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SURGERY Flashcards

1
Q
  1. Celah bibir, mencapai dasar lubang hidung:
  2. Celah bibir, tidak mencapai dasar lubang hidung:
  3. Celah langit langit, palatum primer + sekunder:
  4. Celah langit langit, palatum sekunder:
  5. Celah bibir, langit - langit:
A
  1. LABIOSCHIZIS KOMPLIT
  2. LABIOSCHIZIS INKOMPLIT
  3. PALATOSCHIZIS KOMPLIT
  4. PALATOSCHIZIS INKOMPLIT
  5. LABIOPALATOSCHIZIS

10 wk: labioplasty (rule of 10: pounds>10, Hb>10, WBC<10, >10wk)
<2y: palatoplasty
2-4y: speech therapy

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2
Q

Maloklusi/open bite deformity, epistaksis, hipestesia infraorbita, periorbital ekimosis (II dan III), CSF leak (II dan III)
1. Floating palatum/jaw, patahan horizontal antara akar gigi dan infraorbital rim, nasal fossa rusak:
2. Floating maxilla, patahan piramidal melalui infraorbital rim dan os nasal, infraorbital rim rusak:
3. Floating face, patahan transverse melalui zygomatic arch, zygomatic arch rusak:

A

FR. MAKSILA
1. FR. MAKSILA LE FORT I
2. FR. MAKSILA LE FORT II
3. FR. MAKSILA LE FORT III

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3
Q

Maloklusi rahang bawah

A

FR. MANDIBULA

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4
Q

Tatalaksana Gigitan Ular

A

Imobilisasi area gigitan, posisi lebih rendah dari antung, bersihkan, hindari manipulasi, ABCDE, SABU

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5
Q

Derajat Cedera Kepala

A

GCS ≤8: CKB
GCS 9-12: CKS
GCS ≥13: CKR

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6
Q

Cedera Kepala,
1. Salt and pepper appearance
2. Defisit otak tanpa kerusakan
3. Lucid interval, lesi hiperdens bikonveks/lentikular CT scan
4. Penurunan kesadaran progresif, lesi bikonkav/crescent
5. Thunderclap headache, meningeal sign (+), lesi hiperdens mengisi sulkus/girus (star sign)
6. HT, defisit neurologis mendadak, lesi hiperdens interserebral

A
  1. CONTUSSIO KEPALA
  2. CONCUSSIO KEPALA
  3. EDH (a. meningea media)
  4. SDH (v. bridging)
  5. SAH (aneurisma/AVM)
  6. ICH (a. perforantes)

TX SDH
primary survey, mannitol 0.25-1g/kg IV @30m / hypertonic saline 3% 2-5mL/kg IV @20m, operatif (tebal >10mm, shift >5mm, GCS<9, TIK>20)

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7
Q

Klasifikasi SDH (waktu)
1. Isodens, swirl sign
2. Hiperdens, crescent/bikonkav
3. Isodens, sulit dievaluasi
4. Hipodens, kalsifikasi

A
  1. HIPERAKUT <3 jam
  2. AKUT ≤3 hari
  3. SUBAKUT ≤21 hari
  4. KRONIS >21 hari
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8
Q

Indikasi CT Scan Cedera Kepala

A

≥65y, GCS<15 >2h, GCS≤13, fr. terbuka/depressed/basis kranii, muntah>2x

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9
Q

Trauma kepala, Halo test (+) 2 cincin, glucose strip (+), beta-2 transferrin test (+). Raccoon eyes/periorbital ekimosis, CSF rinore, anosmia, epistaksis, palsy CN I,II

A

FRAKTUR BASIS CRANII ANTERIOR

primary survey, Ab profilaksis; pembedahan

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10
Q

Trauma kepala, Halo test (+) 2 cincin, glucose strip (+), beta-2 transferrin test (+). Battle sign/memar temporal, CSF otore, hemotimpanum, palsy CN III-VIII

A

FRAKTUR BASIS CRANII MIDDLE

primary survey, Ab profilaksis; pembedahan

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11
Q

Trauma kepala, Halo test (+) 2 cincin, glucose strip (+), beta-2 transferrin test (+). Hematoma oksipital, kaku leher, palsy CN IX-XII, serebelum, batang otak

A

FRAKTUR BASIS CRANII POSTERIOR

primary survey, Ab profilaksis; pembedahan

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12
Q

Pembesaran kepala, bulging fontanelle, vena kepala menonjol, SUNSET EYE PHENOMENON (+), mickey mouse ventricles, evans ratio>30%, MRI (GS)
1. Stenosis aliran:
2. Infeksi, SAH:

A
  1. HIDROSEFALUS NON KOMUNIKANS
  2. HIDROSEFALUS KOMUNIKANS

Asetazolamid/mannitol, dekompresi pungsi (awal); VP/VA shunt (definitif)

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13
Q

TRAUMA MEDULLA SPINALIS
1. Brown Sequard
2. Central Cord
3. Anterior Cord
4. Posterior Cord
5. Cauda Equina
6. Conus Medullaris

A

CST (motorik), DC (propriosepsi), STT (nyeri, suhu)
1. CST-i, DC-i, STT-c
2. CST ext atas > bawah, STT
3. CST, STT
4. DC
5. Saddle anesthesia, defisit motor/sensorik ASIMETRIS
6. Saddle anesthesia, defisit motor/sensorik SIMETRIS

stabilisasi, metilprednisolon 30mg/kg 15m lalu 5.4mg/kg @IV 23h (≤3h), metilprednisolon 30mg/kg 15m lalu 5.4mg/kg @IV 47h (3-8h), TIDAK diberi metilprednisolon (>8h)

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14
Q

NEURAL TUBE DEFECT
1. Depresi segmen vertebra, berambut, asimtomatis:
2. Benjolan (+), defisit neuro (-), meningen:
3. Benjolan (+), defisit neuro (+), meningen + spinal cord
4. Benjolan (+), defisit neuro (+), tidak tertutup:
5. Otak ikut keluar:

A
  1. SPINA BIFIDA OCCULTA
  2. MENINGOKEL
  3. MIELOMENINGOKEL
  4. MIELOSKISIS
  5. ENSEFALOKEL
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15
Q

Nyeri testis, phren sign (+) nyeri berkurang, refleks kremaster (+) gores selangkangan testis gerak, demam

A

EPIDIDIMO-ORCHITIS

seftriakson 250mg IM SD + doksisiklin 2x100mg 10d (muda, aktif seksual: c. trachomatis/n. gonorrhea), levofloksasin 1x 500mg PO 10d (tua, UTI: e. coli)

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16
Q

Nyeri testis, phren sign (-), refleks kremaster (+), blue dot sign (+)

A

TORSIO APPENDIX TESTIS

SIMTOMATIS (NSAID, morfin); reseksi/orkidopeksi

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17
Q

Nyeri testis, phren sign (-) testis diangkat tetap nyeri, refleks kremaster (-) gores paha testis tidak gerak, testis horizontal, USG doppler vasc menurun, RF bell clapper deformity

A

TORSIO TESTIS

detorsi manual <6h; orkidopeksi (viabel); orkidektomi (non viabel)

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18
Q

Skrotum besar, transiluminasi (-), nyeri/berat, bag of worm, infertilitas, terlihat saat berdiri/valsava, dilatasi plexus pampiniformis

A

VARICOCELE

varikokelektomi

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19
Q

Skrotum besar, transiluminasi (+) difus, nyeri (-), akumulasi cairan tunika vaginalis

A

HIDROCELE

hidrokelektomi

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20
Q

Skrotum besar, transiluminasi (±), nyeri (-), benjolan superoposterior

A

SPERMATOCELE

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21
Q

Testis tidak turun tapi pada jalur penurunan, sejak lahir, gangguan gonadotropin

A

UDT/KRIPTOKIDISMUS

orkidopeksi inguinoskrotal (prepubertal teraba), orkidopeksi abdominal (prepubertal tidak teraba), orkidektomi (postpubertal, nonviabel)

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22
Q

Testis tidak turun dan diluar jalur penurunan, sejak lahir, insersi abnormal gubernakulum

A

TESTIS EKTOPIK

orkidektomi

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23
Q

Testis naik turun, prepubertas, hiperaktivitas m. cremaster

A

TESTIS RETRAKTIL

observasi

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24
Q

Testis naik menetap

A

KRIPTOKIDISMUS ACQUIRED/ASENDENS TESTIS

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25
Q

Ereksi tanpa rangsang seksual
1. Ringan menjadi sangat nyeri, sangat tegang, warna hitam, USG doppler (-), hemoglobinopati:
2. RIngan sampai sedang, tidak terlalu tegang, warna merah, USG doppler (+), trauma:

A
  1. PRIAPISMUS LOW FLOW/VENOOKLUSIF
  2. PRIAPISMUS HIGH FLOW/ARTERIAL

aspirasi; fenilefrin interkavernosal; distal shunt; proximal shunt (low flow)

observasi dan kompresi; embolisasi arteri; ligasi (high flow)

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26
Q
  1. OUE diatas/dorsal
  2. OUE dibawah/ventral
A
  1. EPISPADIA
  2. HIPOSPADIA
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27
Q

Nyeri, preputium tidak bisa retraksi dan menggembung saat BAK

A

FIMOSIS

jaga kebersihan, retraksi rutin; sirkumsisi elektif

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28
Q

Nyeri, jeratan/edema glans

A

PARAFIMOSIS

reposisi manual; sirkumsisi cito

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29
Q

Nyeri penis, eritema, discharge

A

BALANOPOSTITIS

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30
Q

Nyeri RT (+), demam (+), meares-stamey 4 glass (+) seluruh hasil

A

PROSTATITIS AKUT

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31
Q

Nyeri RT (+), demam (-), Meares-stamey 4-glass: VB1 (-), VB2 (-), EPS (+), VB3 (+)
1. WBC >10/HPF, MS4G semua (-):
2. WBC <10/HPF, MS4G semua (-):

A

PROSTATITIS KRONIS
1. ASYMPTOMATIC PROSTATITIS
2. CHRONIC PELVIC PAIN SYNDROME

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32
Q

Nyeri RT (-), massa kenyal simetris

A

BPH (z. transisional)

alpha adrenergic blocker penurun tonus [tamsulosin, alfuzosin (uroselektif); doxa-pra-terazosin (+anti HT)] (fast acting), 5-alpha reduktase inhibitor penurun ukuran [finasteride, dutasteride] (slow acting), phosphodiesterase-5 enzim inhibitor relaksan otot [tadalafil]; TURP

-sin –> alpha-adrenergic blocker (alfa-1) –> menurunkan tonus
-steride –> 5-ARI –> menghambat DHT = menurunkan ukuran prostat
-fil –> PDE5I –> menigkatkan cGMP = penurun tonus

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33
Q

Nyeri RT (-), massa keras asimetris

A

CA PROSTAT (z. perifer)

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34
Q

Nyeri (-), gross hematuria, LUTS, massa suprapubic, IVP filling defect

A

CA BULI

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35
Q

INKONTINENSIA URIN
1. Kelemahan sfingter uretra, dipicu peningkatan TIA:
2. Overaktivitas detrusor, urgensi/frekuensi:
3. Underaktivitas detrusor, BOO:
4. Campuran beberapa tipe:
5. Keterbatasan fungsi sehingga mengompol:

A
  1. TIPE STRESS
  2. TIPE URGE
  3. TIPE OVERFLOW
  4. TIPE MIXED
  5. TIPE FUNCTIONAL
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36
Q

Meatal bleeding, straddle injury, butterfly hematoma, RUG (+) EKSTRAVASASI:

A

RUPTUR URETRA ANTERIOR

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37
Q

Meatal bleeding, fr. pelvis, prostat melayang, RUG (+) EKSTRAVASASI

A

RUPTUR URETRA POSTERIOR

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38
Q

Rw trauma/kateter/ISK, LUTS obstruktif, VCUG striktur

A

STRIKTUR URETRA

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39
Q

Trauma os pelvis, nyeri localized, RCUG flame shaped

A

RUPTUR BULI EKSTRAPERITONEAL

kateter 7-14d

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40
Q

Trauma buli terisi, nyeri peritoneal, RCUG ekstravasasi dan outlined bowel loops

A

RUPTUR BULI INTRAPERITONEAL

laparoskopi

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41
Q

Trauma flank, CT DENGAN KONTRAS (GS)

A

RUPTUR GINJAL

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42
Q

CT TANPA KONTRAS (GS) BATU
1. Nyeri flank, gross hematuria, nyeri ketok CVA (+):
2. Nyeri kolik, menjalar sesuai perjalanan ureter:
- Pinggang, abdomen atas:
- Pinggang, abdomen depan, umbilikus:
- Abdomen bawah, groin/skrotum/labia:
3. Nyeri suprapubik, disuria, kencing tiba tiba berhenti dan diperbaiki posisi:
4. Nyeri uretral, disuria, kencing bercabang, palpasi penis (+) massa:

A
  1. NEFROLITIASIS
  2. URETEROLITIASIS
    - PROKSIMAL
    - MEDIA
    - DISTAL
  3. VESIKOLITIASIS
  4. URETROLITIASIS

hidrasi ≥2.5L, tamsulosin 1x 0.4mg, NSAID, etiologis (batu <0.5cm, non komplikasi), URS/SWL (ureterolitiasis, batu 0.5-2cm, lower pole 0.5-1cm), PNL (batu >2cm, lower pole >1cm)

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43
Q

Massa perut, nyeri perut, hematuria, usia <5y, WT1 (+)

A

WILMS TUMOR

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44
Q

Massa flank, nyeri flank, hematuria, BB turun, usia tua
1. HP clear:
2. HP papillary:
3. HP prominent cell border, perinuklear halo:

A

RENAL CELL CARCINOMA
1. TIPE CLEAR
2. TIPE PAPILLARY
3. TIPE CHROMOPHOBE

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45
Q

Rw trauma, dIstensi abdomen, seatbelt sign, bising usus turun, dullness
1. Rw trauma, jejas/nyeri RUQ:
2. Rw trauma, jejas/nyeri LUQ, kehr sign (+) menjalar bahu kiri, balance sign (+) traube space redup:

A

TRAUMA ABDOMEN
1. RUPTUR HEPAR
2. RUPTUR LIEN

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46
Q

MANTRELS, kocher sign (+) shifting tenderness, McBurney sign (+) RUQ pain, blumberg sign (+) rebound tenderness, rosving sign (+) nyeri palp LLQ, psoas sign (+) nyeri fleksi pinggul kanan, obturator sign (+) nyeri internal rotasi pinggul kanan, dunphy sign (+) valsava nyeri, tenhorn sign (+) traksi testis nyeri, RT nyeri arah 9-12, USG target sign, CT TANPA KONTRAS (GS)

A

APPENDISITIS AKUT

ABC, fowler, NPO, dehidrasi (IV fluid), NGT, ceftriaxone/cefazolin 1-2g IV, appendektomi (definitif)

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47
Q

Nyeri RLQ, massa (+), fluktuasi (+)

A

ABSES APPENDIX

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48
Q

Nyeri RLQ, massa (+), fluktuasi (-)

A

PERIAPPENDICULAR INFILTRATE

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49
Q

Hematokezia, nyeri LLQ, diare/konstipasi

A

DIVERTICULOSIS

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50
Q

Nyeri LLQ, mual muntah, demam

A

DIVERTICULITIS

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51
Q

Nyeri abdomen generalisata, defans muskular, perut keras seperti papan, rebound tenderness (+), peritoneal fat line (-), psoas line (-), cupula sign (+) pneumoperitoneum
1. Asites, paracentesis PMN >500 sel/uL:
2. TB, fenomena papan catur (+), paracentesis dominan limfosit, SAAG <11:
3. Perforasi GI/GU:
4. Menetap >48h setelah op:

A

PERITONITIS
1. PRIMER (SBP)
2. PRIMER (TB)
3. SEKUNDER
4. TERSIER

FIDAR [fasting, IV, decompression, Ab, rujuk]

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52
Q

Distensi, BAB kentut (-), nyeri kolik (+), darm contour (+), darm steifung (+), bising usus meningkat, metalic sound/borborhygmy, RT ampula kolaps, BOF 3 posisi stepladder (+), string of pearls (+), herringbone (+), udara (-) distal
1. Muntah», BOF 3 posisi udara sentral
2. Distensi», muntah bau feses, BOF 3 posisi udara perifer, haustra prominen:

A

ILEUS OBSTRUKTIF
1. LETAK TINGGI (SBO)
2. LETAK RENDAH (LBO)

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53
Q

Distensi, BAB kentut (-), Nyeri konstan (+), bising usus menurun, RT ampula intak, BOF 3 posisi dilatasi usus difus termasuk rektum, udara (+) difus

A

ILEUS PARALITIK

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54
Q

SIFAT HERNIA
1. Bisa keluar masuk:
2. Tidak bisa keluar masuk:
3. Tidak bisa keluar masuk + gangguan passage usus:
4. Tidak bisa keluar masuk + gangguan vascular:

A
  1. REPONIBILIS
  2. IREPONIBILIS/AKRETA
  3. INKARSERATA
  4. STRANGULATA
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55
Q

Distres napas, perut skafoid, bising usus thorax (+)
1. Hernia diafragma posterior kiri:
2. Hernia diafragma anterior kanan
3. Benjolan diafragma, GERD:

A
  1. HERNIA BOCHDALEK
  2. HERNIA MORGAGNI (MOANA = morgagni anterior kanan):
  3. HERNIA HIATAL/SLIDING
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56
Q

Benjolan groin hingga skrotum, atas ligamen inguinalis, lateral a./v. epigastrik inferior, lewat anulus/kanalis inguinalis, zieman telunjuk (+), finger test (+) ujung jari, thumb test (-), prosesus vaginalis persisten

A

HERNIA INGUINALIS LATERALIS/INDIREK

Pr vaginalis persisten, lewat kanalis inguinalis –> HIL
Kelemahan hesselbach, lewat trigonum hesselbach –> HIM
Kelemahan kanalis femoralis, lewat kanalis femoralis –> HF

Di atas lig. inguinalis –> HI
- lateral BV –> HIL
- medial BV –> HIM
- Di bawah lig inguinalis –> HF

Zieman (jari 2,3,4 posisi double finger)
2 –> HIL
3 –> HIM
4 –> HF

Finger (sodok kanalis inguinalis)
Ujung jari –> HIL (karena HIL di kanalis inguinalis)
Samping jari –> HIM

Thumb (tekan kanalis inguinalis)
Tidak keluar –> HIL (karena ditekan)
Keluar –> HIM / HF (karena bebas bergerak)

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57
Q

Benjolan groin, atas ligamen inguinalis, medial a./v. epigastrik inferior, lewat trigonum hesselbach, zieman tengah (+), finger test (+) samping jari, thumb test (+), kelemahan fasia hasselbach

A

HERNIA INGUINALIS MEDIALIS/DIREK

58
Q

Benjolan groin, bawah ligamen inguinalis, lewat kanalis femoralis/fossa ovalis, zieman manis (+), finger test (-), thumb test (+), kelemahan kanalis femoralis

A

HERNIA FEMORALIS

59
Q

HIL + HIM pada sisi sama

A

HERNIA PANTALOON/SADDLEBAG/ROMBERG

60
Q

Penunjang Hernia Groin

A

Awal USG, GS MRI

61
Q

HERNIA VENTRAL
1. Umbilikus:
2. Bekas operasi:
3. Hernia + meckel diverticulum:
4. Fasia spigelian abdomen anterior:

A
  1. HERNIA UMBILIKALIS
  2. HERNIA INSISIONAL
  3. HERNIA LITTRE
  4. HERNIA SPIEGEL
62
Q

Massa anus (+), demam (-), nyeri (±), merah, konsentrik/full thickness, RT hipotonus

A

PROLAPS REKTI

63
Q

Massa anus (+), demam (-), nyeri (-), ungu, radial, hematokezia (+), atas linea dentata

A

HEMOROID INTERNA

konservatif [tinggi serat, pelunak tinja, sitz bath] (I); rubber band ligation (II, III); pembedahan (IV); skleroterapi (ganguan pendarahan)

64
Q

Massa anus (+), demam (-), nyeri (+), ungu, tepi anus, hematokezia (+), bawah linea dentata

A

HEMOROID EKSTERNA

eksisi

65
Q

Massa anus (+), demam (+), nyeri (+), fluktuasi (+)

A

ABSES PERIANAL

INSISI DRAINASE, Ab, sitz bath/analgetik

66
Q

Massa anus (-), nyeri (+), BAB lendir darah

A

PROKTITIS

67
Q

Massa anus (-), nyeri (+), robekan

A

FISURA ANI

68
Q

Massa anus (-), feses dari selain anus, MRI (GS) fistula

A

FISTULA ANI

69
Q

Disfagia padat lalu cair, GERD, MANOMETRI (GS) aperistalsis, bird beak sign (+)

A

ACHALASIA

patof: degenerasi ganglion myenterik/auerbach pleksus –> LES tdk bs relax

CCB/ISDN; inj botox; heller myotomy/peroral endoscopic myotomy

70
Q

BB turun, dispepsia, GI study filling defect (+), leather bottle appearance (+)

A

CA GASTER

71
Q

BB turun, perubahan pola BAB lalu menjadi feses kotoran kambing, BAB berdarah, CEA >2.5, apple core sign (+)
1. Kolitis, diare, darah samar, anemia (+): KOLON KANAN
2. Obstruksi, konstipasi, darah samar/makro, anemia (-): KOLON KIRI
3. Obstruksi, tenesmus, darah makro, anemia (-), feses kotoran kambing: REKTUM

A

CA KOLOREKTAL
1. KOLON KANAN
2. KOLON KIRI
3. REKTUM

72
Q

BB turun, nyeri RUQ, jaundice obstruktif

A

CA KOLANGIO

72
Q

BB turun, courvoisier sign (palpable nontender gallbladder + jaundice), CA 19-9 (+)

A

CA PANKREAS

73
Q

Usus keluar terbungkus peritoneum/amniotic sac di umbilicus, beckwith-wiedemann syndrome

A

OMPALOKEL/EXOMPHALOS

74
Q

Usus keluar tanpa terbungkus paraumbilicus

A

GASTROSCHIZIS

75
Q

KELAINAN DUKTUS VITELLINUS (OMPHALOMESENTERIK)
1. Gagal obliterasi total:
2. Gagal obliterasi proksimal (ileum):
- Divertikulum asli, rule of 2 (2 kaki dari IC valve, <2 inci, 2 tipe mukosa gaster/pankreas ektopik, <2 tahun), asimtomatik tapi bisa currant jelly stool, scintigraphy/Tc-99m scan (+) hot spot
3. Gagal obliterasi tengah:
4. Gagal obliterasi distal (umbilikus):

A
  1. FISTULA VITELLINUS
  2. MECKEL DIVERTICULUM
  3. KISTA VITELLINUS
  4. SINUS VITELLINUS
76
Q

KELAINAN DUKTUS URACUS (MEDIAL UMBILICAL LIG.)
1. Gagal obliterasi total:
2. Gagal obliterasi proksimal (bladder):
3. Gagal obliterasi tengah:
4. Gagal obliterasi distal (umbilikus):

A
  1. FISTULA URACAL
  2. VESICOURACAL DIVERTICULUM
  3. KISTA URACAL
  4. SINUS URACAL
77
Q

Non bilious vomiting (putih/bening), polihidramnios (+), hipersalivasi/tersedak/coiled NGT (+)

A

ATRESIA ESOFAGUS

78
Q

Non bilious vomiting (putih/bening), polihidramnios (+), muntah setelah lahir, single bubble sign (+)

A

ATRESIA PILORUS

79
Q

Non bilious vomiting (putih/bening) proyektil, polihidramnios (-), 3-6 wk, massa RUQ/Epigastrium (olive sign), caterpillar sign (+) x-ray, cervix/target sign (+) USG (GS), string/double track/mushroom sign (+) barium

A

HYPERTROPHIC PYLORUS STENOSIS

80
Q

Bilious vomiting (kuning/hijau), polihidramnios (+), double bubble sign (+)

A

ATRESIA DUODENUM

81
Q

Bilious vomiting (kuning/hijau), polihidramnios (+), triple bubble sign (+)

A

ATRESIA JEJUNUM

82
Q

Bilious vomiting (kuning/hijau), polihidramnios (-), tidak ada anus, INVERTOGRAM >1.5

A

ATRESIA ANI LETAK TINGGI

kolostomi lalu PSARP

83
Q

Bilious vomiting (kuning/hijau), polihidramnios (-), tidak ada anus, INVERTOGRAM <1.5

A

ATRESIA ANI LETAK RENDAH

PSARP

84
Q

Bilious vomiting (kuning/hijau), polihidramnios (-), mekoneum >24 jam, feses menyemprot, rat tail appearance (+) barium, RECTAL SUCTION BIOPSY (GS) aganglionik segmen rektosigmoid

A

HIRSCHSPRUNG DISEASE

85
Q

Bilious vomiting (kuning/hijau), polihidramnios (-), nyeri kolik, currant jelly stool, sausage sign (+) palpasi abdomen, dance sign (+), pseudoportio (+) RT, claw/cupping/coiled spring sign(GS) BARIUM DENGAN KONTRAS, target sign (+) USG

A

INTUSUSEPSI

reduksi hidrostatik dengan barium

86
Q

Bilious vomiting (kuning/hijau), polihidramnios (-), coffee bean sign (+) BOF, bird beak sign (+) barium

A

SIGMOID VOLVULUS

87
Q

Bilious vomiting (kuning/hijau), polihidramnios (-), double bubble sign (+) BOF, corkscrew/whirlpool sign (+) barium

A

MIDGUT VOLVULUS

88
Q

Suara napas hilang, timpani (+), daerah lusen avaskular, visceral pleural line (+)
1. TIdak ada pendorongan:
2. Pendorongan mediastinum (trakea, jantung):
3. Luka terbuka (-):
4. Luka terbuka (+):

A

PNEUMOTHORAX
1. SIMPLE
2. TENSION
3. CLOSED
4. OPEN

needle decompression ICS 4-5 AAL; WSD (simple, tension), plester 3 sisi; WSD (open)

89
Q

Suara napas hilang, pekak (+), area opak

A

HEMATOTHORAX

WSD; torakotomi (volum>1000mL, tamponade, open pneumothorax, perforasi organ, emboli udara)

90
Q

Gerak napas paradoksal (inspirasi dada ke dalam, ekspirasi dada ke luar), krepitasi

A

FLAIL CHEST

analgesik kuat; fiksasi internal

91
Q

Trias beck (suara jantung jauh, JVP naik, hipotensi), pulsus paradoksus (penurunan SBP saat inspirasi)

A

CARDIAC TAMPONADE

needle perikardiosentesis

92
Q

Gingko leaf sign (+) x-ray

A

EMFISEMA SUBKUTIS

93
Q

<2wk, 6P (pain, pallor, pulseless, paralysis, parethesia, poikiloterm), tungkai biru

A

ACUTE LIMB ISCHEMIA/ALI

embolektomi<6h, heparin bolus 100U/kg lalu 150U/kg/h

94
Q

≥2wk, nyeri saat aktivitas dan membaik dengan istirahat

A

CHRONIC LIMB ISCHEMIA NON KRITIS/KLAUDIKASIO INTERMITEN

arteriodilator cilostazol, tx RF

95
Q

≥2wk, nyeri menetap saat istirahat, ulkus tidak sembuh:

A

CHRONIC LIMB ISCHEMIA KRITIS

revaskularisasi , rx RF

96
Q

Bruit abdomen, nyeri seperti tersayat, CTA robekan aorta

A

DISEKSI AORTA

97
Q

Laki <45y, MEROKOK, fenomena raynaud (+), gangren ujung jari kaki/tangan, ABI turun, ARTERIOGRAFI (+) CORKSCREW PEMB DARAH DISTAL

A

THROMBOANGITIS OBLITERANS/BUERGER DISEASE

98
Q

Nyeri kepala temporal, nyeri kunyah, polimialgia reumatika, arteri sedang-besar, TEMPORAL A. BIOPSY (+) MGC:

A

GIANT CELL ARTERITIS

99
Q

Demam, pulseless, perbedaan TD kanan-kiri, aorta, CTA (GS)

A

TAKAYASU ARTERITIS

Patof:
inflamasi autoimun BV besar (aorta, subklavia, karotid, renal) –> gejala sistemik, pulseless

100
Q

Klaudikasio lengan, pusing/vertigo, perbedaan TD kanan-kiri, bruit supraklavikular, CTA (GS)

A

SUBCLAVIAN STEAL SYNDROME

Patof:
stenosis a subklavia saja –> klaudikasio lengan, penurunan perfusi PCA = vertigo

aspirin, proximal subclavian endarterectomy

101
Q
  1. Ujung jari memucat/biru karena dingin/stres, wanita, idiopatik, reversibel:
  2. Ujung jari memucat/biru karena dingin/stres, wanita, ada penyakit sistemik, ireversibel:
A
  1. PENYAKIT RAYNAUD (PRIMER)
  2. PENYAKIT RAYNAUD (SEKUNDER)
102
Q

Pembengkakakan unilateral ext bawah, stemmer sign (+)

A

LIMFEDEMA

103
Q

Terlalu lama berdiri/hamil/sedentary, nyeri, kaki gatal, sesuai stadium [telangiektasis <3mm, varises >3mm, edema, perubahan kulit, ulkus menyembuh, ulkus aktif]

A

CVI

elevasi kaki, kompresi stocking, rawat luka, ablasi endovena

104
Q
  1. DM, ulkus plantar, nyeri (-), dikelilingi kalus, kebas
  2. CVI, ulkus diatas ankle, nyeri (+), tidak meninggi, hemosiderin (+)
  3. Oklusi arteri, ulkus bawah ankle pada pressure point, nyeri (+), punched out appearance
  4. Imobilitas, ulkus prominensia tubuh, maserasi
  5. Hygiene buruk, ulkus tungkai bawah, nyeri (+), bau busuk, dasar kotor tepi menggaung
A
  1. ULKUS DIABETIKUM
  2. ULKUS VENA
  3. ULKUS ARTERI
  4. ULKUS DEKUBITUS
  5. ULKUS TROPIKUM
105
Q

MASSA PAYUDARA
1. Massa payudara, pembesaran KGB (+), pendarahan puting (+), retraksi puting
2. Massa payudara, pembesaran KGB (+), pendarahan puting (-), retraksi puting
3. Massa payudara, pembesaran KGB (-), membesar cepat, biopsy leaf like
4. Massa payudara, pembesaran KGB (-), tidak nyeri, kenyal, wanita muda:
5. Massa payudara, pembesaran KGB (-), nyeri, kistik
6. Massa payudara, pembesaran KGB (-), sekret puting (+)

A
  1. CA MAMMAE DUKTAL
  2. CA MAMMAE LOBULAR
  3. PHYLLOIDES
  4. FIBROADENOMA/FAM
  5. FIBROCYSTIC CHANGE
  6. PAPILLOMA
106
Q

Penunjang Massa Payudara

A

<40y: USG, ≥40y: MAMMOGRAFI, BIOPSI (GS)

107
Q

Massa kulit, KONGENITAL, isi dermal [rambut, kelenjar], terfiksasi:

A

KISTA DERMOID

108
Q

Massa kulit, isi keratin epitel, bau (-)

A

KISTA EPIDERMOID

109
Q

Massa kulit, isi kental purulen sebum, bau (+), punctum (+)

A

KISTA SEBASEA/ATEROMA

110
Q

Massa kulit, slip sign (+)

A

LIPOMA

111
Q

Massa kulit, NYERI, multipel, cafe au lait spot (+)

A

NEUROFIBROMA

112
Q

Massa kulit, transiluminasi (+), di pergelangan

A

KISTA GANGLION

112
Q

Kompresi jalan napas, phrenic nerve palsy (paralisis diafragma), SVC sindrom (distensi/edema, JVP naik), MG

A

TIMOMA

113
Q

GANGGUAN BONE HEALING
1. Tidak ada kemajuan setelah 3-6 mo
2. Tidak ada penyembuhan setelah 9-12 mo
3. Penyembuhan alignment salah

A
  1. DELAYED UNION
  2. NON UNION
  3. MAL UNION
114
Q

FR. ANTEBRACHII
1. Fr ulna, ds caput radius/elbow:
2. Fr radius, ds radioulnar/wrist:
3. Jatuh pergelangan ekstensi, Ds dorsal, Dinner fork (+):
4. Jatuh pergelangan fleksi, Ds volar/ventral, Garden spade (+):
5. Fr radiokarpal:
6. Fr styloid radius:
7. Fr MCP 5 (kelingking):
8. Fr MCP 1 (jempol):

A
  1. FR. MONTEGGIA
  2. FR. GALEAZZI
  3. FR. COLLES
  4. FR. SMITH
  5. FR. BARTON
  6. FR. CHAFFEUR
  7. FR. BOXER
  8. FR. BENNETT

MUGR
MONTEGGIA –> ulna
GALEAZZI –> radius

CD VS
COLLES –> dorsal
Ventral –> SMITH

Boxing kelingking yang diluar
BOXER –> MCP 5

115
Q

Tatalaksana Fr Klavikula

A

arm sling (ds/sh<2, closed fr), ORIF

116
Q

Tatalaksana Fr Terbuka

A

stabilisasi, sefazolin + gentamisin IV, dressing NaCl, bidai, profilaksis tetanus

117
Q

6P (pain, pallor, paresthesia, paralysis, pulseless, poikilotermia)

A

COMPARTMENT SYNDROME

fasiotomi

118
Q

Abduksi, rotasi eksternal

A

DS. ANTERIOR

119
Q

Adduksi, rotasi internal, x-ray (+) light bulb sign

A

DS. POSTERIOR

120
Q

Gejala konstitusional, gejala infeksi, KULTUR (GS) bakteri
1. <2wk, soft tissue swelling:
2. 2wk-3mo, abses brodie (+):
3. >3mo, kloaka, sekuestrum, involkrum:

A

OSTEOMIELITIS
1. AKUT
2. SUBAKUT
3. KRONIK

sefazolin 4x 1-1.5g IV (s. aureus), vankomisin 2x 1g IV (MRSA), cefepime 2x 2g IV (pseudomonas)

121
Q

MASSA TULANG
1. Nidus sentral radiolusen, tepi sklerotik (+):
2. Mushroom/cauliflower appearance (+), eksositotik/bertangkai:
3. Sunburst appearance (+), codman triangle (+):
4. Onion skin appearance (+)
5. Popcorn appearance (+):
6. Punched out lesion, lesi litik (+):
7. Soap bubble appearance (+) epifisis:

A
  1. OSTEOID OSTEOMA/OSTEOBLASTOMA
  2. OSTEOCHONDROMA
  3. OSTEOSARCOMA
  4. EWING SARCOMA
  5. CHONDROSARCOMA
  6. MULTIPLE MYELOMA
  7. OSTEOCLASTOMA (GIANT CELL TUMOR)
122
Q

Lachman test (+) tonjolan anterior, anterior drawer test (+) tibia geser anterior, Macintosh/pivot shift test (+) tibia jatuh fleksi lutut

A

RP. ACL

123
Q

PCL sag test (+) tibia turun akibat gravitasi, posterior drawer test (+) tibia geser posterior

A

RP. PCL

124
Q

Valgus stress test (+) “gum = nempel = bentuk X”

A

RP. MCL

125
Q

Varus stress test (+)

A

RP. LCL

126
Q

McMurray test (+) hadap atas lutut endorotasi pop, apley compression test (+) hadap bawah lutut rotasi nyeri, thessaly test (+), berdiri satu kaki nyeri

A

RP. MENISKUS LATERAL

127
Q

McMurray test (+) hadap atas lutut eksorotasi pop, apley compression test (+) hadap bawah lutut rotasi nyeri, thessaly test (+) berdiri satu kaki nyeri

A

RP. MENISKUS MEDIAL

128
Q

Repetisi fleksi siku/pronasi, nyeri epikondilus medial

A

EPIKONDILITIS MEDIAL/GOLFER’S/PITCHER’S/THROWER ELBOW

129
Q

Repetisi ekstensi siku/supinasi, nyeri epikondilus lateral:

A

EPIKONDILITIS LATERAL/TENNIS ELBOW

130
Q

Thompson test (+) pijat gastrocnemius TIDAK plantarfleksi, simmonds test (+), calf squeeze test (+), palpable gap (+)
1. THompson test (-)

A

RP. ACHILLES
1. TENDINITIS ACHILLES

131
Q

Kanavel sign (+) [nyeri sepanjang tendon, pembesaran simetris fusiform (sausage like), nyeri ekstensi pasif, flexed posture]

A

TENOSYNOVITIS SUPURATIF

Ab IV broad spektrium, irigasi/debridemen

132
Q

Finkelstein test (+) genggam jempol ekstensi nyeri

A

TENOSYNOVITIS DE QUERVAIN

133
Q

Osteofit/bone spur (+), diskus menyempit (+) spine

A

SPONDYLOSIS

Patof: degenerasi vertebra dan diskus intervertebra

134
Q

Scottie dog sign (+)

A

SPONDYLOLISIS

Patof: fr stress pada pars interartikularis vertebra

135
Q

Inverted napoleon hat sign (+), slippage of vertebra

A

SPONDYLOLISTHESIS

Patof: slippage dan displacement segmen vertebra

136
Q

Schober test (+) fleksi vertebra jarak terbatas, bamboo sign (+), dagger sign (+)

A

ANKYLOSING SPONDYLITIS

137
Q

Adam’s forward bend test (+) rib hump, cobb angle (+):

A

SKOLIOSIS

observasi (<20), bracing (<40), operasi (≥40)

138
Q

Barlow test dan Ortholani test (+) dislokasi lalu reduksi, galeazzi sign (+) perbedaan tinggi lutut

A

DISPLASIA PANGGUL/DDH

pavlic harness (≤6mo), hip-spina cast (≤24mo), operasi/reduksi terbuka (>24mo)

139
Q

CAVE (+) [cavus (lengkung kaki tinggi), adductus (kaki depan aduksi), varus (kaki belakang varus), equinus (tumit ekuinus)]

A

CTEV

cast teknik ponseti; operatif (>9mo); fiksasi eksternal (profilaksis relaps)

140
Q

Sklera biru, gigi biru, fraktur berulang

A

OSTEOGENESIS IMPERFECTA/BRITTLE BONE DISEASE

GAS (14 decks)

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