LAPORAN TUTORIAL

SKENARIO F BLOK 24 TAHUN 2016

Tutor : dr. H. Amir Fauzi, SpOG(K)

Disusun oleh: Kelompok B8

Kevin Arjun (04011281320012)

Dicky Hartono (04011281320016)

Darian Davin (04011381320022)

Muhammad Kokoh Saputra (04011381320024)

Sisca (04011381320032)

Cahaya Intan (04011381320044)

Deanita Rahmanda P (04011381320062)

Muhammad Rusdi (04011381320064)

M Ilham Satya Nugraha (04011181320072)

Triza Ahmad P (04011181320074)

Afifa Jasmon (04011181320076)

Nurveny Hidayanti (04011181320082)

PROGRAM STUDI PENDIDIKAN DOKTER

FAKULTAS KEDOKTERAN UNIVERSITAS SRIWIJAYA

2016

KATA PENGANTAR

Puji syukur kami haturkan kepada Allah SWT atas segala rahmat dan karunia-Nya

sehingga kami dapat menyelesaikan laporan tutorial yang berjudul “Laporan Tutorial

Skenario F Blok 24 Tahun 2016” sebagai tugas kompetensi kelompok. Salawat beriring

salam selalu tercurah kepada junjungan kita, nabi besar Muhammad SAW beserta para

keluarga, sahabat, dan pengikut-pengikutnya sampai akhir zaman.

Kami menyadari bahwa laporan tutorial ini jauh dari sempurna. Oleh karena itu kami

mengharapkan kritik dan saran yang bersifat membangun guna perbaikan di masa mendatang.

Dalam penyelesaian laporan tutorial ini, kami banyak mendapat bantuan, bimbingan dan

saran. Pada kesempatan ini, kami ingin menyampaikan rasa hormat dan terima kasih kepada:

1. Allah SWT, yang telah memberi kehidupan dengan sejuknya keimanan,

2. tutor kelompok B.8, dr. H. Amir Fauzi, SpOG(K)

3. teman-teman sejawat FK Unsri,

4. semua pihak yang telah membantu kami.

Semoga Allah SWT memberikan balasan pahala atas segala amal yang diberikan kepada

semua orang yang telah mendukung kami dan semoga laporan tutorial ini bermanfaat bagi

kita dan perkembangan ilmu pengetahuan. Semoga kita selalu dalam lindungan Allah SWT.

Amin.

Palembang, 02 Maret 2016

Kelompok B.8

i

Daftar Isi

Kata Pengantar............................................................................................................. i

Daftar Isi........................................................................................................................ ii

Kegiatan Tutorial.......................................................................................................... iii

Skenario......................................................................................................................... iv

I. Klarifikasi Istilah..................................................................................... 1

II. Identifikasi Masalah................................................................................ 1

III. Analisis Masalah..................................................................................... 2

IV. Hipotesis.................................................................................................. 35

V. Kerangka Konsep.................................................................................... 35

VI. Sintesis Masalah...................................................................................... 36

VII. Kesimpulan.............................................................................................. 56

VIII. Daftar Pustaka......................................................................................... 57

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KEGIATAN TUTORIAL

Tutor : dr. H. Amir Fauzi, SpOG(K)

Moderator : Kevin Arjun

Sekretaris : Dicky Hartono dan M. Ilham Satya Nugraha

Pelaksanaan : 1 Maret 2016 dan 2 Maret 2016

Peraturan selama tutorial :

- Meminta izin kepada moderator untuk meninggalkan

ruangan di tengah tutorial

- Alat komunikasi mode silent

- Pada saat ingin berbicara terlebih dahulu mengacungkan

tangan, lalu setelah diberi izin moderator baru bicara

- Saling menghargai dan tidak saling menggurui

iii

Skenario F Blok 24 Tahun 2016

Mrs. Tari 37 years old, from middle income family comes to doctor at a public health centre with chief complain of vaginal bleeding. She experienced post coital bleding for 1 month. Since 1 years ago she has been complaining about vaginal discharge with smelly odor and sometimes accompanied by vulvar itchy. She already has 2 children before and the youngest child is 6 years old. Her husband is a truck driver. She has never gone to the doctor related to her complain about vaginal discharge not using any medication, no history of paps smear examination, and no history of HPV vaccination, she has a history of using intrauterine device (IUD) as contraception for 5 years since her youngest child birth and the IUD has been removed 1 year ago. Her older sister died two years ago caused by breast cancer.

You act as the doctor in public health centre and be pleased to analyse this case

In the examination findings:

Height : 155 cm, weight: 50 kg

Blood pressure : 120/80mmHg, pulse : 80 x/m, RR : 20 x/m

Palpebral conjungtiva : anemic

Breast : there was no mass on both mammae

Abdomen : flat and soufflé, symmetric, uterine fundus is not palpable, there are no mass , no painful tenderness, and no free fluid sign.

Internal exam ination :

Inspection : vulva and uretra was normal, there was no mass on the vulva uretra hymen and perineum

Speculum examination:

Mass on the portio size 2x2 cm, exophytic , fragile, easy to bleed, no infiltration to the vagina, flour +

Bimanual examination :

Cervix is soft, the external os is closed, no servical motion tenderness, exophytic mass 2x2x1 cm, fragile, easy to bleed, uterine size normal, no infiltration to the vagina, both adnexa and parametrium are wihin the normal limit.

Then you performed VIA, result was you could define the external os, squamocollumnar junction, and there was thick acetowhite epitelium, at the 2o’clock until 5 o’clock position, so you perform biopsy.

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Laboratory result : HB 8,3 g/dl , WBC 12,000/mm3 , thrombocyte 770.000/mm3, ESR 30 mm/hour.

The next week, the patient come with the histopathology result “squamous cell carcinoma, moderate differentiation, without limphovascular space invasion”. You gave the informed consent to the patient and family to refer her to the hospital. She asked you the diagnosis, kind of examination that will be performed to her, and the possible treatment

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