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    Tugas Baca

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    Wayan Ferly
    The document is a night shift report from February 18, 2023 at an unnamed hospital. It lists the physicians on duty that night in the emergency department and rooms, including the chief physician and consultants. It also references several academic journal articles on topics like Pneumocystis pneumonia (PCP) diagnosis and treatment, TNM staging for lung cancer, and post-obstructive pneumonia.

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    Tugas Baca

    Uploaded by

    Wayan Ferly
    31 views20 pages
    The document is a night shift report from February 18, 2023 at an unnamed hospital. It lists the physicians on duty that night in the emergency department and rooms, including the chief physician and consultants. It also references several academic journal articles on topics like Pneumocystis pneumonia (PCP) diagnosis and treatment, TNM staging for lung cancer, and post-obstructive pneumonia.

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    The document is a night shift report from February 18, 2023 at an unnamed hospital. It lists the physicians on duty that night in the emergency department and rooms, including the chief physician and consultants. It also references several academic journal articles on topics like Pneumocystis pneumonia (PCP) diagnosis and treatment, TNM staging for lung cancer, and post-obstructive pneumonia.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    31 views20 pages

    Tugas Baca

    Uploaded by

    Wayan Ferly
    The document is a night shift report from February 18, 2023 at an unnamed hospital. It lists the physicians on duty that night in the emergency department and rooms, including the chief physician and consultants. It also references several academic journal articles on topics like Pneumocystis pneumonia (PCP) diagnosis and treatment, TNM staging for lung cancer, and post-obstructive pneumonia.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 20

    LAPORAN JAGA

    Senin Malam, 18 Februari 2023

    Penanggung Jawab Ilmiah : dr. Adityo Wibowo Sp.P


    Konsulen Ruangan : Dr. dr. Retno Ariza S Soemarwoto Sp. P(K), FCCP,FISR
    Konsulen Laporan Jaga : dr. R. Dicky Wirawan L, Sp. P
    Dokter Jaga IGD : dr. Rizki Putra Sanjaya
    Dokter Jaga Ruangan : dr. Hetti/ dr. Pratiwi/ dr. Wayan
    Microbes Infect Chemother, 2021, v.1, 1-6, e1196
    Diagnosis PCP

    • Diagnosis of PCP is multifactorial and may include clinical suspicion, patient risk factors, laboratory evaluations, chest
    radiograph, chest computed tomography (CT), sputum studies, evaluation of bronchoalveolar lavage fluid, or lung biopsies.
    • Laboratory findings can be nonspecific for PCP, and of most notable mention is an elevated serum lactate dehydrogenase
    (LDH) in HIV-infected patients

    Justina Truong; John V. Ashurst, Kingman Regional Medical Center, Pneumocystis Jirovecii Pneumonia, November 23,
    2022
    Treatment PCP
    • First-line treatment choice for HIV-infected and uninfected patients is 21 days of trimethoprim-sulfamethoxazole (TMP-SMX)
    • For mild to moderate treatment, TMP 15 to 20 mg/kg/day and SMX 75 to 100 mg/kg/day, given orally in 3 or 4 divided doses or TMP-SMX DS,
    two tablets three times per day.
    • For moderate to severe cases (e.g., PaO ≤ 60 mmHg, respiratory rate > 25), TMP 15 to 20 mg/kg/day and SMX 75-100 mg/kg/day are given
    intravenously (IV) every 6 to 8 hours with a switch to oral when the patient shows clinical improvement

    Alternative drug regimens for the treatment of PCP in those with sulfa allergies and mild to moderate disease include:
    • Atavaquone 750 mg, orally twice daily for 21 days (must be taken with food).
    • Trimethoprim 15 mg/kg/day by mouth twice daily plus dapsone 100 mg by mouth every day
    • Primaquine 30 mg daily, plus clindamycin by mouth 450 mg every 6 hours or 600 mg every 8 hours.

    Alternative treatments for moderate to severe cases include:


    • Pentamidine 4 mg/kg IV once daily over 60 minutes
    • Primaquine 30 mg by mouth every day plus clindamycin IV 600 mg every 6 hours or 900 mg every 8 hours.

    Corticosteroids also may be recommended in HIV-uninfected patients with PCP due to the potential for high mortality and fulminant course of illness,.
    Dosing for prednisone should be started as soon as possible or within 72 hours of starting treatment for PCP and is as follows:
    40 mg by mouth twice per day on days 1 through 5,
    40 mg by mouth daily on days 6 through 10
    20 mg orally daily on days 11 through 21. IV
    Methylprednisone can be given at 75% of the prednisone dose if oral therapy cannot be tolerated. HIV-infected patients who are not already on them
    should have antiretroviral therapy (ART) initiated within two weeks of Pneumocystis treatment or as soon as they are stable enough to begin treatment.
    Patients usually show slightly worsening clinical signs around days 3 to 4 due to the host's inflammatory response to dying organisms and then
    improvement afterward.

    Justina Truong; John V. Ashurst, Kingman Regional Medical Center, Pneumocystis Jirovecii Pneumonia, November 23,
    2022
    TNM 8
    Performa Status
    Pain management
    Post-Obstructive Pneumonia
    • Post-obstructive pneumonia
    is defined as infection of the
    lung parenchyma distal to a
    bronchial obstruction.

    Rolston KVI, Nesher L. Post-Obstructive Pneumonia in Patients with Cancer: A Review. Infect Dis Ther.
    2018 Mar;7(1):29-38.
    Demam Berdarah Dengue

    Sumber: PPK Interna 2019


    Efusi Pleura

    Tumor

    Kemokin:
    chemoattract
    ant protein-1

    Kriteria EFUSI PLEURA KEGANASAN: Meningkatka


    1. CP berwarna xerous hemoragic atau hemoragic yang n
    berulang dengan volume masif Permeabilitas
    2. Hasil sitologi CP atau biopsi pleura menunjukkan sel Kapiler
    ganas
    3. Ditemukan kanker primer di paru atau organ lain diparu.

    Efusi

    Sumber : EFUSI PLEURA MALIGNA: DIAGNOSIS DAN PENATALAKSANAAN TERKINI, Divisi Pulmonologi Bagian FK Unud
    PCP (Pneumocytis pneumonia)

    Sumber: PPK Interna 2019

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