UKMPPD > HOM > Flashcards

HOM Flashcards

(44 cards)

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1
Q

Pd terdiri dari

A

Plasma : air, protein (albumin dan globulin), fr pembekuan 1-13

Sel : eritrosit, leukosit, trombosit

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2
Q

Anemia mikrositik hipokrom (mcv dan mch⬇️)

A

Kafetasik

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3
Q

Anemia def. Besi

A

Mdt : sel pensil, ciger cell, cerutu
Gold : profil besi : si⬇️, feritin⬇️, tibc ⬆️

Tx non farmako
⬆️ besi : daging, hati ayam
⬆️ fe : vit c, jus jeruk
Hindari : ppi, antasida, teh, kopi

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4
Q

Tx farmako anemia def besi

A

Sf 3x200/325 (60-65 besi elemental) -> cek 3-4 minggu sampe 3-6 bulan setelah normal

Transfusi jika hb <7 + gang. Hemodinamik

Vit c, asam askorbat

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5
Q

Anemia sideroblastik

A

Patof : gang. Pengikatan besi, mutasi gen. Terkait kromosom x

Px : BMP ring sideroblastik (paperheimer body)

Tx : rujuk

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6
Q

Anemia penyakit kronik

A

Px : feritin n/⬆️, tibc n/⬇️

Tx : terapi yg mendasari

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7
Q

Thalasemia

A

Etio : defek rantai globin,autosomal resesif

Dx : 5 l , jaundice, organomegali, facies coley / rodent, transfusi berulang

Px :
- mdt : sel target, tear drop
- foto schaedel : hair on end
- gold : hb elektroforesa ( beta : hba2 & hbf⬆️, alfa : hba1⬇️ )

Tx. Transfusi prc seumur hidup + kelasi besi (deferoxamine/deferiprone/deferiprox)

Eso transfusi : hemosiderosis

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8
Q

RETIKULOSIT ⬆️ (>= 15%)
Anemia Hemolitik

A

Anemia hemolitik (imun)
-AIHA
-inkompabilitas ABO-RH

ANEMIA HEMOLITIK (non imun)
- G6PD

Anemia perdarahan akut

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9
Q

AIHA

A

Px : coomb test +

Tx : ks (prednison 3x5)- rujuk, transfusi WRC

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10
Q

Anemia G6PD

A

G6PD (glucosa 6 phosfate dehidrogenase)

Etio : radikal bebas, penggunaan obat, genetik

Px : mdt : heinz body/bite cell, coombtest -

Tx : stop obat, simptomatik

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11
Q

Retikulosit ⬇️

A

Aplastik

Renalis

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12
Q

Aplastik

A

Etio :
- primer : gang. Sumsum tulang
- sekunder : r. Kloramfenikol

Px : gold (bmp : hiposeluler/hipoplastik + dominasi sel lemak)

Tx : rujuk -> transplantasi sumsum tulang (definitif), cyclophosphamide, ks

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13
Q

Renalis

A

Tx : atasi penyakit ginjal + eritropoetin

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14
Q

Anemia def. B12/sianokobalamin

A

Fr. Lambung, gastrektomi, ppi, antasida, metfromin, bypas ileus

Gx : kesemutan, kebas

Px : uji shilling 1 mg, kadar b 12

Tx :
Inj. B12 1 mg/hari 1 minggu
Inj. B12 100 mcg/2 hari 2 minggu
Inj. B12 100 mcg/3 hari 3 minggu

Makroovalosit (px : MDT)

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15
Q

Def. Asam folat/b9

A

Fr: hamil, alkohol, obat toxo, obat epilepsi,duodenum

Px gold : kadar b9 serum rendah

Tx :
Asam folat 5 mg/hari (1-4 bln)
Hamil + ada r. Spina bifida/labiopalatoskisis/anensefali : 1x 4000 mcg/4 mg
Hamil + tidak ada r.apapun : 1x 400 mcg/0,4 mg selama hamil

Hipersegmented neutrofil

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16
Q

Glositis ditemukan pada anemia apa

A

Besi, b9, b12

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17
Q

Polisitemia/eritrositosis

A

Hb>16 atau eritrosit >6 jt

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18
Q

Klasifikasi polisitemia vera (Absolut : ⬆️ eritrosit)

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A

Klasifikasi :
1. Primer/vera/rubra : kelainan di sumsum tulang (eritrosit⬆️, leukosit⬆️, trombo⬆️), genetik (JAK 2)

  1. Sekunder : cuma eritrosit⬆️ yang lain normal
    - patologis : penyakit paru, penyakit ginjal, keracunan co, kongenital
    - fisiologis : chronic mountain sickness/monges disease, tinggal di pegunungan
19
Q

Polisitemia bera relatif

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A

Sel darah merah seakan akan tinggi

Dehidrasi, perdarahan, luka bakar

20
Q

Tx polisitemia

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A

Primer : rehidrasi, flebotomi, ruxolitinib, aspirin -> awal : flebotomi + aspirin

Patologis : rehidrasi, atasi penyakit yang mendasar

Fisiologis : rehidrasi

Relatif : rehidrasi

21
Q

Gang. Hemostasis

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A

Proses henti perdarahan

Pd, trombosit -> bt (trombosit, vasokonstriksi)
Coagulasi -> ct (pt : 2,7 ; tt : 5,10 ; aptt/intrinsik: 8,9,11,12)

22
Q

Kelainan vasokonstriksi (HSP)

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A

Px : Bt⬆️, trombosit normal, serum ig a ⬆️, pt dan aptt normal, red blood cast+

Hematuria, small child, palpable purpura, arthiritis, ig a, abdominal pain

Tx : prednison 1-2 mg/ bb

23
Q

Kelainan di trombosit (itl,vwd )

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A

Itp :
- Px : bt⬆️, trombosit ⬇️
- Gx : Autoimun, peteki, purpura, r.ispa, diare, vaksin
- tx : rujuk, prednison

Vwb :
- px : bt⬆️, ct dan aptt⬆️, trombosit normal,
- Gold : vwf ⬇️, ristocetin +
- tx : vwf, desmopressin, kriopresipitat, fr.viii

24
Q

Gang. Koagulasi (APCD/def. Vit K, hemofilia)

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A

APCD/vkbd (fr. II, VII, IX, X rendah)
- px : ct ⬆️, aptt⬆️/normal, pt⬆️, tt, bt normal
- fr.: bayi yg lahir di dukun, minum susu formula
- tx : vit k 1 mg/ hari (3 hari berturut turut), rujuk

Hemofilia :
- lab : ct ⬆️ dan aptt ⬆️, bt dan pt normal
- etio : x linked resesif kromosom x
- klasifikasi : viii (klasik), ix (critmas disease), xi
- gx : perdarahan di sendi
- tx : a (f.viii, kriopresitat), b (f9, ffp), c (f11, ffp)

25
Kelainan pemecahan fibrin
Melibatkan trombosit, fr. Coagulasi DVT : - px : bt dan ct⬆️ , d dimer ⬆️, trombo⬇️, pt⬆️, fibrinogen⬇️ - gold : venografi, usg doppler - gx : edema tungkai unilateral, homan sign (nyeri saat dorsofleksi) +, d dimer ⬆️ - tx : antikoagulan ( heparin, warfarin) DIC : -px : bt dan ct⬆️,trombo ⬇️, aptt⬆️, d dimer ⬆️, fibrinogen⬇️ -etio : komplikasi penyakit : keganasan, sepsis, pph - tx : transfusi ffp, trombosit concentrate, kriopresipitat
26
Px Leukimia
Gold : bmp Leukost > 30.000
27
Klasifikasi leukimia :
Akut -usia muda, sel blast >20%, organomegali (-) Kronis -tua, sel blast <20%, organomegali +
28
AML VS ALL
Aml (acute myoblastic leukimia) : dewasa, myeloblatic (basofil, eosinofil, neutrofil, monosit) +, auer rod ALL (acute lymphoblastic leukimia): 90% anak,limfoblast
29
CML VS CLL
Cml :, myelosit +, philadelpia (9:22), dwart megakarosit, abnormalitas kromosom Cll : smudge cell/ basket cell
30
Difftell
Lihat aja : limfosit (2 dari belakang)
31
Pembesaran kgb + alarm sign
Limfoma maligna
32
Klasifikasi limfoma
Etio : ebv Gold : biopsi Klasifikasi : 1. Non hodgkin (sel b dan t): sel uniform/homogen/ benjolan multiple Ex : burkit : starry sign, polimorfik, mayoritas sel b 2. Hodgkin (sel b): reedstenberg +, owl eyes, benjolan tunggal
33
Hipersensitivitas
1 : reaksi cepat/anarilaksis- IgE/sel mast - ex : syok anafilaksis, rhinitis, atopi, alergi makanan, asma 2: sitotoksik - mediator : igm, igg -ex : AIHA/inkompabilitas, itp, transfusi darah 3: kompleks ag-ab/kompleks imun - mediator komplemen c3 -ex : gnaps, sle 4: reaksi lambat- sel t helper -ex : dka, tb, rx kusta, AIHA
34
Syok anafilaksis
Epi/adrenalin : dewasa (0,3-0,5 ml), anak (0,01 cc/bb) 1: 1000 IM -> bisa diulang satu kali Resusitasi : 20 cc/bb/jam AH Steroid : hidrokortison, metil iv/Im
35
Tx anemia pada bblr
Suplementasi besi 3-4 mg/ bb/ hari sejak usia 4 bln hingga 2 thn
36
Tx anemia pasa berat normal
Suplementasi besi 2 mg/ bb/ hari sejak usia 4 bln hingga 2 thn
37
AIHA warm vs cold
Warm : - SB 37 - usia muda -igG - spherocyte Cold : - etio : raynaund, inf (mikoplasma pneumonia) - usia tua IgM + RBC -agglutinasi
38
Aml
Anemia, lesi abu abu pada kulit, gx neurologis, pansitopenia
39
All
Nyeri tulang, manifestasi perdarahan, hepatosplenomegali, Px : leukositosis, sel limfoblast tanpa auerer ros
40
Cml
Rasa lelah, gx ga, splenomegali
41
Cll
Asimtomatik, limfadenopati, hepatosplenomegali
42
R. Konsumsi kloramfenikol + mcv <80
Anemia aplastik
43
Klasifikasi anemia makrositik (normokrom makrositer)
Alkohol, retikulositosis, liverdisease, hipotiroidism
44
Anemia pernisiosa
Penyebab spesifik def.b12 Autoimun, anti if (+), intrinsic factor menurun/tidak ada, gastritis atrofi +
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