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    PLENO KELOMPOK 1

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    Mala Needs Injection

    Mrs.Mala, 30 years old, come to the doctorcomplaining about her oint discom!ort. "he !eels ite#ery morning in her $nees. "he also !eels that her

    $nee is s%elling. &eside that, Maya also !eel ache inher arm. '!ter !ollo%ing the historical diseases, Malasaid that she o!ten had cough, (u, and sorethroat.

    &ecause she)s already bored !or consuming drugs,Mala %ants to be inected by analgetic. '!ter the

    doctor as$s about the history o! drug allergic andshe hasn)t ha#e it, Mala is inected %ith ananalgetic. *e% times later, Mala !eels di++y, blurringeyes and hard to breath. hat is actually happenedto Mala.

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    "-EP 1

    -here is no un!amiliar terminology

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    "-EP

    1. hat is the diagnose and dierentialdiagnose !rom mrs Mala disease

    . hat is supporti! e2amination !or Mrs Mala

    3. hat is the etiology and ris$ !actor !rom MrsMala disease

    . hy Mrs Mala got di++y, blurring eyes andhard to breath a!ter she got inected an

    analgetic4. hat is the treatment !or Mrs Mala

    5. hat is the complication !rom Mrs Mala

    disease

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    "-EP 3

    1. &ased on scenario %e suspect thatMrs Mala 6ot Reumathoid ArthritisandHipersensitivity Reaction (Anaflaktik)

    'nd the dierential diagnose !or Mrsmala disease is 7 "LE, Osteoarthritis,'rthritis 6out

    'nd other hypersensiti#ity reaction

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    . Laboratory e2amination and othere2amination %e can do are 7

    89P

    Led

    Leu$ocyte count

    3. -he etiology o! Mrs Mala disease is 7

    'utoimun 6enetic

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    'nd !or the ris$ !actor o! Mrs Maladisease is 7

    6ender

    'ge

    9adiation

    . Mrs Mala !elt the Mani!estation clinic

    o! 'na:lactic reaction

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    4. -reatment !or Mrs Mala are7

    *armacology and Non;*ramacology treatment

    5. -he complication o! Mrs Mala diseaseare7

    anemia

    8arpal tunnel syndrome

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    "tep

    1. ' chronic disease characteri+ed bythe in(ammation o! the lining o! the

    oints, %hich is called the syno#ium.

    More common in %omen than men.-he e2act cause o! 9' is un$no%n.

    "uspected causes are7&acterial ?iral "tress

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    8linical mani!estation o! 9' patients are7

    *atigue.

    "tiness, especially in early morningand a!ter sitting a long period o! time.

    Lo% 6rade *e#er, ea$ness.

    Muscle pain and pain %ith prolongedsitting.

    "ymetrical, aects oints on bothsides o! the body.

    9heumatoid nodules.

    =e!ormity o! your oints o#er time.

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    =iagnose 8riteria o! 9eumathoid'rthritis

    Morning stiness

    'rthritis o! 3 or more oints 'rthritis o! hand oints

    "ymmetric arthritis

    9heumatoid nodules

    "erum rheumatoid !actor

    9adiographic changes

    ' person shall be said to ha#e

    rheumatoid arthritis i! he or she hassatis:ed o! @ criteria, %ith criteria

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    -he dierential diagnose !or 9' are7

    "LE, Osteoarthritis,

    'rthritis 6out

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    . Laboratory e2amination89P 7 increase until A 0,@ pgBml

    LE= 7 increase until A 30 mmBhour

    Cb 7 decrease, until 10gBdl

    Leu$ocyte count 7 usually increase

    -rombocyte count 7 increase

    9* 7 positi#e in D0 9')s patient

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    9adiology 9adiology 7 normalB there is

    osteopeni or erosion

    "ymmetrical

    Early7 no sig changes

    Late7

    Fu2ta;articular osteoporosis %Bdecr bone density

    Gni!orm t narro%ing

    Marginal erosions

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    3. -he etiology o! Mrs Mala disease isH9'I is un$no%n. "uspected causes

    are7

    &acterial

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    'nd !or the ris$ !actor o! Mrs Maladisease is 7

    6ender

    'ge

    *amilial history

    "mo$ing

    9adiation

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    . 'naphyla2is may be an allergic response

    that is immunologically mediated, or anon;immunologically mediated response,or idiopathic. 8ertain !oods, insect#enoms, some drugs and late2 are

    common precipitants o! immunoglobulinE H

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    4. -reament !or Mrs Mala are7

    pharmacology HsymptomaticI7

    'nlagetic O'

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    Non;pharmaclogy7 -a$e a rest *asting

    E2ercise

    8od li#er oil suplement HN"'

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    5. -he complication o! Mrs Maladisease are7

    'nemia

    8ancer

    8ardiac complication

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    "tep 4

    1. Nutrition !or management !or 9'patients

    . 'nother autoimmune disease that can

    damage the untional3. 'nother medicine than can cause

    allergy

    . 9eumathoid Non;in(amation4. -reatment !or ana:la$sis

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    "tep 5

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    "tep @

    1. Nutritonal or 9' patein is moreconsumption7

    . ?it =

    . ?it E Hantio$sidanI

    . Omega 3 Hantural analgeticI

    . 8od li#er oil HN"'

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    . "LE H"ystemic Lupus EritematousI

    Systemic lupus erythematosusHalso calledSLE, or lupusI is an autoimmune disease o!the bodyJs connecti#e tissues.Autoimmunemeans that the immune system attac$s thetissues o! the body.

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    8linical mani!estation 7

    *atigue

    eight loss

    Musculosceletal mani!est

    "$in mani!est Hmalar rashI Lung mai!est HpneumonitisI

    Ceart mani!est HpericarditisI

    9ena mani!est

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    8riteria diagnose !or "LE7

    -here is positi#e i! %e can !ound ormore sign

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    -reatment !or "LE patient7

    Pharmacology7

    N"'

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    3. -he medicine that can cause alergy7

    'ntibiotics >'nalgesics Penicilline ; 8odein

    HN"'

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    . 'rthritis non;in(amatory7

    Osteorthritis7'ge o! Onset A 0 years

    8ommonly 'ected Foints

    8er#ical and lumbar spine

    *irst carpometacarpal oint

    Pro2imal interphalangeal oint

    =istal interphalangeal oint

    Cip

    Knee

    "ubtalar oint *irst metarsophalangeal oint

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    =iagnose 7 "ymptoms

    Pain

    "tiness 6elling

    Physical e2amination 8repitus &ony enlargement =ecreased range o! motion Malalignment-enderness to palpation

    -he more !eatures, the more li$ely the diagnosis

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    -reatment7

    Non;pharmacology7 pharmacology7

    eight loss > 'nalgetic

    Physicology > N"' 8orticosteroid E2ercise > operation

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    -reatment !or 'naphylactic

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    -C'NK OG