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CRA6E N|KEN 8AHAYA

0810714009
H00ULE 2

1. 0ef|ne d|arrhea!
0|are ada|ar ouarg a|r oesar (dele|as|) dergar jur|ar l|rja yarg |eo|r oarya| dar| o|asarya (rorra| 100-200 r| per
jar l|rja), dergar l|rja oeroerlu| ca|rar alau selergar ca|r (selergar padal), dapal pu|a d|serla| lre|uers| dele|as|
yarg rer|rg|al. Verurul wl0 (1980), d|are ada|ar ouarg a|r oesar ercer alau ca|r |eo|r dar| l|ga |a|| serar|. 0|are
leroag| dua oerdasar|ar ru|a dar |ararya, ya|lu d|are a|ul dar |ror||.

2. 0escr|be the ep|dem|o|ogy of acute d|arrhea |n ped|atr|c! when the most preva|ence ep|sode of d|arrhea
occurred |n ch||dren? And why?
eoarya|ar lerjad| pada 2 larur perlara |er|dupar. lrs|der pa||rg l|rgg| pada go|orgar urur -11 ou|ar pada rasa
d|oer||ar ra|arar perdarp|rg.

. Exp|a|n the et|o|ogy acute d|arrhea |n ped|atr|

!eryeoao |argsurg


4. 6|ass|fy d|arrhea |n ped|atr|c!
erdasar|ar palogeres|srya:
0|are osmot|k
%erjad| |el||a lerdapal zal ler|arul oer|eo|r yarg lerlarar pada |urer |rlesl|ra|. ord|s| |r| reryeoao|ar a|r l|da|
dapal d|aosorps| dar lerjad| d|are. !eryeoaorya:
4ra|aosorps|, corlorrya |aclose |rlo|erarce a||oal del|s|ers| |aclase pada orusr oorder, ser|rgga |aclose l|da|
dapal d|g|dro||s|s rerjad| ga|a|losa dar g|u|osa urlu| d|aosorps|. La|losa yarg lerlarar |r| rerarar a|r lelap
d| da|ar |urer usus. 0|laroar |ag|, |a|losa d| da|ar co|or d|lerrerlas| o|er rorra| l|ora, ser|rgga
reryeoaoar produ|s| gas.
4Vergorsurs| suoslral yarg su||l d|aosorps|, o|asarya |aroor|dral alau |or d|va|er r|sa| Vg301, Vg0l2.
0|are sekretor|k
%erjad| |el||a se|res| a|r |e da|ar |urer |rlesl|re re|eo|r| aosorps|rya, d|seoao|ar o|er lo|s|r (v|or|o cro|era, E.
co||) yarg rerga|l|vas| adery| cyc|ase ser|rgga lerjad| per|rg|alar oer|eparjargar |orserlras| cAV! pada
|rlrase|u|er d| crypla erleros|l. !eruoarar |r| reryeoao|ar perou|aar |ara| ||or|da yarg |eo|r |ara ser|rgga
lerjad| se|res| yarg l|da| ler|orlro|. !eryeoao |a|r yarg dapal reryeoao|ar d|are se|relor| dergar cara
rerga|l|l|ar re|ar|sre se|relor|, ya|lu percarar, rorror yarg d|e|s|res||ar pada jer|s luror lerlerlu
(vasoacl|ve |rlesl|ra| pepl|de), ooal-ooalar (asra, arl|depresar, ooal jarlurg), |ogar, lo|s|r orgar||, dar produ|
lararar (arser, |rse|l|s|da, lo|s|r jarur, calle|re)
0|are yang berhubungan dengan kerusakan mot|||tas

Adarya |e|a|rar da|ar rol|||las yarg rerpercepal Wa|lu lrars|l dapal rerurur|ar aosorps| ser|rgga
rergras|||ar d|are. ar|ar,proses aosorps| a|ar lerjad| |eo|r aWa|. !eruoarar da|ar rol|||las |rlesl|ra| (o|asarya
per|rg|alar propu|s|) d|aral| pada oeoerapa l|pe d|are.
0|are |nfeks| dan |nf|amas|
Adarya |erusa|ar ep|le| |rlesl|r |arera paloger alau |rle|s| v|rus rerupa|ar peryeoao pa||rg urur dar| d|are.
0eslru|s| dar| ep|le| l|da| rarya rergras|||ar e|sudas| seur dar darar |e da|ar |urer,lelalap| ser|rg juga
d|ruourg|ar dergar per|uasar deslru|s| dar| ep|le| aosorps|. !ada oeoerapa |asus, aosorps| a|r sargal l|da|
ele|l|l d|are.
erdasar|ar |||r|s:
Acute watery diarrhoea
arg lerjad| oeoerapa jar r|rgga rar|. araya ulara ada|ar der|dras|, r|argrya oeral oadar, dapal lerjad| j||a
l|da| d|serla| dergar asupar ra|arar yarg ade|ual.
Corlor :|o|era
Acute bloody diarrhoea (d|senter|}
orp|||as| ulara :|erusa|ar |rlesl|re, seps|s, dar ra|rulr|s|.der|dras| o|sa lerjad|
!ersistent diarrhoea
||a lerjad| > 11 rar|. orp|||as| : ra|rulr|s|, |rle|s| |rlesl|ra| yarg ser|us
iare dengan malnutrisi yang berat (marasmus | kwas|orkor}
orp|||as| ulara : |rle|s| s|sler||, der|dras|, gaga| jarlurg, del|s|ers| v|lar|r dar r|rera|
iare kronik
0|are yarg |rlerr|ller (r||arg l|rou|), yarg oer|argsurg |ara dergar peryeoao ror |rle|s|. V|sa|: r|persers|l|v|las
g|uler, gargguar relaoo||sre yarg rerurur

. Exp|a|n pathogenes|s of acute d|arrhea that caused by
a. v|ra| |nfect|on
dergar rerusa| se| ep|le| ru|osa Wa|aupur rarya oers|lal superl|s|a|, ser|rgga rerggarggu aosorps| a|r, dar
e|e|lro||l. 3eoa|||rya se|-se| |r|pl| a|ar oerpro||leras|, dar oerlaroarrya se|res| ca|rar |e da|ar |urer usus.
3e|a|r |lu, lerjad| pu|a |erusa|arerz|r-erz|r d|sa|ar|da yarg reryeoao|ar |rlo|erars| |a|losa, yarg a|r|rrya
rerper|ara d|are.
b. |actose |nto|erance
Biaie yang muncul uisebabkan bebeiapa hal, yang peitama kaiena laktose tiuak uapat uiceina
sehingga uikeluaikan oleh tubuh. Caiian yang banyak uifeses uikaienakan tubuh
mengeluaikan sejumlah caiian lain untuk menstabilkan keauaan pB ualam peiut uan
mencoba menceina laktosa. Yang keuua, uiaie muncul kaiena auanya stimulus uaii saiaf
bahwa auanya zat asing yang masuk ke ualam tubuh melewati saluian penceinaan. Tubuh
beiusaha untuk mengeluaikan zat asing teisebut uan meiesponnya uengan mengeluaikannya
banyak caiian paua uiaie
c. enterotox|n (E.co||, V.cho|era}
lo|s|r yarg d|produ|s| o|er oa|ler| a|ar ler||al pada ru|osa usus ra|us, rarur l|da| rerusa| ru|osa. %o|s|r
rer|rg|al|ar |adar s||||| AV! d| da|ar se|, reryeoao|ar se|res| a|l|l ar|or ||or|da |e da|ar |urer usus yarg
d|||ul| a|r, |or |arooral, |al|or ralr|ur, dar |a||ur. 3ecara |||r|s dapal d|leru|ar d|are oerupa a|r seperl| a|r cuc|ar
oeras dar rer|rgga||ar duour secara deras dar oarya| (;4:234:8). eadaar lerseoul d|seoul d|are se|relor||
|solor|| vo|ur|ra|.
d. sh|ge||a and entamoeba
d|are reryeoao|ar |erusa|ar d|rd|rg usus oerupa re|ros|s dar u|seras|, dar oers|lal se|relor|| e|sudal|l. Ca|rar
d|are dapal oercarpur |erd|r dar darar.
. Exp|a|n the c||n|ca| presentat|on of acute d|arrhea |n ped|atr|c (the s|gn and|or symptomp of some dehydrat|on
and severe dehydrat|on}
Verurul wl0



Verurul !2 0|are 0E!E3 Rl

7. Exp|a|n the f|ve pr|nc|p|es of therapy of acute d|arrhea |n ped|atr|c!
O |u|d adr|r|slral|or
O Corl|rued orealleed|rg ard leed|rg
O Arl|o|ol|cs, or|y |l |rd|caled
O 0o rol roul|re|y g|ve arl|d|arrrea| agerls
O %real accorpary|rg d|sease, |l preserl


8. Exp|a|n:
a. what |s ora| rehydrat|on so|ut|on ?
Ca|rar perggarl| yarg d|oer||ar |epada pas|er d|are urlu| rerggarl||ar ca|rar yarg r||arg. 0ar pa||rg l|da|
rergardurg garar.
b. what |s su|tab|e f|u|d and unsu|tab|e f|u|d?
a.3u|lao|e l|u|d ada|ar ca|rar yarg serarusrya d|oer||ar secara rorra| d|oer||ar |epada ara|. Ca|rar |r| d|oag|
dua
|. Ca|rar yarg sudar rergardurg garar ya|lu : 0R3, sa|led dr|r| (a|r laj|r oergarar alau yogrurl oergarar),
sup sayur alau ayar dergar garar
||. Ca|rar yarg l|da| rergardurg garar : a|r pul|r, a|r laj|r, sup larpa garar, yogrurl larpa garar, a|r |e|apa
r|jau, ler laWar, jus ouar larpa gu|a
o.ursu|lao|e l|u|d ada|ar seoag|ar |ec|| ca|rar yarg oeroaraya dar serarusrya d|r|rdar| se|ara d|are, r|asa|rya :
soll dr|r|, r|rurar ouar rar|s, ler rar|s, ca|rar |a|r dergar ele| purgal|l d|urel||, sl|ru|ar (|op|, oeoerapa
ler ooal-ooalar, |rlus|or)
c. Exp|a|n compos|t|on of newora|yte !
O0ra||t
ardurgar ur|ar g/L lor orserlras| r.ro|/|
Nalr|ur ||or|da 2, Nalr|ur Z5
%r| ralr|ur s|lral 2,9 3|lral 10
0|r|dral 1,0 a||ur ||or|da 20
a||ur ||or|da 13,5 0|u|osa 5
0|u|osa (arr|drous) Z5
O|nc
|rc supp|ererlal|or reduced lre sever|ly ard dural|or ol d|arrrea, decreased lre occurarce ol pro|orged
d|arrrea or pers|slerl d|arrrea ard a|so decreased d|arrrea| ep|sode |r lre rexl 3 rorlrs
!reserlal|or: z|rc su|lale lao|el 20 rg
d. Exp|a|n how to g|ve ora|yte and z|nc !
0ra|yte : !eroer|ar sesua| |eoulurar seperl| pada saal d|are saja
|nc: 0ose: age 2-5 rorlrs = 10 rg/day
Age > rorlrs = 20rg/day
3rou|d oe g|ver lor 10-11 days