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PEDIATRICS Flashcards

1
Q

ALUR RESUSITASI NEONATUS

A
  1. Konseling [UK, air ketuban, RF, manajemen tali pusat], tim [3 orang: ventilasi, sirkulasi, alat alat], alat [TABCD - termoregulasi, airway, breathing, circulation, drugs]
    1. Bayi lahir, jika prematur/napas ireguler/nangis lemah/tonus lemah —> LANGKAH AWAL - HP BEKAS PAK ESAN [hangatkan, posisikan, bersihkan jalan napas, keringkan, stimulasi, posisikan kembali, evaluasi]
      • Jika tidak —> RAWAT BERSAMA IBU
    2. Jika megap2/DJJ<100 —> VTP 30 DETIK; EVALUASI SRIBTA [SUNGKUP, REPOSISI, ISAP, BUKA MULUT, TEKANAN, ALT AIRWAY]
      • *Jika nafas spontan + DJJ≥100 —> CEK RETRAKSI/MERINTIH/TAKIPNEA. Jika ya —> CPAP; VTP; INTUBASI. Jika tidak —> CEK SIANOSIS/SPO2. Jika ya —> O2 ALIRAN BEBAS. Jika tidak —> RAWAT BERSAMA IBU. Apabila sudah mendapat CPAP/O2 ALIRAN BEBAS —> PERAWATAN PASKA RESUSITASI
    3. Jika DJJ <60 —> VTP + KOMPRESI 1:3 60 DETIK
      • Jika DJJ<100 —> KE POIN 3
      • JIka DJJ≥100—> KE POIN 3*
    4. Jika masih DJJ <60 —> VTP + KOMPRESI 1:3 60 DETIK + ADRENALIN 1:10000
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2
Q

SKORING NEONATUS
1. Asfiksia
2. Distres napas
3. Maturitas neuromuskular

A
  1. APGAR
  2. DOWN
  3. NEW BALLARD
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3
Q

Asfiksia: Preterm, x-ray (+) ground glass app / reticulogranular pattern / air bronkogram, surfaktan (-)

A

HMD

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4
Q

Asfiksia: Preterm, x-ray (+) atelektasis / hiperinflasi, CT scan (+) mosaic lung

A

BPD

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5
Q

Asfiksia: Lahir SC, x-ray (+) efusi, fuzzy perihilar

A

TTNB

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6
Q

Asfiksia: Postterm, x-ray (+) patchy infiltrate

A

MAS

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7
Q

TRAUMA LAHIR
1. Lewat sutura, klinis baik:
2. Lewat sutura, klinis buruk:
3. Tidak lewat sutura:
4. Refleks genggam (+):
5. Refleks genggam (-):

A
  1. CAPUT SUCCADANEUM
  2. PENDARAHAN SUBGALEAL
  3. SEFALHEMATOM
  4. ERB PALSY
  5. KLUMPKE PALSY
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8
Q

Rw prematur/KPD>24h/demam peripartum, sindrom infeksi sistemik
- ≤3d:
- >3d:

A

SEPSIS NEONATORUM
- DINI
- LAMBAT

Stabilisasi, ampisilin 100mg/kg/d + gentamisin 5mg/kg/d

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9
Q

IKTERUS NEONATORUM
1. Bisa kehamilan pertama, Ibu goldar O, anak A/B, ikterus hemolitik:
2. KEHAMILAN KEDUA, Ibu Rh(-) janin 1 dan 2 Rh(+), ikterus hemolitik:
3. Kurang ASI <8x/d:
4. ASI cukup, beta-glucoronidase dalam ASI:
5. <2mo, Ikterus obstruktif [urin gelap, feses pucat, hepatomegali, hiperbilirubinemia direk], USG (+) TRIANGULAR CORD SIGN:

A
  1. INKOMPATIBILITAS ABO
  2. INKOMPATIBILITAS RHESUS
  3. BREASTFEEDING JAUNDICE
  4. BREASTMILK JAUNDICE
  5. ATRESIA BILIER

Fototerapi (<20), transfusi tukar (>25), atresia bilier: metode kasai; transplantasi hati (definitif)

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10
Q

Rw persalinan tidak steril (paraji), spasme, tes spatula (+) menggigit

A

TETANUS NEONATORUM

stabilisasi, metronidazole 4x 30mg/kg / penisilin G 100rb IU/kg/d + HTIg 500 IU / ATS 5000 IU IM

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11
Q

SINDROM KONGENITAL
1. Perempuan, 45XO, pendek, webbed neck, hiperGT hipogonad:
2. Laki, 47XXY, tinggi, ginekomastia, hiperGT hipogonad: SINDROM KLINEFELTER
3. Trisomi 13, polidaktili, bibir sumbing, ggn SSP berat: SINDROM PATAU
4. Trisomi 18, overlapping finger, mikrognathia, club foot, ggn perkembangan berat: SINDROM EDWARDS
5. Trisomi 21, mongoloid face, makroglossia, epicanthal fold, simian crease: SINDROM DOWN
6. Delesi 5p autosomal, tangisan seperti kucing: SINDROM CRI DU CHAT
7. Webbed neck, garis rambut rendah, ROM leher terbatas: SINDROM KLIPPEL-FEIL

A
  1. SINDROM TURNER
  2. SINDROM KLINEFELTER
  3. SINDROM PATAU
  4. SINDROM EDWARDS
  5. SINDROM DOWN
  6. SINDROM CRI DU CHAT
  7. SINDROM KLIPPEL-FEIL
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12
Q

KLASIFIKASI BB/U (underweight)

A

<-3: BB sangat kurang
-3 sd -2: BB kurang
-2 sd 1: BB normal
>1: risiko BB lebih

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13
Q

KLASIFIKASI TB/U (stunted)

A

<-3: sangat pendek
-3 sd -2: pendek
-2 sd 3: normal
>3: tinggi

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14
Q

KLASIFIKASI BB/TB (wasted)

A

<-3: gizi buruk
-3 sd -2: gizi kurang
-2 sd 1: gizi baik
1 sd 2: risiko gizi lebih
2 sd 3: gizi lebih
>3: obesitas

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15
Q

KLASIFIKASI IMT/U (wasted)

A

<-3: gizi buruk
-3 sd -2: gizi kurang
-2 sd 1: gizi baik
1 sd 2: risiko gizi lebih
2 sd 3: gizi lebih
>3: obesitas

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16
Q

DEFINISI GIZI BURUK

A

BB/TB <-3 / lila <11.5 / pitting edema bilateral

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17
Q

Defisiensi kalori, edema (-), old man face, iga gambang, baggy pants

A

MARASMUS

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18
Q

Defisiensi protein, edema (+), crazy pavement dermatosis, rambut jagung, perut kembung

A

KWASHIORKOR

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19
Q

TATALAKSANA GIZI BURUK

A
  1. Hipoglikemia —> glukosa 10% 50mL PO / glukosa 10% 5mL/kg IV, lalu F75
  2. Hipotermia —> lampu / dekatkan ibu
  3. Dehidrasi —> resomal 5mL/kg @30m 2h lalu 5-10mL/kg/h selang seling F75 1h
  4. Elektrolit —> K+, Mg2+ (pisang, bayam)
  5. Infeksi —> amoksisilin 3x 15mg/kg PO 5d (komplikasi (-)), ampisilin 4x 50mg/kg IV 2d + gentamisin 5mg/kg/d 7d IV (komplikasi (+)), imunisasi campak
  6. Gizi mikro —> as folat 5mg lalu 1mg/d, zinc 2mg/kg/d, tembaga 0.3mg/kg/d, vitamin A sesuai usia; besi 3mg/kg/d (fase rehab)
  7. Stabilisasi-transisi —> F75 sesuai kebutuhan
  8. Kejar tumbuh —> peningkatan BB 5-10g/kg/d, ganti F75 dengan F100
  9. Kembang-stimulus —> lingkungan nyaman, terapi bermain
  10. Rumah —> pemberian makan sesuai, terapi bermain, kontrol, imunisasi booster
    • SESUAI STRT
      • Stabilisasi (hari 1-2) —> F75 [energi 80-100, protein 1-1.5, cairan 130]
        • 1,2,3,4,5,6,7,9
      • Transisi (hari 3-7) —> F100/RUTF [energi 100-150, protein 2-3, cairan 150]
        • 4,5,6,7-8, 9,10
      • Rehabilitasi (wk 2-6) —> F100/F135/RUTF [energi 150-220, protein 4-6, cairan 150-200]
        • 4,5,6,8,9,10
      • Tindak lanjut (wk 7-26)
        • 5,6,8,9
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20
Q

PEMILIHAN MPASI (USIA)

A

0-6mo: ASI eksklusif
- 6-8mo: ASI + MPASI halus, 200kkal/d
- 6-7mo: ASI + bubur susu
- 8mo: ASI + bubur tim
9-11mo: ASI + MPASI bertekstur, 300kkal/d
- 9mo: ASI + bubur nasi
- 10mo: ASI + nasi tim
- 11mo: ASI + nasi lembek
≥12mo: makanan dewasa, 550kkal/d

21
Q

PRINSIP TATALAKSANA DIARE

A

OZAWA: ORALIT, ZINC, ANTIBIOTIK, WEJANGAN, ASI-MAKAN

22
Q

TATALAKSANA DIARE: O - ORALIT

A

BERAT, 2/4 [letargis, cekung, tdk minum makan, turgor sgt lambat] IV
- <12 bln: 30 ml/kg dlm 1 jam, 70 ml/kg dlm 5 jam
- ≥12 bln: 30 ml/kg dlm 0.5 jam, 70 ml/kg dlm 2.5 jm
- cek setiap 15-30 menit. periksa sesudah 6 atau 3 jam, klasifikasi dehidrasi, lanjut penanganan. kalo iv gabisa, ng tube.
RINGAN-SEDANG, 2/4 [gelisah, cekung, haus, turgor melambat]
- 3 jam pertama: 75ml/kg oralit, jika BB tdk tahu
- <6 kg 200-400
- 6-10 400-700
- 10-12 700-900
- 12-19 900-1400
- muntah: tunggu 10 mnt, lanjutkan dg pemberian lbh lambat
- gagal oral: cairan IV 70 ml/kg dl, 5 jam atau 2.5 jam (<12 dan ≥12 bln)
- stlh 3 jam ulang klasifikasi
TANPA DEHIDRASI, 2/4 [sadar baik, tidak cekung, minum biasa, turgor baik]
- beri cairan tambahan sebanyak anak mau: ASI/oralit
- cegah dehidrasi: <12 bln 50-100 ml/diare, ≥12 bln 100-200 ml/diare, diminumkan sedikit sedikit
- berikan 6 bungkus oralit 200 ml

CAIRAN PEMBEDA DI USIA <12 DAN ≥12 MO

23
Q

TATALAKSANA DIARE: Z - ZINC

A

Zinc (tablet dispersibel)
- <6 bln: 1/2 tablet 10 mg/d 10 hari
- ≥6 bln: 1 tablet 20 mg/d 10 hari

ZINC PEMBEDA DI USIA <6 DAN ≥6 MO

24
Q

TATALAKSANA DIARE: A-W-A - ASI-WEJANGAN-ANTIBIOTIK

A

A - sesuai usia, ASI
W - edukasi
A - sesuai indikasi

25
Q

Diare, begah, feses asam, hydrogen breath test (+), pH tinja asam

A

INTOLERANSI LAKTOSA

susu bebas laktosa

26
Q

Diare, urtikaria/ruam, ELIMINASI PROVOKASI/FOOD CHALLENGE (+), IgE RAST (+)

A

ALERGI SUSU SAPI

hindari dairy, susu terhidrolisis ekstensif/kedelai

27
Q

PREMATUR MINUM SUSU, diare berdarah, distensi abdomen, neonatus, prematur, x-ray (+) pneumatosis intestinalis

A

ENTEROKLITIS NEKROTIKANS

dekompresi NGT, bowel rest, ampisilin + gentamisin + metronidazole; laparotomi

28
Q

Demam, makulopapular, wajah ke badan, slapped cheek/lacy, parvovirus B19

A

ERITEMA INFEKSIOSUM/FIFTH DISEASE

29
Q

Demam, makulopapular, wajah ke badan, 3C, koplik spot, paramyxovirus

A

RUBEOLA/MEASLES/CAMPAK/MORBILI

30
Q

Demam, makulopapular, wajah ke badan, limfadenopati postaurikular/suboksipital, forscheimer spot (+) bercak palatum-uvula, rubellavirus

A

RUBELLA/CAMPAK JERMAN

31
Q

Demam, makulopapular setelah demam selesai, badan ke wajah/ext., HHV6

A

ROSEOLA INFANTUM/EKSANTEMA SUBITUM

32
Q

Demam, papulovesikular, seluruh tubuh, VZV

A

VARICELLA/CHICKENPOX

33
Q

Demam, papulovesikular, dermatomal, VZV:

A

HERPES ZOSTER/SHINGLES

34
Q

Demam, papulovesikular, telapak dan mulut, coxsakievirus A16

A

HMFD

35
Q
A
36
Q

Demam, deskuamasi, leher-dada ke badan, strawberry tongue, sandpaper rash, ASTO (+), GAS

A

SCARLET FEVER

37
Q

Demam, deskuamasi seluruh tubuh, limfadenopati servikal, konjungtivitis bilateral, strawberry tongue, edema perifer, ggn jantung

A

KAWASAKI DISEASE

38
Q

Demam, TANPA RUAM, limfadenopati, sakit tenggorok, EBV

A

INFECTIOUS MONONUCLEOSIS

39
Q

Darah/pus umbilikus purulen, gejala infeksi

A

OMFALITIS

perawatan tali pusat, ampisilin 100mg/kg/d + gentamisin 5mg/kg/d

40
Q

Gejala konstitusional lalu bengkak parotis

A

PAROTITIS

simtomatis

41
Q

USIA <2Y, demam, rinore, batuk kering, wheezing, x-ray hiperaerasi, RSV

A

BRONKIOLITIS

O2, antipiretik, SABA; ICU

42
Q

Batuk (+) rejan, daerah mata menghitam, KULTUR SWAB (+) batang gram (-) bordetella pertussis

A

PERTUSSIS

azitromisin 10mg/kg/d 5d, O2

43
Q

Batuk (+) menggonggong, stridor, x-ray (+) steeple/pencil/wine bottle sign, parainfluenza virus
- Retraksi (-), interaksi (+):
- Retraksi (+) minimal, interaksi (+), stridor (+):
- Retraksi (+) jelas, interaksi (-), stridor (+) istirahat:

A

CROUP/LARINGOTRAKEOBRONKITIS
- RINGAN
- SEDANG
- BERAT

dexamethason 0.3-0.6mg/kg/d PO (ringan-sedang); O2 + nebulisasi adrenalin 2 mL 20m (berat)

44
Q

Batuk (±), 4D [disfagia, demam, drooling, distres], hot potato voice, stridor, x-ray (+) thumbprint sign, Hib

A

EPIGLOTITIS

airway management, seftriakson 1x 50mg/kg IV + vankomisin 2x 15mg/kg IV

45
Q

Batuk (-), 1-8mo lalu remisi usia 2y, stridor inspirasi memburuk saat terlentang/makan, laringoskopi (+) omega shaped epiglotis

A

LARINGOMALASIA

observasi

46
Q

Kejang yang dipicu demam >38, usia 6mo-5y, kelainan intrakranial/elektrolit (-), rw kejang tanpa demam (-)
<15m, general, 1x/d: SIMPLEKS
≥15m, fokal/menuju general, >1x/d:

A

KEJANG DEMAM
- SIMPLEKS
- KOMPLEKS

diazepam 5mg supp / 10mg supp max 2x @5m (<12/≥12kg, prehospital); diazepam 0.2-0.5mg/kg IV 2mg/m max 10mg; fenitoin 20mg/kg dalam 50mL NaCl 0.9% 20m / fenobarbital 20mg/kg @IV; ICU midazolam / propofol / pentobarbital. Fenitoin 5-10mg/kg / fenobarbital 5mg/kg (maintenance jika kejang berhenti). Diazepam 3x 0.3-0.5 mg/kg PO-PR 48h demam (profilaksis)

47
Q

Laki - laki saja, 2-5y, paresis atrofik hiporefleks progresif mulai pelvic girdle, waddling gait, gower sign (+) tangan bertumpu pada paha, ANALISIS GENETIK (+) mutasi distrofin

A

DMD

48
Q

Kelahiran prematur, scissor gait, retardasi mental:
- Satu sisi ext:
- Ext bawah saja:
- Semua ext:
- Hipotonus, gerak involunter:
- Gangguan keseimbangan:
- Campuran:

A

CP
- SPASTIK HEMIPLEGIK
- SPASTIK DIPLEGIK
- SPASTIK KUADRIPLEGIK
- DISKINETIK/ATETOID
- ATAXIC
- CAMPURAN

49
Q
A

GAS (14 decks)

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