CASE DR.CUT ppt
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TUBERCULOSIS PARUDEVI KHARISMA
AINUN ZAMIRA
INTAN CANTIKALUTHFITA RAHMAWATI
PEMBIMBING:
Dr. Cut Yuli ! S".P
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IDENTITAS PASIEN
N# : T$. I$%r
U#ur : &' t(u$
)*$i+ ,*l#i$ : L,i-l,i
Al#t : C*#", Puti( Brt IV
T$l MRS : /' S*"t*#0*r &/12
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ANAMNESIS
K*lu($ Ut#
N3*ri %% ,$$ +*4, 5 (ri SMRS
K*lu($ T#0($
S*+,! 0tu,! %*##! "*$uru$$ 0*rt 0%$!
$6+u #,$ #*$uru$! l*#+
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Ri73t P*$3,it S*,r$
P+i*$ #+u, RSI)CP %*$$ ,*lu($ $3*ri "% %% ,$$ 3$
(*0t %$ %i+*rti %*$$ +*+, $6+. N3*ri %% %ir+,$+*#,i$ 0*rt#0( ,*ti, 0*r$6+. N3*ri %ir+,$ "% %%
,$$ %$ ti%, #*$4lr. N3*ri %ir+,$ +*4, 5 (ri SMRS.
S*0*lu#$3 "+i*$ 0*lu# "*r$( #*$*lu( $3*ri %% %i+*rti
+*+, $6+. P+i*$ 4u #*$*lu( 0tu, 0*r%(, +*4, 1 #i$u
SMRS! 0tu, 0*r%(, 0*r7r$ ,u$i$! ,*$tl. P+*i$ 4u #*r+
%*## +*4, 5 (ri SMRS! %*## %ir+,$ $i, turu$! #*$iil
ti%, %. Flu %i+$,l! #ul %$ #u$t( ti%, %. P+i*$ 4u#*r+ 0*rt 0%$ +*#,i$ #*$uru$ %$ ,(ir-,(ir i$i "+i*$
4r$ #,$ %$ #u%( #*r+ l*#+
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Ri73t P*$3,it D(ulu P+i*$ 0*lu# "*r$( #*$l#i ,*lu($ $3*ri %%
+*0*lu#$3
P+i*$ "*r$( #*$l#i Tu0*r8ul9+i+ & t(u$ 3$ llu %$"*$90t$ tu$t+
Ri73t Di0*t*+ M*litu+ %i+$,l
Ri73t Hi"*rt*$+i %i+$,l
Ri73t P*$3,it K*lur K*lur ti%, "*r$( #*$l#i ,*lu($ 3$ +#
%*$$ "+i*$
P#$ "+i*$ "*r$( #*$l#i ,*lu($ 0tu, 0*r%(,+*4, ,ur$ l*0i( & #i$u 3$ llu.
K*lur "+i*$ ti%, #*#ili,i "*$3,it Hi"*rt*$+i! Di0*t*+M*litu+.
Ri73t Al*ri
Al*ri #,$$! 90t-90t$ %$ 8u8 %i +$,l
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Ri73t P*$90t$
P+i*$ "*r$( #*$,9$+u#+i 90t TB & t(u$ 3$ llu
+*8r tu$t+
Ri73t P+i,9+9+il
P+i*$ #,$ ti%, t*rtur
P+i*$ +*ri$ #*r9,9, 1 0u$,u+ "*r(ri +*l# t(u$
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PEMERIKSAAN FISIK
K*%$ u#u# : T#", S,it S*%$
K*+%r$ : C9#"9+ M*$ti+ GCS 12
Sttu+ i;i
BB +*0*lu# +,it : < ,
BB ,*ti, +,it : 2 ,
TB : 1=5 8# K*+i#"ul$ : 1=!> ?u$%*r7*i(t@
T$% itl
T*,$$ %r( : 1&/
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Sttu+ G*$*rli+ K*"l : $9r#98*"(l
Mt : ,9$4u$ti $*#i+ --! +,*lr i,t*ri, --
Hi%u$ : $9r#9$i
T*li$ : $9r#9ti! +*ru#$ ?-@
Mulut : 6ri$ (i"*r*#i+ ?-@! #u,9+ 0i0ir ,*ri$
T(9r
Pru-"ru
I$+"*,+i : "*r*r,$ %% ti%, +i#*tri+! *r,$ %% t*rti$l "% %%
,$$
Pl"+i: 98l 6r*#itu+ ti%, t*r0 +#! l*0i( ,ut "% %% ,iri!
t*r0 #+ "% li$* ilri+ "9+t*ri9r ICS =-' %*$$ %i#*t*r 8#!
,9$+i+t*$+i ,*$3l! "*r#u,$ rt! #90il*! t*r0 $3*ri.
P*r,u+i : +9$9r "% "ru ,iri! %$ "*ru0($ +9$9r ,* r*%u" "% li$*
#i%,li,ulri+ ,$$ ICS -2 %$ "% li$* ilri+ ,$$ $t*ri9r ICS
-2
Au+,ult+i : *+i,ulr #*$uru$ "% l"$ 07( "ru! r9$,(i ,+r "%l"$
t+ ?@
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T(9r
)$tu$
I$+"*,+i : I8tu+ 89r%i+ ti%, t*rli(t
Pl"+i : I8tu+ 89r%i+ ti%, t*r0
P*r,u+i
Bt+ t+: li$* "r+t*r$li+ %*tr ICS II
Bt+ ,$$ : li$* "r+t*r$li+ %*tr ICS V
Bt+ ,iri : li$* #i%,li,ul +i$i+tr ICS V
Au+,ult+i : Bu$3i 4$tu$ 1 %$ & r*ulr! ll9" ?-@!#ur#ur ?-@
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A0%9#*$
I$+"*,+i : %tr! +8r ?-@
Au+,ult+i : 0i+i$ u+u+ ?@ 1/#*$it! $9r#l
Pl"+i: #++ ?-@! $3*ri t*,$ "% (i"989$%ri8 ,$$
P*r,u+i: ti#"$i %i +*luru( ,u%r$ 0%9#*$
E,+tr*#it+
Su"*ri9r : A,rl ($t! *%*# ?-@! +i$9+i+ ?-@! RCT &
%*ti,
I$6*ri9r : A,rl ($t! *%*# ?-@! +i$9+i+ ?-@! RCT &
%*ti,
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PEMERIKSAAN PENUN)ANG
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-RAY THORA PA LATERAL
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RESUME
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DAFTAR MASALAH
E6u+i "l*ur *.8 TB Pru R*8urr*$t
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ASSESMENT E6u+i "l*ur *.8 TB Pru R*8urr*$t
S: P+i*$ #+u, RSI)CP %*$$ ,*lu($ $3*ri "% %%
,$$ 3$ (*0t %$ %i+*rti %*$$ +*+, $6+.N3*ri %% %ir+,$ +*#,i$ 0*rt#0( ,*ti,0*r$6+. N3*ri %ir+,$ +*4, 5 (ri SMRS. P+i*$ 4u#*$*lu( 0tu, 0*r%(, +*4, 1 #i$u SMRS! 0tu,0*r%(, 0*r7r$ ,u$i$! ,*$tl. P+*i$ 4u #*r+%*## +*4, 5 (ri SMRS! %*## %ir+,$ $i, turu$.P+i*$ 4u #*r+ 0*rt 0%$ +*#,i$ #*$uru$ %$,(ir-,(ir i$i "+i*$ 4r$ #,$ %$ #u%( #*r+l*#+. P+i*$ "*r$( #*$l#i Tu0*r8ul9+i+ & t(u$
3$ llu. P#$ "+i*$ "*r$( #*$l#i ,*lu($0tu, 0*r%(, +*4, ,ur$ l*0i( & #i$u 3$ llu.P+i*$ "*r$( #*$,9$+u#+i 90t TB & t(u$ 3$ llu+*8r tu$t+. P+i*$ +*ri$ #*r9,9, 1 0u$,u+ "*r(ri+*l# t(u$.
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O : ,*%$ u#u# t#", +,it +*%$! +ttu+ i;iu$%*r7*i(t ?1=!>@. Pru-"ru : I$+"*,+i : "*r*r,$
%% ti%, +i#*tri+! *r,$ %% t*rti$l "% %%,$$. Pl"+i: 98l 6r*#itu+ ti%, t*r0 +#! l*0i(,ut "% %% ,iri! t*r0 #+ "% li$* ilri+"9+t*ri9r ICS =-' %*$$ %i#*t*r 8#! ,9$+i+t*$+i,*$3l! "*r#u,$ rt! #90il*! t*r0 $3*ri. P*r,u+i :
+9$9r "% "ru ,iri! %$ "*ru0($ +9$9r ,* r*%u" "%li$* #i%,li,ulri+ ,$$ ICS -2 %$ "% li$*ilri+ ,$$ $t*ri9r ICS -2. Au+,ult+i : *+i,ulr#*$uru$ "% l"$ 07( ,*%u "ru! r9$,(i ,+r"% l"$ t+ ,*%u "ru ?@. P% "*#*ri,+$
0%9#*$ %i%"t,$ $3*ri t*,$ "% (i"98r%i8%*tr
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A: E6u+i "l*ur DD P*$*0l$ "l*ur *.8 +u+"*,TB Pru R*8urr*$t
Pl$$i$
P*#*ri,+$ USG T(9r! +r$ "*#*ri,+$CT S8$ t(9r %*$$ ,9$tr+
DOTS ?9rl@ 1 & t0 G+tri%i$ ?9rl@ &1
A+# M*6*$#t ?9rl@ 51
Str*"t9#38i$ IM %9+i+ 12#,BB(ri
122, ='2 #(ri
Cir$ : A+*ri$ 1& 4#
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TUBERCULOSIS PARU
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DEFINISI
TB Paru adalah penyakit menular langsung yang
disebabkan oleh Mycobacterium tuberculosis yangmenyerang jaringan (parenkim) paru, tidak termasuk
pleura (selaput paru). (DepKes, !"").
Tuberkulosis adalah penyakit menular langsung yang
disebabkan oleh kuman TB (Mycobacterium
tuberculosis). (DepKes, !"")
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EPIDEMIOLOGI
Gambar . Insidens TB didunia (WHO, 2004)
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ETIOLOGI
P*$3*00 tu0*r8ul9+i+ %l(Mycobacterium tuberculosis, +*4*$i+ ,u#$0*r0*$tu, 0t$ %*$$ u,ur$ "$4$ 1-u# %$ t*0l /!5-/!=u#
Si6t ,(u+u+ 3itu t($ t*r(%" +# "%"*7r$$! 9l*( ,r*$ itu %i+*0ut "ul+*0i B+il T($ A+# ?BTA@
Ku#$ TB 8*"t #ti %*$$ +i$r #t(ril$+u$
D t 0*rt($ (i%u 0*0*r #
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PATOGENESISKuman
TB Droplet l!eolus
"a#ro$a%
Di&an'ur#an
Ber#emban%Bia#
"atio#usrimerGo&n
*al. +im$e
+im$an%itis
+im$adenitis
Komple#srimer
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Gambar 3.1. Patogenesis tuberkulosis3
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"I-*T*I K+IIK
G*4lr*+"irt9ri,
Btu, i$u
Btu, %r(
S*+, $"+ N3*ri %%
G*4l +i+t*#i,
%*## #li+* K*ri$t
#l# $9r*,+i BB
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PEMERIKSAAN FISIK
K9$4u$ti $*#i+ %$ ,ulit "u8t
Su(u %*## ?+u06*0ri+@
B%$ ,uru+
P*r,u+i : r*%u"
Au+,ult+i : +ur 0r9$,il
Sur $"+ t#0($ : r9$,i 0+(! ,+r! $3ri$
P*$*0l$ "l*ur : *+i,ul*r #*l*#(
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P*#*ri,+$ R%i9l9i, P*#*ri,+$ %r( : LED P*#*ri,+$ +"utu# : %i$9+i+
"+ti BTA ?@ P*#*ri,+$ u4i Tu0*r,uli$ ?#$t9u
t*+@
P*#*ri,+$ "*$u$4$
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ALUR DIAGNOSIS
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PENATALAKSANAAN
P*$90t$ TB 0*rtu4u$ :
1. M*$3*#0u(,$ "+i*$&. M*$8*( ,*#ti$
5. M*$8*( ,*,#0u($
. M*#utu+,$ r$ti "*$ulr$ %$#*$8*(
t*r4%i$3 r*+i+t*$+i ,u#$ t*r(%"OAT
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PADUAN OAT YANG DIGUNAKAN DI
INDONESIA
Kt*9ri 1 : &?HRZE@?HR@5.
Kt*9ri & : &?HRZE@S?HRZE@2?HR@5E5
Di+#"i$ ,*%u ,t*9ri i$i! %i+*%i,$ "%u$90t +i+i"$ ?HRZE@
O0t 3$ %iu$,$ %l# ttl,+$ "+i*$ TBr*+i+t$ 90t %i I$%9$*+i t*r%iri %ri OAT li$i ,*-&3itu K$#38i$! C"r*9#i+i$! L*9J9,++i$!Et(i9$#i%*! +i,l9+*ri$ %$ PAS! +*rt OAT li$i-1!3itu "ir;i$#i% $% *t#0ut9l.
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P%u$ OAT ,t*9ri-1 %$ ,t*9ri-& %i+*%i,$%l# 0*$tu, ",*t 0*ru" 90t ,9#0i$+i %9+i+ t*t"?OAT-KDT@. T0l*t OAT KDT i$i t*r%iri %ri ,9#0i$+i &
tu 4*$i+ 90t %l# +tu t0l*t. D9+i+$3%i+*+ui,$ %*$$ 0*rt 0%$ "+i*$. P%u$ i$i%i,*#+ %l# +tu ",*t u$tu, +tu "+i*$.
P,*t K9#0i",. A%l( ",*t 90t l*"+ 3$ t*r%iri%ri I+9$i+i%! Ri6#"i+i$! Pir;i$#i% %$ Et#0ut9l3$ %i,*#+ %l# 0*$tu, 0li+t*r. P%u$ OAT i$i%i+*%i,$ "r9r# u$tu, %iu$,$ %l#"*$90t$ "+i*$ 3$ #*$l#i *6*, +#"i$ OAT
KDT.
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TATALAKSANA
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TERIMA KASIH