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1. Skenario A Blok 21
Mr. Rudi, 54-year-old, 70 kilograms body weig!, 1"# $en!ime!ers
eig!, $om%lain! a
sudden onse! o& %ain in is rig! knee !a! awakened im
&rom slee%. 'e does no!
re%or! any !rauma and was essen!ially asym%!oma!i$ wen e wen! !o
bed. 'is is!ory
is remarkable &or !wo e%isodes o& similar, se(ere %ain )
mon!s and 2 years ago,
es%e$ially wen e $onsumed a lo! o& sea &ood su$ as
srim%s and lobs!ers. 'e is
%ain-&ree be!ween e%isodes. 'e is a&ebrile !oday. 'is
knee is a&ebrile, !ender !o !ou$,
ery!ema!ousand limi!ed a$!i(e and %assi(e range o&mo!ion
$ause o& %ain.
*abora!ory &ea!ure + ureum #4 mgdl, $rea!inine1,0 mgdl,
blood uri$ a$id 11,1 mgdl
and urine uri$ a$id is 240 mgdl
2. lari&ikasi s!ila
1. /rauma + luka a!au $edera baik &isik mau%un %sikis
2. reum + %roduk akir dari me!abolisme %ro!ein di dalam !ubu
yang
di%roduksi ole a!i dan dikelurkan lewa! urin
#. rea!inine + sua!u anidrida krea!in, asi akir me!abolisme
&os&okrea!in
4. Asam ura! + %roduk akir me!abolisme %urin %ada %rima!a
yang
!idak laru! dalam air, enda%annya dalam ben!uk kris!al %ada
%ersendian dan
ginal menyebabkan %enyaki! %irai5. Asam ura! urin 3uri$osuria +
ekskresi asam ura! %ada urin
". ri!ema + kemeraan %ada kuli! yang diasilkanole
konges!i %embulu ka%iler
7. Sudden onse! o& %ain + %erasaan !idak nyaman menderi!a
a!au nyeri disebabkan
ole rangsangan %ada uung-uung sara& !er!en!u se$ara
!iba-!iba
6. A&ebrile + !an%a demam
3. Identifikasi masalah
a. Mr. Rudi, 54-year-old, 70 kilograms body weig!, 1"#
$en!ime!ers eig!,
$om%lain! a sudden onse! o& %ain in is rig! knee !a!
awakened im &rom slee%.
'e does no! re%or! any !rauma and was essen!ially asym%!oma!i$
wen e wen! !o
bed. 3$ie& $om%lain!
b. 'is is!ory is remarkable &or !wo e%isodes o& similar,
se(ere %ain ) mon!s and 2
years ago, es%e$ially wen e $onsumed a lo! o& sea &ood
su$ as srim%s and
lobs!ers. 'e is %ain-&ree be!ween e%isodes.
$. 'e is a&ebrile !oday. 'is knee is a&ebrile, !ender !o
!ou$, ery!ema!ousand limi!ed
a$!i(e and %assi(e range o&mo!ion $ause o& %ain
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d. *abora!ory &ea!ure + ureum #4 mgdl, $rea!inine1,0 mgdl,
blood uri$ a$id 11,1
mgdl and urine uri$ a$id is 240 mgdl 3main %roblem
4. Analisis Masalah
1. Mr. Rudi, 54-year-old, 70 kilograms ody !eight, 1"3
#entimeters height,
#om$laint a sudden onset of $ain in his right knee that a!akened
him from
slee$. %e does not re$ort any trauma and !as essentially
asym$tomati# !hen
he !ent to ed.
a. Bagaimana ana!omi sendi lu!u!8ami, mer!a
b. A%a ubungan usia, enis kelamin, dan M/ !erada% kasus 9olanda
:akia
;radi!ya
$. A%a e!iologi nyeri %ada lu!u! kanan /u!i erna
d. Menga%a nyeri membua! Mr. Rudi !erbangun 3menga%a !eradi saa!
!er!idur
Anindi!a yuliae. ali &i!ri
g. Bagaimana !a!alaksana awal dari keluaan ka, $i!ra
&. %is history is remarkale for t!o e$isodes of similar,
se'ere $ain ( months
and & years ago, es$e#ially !hen he #onsumed a lot of sea
food su#h as
shrim$s and losters. %e is $ain-free et!een e$isodes.
a. Bagaimana ubungan riwaya! %enyaki! daulu dengan keluan yang
dialami
sekarang8ami, mer!ab. A%a kemungkinan %enyebab !eradi e%isode
rekuren 9olanda :akia ;radi!ya
$. :a! a%a yang !erkandung %ada udang dan lobs!er yang
menyebabkan nyeri
/u!i erna
d. Menga%a nyeri yang dirasakan in!ermi!!en 3!idak
mene!a%Anindi!a yulia
3. %e is aferile today. %is knee is aferile, tender to tou#h,
erythematousand
limited a#ti'e and $assi'e range ofmotion #ause of $ain
a. Bagaimana mekanisme dari+
1. A&ebrile 3menga%a dia a&ebrile %adaal ada radang n!an
ri=ka
2. /ender !o !ou$>ali &i!ri#. ri!em ka, $i!ra
4. >erakan yang !erba!as8ami, mer!a
b.
