Sepsis?

A

First line: Norepinephrin 35-90 μg/menit untuk mencapai target MAP 65mmHg
–>
ga mencapai target?
Tambahkan vasopressin 0,03 unit/ menit
–>
ga mencapai target?
tambahkan epinephrine 20-50 μg
–>
ga mencapai target?
tambahkan phenylephrine 200-300 μg/menit

84
Q
A
85
Q

Grading DHF?
DF?
DHF Grade 1?
DHF Grade 2?
DHF Grade 3?
DHF Grade 4?

A

DF: demam disertai 2 dari gejala berikut:
- sakit kepala
- retroorbital pain
- myalgia
- arathralgia
- rash
- manifestasi perdarahan

DHF Grade 1: demam, manifestasi perdarahan (positive tourniquet) dan ada bukti kebocoran plasma (HCT≥20%)

DHF Grade 2: dhf grade 1 + perdarahan spontan

DHF Grade 3: seperti grade 1 atau 2 + kegagalan sirkulasi (nadi lemah, narrow pulse ≤ 20 mmHg, hipotensi)

DHF Grade 4: seperti grade 3 + nadi ga teraba

86
Q

Warning sign Dengue apa saja?

A

Demam turun tapi klinis memburuk
nyeri perut hebat
muntah persisten
tidak dapat minum
letargi
gelisah
perdarahan mukosa
akral pucat, dingin, basah
oligouria

87
Q

Tatalaksana Dengue with warning sign?

A

Cairan infus kristaloid 1500 + (20x (BB-20 kg))
Periksa Hb, HCT, trombosit setiap hari

88
Q

Tatalaksana Dengue with warning sign?

A

Terapi awal cairan kristaloid 5-7 ml/kg/jam-> evaluasi 1-2 jam

membaik?
turunin jadi 3-5ml/kg/jam (evaluasi 2-4 jam) –> 2-3
kalo udah perbaikan terapi cairan digentikan 24-48 jam

memburuk?
naikkan jadi 5-10ml/kg/jam (evaluasi 2 jam) –> 15ml

89
Q

Tatalaksana DSS?

A

Resusitasi cairan kristaloid 5-10 ml/kg/jam selama 1 jam

ada perbaikan? ya
maka cek HCT
HCT turun= transfusi
HCT naik= bolus cairan kedua 10-20 ml/kg/jam selama 1 jam

90
Q

Indikasi transfusi Trombosit pada dengue?

A
  1. PLT <20.000 + perdarahan spontan
  2. PLT <10.000
91
Q

Tatalaksana leptospirosis anikterik?

A

Doksisiklin 2x100 mg PO (7 hari)

Pilihan lain:
Amoksisilin 4x500 mg PO (7 hari)
Ampisilin 4x500-750 mg PO (7 hari)

92
Q

Tatalaksana leptospirosis ikterik?

A

Penisilin G 1,5 Juta Unit IV tiap 6 jam selama 7 hari

Pilihan lain:
Ampisilin 1 gr IV tiap 6 jam
Amoksisilin 1 gr IV tiap 6 jam
Seftriakson 1 gr IV tiap 24 jam

93
Q

Trias Malaria?

A

mengigil, demam, berkeringat

94
Q

demam intermiten/kontinyu
tanda khas: Maurer spots
tropozoit: accole ring
gametosit: bulan sabit, pisang, sosis
dx?

A

Malaria falciparum

95
Q

klinis: demam, menggigil, berkeringat
pola demam : interval bebas demam 2 hari
tanda khas: schufner dots
dx?

A

Malaria vivax

96
Q

klinis: demam, mengigil, berkeringat
pola demam: interval bebas demam 2 hari
tanda khas: james dots
skizont: comet
dx?

A

Malaria Ovale

97
Q

klinis: demam, mengigil, berkeringat
tanda khas: Ziemann’s dots
tropozoit: Pita, rectangular
skizont: Rossete (seperti mawar)
dx?

A

Malaria Malariae

98
Q

Apa obat profilaksis malaria?

A

Doksisiklin 100mg/hari diminum 1 hari sebelum berangkat hingga 4 minggu setelah pulang dari daerah endemis

99
Q

Obat Malaria Falciparum apa?
1st line:
2nd line:

A

1st line:
DHP selama 3 hari + Primakuin dosis tunggal
2nd line:
(Kina + doksi/tetrasiklin) selama 7 hari dan Primakuin dosis tunggal

100
Q

Obat Malaria vivax, ovale, dan campuran?
1st line:
2nd line:

A

1st line:
DHP selama 3 hari + Primakuin selama 14 hari
2nd line:
Kina selama 7 hari + primakuin selama 14 hari

101
Q

Apa obat Malaria Malariae?1st line:
2nd line:

A

1st line: DHP selama 3 hari
2nf line: Kina selama 7 hari

102
Q

Apa obat malaria pada ibu hamil?

A

DHP selama 3 hari

103
Q

Apa obat malaria berat?

A

Artesunat IV 2,4 mg/kgNN pada jam 0,12,24 dan selanjutnya setiap 24 jam sampai pasien sadar
or
Artemeter IM 1,6 mg/kg/jam tiap 12 jam pada hari pertama, dilanjutkan 1,6 mg/kg/jam tiap 24 jam sampai pasien sadar
–>
kalo dah sadar ganti ke ACT oral

Malaria berat: ada gangguan fungsi organ
penurunan kesadara, kelemahan otot generalisata, kejang berulang, asidosis, hipoglikemia, syok, dll

104
Q

Gimana bedain ulkus duodenum dan ulkus gaster?

A

ulkus duodenum: keluhan berkurang setelah makan
ulkus gaster: keluhan memberat setelah makan

105
Q

Tatalaksana asites pada sirosis hati?

A

Spironolakton 100-200 mg/hari (dapat dikombinasikan dengan furosemide 20-40 mg/hari), parasintesis

106
Q

Tatalaksana varises esofagus pada sirosis hati?

A

beta blocker non selektif
somatostatin
octreotide
ligasi

107
Q

Tatalaksana ensefalopati hepatikum pada sirosis hepatis?

A

Laktulosa, neomisin

108
Q

Hepatitis yang penularannya fecal oral apa saja?

A

Hepatitis A
Hepatitis E

109
Q

Hepatitis yang penularannya lewat darah/cairan tubuh?

A

Hepatitis, B, C, D

110
Q

IgM anti HAV (+)
dx?

A

Hepatitis A akut

111
Q

IgG anti-HAV (+)
dx?

A

Riwayat hepatitis A

112
Q

HbsAg (+)
IgM Anti HBc (+)
dx?

A

Hepatitis B Akut

113
Q

HbsAg (+)
IgG anti Hbc (+)
HbeAg (+)
ALT normal
dx?

A

Hepatitis B Kronik fase imunotolerant

114
Q

HbsAg (+)
IgG anti Hbc (+)
HbeAg (+)
ALT meningkat
dx?

A

Hepatitis B Kronik fase imunoaktif

115
Q

HbsAg (+)
IgG Anti HBc (+)
HbeAg (-)
ALT normal
dx?

A

Hepatitis B Kronik fase karier inaktif

116
Q

HbsAg (+)
IgG Anti HBc (+)
HbeAg (-)
ALT meningkat
dx?

A

Hepatitis b kronis fase reaktivasi

117
Q

HbsAg (-)
anti HBs (-)
IgM anti HBc (+)
dx?

A

Window period

118
Q

HbsAg (-)
anti HBs (+)
IgG anti HBc (-)
dx?

A

Imunitas dari vaksinasi

119
Q

HbsAg (-)
anti HBs (+)
IgG anti HBc (+)
dx?

A

imunitas dari riwayat infeksi hepatitis B

120
Q

Terapi antibiotik demam tifoid?

A

1st line :
dewasa: Kloramfenikol 4x500 mg selama 10 hari
anak: 100mg/kg/hari, dibagi 4 dosis, selama 10-14 hari

121
Q

Klinis: diare lendir/darah, nyeri perut, tenesmus, konstipasi, mual muntah, distensi abdomen
Temuan endoskopi:
Cobblestone (skip lesion) (+)
Granuloma (+)
String sign (+)
dx?

A

Crohn’s disease

122
Q

Klinis: diare lendir/darah, nyeri perut, tenesmus, konstipasi, mual muntah, distensi abdomen
Temuan endoskopi:
Pseudopolip (+)
Lead pipe colon (+)
dx?

A

Kolitis Ulseratif

123
Q

Kriteria penegakan pankreatitis akut, jika didapatkan 2 dari 3 kriteria yaitu:

A
  1. Nyeri abdomen (nyeri epigastrium/kiri atas, yang menyebar ke punggung)
  2. Peningkatan enzim amilase dan/ lipase >3x normal
  3. Temuan radiologis
124
Q

Tanda khas:
Cullen Sign (ekimosis di umbilikus)
Grey Turner Sign (ekimosis di pinggang)
dx?

A

Pankreatitis Akut

125
Q

Nyeri perut kuadran kanan atas
demam -
tanda ikterik -
dx?

A

Kolelithiasis

Terapi:
NSAID
Antispasmodik
UDCA

126
Q

Nyeri perut kuadran kanan atas
demam -
tanda ikterik +
dx?

A

Koledokolithiasis

Terapi:
Kolekistektomi

127
Q

nyeri perut kuadran kanan atas
demam +
tanda ikterik -
murphy sign +
dx?

A

Kolesistitis

Terapi:
antibiotik IV
kolekistektomi

128
Q

nyeri perut kuadran kanan atas
demam +
tanda ikterik +
dx?

A

Kolangitis

Terapi:
Stabilkan ABC
Antibiotik IV
Drainase bilier (ERCP)

129
Q

efek samping metformin?

A

gejala GIT
dispepsia, diare, asidosis laktat

130
Q

efek samping thiazolidinedione?

A

edema

131
Q

efek samping sulfonilurea?

A

bb naik, hipoglikemia

132
Q

efek samping obat glinid?

A

bb naik, hipoglikemia

133
Q

Efek samping obat alfa-glukosidase inhibitor (acarbose)?

A

flatus, tinja pembek

134
Q

Efek samping obat alfa-glukosidase inhibitor (acarbose)?

A

flatus, tinja pembek

135
Q

Efek samping obat DPP-4 inhibitor?

A

sebah, muntah

136
Q

Efek samping obat DPP-4 inhibitor?

A

sebah, muntah

137
Q

efek samping obat sglt 2 inhibitor?

A

ISK

UKMPPD (9 decks)

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