Skenario B Blok 15
Skenario B Blok 15
Skenario B Blok 15
Mr. E 38 years old, came to the emergency department with complaint of yellow eyes in the
last 3 days. The complaint was accompanied by urine that looks like dark tea, no history of
putty-like stool and itchy skin. Patient has been having mild fever in the last 1 week. Mr. E also
complained weakness of the body, epigastric pain, nausea and decreased appetite.
Mr. E had hepatitis B from birth, his mother and his brother, had hepatitis B too. Mr. E had no
history of long-term medication, consumption of alcohol, and drugs abused.
Physical Examination
Vital Sign: BP 120/80 mmHg, pulse 90x/min, RR 20x/min, temperature 37,2 celcius
Specific Examination
Head: Palpebra conjunctiva was not pale, sclera was yellow (+/+)
Thorax:
Pulmo:
- Inspection: Flat, caput medusa (-), cullen sign (-), gray turner sign (-)
- Palpation: Weak, Murphy sign (-), liver not palpable, lien S2, ballottement(-)
- Percussion: Shifting dullness (+)
- Auscultation: Normal Bowel sound
Extremities: Pretibial edema (+), Palmar Erythema (+)
Laboratory examination:
2. Identifikasi Masalah
Physical Examination VV
Specific Examination VV
Thorax:
Pulmo:
Laboratory examination: VV
3. Analisis Masalah
1. Mr. E 38 years old, came to the emergency department with complaint of yellow eyes
in the last 3 days.
a. Bagaimana anatomi dan fisiologi dari hepatobilier? (vania, rafi, aldo)
b. Apa penyebab dan bagaimana mekanisme dari jaundice pada kasus? (rafi, aldo,
bella)
c. Apa saja etiologi dari terjadinya jaundice? (bella, afiya, icha)
d. Apa makna keluhan mata kuning sejak 3 hari pada kasus? (afiya, icha, ale)
2. The complain was accompanied by urine that looks like dark tea, no history of putty-
like stool and itchy skin. Patient has been having mild fever in the last 1 week. Mr. E
also complained weakness of the body, epigastric pain, nausea and decreased appetite.
a. Bagaimana patofisiologi urin berwarna seperti teh pekat? (icha, ale, intan)
b. Bagaimana interpretasi no history of putty-like stool and itchy skin? (ale, intan,
alif)
c. Bagaimana ciri-ciri urin dan feses yang normal? (intan, alif, peksi)
d. Bagaimana patofisiologi mild fever pada kasus? (peksi, safira, sandora)
e. Bagaimana patofisiologi weakness of the body pada kasus? (safira, sandora,
vania)
f. Bagaimana patofisiologi epigastric pain pada kasus? (sandora, vania, rafi)
g. Bagaimana patofisiologi mual dan penurunan nafsu makan pada kasus? (vania,
rafi, aldo)
3. Mr. E had hepatitis B from birth, his mother and his brother, had hepatitis B too. Mr.
E had no history of long-term medication, consumption of alcohol, and drugs abused.
a. Apa saja faktor risiko dari penyakit hepatitis B? (rafi, aldo, bella)
b. Apa saja komplikasi dari penyakit hepatitis B? (aldo, bella, afiya)
c. Bagaimana patofisiologi dari penyakit hepatitis B? (bella, afiya, icha)
d. Bagaimana hubungan penyakit hepatitis B dengan keluhan yang dialami pasien?
(afiya, icha, ale)
e. Bagaimana tatalaksana pengobatan penyakit hepatitis B? (icha, ale, intan)
4. Physical Examination
a. Apa interpretasi pemeriksaan fisik pada kasus? (ale, intan, alif)
b. Bagaimana mekanisme abnormalitas pemeriksaan fisik pada kasus? (intan, alif,
peksi)
c. Mengapa seminggu yang lalu pasien mengalami mild fever tetapi terjadi
perbaikan suhu pada pasien? (alif, peksi, safira)
5. Specific Examination
a. Apa interpretasi pemeriksaan spesifik pada kasus? (peksi, safira, sandora
b. Bagaimana mekanisme abnormalitas pemeriksaan spesifik pada kasus? ? (safira,
sandora, vania
c. Bagaimana cara pemeriksaan shifting dullness? (sandora, vania, rafi)
6. Laboratory examination:
a. Apa interpretasi pemeriksaan laboratorium pada kasus? (vania, rafi, aldo)
b. Bagaimana mekanisme abnormalitas pemeriksaan laboratorium pada kasus? (rafi,
aldo, bella)
HIPOTESIS
Kerangka Konsep
4. Learning Issue
a. Sirosis hepatis
b. Hepatitis B
c. Anatomi, fisiologi hepatobilier
Kesimpulan
Mr. B, 30 tahun mengidap infeksi tuberculosis paru dengan BTA positif dan limfadenitis TB.