Perihal: Permohonan Kewenangan Klinik Dokter Umum

Lampiran: 1 Berkas

Kepada Yth:

Direktur Rumah Sakit Umum Daerah Majalengka

Di tempat

Dengan hormat,

Dengan ini kami mengajukan permohonan kewenangan klinik dokter umum sebagai staf medis Rumah Sakit Umum Daerah Majalengka (Paruh waktu/ Purna waktu*).

Demikianlah permohonan ini kami sampaikan. Atas perhatiannya diucapkan terima kasih.

Majalengka, ..

Pemohon,

Dr. Dewi Nurmalasari

Keterangan:

* Coret yang dianggap tidak perlu

* Berkas yang dilampirkan: fotocopy STR, fotocopy Surat Pindah/ SK Pensiun, fotocopy ijazah dan CV

KEWENANGAN KLINIK DOKTER UMUM

DOKTER YANG MENGAJUKAN : dr. DEWI NURMALASARI

LULUSAN: TAHUN LULUS :

No

Kewenangan Klinik

Permohonan Kemampuan Klinik

Disetujui Kemampuan Klinik

1

2

3

4

1

2

3

4

1

Angina pectoris

2

Unstable angina

3

Myocardial Infarction

4

Imminent Myocardial Infarction

5

Cardiac aneurysm

6

Heart failure

7

Cardiorespiratory arrest

8

Mitral stenosis

9

Mitral regurgitation

10

Aortic stenosis

11

Aortic regurgitation

12

Other valvular heart diseases

13

VSD

14

ASD

15

Sinus tachycardia

16

Supraventricular tachycardia

17

Atrial fibrillation

18

Atrial flutter

19

Supraventricular extrasystole

20

Ventricular extrasystole

21

BBB

22

Other arrhythmias

23

Endocarditis

24

Pericarditis

25

Myocarditis

26

Cardiomyopathy

27

Essential hypertension

28

Secondary hypertension

29

Pulmonary hypertension

30

Raynaud's disease

31

Arterial thrombosis

32

Coarctation of the aorta

33

Burger's disease

34

Arterial embolism

35

Atherosclerosis

36

Subclavian steal syndrome

37

Aortic aneurysm

38

Dissecting aneurysm

39

Claudicatio

40

Cardiogenic shock

41

Septic shock

42

Hypovolemic shock

43

Varices (primary,secondary)

44

Obstructed venous return

45

Deep vein thrombosis

46

Thrombophlebitis

47

Lymphangitis

48

Lymphadenitis

49

Lymphedema, primary and secondary

50

Uncomplicated Pulmonary Tuberculosis

51

TBC with HIV

52

TBC with pneumothorax

53

Acute Bronchitis

54

Bronchiolitis

55

Bronchial asthma

56

Status asmaticus

57

Lung emphysema

58

Atelectasis

59

Bronchiectasis

60

COPD

61

SARS

62

Pneumonia

63

Avian influenzae

64

Lung abscess

65

Pulmonary embolism

66

Lung infarction

67

Pleurisy TBC

68

Pleurisy Cancer

69

Pleurisy Lupus

70

Pneumothorax

71

Cystic fibrosis

72

Aspiration pneumonia

73

Cleft lip and palate

74

Micrognatia and macrognatia

75

Leukoplakia

76

Candidiasis

77

Mouth ulcers (aphthous, herpes)

78

Glossitis

79

Esophageal atresia

80

Achalasia

81

Corrosive lesions of esophageus

82

Esophageal varices

83

Esophageal rupture

84

Reflux esophaghitis

85

Diaphramatic hernia

86

Hiatus hernia

87

Inguinal hernia, direct and indirect

88

Femoral hernia Bedah

89

Epigastric hernia

90

Incisional hernia

91

Umbilical hernia

92

Peritonitis

93

Abscess in pouch of Douglas

94

Ileus

95

Perforation

96

Salphingitis

97

Acute appendicitis

98

Appendicular abscess

99

Mesenteric lymphadenitis

100

Gastritis

101

Gastric/duodenal ulcer

102

Gastrointestinal bleeding

103

Zollinger-ellison syndrome

104

Mallory-weiss syndrome

105

Gastroenteritis

106

Fatty liver

107

Hepatitis A

108

Uncomplicated Hepatitis B

109

Active Hepatitis C

110

Cirrhosis hepatis

111

Amoebic liver abscess

112

Liver failure

113

Chole(docho)lithiasis

114

Acute cholecystitis

115

Hydrops of gall bladder

116

Empyema of gall bladder

117

Pancreatitis

118

Intestinal atresia

119

Meckel's diverticulum

120

Umbilical fistula, omphalocoele-gastroschisis

121

Malrotation

122

Enteritis

123

Irritable bowel syndrome

124

Necrotizing enterocolitis

125

Diverticulosis/diverticulitis

126

Colitis

127

Rectal, anal prolapse

128

Proctitis

129

Hemorrhoids

130

(peri)anal abscess

131

Fistula

132

Anal fissure

133

Esophageal atresia

134

Intestinal atresia

135

Anal atresia

136

Diapragmatic hernia (congenital)

137

Pyloric stenosis

138

Gastro-esophageal reflux

139

Gastro-enteritis

140

Gastro-enteritis dengan dehidrasi

141

Worms

142

Dehydration

143

Malabsorbsion

144

Food intolerance

145

Acute abdomen

146

Ileus

147

Peritonitis tuberculosis

148

Peritonitis pancreatitis

149

Intussussception

150

Malrotation

151

Umbilical hernia

152

Meckell's diverticulum

153

Crohn's disease

154

Ulcerative colitis

155

Hirschsprung's disease

156

Biliary atresia

157

Hepatitis

158

Reye's syndrome

159

Cirrhosis of the liver

160

Food allergy

161

Acute renal failure

162

Chronic renal failure

163

Nephrotic syndrome

164

Acute glomerulonephritis

165

Chronic glomerulonephritis

166

Interstitial nephritis

167

Renal colic

168

Urinary stone diseases or urinary calculi without colic

169

Polycystic kidneys symptomatic

170

Urinary tract infection

171

Acute tubular necrosis

172

Horse shoe kidney

173

Uncomplicated Pyelonephritis

174

Urinary incontinence

175

Nocturnal and diurnal enuresis

176

Prostatitis

177

Hypospadia

178

Epispadia

179

Undescended testes/cryptorchidism

180

Retractile testes

181

Torsion of testis

182

Epididymitis

183

Spermatocele

184

Varicocele

185

Hydrocele

186

Phimosis

187

Paraphimosis

188

Ruptur uretra

189

Ruptur kandung kencing

190

Ruptur ginjal

191

Striktura uretra

192

Priapismus

193

Penyakit peironi

194

Ekstrophia vesicae

195

Infertility

196

Erection disorders

197

Ejaculation disorders

198

Vulvitis

199

Dystrophy of vulva

200

Cyst of bartholin, abscess of bartholin's gland

201

Abscess of hair follicle or sebaceous gland

202

Condylomata acuminata

203

Congenital malformations

204

Vaginitis

205

Bacterial vaginosis

206

Cyst of gartner

207

Cystocoele

208

Rectocoele

209

Enterocoele

210

Fistula (vesico-vaginal, uretero-vaginal, recto- vaginal fistula)

211

Foreign body

212

Cervicitis

213

Polyps

214

Nabothian cyst

215

Congenital malformations

216

Uterine prolaps

217

Hematocolpos

218

Endometriosis

219

Salpingitis

220

Adhesions

221

Ovarian cyst

222

Polycystic ovarian disease

223

Carcinoma of ovary

224

Ectopic pregnancy

225

Torsion tumour / ovarian cyst

226

Rupture of ovarian cyst / tubo - ovarian abscess

227

Uterine bleeding at ovulation

228

Inflammations of breast

229

Mastopathy

230

Aplastic/hypoplastic anemia

231

Iron deficiency anemia

232

Macrocytic anemia

233

Hemolytic anemia

234

Hemoglobinopathy

235

Anemia associated with chronic diseases

236

Polycytemia

237

Thrombocytopenia

238

Thrombocytosis

239

Hemophilia

240

Von willebrand's disease

240

DIC

241

Agranulocytosis

242

Haemorheologic disorders

243

Antiphospholipid syndrome

244

Uncomplicated SLE

245

Complicated SLE

246

Scleroderma

247

Polyarteritis nodosa

248

Vasculitis Lupus

249

Polymyalgia rheumatica

250

Rheumatoid arthritis

251

Anaphylactic reaction

252

Rheumatic fever

253

Juvenile chronic arthritis

254

Henoch-schoenlein purpura

255

Erythema multiforme

256

Atopy

257

Steven johnson's syndrome

258

Transplantation immunology

259

Down's syndrome

260

Turner's syndrome

261

Klinefelter's syndrome

262

Gonadal xy-dysgenesis

263

Testicular feminization

264

Fragile x syndrome

265

PKU (Phenyl Ketonuria)

266

Galactosemia

267

Glycogen storage disease

268

Other storage diseases

269

Spina bifida

270

Anencephaly

271

Hydrocephalus

272

Cleft palate and/or lip

273

Marfan's syndrome

274

Hypothermia

275

Bacteraemia and septicemia

276

Respiratory stress syndrome

277

Bronchopulmonary dysplasia

278

Aspiration pneumonia

279

Pneumo thorax

280

Apnea attacks

281

Jaundice of newborn

282

Severe neonatal jaundice (kern icterus)

283

Hypoglycemia

284

Child of diabetic mother

285

Neonatal convulsion

286

Necrotizing enterocolitis

287

Retinopathy of prematurity

288

Anemia

289

Rhesus incompatibility

290

Blood group incompatibility

291

Vitamine k defficiency

292

Cerebral hemorrhage

293

Conjuctivitis

294

Infection of umbilicus

Sudden infant death syndrome (sids)

295

IDDM

296

NIDDM

297

Complication of DM (acute and chronic)

298

Hypoglycemia

299

Diabetes incipidus

300

Acromegaly, gigantism

301

Growth hormone deficiency

302

Hyperparathyroidism

303

Hypoparathyroidism

304

Hyperthyroidism

305

Hypothyroidism

306

Thyroiditis

307

Cushing's disease

308

Adrenal cortex failure

309

Primary hyperaldosteroidism

310

Phaeochromocytoma

311

Precocious puberty

312

Testicular feminization syndrome

313

Hypogonadism

314

Adrenogenital syndrome

315

Addison's disease

316

Multiple endocrinological neoplasia (men syndrome)

317

Tumor with ectopic production of hormone

318

Kwashiorkor

319

Vitamin deficiencies

320

Hyperlipoproteinemia

321

Porphyria

322

Gout

323

Obesity

324

Metabolic Encephalopathy

325

Comatous

326

Brain death

327

Tension headache

328

Migraine

329

Cranial arteritis

330

Trigeminal neuralgia

331

Cluster headache

332

TIA

333

Cerebral infarction

334

Intracerebral hematoma

335

Subarachnoid hemmorhage

336

Hypertensive encephalopathy

337

Bels palsy

338

Brain stem lesions

339

Menier's disease

340

Benign paroxysmal positional vertigo

341

Vertigo Central

342

Vascular dementia

343

Alzheimer's disease

344

Pick's disease

345

Parkinson's disease

346

Tremor

347

Secondary parkinsonism

348

Huntington disease

349

Chorea sydenham

350

Dystonia

351

Hemifacial spasm

352

Focal epilepsy

353

Generalized epilepsy

354

Absence seizure

355

Status epilepticus

356

Narcolepsy

357

Sleep apnea syndrome

358

Multiple sclerosis

359

Optic neuromyelitis (Devic's disease)

360

Amyotrphic lateral sclerosis (ALS)

361

Complete spinal transection

362

Brown sequard syndrome

363

Cauda equina syndrome

364

Neurogenic bladder

365

Syringomyelia

366

Myelopathy

367

Dorsal root syndrome

368

Medulla compression acute

369

Radicular syndrome/HNP

370

Spondilitis TB

371

Horner syndrome

372

Carpal tunnel syndrome

373

Tarsal tunnel syndrome

374

Neuropathy

375

Peroneal palsy

376

Guillain Barre syndrome

377

Myasthenia gravis

378

Polymyositis

379

Duchenne muscular dystrophy

380

Neurofibromatosis (von reckling hausen disease)

381

Meningitis

382

Encephalitis

383

Malaria cerebral

384

Tetanus

385

Cerebral Toxoplasmosis

386

Tuberculoma

387

Brain abscess

388

HIV AIDS

389

Hydrocephalus

390

Spina bifida

391

Phenyl ketonuria

392

Meningitis

393

Encephalitis

394

Cerebral abscess

395

Epilepsi

396

Infantile spasms

397

Petit mal epilepsy

398

Febrile convulsion

399

Duchene muscular dystrophy

400

Poliomyelitis

401

Cerebral palsy

402

Kernicterus

403

Mental Retardation

404

Autism

405

ADHD

406

Amnesia Pasca trauma

407

Afasia

408

MCI (Mild Cognitive Impairment)

409

VCI (Vascular Cognitive Impairment)

410

Epidural hematom

411

Subdural hematom

412

SAH (Sub Arachnoid Hemorrhage)

413

Trauma Medula Spinalis

414

Tumor primer

415

Tumor sekunder

416

Nyeri Nosiseptif

417

Nyeri neuropatik

418

Buta mendadak

419

Diplopia

420

Visual field disorders

421

Inflammation of auricle

422

Herpes zoster oticus

423

Pre-auricular fistula

424

Foreign body in ear

425

Wax (serumen)

426

Otitis externa

427

Acute otitis media

428

Otitis media serous (glue ear)

429

Chronic otitis media

430

Perforated tympanic membrane

431

Bullous myringitis

432

Otosclerosis

433

Tymphanosclerosis

434

Cholesteatoma

435

Presbyacusis

436

Mastoiditis

437

Labyrinthitis

438

Benign postural vertigo

439

Motion sickness

440

Meniere's diseases

441

Vestibular neuritis

442

Acoustic neuroma

443

Acute acoustic trauma

444

Ear, other trauma

445

Perceptive hearing loss

446

Conductive hearing loss

447

Congenital deafness

448

Facial palsy or paralysis

449

Epistaxis

450

Furuncle of nose

451

Acute rhinitis (common cold)

452

Vasomotor rhinitis

453

Allergic rhinitis

454

Chronic rhinitis

455

Rhinitis medicamentosa

456

Acute frontal sinusitis

457

Acute maxillary sinusitis

458

Acute ethmoiditis

459

Chronic sinusitis

460

Deviation of nasal septum

461

Choanal atresia

462

Foreign body in nose

463

Pharyangitis

464

Tonsilitis

465

Hypertrophy of adenoids

466

Pseudo-croop acute epiglotitis

467

Medial and lateral branchial cyst and fistula

468

Cystic hygroma

469

Torticollis

470

Cyst Tiroid

471

Goitre

472

Hyperthyroidism

473

Hyperparathyroidism

474

Hypoparathyroidism

475

Aspiration

476

Foreign bodies

477

Tracheitis

478

Conjunctiva, foreign body

479

Conjunctivitis, allergy

480

Conjunctivitis, viral

481

Conjunctivitis, bacterial

482

Pterygium

483

Subconjunctival haemorrhage

484

Blepharitis

485

Hordeolum

486

Chalazion

487

Eyelid laceration

488

Entropion

489

Trichiasis

490

Lagophtalmos

491

Epicanthus

492

Ptosis

493

Eyelid retraction

494

Xanthelasma

495

Dacryoadenitis

496

Dacryocystitis

497

Dacryostenosis

498

Lacrimal duct, laceration

499

Scleritis/episcleritis

500

Erosion

501

Cornea, foreign body

502

Burn

503

Keratitis

504

Kerato-conjunctivitis sicca

505

Corneal oedema

506

Corneal dystrophy

507

Keratoconus

508

Endophtalmitis

509

Microphtalmos

510

Buphtalmos

511

Hyphaema

512

Hypopyon

513

Iridocyclitis, iritis

514

Tumour of iris

515

Glaucoma, congenital

516

Simple glaucoma

517

Acute glaucoma

518

Secondary glaucoma

519

Cataract

520

Aphakia

521

Psudoaphakia (artificial lens)

522

Lens dislocation

523

Hypermetropia

524

Myopia

525

Astigmatism

526

Presbyopia

527

Anisometropia

528

Amblyopia

529

Diplopia

530

Suppresion

531

Night-blindness

532

Scotoma

533

Hemianopia, bitemporal and homonymous

534

Loss of vision and blindness

535

Retinal detachment

536

Retina, vessel occlusion or bleeding

537

Degeneration of macula, age dependent

538

Retinopathy of prematurity (rop)

539

Diabetic retinopathy

540

Hypertensive retinopathy

541

Chorioretinitis

542

Vitreous haemmorrhage

543

Optic disc cupping

544

Papilloedema

545

Optic atrophy

546

Optic neuropathy

547

Optic neuritis

548

Contact dermatitis irritant

549

Contact dermatitis allergica

550

Atopic dermatitis (kecuali recalcitrant)

551

Nummular dermatitis

552

Lichen simplex chronicus

553

Napkin eczema

554

Psoriasis vulgaris

555

Plamoplantar pustulosis

556

Seborrheic dermatitis

557

Pityriasis rosea

558

Acne vulgaris

559

Rosacea

560

Hidradenitis suppurativa

561

Perioral dermatitis

562

Miliaria

563

Verruca vulgaris

Condyloma accuminata

564

Molluscum contagiosum

565

Herpes zoster

566

Impetigo

567

Ulcerative impetigo (ecthyma)

568

Superficial folliculitis

569

Furuncle, carbuncle

570

Erythrasma

571

Erysipelas

572

Tinea capitis

573

Tinea barbae

574

Tinea faciale

575

Tinea corporis

576

Tinea Manus

577

Tinea unguium

578

Tinea Cruris

579

Mucocutaneous candidiasis

580

Tinea pedis

581

Tinea versicolor

582

Pediculosis capitis

583

Pediculosis pubis

584

Scabies

585

Insect bites reactions

586

Pemphigus vulgaris

587

Pemphigoid

588

Dermatitis herpetiformis

589

Toxic epidermal necrolysis

590

Stevens-johnson's disease

591

Dermatomyositis

592

Systemic sclerosis

593

Scleroderma/morphea

594

Lupus erythematosus

595

Alopecia areata

596

Androgenic alopecia

597

Trichotillomania

598

Telogen eflluvium

599

Ichthyosis vulgaris

600

Lichen planus

601

Granuloma annulare

602

Morphea

603

Lichen sclerosus er atrphicus

604

Exanthematous drug eruption

605

Fixed drug eruption

606

Vitiligo

607

Melasma

608

Albinism

609

Post-inflammatory hyperpigmentation

610

Post-inflammatory hypopigmentation

611

Paronychia

612

Suppurative tenosynovitis

613

Human bite

614

Suppurative parotitis

615

Suppurative cervical adenitis

616

Peritonsilar abscess

617

Ludwig's angina

618

Bezold abscess

619

Superficial infections, including folliculitis, hidradenitis suppurativa, carbuncle.

620

Osteomyelitis

621

Staphylococcal pneumonia

622

Staphylococcal bacteremia

623

Rheumatic fever

624

Sinusitis, otitis media, mastoiditis, pertonsilar abscess - THT

625

Rheumatic heart disease

626

Meningitis (neuro)

627

Nasopharyngitis

628

Gonorrhea

629

Urinary tract infection (UTI)

630

Typhoid fever

631

Dysentry bacilli

632

Cholera

633

Pertussis

634

Plague (Pes)

635

Chancroid

636

Diphteria (THT)

637

Tetanus (pediatri)

638

Tuberculosis kutis

639

Leprosy

640

Lepra reaction

641

Syphilis

642

Yaws

643

Leptospirosis

644

Actinomycosis

645

Chromoblastomycosis

646

Maduromycosis

647

Influenza

648

avian influenza (THT)

649

Viral gastroenteritis

650

Poliomyelitis

651

Rabies

652

Morbilli

653

Varicella

654

Herpes zoster

655

Herpes simplex

656

Mumps

657

CMV infections

658

Dengue hemorrhagic fever (DHF)

659

HIV-AIDS

660

Amebiasis

661

Malaria

662

Leishmaniasis dan tripanosomiasis

663

Toxoplasmosis

664

Giardiasis

665

Trichomoniasis

666

Hookworm diseases

667

Strongyloidiasis

668

Ascariasis

669

Filariasis

670

Schistosomiasis

671

Cutaneus larva migran

672

Taeniasis

673

Non-hodgkin's lymphoma

674

Hodgkin's lymphoma

675

Acute leukemia

676

Chronic leukemia

677

Myelodysplastic syndromes

678

Multiple myeloma

679

Langerhans' cell histiocytosis

680

Bronchogenic carcinoma

681

Bronchoalveolar carcinoma

682

Neuroendocrine tumor (carcinoid tumor)

683

Mesothelioma

684

Leukoplakia

685

Polyps

686

Nasopharynx carcinoma

687

Pleomophic adenoma

688

Warthins tumor

689

Benign polyps

680

Squamous cell carcinoma

681

Adenocarcinoma

682

Carcinoid tumor

683

Lymphoma

684

Liver cell adenoma

685

Hepatocellular carcinoma

686

Cholangiocarcinoma

687

Carcinoma of the pancreas

688

Cortical adenoma

689

Renal cell carcinoma

690

Wilm's tumor

691

Squamous cell carcinoma

692

Seminoma

693

Teratoma testis

694

Benign prostatic hyperplasia

695

Carcinoma of the prostate

696

Condyloma accuminata

697

Cervical carcinoma

698

Extramammary Paget's disease

699

Endometrial hyperplasia

700

Endometrial carcinoma

701

Ovarial teratoma (dermoid cyst)

702

Ovarian carcinoma

703

Hydatidiform mole

704

Choriocarcinoma

705

Fibrocystic change

706

Fibroadenoma mammae

707

Phyllodes tumor

708

Breast carcinoma

709

Paget's disease of the breast

710

Gynecomastia

711

Somatotropic adenoma

712

Prolactinoma

713

Thyroid adenoma

714

Thyroid carcinoma

715

Thymoma

716

Benign epithelial tumors

717

Seborrheic keratosis

718

Epithelial cyst

719

Actinic keratosis

720

Bowen's disease

721

Squamous cell carcinoma

722

Basal cell carcinoma

723

Xanthoma

724

Hemangioma

725

Lymphangioma

726

Angiosarcoma

727

Mycosis fungoides

728

Mastocytosis

729

Langerhans' cell histiocytosis

730

Lentigo

731

Nevus pigmentosus

732

Malignant melanoma

733

Osteoma

734

Osteoid osteoma

735

Osteoblastoma

736

Osteosarcoma

737

Osteochondroma

738

Chondroblastoma

739

Chondrosarcoma

740

Fibrous dysplasia

741

Fibrosarcoma and mfh

742

Ewing sarcoma

743

Giant cell tumor

744

Ganglion cyst

745

Lipoma

746

Liposarcoma

747

Fibromatosis

748

Desmoid tumor

749

Fibroma

750

Fribrosarcoma

751

Benign fibrous histiocytoma

752

Malignant fibrous histiocytoma (mfh)

753

Rhabdomyosarcoma

754

Leiomyoma

755

Leiomyosarcoma

756

Synovial sarcoma

757

Astrocytoma

758

Oligodendroglioma

759

Ependymoma

760

Medulloblastoma

761

Retinoblastoma

762

Meningioma

763

Neurofibroma

764

Schwannoma

765

Mental deficiency

766

Autistic disorder

767

Disorder of intellectual skills

768

Disorder of motor development

769

Disorder of coodination

770

Behavior and attention disorders

771

Anorexia nervosa

772

Bulimia

773

Pica

774

Rumination in infancy

775

Gilles de la tourette syndrome

776

Chronic motor of vocal tic disorders

777

Transient tic disorders

778

Functional encoperasis

779

Functional enuresis

780

Uncoordinated speech

781

Stammer

782

Schizophrenia

783

Other psychoses including reactive psychosis and puerperal psychosis

784

Bipolar disorder, manic episode

785

Bipolar disorder, depressive episode

786

Cyclothymic disorder

787

Endogenous depression, single episode and recurrent

788

Dysthymic disorder (or neurotic depression)

789

Depressive disorder not otherwise classified

790

Panic disorder with agoraphobia

791

Panic disorder without agoraphobia

792

Agoraphobia without history of panic disorder

793

Social phobia

794

Simple phobia

795

Obsessive compulsive disorder (neurosis)

796

Post traumatic stress disorder

797

Diffuse anxiety disorder

798

Anxiety disorder not otherwise classified

799

Disorder of body sensation

800

Conversion disorder (hysterical neurosis)

801

Hypochondriasis (hypochondriacal neurosis)

802

Somatisation disorder

803

Somatoform pain disorder

804

Undifferentiated somatoform disorder

805

Somatoform disorder not otherwise classified

806

Multiple personality

807

Fugu states

808

Psychogenic amnesia

809

Depersonalisation disorder or depersonalisation neurosis

810

Dissociative disorder, noc

811

Paraphilia

812

Disorder of sexual desire

813

Disorder of sexual exitement

814

Disorder of orgasm

815

Sexual pain disorders

816

Sexual dysfuctions, noc

817

Sexual disorders, noc

818

Insomnia

819

Hypersomnia

820

Sleep-wake cycle disturbances

821

Nightmares

822

Night terrors

823

Sleep walking

824

Paranoid personality

825

Schizoid personalinty

826

Schizotypal personality

827

Antisocial personality

828

Borderline personality

829

Histerionic personality

830

Narcisistic personality

831

Avoidance personality

832

Dependent personality

833

Obsessive-compulsive personality

834

Passive-aggressive personality

835

Personality disorders, noc

836

Extrapyramidal side effects (eg. Acute dystonia, tradive dyskenia, parkinsonism)

837

Anticholinergic side effects

838

Sedative side effects

839

Malignant neuroleptic syndrome

840

Knowledge of forensic psychiatry

841

Knowledge of indication for involuntary admission to hospital

842

Knowledge of basic principles of methods used by different psychotherapeutic schools (eg. Rogerrian, psychoanalytic, etc)

843

Pseudoconstipation

844

Encopresis

845

Anorexia nervosa

846

Bulemia

847

Tics, neuropathic behavior

848

Hyperkinetic syndrome

849

Primary infantile autism

850

Disorders of mother-child relationship

851

Disorders due to social deprivation

852

Neurotic disorder of chilhood

853

Breath holding due to exitement

854

Congenital dislocation of the hips

855

Arthritis

856

Genu varum (bow legs)

857

Genu valgum (knock knee)

858

Pes planus

859

Scoliosis

860

Kyphosis

861

Lordosis

862

Terthes disease

863

Slipped epiphysis

864

Osgood-schlatter diseasev

865

Chondromalacia patellae

866

Club foot

867

Marfan's disease

868

Osteogenesis imperfecta

869

Bone cyst

870

Achondroplasia

871

Rickets, osteomalacia

872

Osteoporosis

873

Fibrous dysplasia

874

Paget's disease

875

Physical overload

876

Aseptic necrosis of bone

877

Osteomyelitis, acute

878

Arthritis

879

Trauma of joint cartilage

880

Trauma of joint capsule

881

Ganglion

882

Primary bone tumors

883

Bone metastasis

884

Pathological fracture

885

Arthrosis deformans

886

Crystal arthropathy

887

Rheumatoid arthritis

888

Bechterew disease

889

Spina bifida

890

Sacrococcygeal teratoma

891

Scoliosis

892

Kyphosis

893

Lordosis

894

Spondylarthrosis, spondylosis

895

Spondylitis, spondylodiscitis

896

Hernia of nucleus pulposus

897

Spondylolisthesis

898

Spondylolysis

899

Metastases from elsewhere

900

Pathological fractures

901

Fractures and dislocations of spine

902

Spinal transaction

903

Congenital hip dislocation

904

Hip dysplasia

905

Femoral head necrosis

906

Intermittent arthritis of the hip

907

Fractures of pelvis

908

Fractures of hip

909

Dislocation of hip

910

Ligamentous lesions of hip

911

Arthritis of hip

912

Fractures of femur

913

Fractures, capsule, tendon and ligament lesions of knee

914

Lesion of meniscus, medial and lateral

915

Abnormal patellear cartilage

916

Genu varum, genu valgum

917

Osteochondritis dissecans

918

Arthritis of the knee

919

Achilles tendonitis

920

Rupture of achilles tendon

921

Tarsal tunnel syndrome

922

Instability of ankle

923

In growing toe nail

924

Pes planus

925

Club foot

926

Claw foot

927

Hallux valgus

928

Hammer toe

929

Metatarsalgia

930

Onychogryposis

931

Anisomelia

932

Caput succedaneum

933

Brachial plexus injury

934

Fracture (clavicle, humerus, rib)

935

Drowning

936

Head injury

937

Burning

938

Poisoning

939

Suffocation

940

Bleeding

941

Hypovolemic shock

942

Dislocation of jaw

943

Fracture of jaw

944

Dislocation of knee

945

Dislocation of patella

946

Prepatellar bursitis

947

Fractures of tibia

948

Rib fractures/contusion

949

Injury caused by rib fractures

950

Sternal fractures

951

Fractures of toes

952

Crush injury to the heel (in children)

953

Fractures of fibula

954

Whiplash

955

Fractures, capsule, tendon and ligament lesions of ankle

956

Pneumothorax

857

Hemothorax

858

Injury to specific internal organs, such as liver, kidney, lung, etc

859

Injury of peripheral nerves

860

Fractures of shoulder

861

Dislocation of shoulder

862

Ligamentous lesions of shoulder

863

Instability of shoulder

864

Frozen shoulder

865

Fracture of clavicle

866

Fracture of humerus

867

Fracture of radius/ulna

Fractures, capsule, tendon, ligament lesions of elbow

868

Fractures, capsule, tendon, ligament lesions of wrist

869

Fractures, capsule, tendon, ligament lesions of fingers and thumb

870

Lateral epicondylitis (tennis elbow)

871

Dislocation of distal radius

872

Dislocation of wrist

873

Progressive inflammation of finger following injury

874

Olecranon bursitis

875

Carpal tunnel syndrome

876

Injury to finger tendon, e.g. Boutonniere-deformity

877

Mallet finger

878

Dupuytren's contracture

879

Nail loss

880

Subungual hematome

881

Traumatic vessel injury

882

Head injuries

883

Diffuse brain damage

884

Cerebral concussion and contusion

885

Brain death

886

Extradural hemorrhage

887

Subdural hemorrhage

888

Basilar fracture scalp

889

Acute traumatic spinal transaction

890

Injury of plexus and peripheral nerves

891

Syphillis

892

Rubella

893

CMV infection

894

Toxoplasmosis

895

AIDS

896

Gonorrhoea

897

Herpes virus infection type 2

898

Hepatitis B

899

Mother taking tobacco

900

Mother taking drugs of addiction

901

Mother taking tobacco

902

Mother taking drugs of addiction

903

Vasa previa

904

Abruptio placenta - SOL

905

Cervical incompetence

906

Polyhydramnion

907

Jaundice late in pregnancy

908

Urinary tract infection

909

Pyelitis in pregnancy

910

Iron dificiency anaemia

911

Megaloblastic anaemia

912

Dead fetus

913

Premature contractions

914

Premature delivery

915

Rupture of uterus

916

Postmature infant

917

Premature rupture of membranes

918

Unstable lie / malposition after 36 weeks

919

Dystocia, fetal and passage

920

Malpresentation of fetus

921

Prolonged delivery

922

Primary mild contractions IMININ

923

Secondary mild contractions

924

Cord presentation / cord prolapse

925

Hypoxia of fetus

926

Failure to rotate / incorrect rotation

927

Rupture of cervix

928

Rupture of perineum

929

Shoulder distortion, infant

930

Retained placenta

931

Retained placental tissue

932

Uterine inversion

933

Postpartum haemorrhage

934

Thrombo embolism

935

Blood group incompatibility

936

Mastitis

937

Cracked nipple

938

Inverted nipple

939

Endometritis

940

Inflammation of pelvis (salpingitis, pelviperitonitis, perimetritis etc)

941

Incontinence of urine

942

Incontinence of faeces

943

Deep venous thrombosis

944

Thrombophlebitis

945

Embolism

946

Post-natal psychoses

947

Post-natal depression

948

Subinvolution of uterus

KETERANGAN KEMAMPUAN KLINIK DOKTER UMUM :

Tingkat Kemampuan 1 : Mengenali gambaran-gambaran klinik sesuai penyakit

Tingkat Kemampuan 2: Mampu membuat diagnosis klinik

Tingkat Kemampuan 3: Mampu mendiagnosis klinik, memberi terapi, pendahuluan

Tingkat Kemampuan 4: Mampu mendiagnosis klinik, memutuskan dan mampu menangani problem itu secara mandiri hingga tuntas

No

Kewenangan Klinik

Permohonan Kemampuan Klinik

Disetujui Kemampuan Klinik

1

Tindakan Resusitasi Jantung Paru

1

2

3

4

1

2

3

4

2

Penanganan sesak napas ringan sampai berat (tanpa ventilator)

3

Penanganan awal kegawatdaruratan pada jantung

4

Penanganan Pasien dengan Syok

5

Menjahit luka ringan sampai sedang

6

Pemasangan tampon hidung bagian anterior

7

Partus normal dengan posisi kepala sudah di pintu vagina

8

Penanganan awal luka bakar

9

Penanganan kejang

10

Penanganan keracunan dan gigitan binatang

11

Penanganan awal trauma kepala

12

Penanganan awal fraktur terbuka dan fraktur tertutup

KETERANGAN KETERAMPILAN KLINIK DOKTER UMUM :

Tingkat Keterampilan 1: Memiliki pengetahuan teoritis

Tingkat Keterampilan 2: Pernah melihat, atau didemonstrasikan keterampilan ini

Tingkat Keterampilan 3: Menerapkan dibawah supervisi

Tingkat Keterampilan 4: Mampu menangani problem itu secara mandiri hingga tuntas

CATATAN:

a. Mengkonsultasikan semua kebutuhan pasien rawat inap kepada DPJP

b. Apabila dokter DPJP tidak bisa dihubungi, dokter jaga boleh memberikan terapi sesuai dengan keluhannya.

c. Dokter jaga IGD dan Dokter jaga rawat inap merujuk pasien ke RS lain dengan fasilitas yang lebih lengkap setelah dikonsultasikan ke dokter spesialis yang berkaitan

d. Diluar kewenangan klinis diatas dokter umum wajib mengkonsultasikan ke dokter spesialis sesuai dengan kewenangan klinis dokter spesialis tersebut.

e. Sudah mengikuti pelatihan ATLS/ ACLS/ PPGD

Majalengka,...

Pemohon Ketua Komite Kredensial

..

Anggota :

1. ..

2. ..

Nomor: / Kred / KM-RSMJL / . / 20..

Perihal: Kewenangan Klinik Dokter Umum

Lampiran: 1 Berkas

Kepada Yth,

Ketua Komite Medik RSUD Majalengka

Di Tempat

Dengan Hormat,

Menganai permohonan dr. Dewi Nurmalasari, sebagai dokter umum yang melamar untuk menjadi staff medis di RSUD Majalengka, setelah kami mengevaluasi kompetensi, perilaku etis dan kelengkapan berkas-berkas permohonan yang bersangkutan, maka dengan ini kami merekomendasikan untuk memberikan / tidak memberikan / belum memberikan* kewenangan klinik sebagai dokter umum, purna waktu / paruh waktu* dengan alasan:

..

..

..

Untuk itu dapat diproses penugasan klinik sesuai dengan ketentuan/ prosedur yang berlaku.

Adapun wewenang klinis yang dapat diberikan terlampir.

Majalengka,..

Ketua Komite Kredensial

Anggota:

1. ..

2. ..

Keterangan:

* Coret yang dianggap tidak perlu

Nomor: ../ KM-RSMJL/ ./ 20

Perihal: Kewenangan Klinik Dokter Umum

Lampiran: 1 (satu) berkas

Kepada Yth,

Direktur RSUD Majalengka

Di tempat

Dengan Hormat,

Setelah Komite Rekredensial, melakukan kredensialing, maka dengan ini kami merekomendasiklan nama dokter umum dr. Dewi Nurmalasari dapat diberikan kewenangan klinik (terlampir) sebagai staff medis di Rumah Sakit Umum Daerah Majalengka.

Untuk itu diusulkan kepada Direktur Rumah Sakit Umum Majalengka untuk dapat memproses penugasan klinik.

Demikian surat ini kami sampaikan, atas perhatiannya diucapkan terimakasih.

Majalengka,

Hormat Kami,

Ketua Komite Medik