Penyakit Pada Gaster

Question 1

Penyakit Pada Gaster

Answer 1

= Dispepsia
Kumpulan gejala rasa tidak nyaman di perut bagian atas

Question 2

Klasifikasi Penyakit Pada Gaster (2)

Answer 2

Dispepsia fungsional
Dispepsia organik

Question 3

Dispepsia fungsional (3)

Answer 3

Endoskopi → normal

Type like ulcer
Type dismotility
Mixed

Question 4

Dispepsia fungsional type like ulcer

Answer 4

Nyeri epigastrium

• Tx
  
  1. PPI
  2. Ranitidin
     + Mukoprotektor (sukralfat) → ES: Konstipasi

Question 5

Dispepsia fungsional type dysmotility

Answer 5

Gangguan peristaltik
Mual, muntah, kembung, sendawa

• Tx
  
  1. Prokinetik:
     Domperidon ATAU
     Metoclopramide 3x10 mg → ES: EPS
  2. PPI

Question 6

Tx dispepsia fungsional mixed

Answer 6

PPI + prokinetik

Question 7

Tx Dispepsia Fungsional

Answer 7

Tx empiris → 2 mgg → membaik → lanjutkan
Durasi tx → 4-8 mgg

Semua tx dispepsia 1st PPI, kecuali dysmotility 1st prokinetik

Question 8

Dispepsia Organik

Answer 8

Endoskopi → Normal (-)

P S M B A
Perdarahan Saluran Makan Bagian Atas
Ciri: Hematemesis & Melena

Question 9

Dispepsia Organik (3)

Answer 9

Ulkus Peptikum
Gastritis Erosive
Gastritis ec Infeksi H. pylori

Question 10

Dx Ulkus Peptikum

Answer 10

Dispepsia, hematemesis, melena

Question 11

Ulkus Peptikum (2)

Answer 11

Ulkus Gaster
Ulkus Duodenum

Question 12

Ulkus Gaster

Answer 12

Hunger pain, food pain

Gaster
Gak syukur

Question 13

Ulkus duodenum

Answer 13

Hunger pain, food relieve

Question 14

Endoskopi Ulkus Peptikum

Answer 14

Mucosal break (+)/luka dalam >3 mm

Question 15

Tx Ulkus Peptikum

Answer 15

PPI

+

mukoprotektor
(sukralfat,
analog prostaglandin → misoprostol, KI: hamil)

Question 16

Gastritis Erosive

Answer 16

= Gastropati NSAID

Question 17

FR Gastritis Erosive

Answer 17

Riw. NSAID COX-1 → hambat sintesis prostaglandin → mukoprotektor

Question 18

Dx Gastritis Erosive

Answer 18

Dispepsia, hematemesis, melena

Question 19

Endoskopi Gastritis Erosive

Answer 19

Erosi gaster (+)

Question 20

Tx Gastritis Erosive

Answer 20

Ganti dengan NSAID COX-2 + PPI + Mukoprotektor
1. Selekoksib 2x200 mg
2. Na diklofenak 2x50 mg
3. Meloxicam 2x7,5 mg

NSAID COX-2
Se Na M

Question 21

Etio Gastritis ec Infeksi H. pylori

Answer 21

H. pylori → bakteri gram (-), flagel (+), fermentase urease

Question 22

Dx Gastritis ec Infeksi H. pylori

Answer 22

Dispepsia, hematemesis, melena, Urea Breath Test/UBT (+)

Question 23

Tx Gastritis ec Infeksi H. pylori

Answer 23

Eradikasi - 14 hari

💡
1. O K A → 2x1
2. TEr B O M → 4, 2, 2, 3
3. M O K A → 3, 2, 2, 2

1. Omeprazole 2x20 mg
   Klaritromisin 2x500 mg
   Amoksisilin 2x1000 mg
2. TEtrasiklin 4x250-500 mg
   Bismuth 2x2
   Omeprazole 2x20 mg
   Metronidazol 3x500 mg
3. Metronidazol 3x500 mg
   Omeprazole 2x20 mg
   Klaritromisin 2x500 mg
   Amoksisilin 2x1000 mg

💡 Omeprazole bisa diganti dengan PPI apapun selama dosis benar

Question 24

Indikasi Endoskopi

Answer 24

Dispepsia/GERD + Alarm symptoms

💡 Orang 45 tahunan MUDIk BERsama-sama ke PARIaMAn → salah 1 → endoskopi

U >45 tahun
MUntah persisten
DIsfagia berat
BB ↓
PSMBA
Anemia
RIw. Ca gaster
MAssa di abdomen