emg kelompok 2

8/19/2019 Emg Kelompok 2

1/27

SEORANG WANITA YANGMENGELUH JANTUNGNYA

KADANG-KADANG BERDEBARDAN NYERI DADA

KELOMPOK 2


2/27

030.05.172 Put! M"#$t! 030.07.0%2 D"&$ Putu S.M.S.

030.07.212 R"'!($ )!*t$*$!

030.07.012 A+,$ Mu*$

030.0.022 A($*t$*!$ /$#!(

030.0.02 A!*t$ St+$!$

030.0.052 A+$! G$("*+$

030.0.072 /4(t+!$ K$$,!($ E.

030.0.102 )"4

030.0.132 Ju#!$ Mut!$$(!

030.0.12 L$u$ E*t"#!$

030.0.1%2 M!#$ W!4$*tut!

030.0.12 N" K$,!#$

030.0.12 P$6(4$ P$$,!t+$ N.


3/27

PENDAHULUAN

P"(4$!t G$"* ,"u8$$( 9"(tu t!t*!*!* :+!8"t!!; 4$(' 8$#!('

*"!(' !6u,8$! $#$, 8$t" *"+$!-+$!. D$8$t t"6$! 8$$ *",u$ u,u<

*"!(' !t",u$( 8$$ &$(!t$ $! 8$$ 8!$. T$($ $( '"6$#$ 8"(4$!t G$"*

4$(' 8$#!(' ,u$+ !"($#! !$#$+ $$(4$ *tu,$< t!t*!*!* $( *"!('

!*"t$! =t$#,8$t!

P$t'"("*!* 8"(4$!t G$"* *$,8$! *"6$u+ !(! 9"#u, !"t$+u! *">$$ 8$*t!.

N$,u( !u'$ =$t '"("t! $( #!('u('$( !ut 9"8"$( $#$, ,"$(!*,"

4$(' 9"#u, !"t$+u! *">$$ 8$*t! ,"(!('$t(4$ !*! ,"("!t$ 8"(4$!tG$"*. B"$*$$( >!!->!! 8"(4$!t(4$< 8"(4$!t G$"* !"#,8$( "

$#$, 8"(4$!t $ut!,u(< $(t$$ #$!( "('$( !t",u$((4$ $(t!9! t"+$$8

"*"8t TSH :T+4t8!( St!,u#$t!(' H,(" - R">"8t A(t!94 ?TSHR-A9;

"('$( $$ 9"$!$*!.


4/27

LAPORAN KASUS

Anamnesis K"#u+$( ut$,$

6$(tu(' $$(' 9""9$ "9$ $$(4$ t"$*$ (4"! *"6$ 9"9"$8$ 9u#$( t"$+!

K"#u+$( t$,9$+$( 6$(tu('(4$ ",9$#! 9""9$ $( *"8"t! $$(

8!('*$( tu9u+ *",$!( uu* 3 t$+u( *u$+ t!$ +$! #$'!

R!&$4$t 8"(4$!t *"$$(' 8"(4$!t 6$(tu(' $( ,"($8$t$( 9$t 4$(' *$#$+.


5/27

LAPORAN KASUS

J$(tu('(4$ $$('-$$(' 9""9$ C $$(4$ t"$*$ (4"!

*"6$ 9"9"$8$ 9u#$( t"$+! *$$t !(! 6$(tu('(4$ ",9$#!

9""9$ $( t$! 8$'! !$ $$( 8!('*$(.

P"($+ 9"9$t " t"

!(4$t$$( ,"("!t$ 8"(4$!t

6$(tu(' !9"! 9$t 4$(' ,"*t! !,!(u, 3 *"+$! *"t"#$+

9"9"$8$ +$! ,"('+"(t!$( ,!(u, 9$t $"($ ,"(4"9$9$(

*$!t "8$#$ ,"($8$t 9$t #$!( 4$(' !,!(u, *"$#! *"+$!

!+"(t!$( 6u'$ *"t"#$+ +$,8! *",!(''u $"($ 8"ut(4$

*$!t


6/27

LAPORAN KASUS

Pemeriksaan fsik Su+u 37


7/27

J$(tu(' HR *u#!t !t"(tu$(

I$,$ t!$ t"$tu *$,$ *"$#!

BJ I $( II t!$ (*t$(

B!*!(' :-;

P$u-8$u t!$ $$ "#$!($(

A9,"( #",$*< +"8$ $( #!"( t!$t"$9$

E*t",!t$* "",$ -?-


8/27

PEMERIKSAAN

LABORATORIUMPemeriksaan Hasil Normal InterpretasiHb 10,5g/dl 12-15g/dl Anemi disebabkan

melena

Lekosit 6300/mm3 5000-1000/mm3 Normal

!"# 36 $/L 5-%0 $/L Normal

!P# %5 $/L 5-%1 $/L &eningkat

're$m %0mg/dl 15-%0mg/dl Normal

(reatinin 0,)mg/dl 0,6-1,2mg/dl Normal


9/27

PEMERIKSAAN PENUNJANG

Pemeriksaan Hasil Interpretasi

*+ *# 62. dengan elangatio

aorta

(ardiomegali

(! - rate 120+/m

-Pada lead II panang

tidak tampak gelombang

P

-# eleasi/depresi -4

-!elombang patologis

-4

-takikardi

-aritmia

-tiada &I


10/27

PEMBAHASAN

Masalah Dasar Masalah Hipotesis

T!t*!*!* - "#"(6$ t!!4$(' ,",9"*$- tu9u+ uu*

- >",$*- *u#!t t!u- 8"(!('$t$(t"$($( $$+- "(4ut 6$(tu('!"'u#$

- 8"(!('$t$( *u+u- "8+t$#,u*

- +!8"t!!- "=" *$,8!('9$t 4$('

!9"!$(*"9"#u,(4$:$,!$(";

A(",!$ P"(uu($( H9 8$$8","!*$$( #$9$$+

- 8"$$+$( S/BA- 8"(4$!t"tuu($( :$(",!$+",#!t!;


11/27

Masalah Dasar Masalah Hipotesis

G$(''u$( S/BA M"#"($< 8"(uu($(H9

E=" *$,8!(' 9$t4$(' !9"!$(*"9"#u,(4$

:*$#!*!#$t;I*#$t" *4*t#!>+48"t"(*!(

P","!*$$( TD155?5

- 8!,"- +!8"t!!

/$!,"'$#! - /TR %2F- E#('$t!( $t$

- +!8"t"(*! (!*- +!8"t!!

At!$# )!9!#$*! - EKG #"$ II t!$t$,8$ '"#,9$('P- RS $t" 120?,- HR *u#!t

!t"(tu$(- I$,$ t!$


12/27

Diagnosis kerja

B"$*$$( $($,("*!*< 8","!*$$( #$9<$( 8","!*$$( 8"(u(6$('

Tirotoksikosis


13/27

HORMON TIROID

H,(-+,( t!! ,"(*t!,u#$*! ,"t$9#!*,"

$! *"#-*"#. M""$ !8u*! #"+ "#"(6$ t!!.

K"#"(6$ t!! 9"t",8$t 8$$ 9$'!$( 9$&$+

#"+". K"#"(6$ ,",9u('u* *""#!#!(' *$#u$(

u$$ :t$>+"$; $( ,",8u(4$! *u$tu 9"(tu

4$(' ,"(4"u8$! u8u-u8u 4$(' !9"(tu #"+

u$ *$4$8 :#9"*; $( !#"$t$( #"+ *u$tu

9$'!$( t"('$+ :!*t+,u*;.


14/27

Du$ +,(-+,( t!! 4$(' 8$#!(' 8"(t!('

$$#$+ t+4!(" :T; $( t!!t+4(!(" :T3;

H,( 4$(' 8$#!(' $t!= *">$$ 9!#'!

:>(t+(4$< "=" 4$(' 8$#!(' 9"*$ 8$$ tu9u+;

*"9"($(4$ $$#$+ T3. S"$#! !#"8$* $!

"#"(6$ t!! "$#$, $$+< *u$tu 6u,#$+ 4$('

9"*$ $! T !u9$+ " T3 - +,( 4$(' #"9!+

$t!= 4$(' ,",8"('$u+! ,"t$9#!*," *"#-*"#.


15/27

TIROTOKSIKOSIS

T!t*!*!* $$#$+ *u$tu (!*!

"$>u($( 4$(' !*"9$9$( #"+ *u$tu

"#"9!+$( +,(-+,( t!! $!

8"(4"9$9 ,$($ *$6$. T!t*!*!* $8$t

!*"9$9$( #"+ *u$tu 8",$*u$( 4$('

9"#"9!+$( $! +,(-+,( t!! $t$u#"+ 8u*! +,(-+,( t!! 4$('

9"#"9!+$( #"+ "#"(6$ t!!


16/27

PATO)ISIOLOGI

P"(4$!t 6$(tu(' G$" D!*"$*" G#!*$,!('!#$( !9"#$$(' ,$t$

R"t"(*! A! E8t+$#,u*

A,!$(S$#!*!#$ t I!t$*! L$,9u(' P"$$+$( S/BA

T!! M"#"($ A(",!$

P"$('*$('$( G$(''u G(RH M"t$9#!*," RR *!,8$t!* BB Su+u

HR R$*$ /",$* A,"(+"$ G#!#!*!* < L!8#!*!* < Pt"#!*!*

$*(*t!*! H!8"t"(*! /$!,"'$#!


17/27

D!$'(*!*P","!*$$( L$9.


18/27

)u('*! +,( t!!

1. ">"8$t$( ,"t$9#!*,<

2. E=" $#!'"(!

3. '#!'"("*!*

. P"('$u+ 8$$ *!*t", *$$= *!,8$t!*

5. P"('$u+ 8$$ $!$*u#" $"($

,"(!('$t$( "=" *$$= *!,8$t!* %. P"tu,9u+$( $( 8"",9$('$(

*!*t", *$$=


19/27

N$=*u ,$$( $( $*u8$( ,$$($(,"(!('$t ,"(!('$t(4$ "9utu+$( ,"t$9#!<

BB 9!$*$(4$ 9"u$(' $t$u kurus $"($tu9u+ ,",9$$ 9$+$( 9$$ "('$(">"8$t$( $9(,$#.


20/27

T!t*!*!* "#$!($( $!$*u#"

D!*"9$9$( "=" #$('*u(' +,( t!!4$(' ,",8u(4$! 8"('$u+ 8$$

"*!t$9!#!t$* 6$(tu(' 4$(' ,"(!('$t$(="u"(*! "(4ut 6$(tu(' $( 6u'$ #"+!(t"$*! +,( t!! !tu *"(!! "('$($t"#$,!(.

Kecepatan dan kekuatan denyut jantungdapat menjadi sangat meningkat palpitasi


21/27

K"t"#!9$t$( *u*u($( *$$= ! t$($! "&$*8$$$( ,"(t$# 4$(' 9"#"9!+$(

*$,8$! 8$$ "$$$( 8$*!"( 4$(' ,u$+

t"*!(''u('< t"'$(' , cemas< $( *$('$t",*!($#..


22/27

P","!*$$( Y$(' D!$(6u$(

P","!*$$( #$9$t!u, #$9$t!u, $$+ #"('$8

TSH *"u, T 9"9$*

P","!*$$( 8"(u(6$(' USG t!!

S>$((!(' t!!


23/27

R"(>$($ T!($ S"#$(6ut(4$

P$*!"( !$&$t !($8 M"!$,"(t*$

O9$t $(t! t!! PTU t$9#"t 50 ,'. *!*100,'? 6$,

O9$t 6$(tu(' 9"t$ 9#>"

O9*"$*! $(",!$ Ru6u " S8"*!$# P"(4$!t D$#$, $(

S8"*!$#!* M$t$


24/27

PROGNOSIS


25/27

KESIMPULAN

"*!,8u#$( $! $*u* 4$(' !9"!< N4.A($ ,"("!t$ t!*!*!* 4$('",u('!($( 9"*$ !*"9$9$(

(*u,*! 9$t $,!$(" 9$'! 8"(4$!t 6$(tu('(4$. P"($t$#$*$($$( 4$('*"'"$ $( $"u$t 8"#u u(tu,"(>"'$+ ,u(>u#(4$ ,8#!$*!

9"9$+$4$ 4$(' 9#"+ ,"('$(>$, 6!&$N4. A($.


26/27

DA)TAR PUSTAKA

P!>" SA< W!#*( LM. P$t+8+4*!#'4 >#!(!>$#>(>"8t* = !*"$*" 8>"**"*. E %. E#*"!"S>!"(>" 2002.

G$9" AJ.$*>u#$ !*"$*" $( #!8!* !( !$9"t"*.M" /#!( Nt+ A,. 1231.

Su4 AW< S"t!4+$! B< A#&! I< S!,$!9$t$ KM<S"t!$t! S. Buu A6$ I#,u P"(4$!t D$#$,. E I.

J$$t$ B$#$! P"("9!t )KUI 200%. S+"& L. )!*!#'! M$(u*!$ $! S"# " S"#. E. 2.

O'$( E(!( P"!=" K"#"(6$ T!!. J$$t$ P"("9!t Buu K"t"$( EG/2002

R$,!" JL< P"t(" P< Ku(>! EJ< A*"(*! JA. T+4!St, I(u>" 94 St$('u#$t!(. Sut+"( M"!>$#A**>!$t!( 200


27/27

TERIMA KASIH

emg kelompok 2

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