Modul 1

Blok 3.
1
Neurobehaviour
Audra Lovita Vianny
Muhammad Ferdiansyah
MODUL 1
SKENARIO 1 : STROKE BERULANG

Bu Hasnidar, 60 tahun dirujuk dari RS Padang Panjang ke RS Dr M Djamil Padang dengan keluhan tiba
tiba lemah anggota gerak sebelah kanan saat ke kamar mandi. Pasien tidak mengeluh sakit kepala
dan tidak ada muntah, tapi terlihat seperti mengantuk dan masih menjawab bila dipanggil.Tiga
tahun yang lalu, pasien mengalami serangan stroke iskemik dengan kelemahan sisi kiri dan sudah
bisa beraktivitas tanpa bantuan.Sebelumnya dokter sudah menganjurkan untuk kontrol secara
teratur supaya hipertensi yang dideritanya dapat dikendalikan. Pada pemeriksaan di IGD RS Dr M
Djamil didapatkan TD 170/90 mmHg, nadi 72 x/mnt, suhu 36,8C, kesadaran soporous dengan GCS
E3,V4 dan M5. Ditemukan paresis N VII dan XII kanan sentral dan hemiparesis kanan.Reflek Babinski
kanan (+), Hofman Tromer kanan (+), KPR dan APR kanan (+++).Dari hasil pemeriksaan Brain CT Scan
ditemukan gambaran lesi hiperdens di hemisfer kiri, kemudian pasien segera dirawat di ruang
emergensi neurologi dan mendapatkan berbagai jenis obat-obatan.
Di sebelah Bu Hasnidar, di ruang emergensi ini dirawat juga beberapa orang pasien, hampir
semuanya dengan penurunan kesadaran, seperti pada bed nomor satu, terbaring pasien muda usia
yang mengalami koma setelah kecelakaan lalu lintas, pada bed nomor lima, terbaring seorang pasien
dengan meningitis, juga dengan kesadaran menurun. Menurut kepala ruangan, semua pasien
diruang emergensi ini, walaupun dalam keadaan koma, tetap dilakukan fisioterapi pasif, untuk
mencegah kontraktur.
Bagaimanakah anda menjelaskan berbagai kondisi dengan gangguan kesadaran ini?
TERMINOLOGY 7. Hofman tromer
Refleks pada jari-jari tangan
1. Stroke Iskemik
kondisi medis yang ditandai dengan
8. KPR
terganggunya aliran darah ke dalam otak akibat
Knee Pess Refleks/Refleks Patella, refleks
dari sumbatan pada pembuluh darah di dalam
sistem saraf berupa refleks kontraksi otot di
otak oleh gumpalan darah.
sekitar patela sehingga kaki akan terlihat
seperti menendang
2. Soporous
Disebut juga stupor yaitu keadaan mengantuk
9. APR
yang dalam.Pasien masih dapat dibangunkan
Achilles Pess Refleks/Refleks Achilles; reflex
dengan ransangan kuat tetapi pasien tidak
pada tendon Achilles yaitu tendon di bagian
terbangun sempurna dan tidak dapat
belakang tungkai bawah
memberijawaban verbal yang baik.
10.Lesi hiperdens
3. GCS E3,V4,M5
Lesi: istilah kedokteran untuk merujuk pada
keadaan jaringan yang abnormal pada tubuh
Hiperdens : densitas(kepadatan) berlebihan
11.Koma
kondisi medis yang ditandai dengan hilangnya
kesadaran dan kewaspadaan, serta
ketidakmampuan untuk dibangunkan
12.Fisioterapi pasif
Terapi untuk mengembalikan fungsi tubuh yang
4. Paresis dilakukan secara pasif (dengan bantuan bukan
suatu kondisi ditandai oleh lemahnya gerak dengan dirinya sendiri)
badan, atau hilangnya sebagian gerakan badan

atau adanya gangguan gerakan. (Kekuatan otot 13.Kontraktur
berkurang) pemendekan permanen dari kulit dan atau

jaringan dibawahnya yang menyebabkan
5. Hemiparesis deformitas dan keterbatasan gerak.
kelemahan pada satu sisi tubuh
6. Reflek Babinski
tindakan refleks jari-jari kaki
IDENTIFIKASI MASALAH
1. Adakah hubungan usia& jenis kelamin Bu Hasnidar terhadap apa yang dideritanya?
2. Mengapa bu Hasnidar memiliki keluhan tiba-tiba lemah anggota gerak sebelah kanan?
3. Mengapa bu Hasnidar terlihat mengantuk tetapi masih menjawab ketika dipanggil? Apa
kemungkinan yang terjadi jika keluhan ini disertai dengan sakit kepala dan muntah?
4. Adakah hubungan kondisi ini dengan serangan stroke iskemik yang disertai kelemahan sisi kiri
yang dialami bu Hasnidar 3 tahun yang lalu?
5. Adakah hubungan hipertensi dengan apa yang dialami bu Hasnidar?
6. Apa interpretasi dari pemeiksaan fisik TD 170/90mmHg, nadi 72x/menit, suhu 36,8C, kesadaran
soporous dengan GCS E3, V4, dan M5?
7. Apa maksud dari ditemukannya paresis N VII dan XII kanan sentral dan hiperemis kanan?
8. Bagaimana cara melakukan pemeriksaan tes Babinski, Hoffman Tromer, KPR dan APR?
9. Mengapa perlu dilakukan pemeriksaan Brain CT Scan? Apa interpretasi dari ditemukannya
gambaran lesi hiperdens di hemisfer kiri?
10.Mengapa bu Hasnidar perlu dirawat di ruang emergensi neurologi? Jenis obat seperti apa yang
mungkin diberikan?
11.Mengapa pada pasien berikutnya dapat terjadi koma karena kecelakaan lalu lintas?
12.Mengapa pada pasien meningitis dapat terjadi juga penurunan kesadaran?
13.Apa tujuan dari dilakukannya fisioterapi pasif pada pasien koma? Bagaimana caranya?
14.Apa yang terjadi jika pasien mengalami kontraktur?
15.Bagaimana penatalaksanaan dan prognosis dari ketiga pasien dalam scenario ini?
BRAINSTORMING
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MODUL 2
SKENARIO 2 : KENAPA WANDI KEJANG LAGI ?
Wandi, 20 tahun berobat ke dokter keluarga dengan keluhan kejang berulang.Kejang pertama terjadi
sekitar dua bulan yang lalu, dan yang kedua kemarin sore. Menurut ibunya, pola kejangnya sama
yaitu dimulai dari lengan dan kaki kanan kemudian mengenai seluruh tubuh. Sebelum mengalami
kejang, Wandi sering mengeluhkan sakit kepala, awalnya pada malam dan pagi hari, tapi sekarang
sepanjang hari.Dari pemeriksaan ditemukan beberapa tanda peninggian tekanan intrakranial.Wandi
segera dirujuk ke Bagian Saraf RS Dr M Djamil Padang.
Setelah diperiksa di Poliklinik Saraf RS Dr M Djamil, Wandi dirawat untuk dilakukan pemeriksaan
penunjang.Sore harinya Wandi kejang lagi, setelah diberi satu ampul diazepam intravena, kejang
berhenti dan nampak Wandi tertidur.Dari pemeriksaan tanda vital didapatkan tekanan darah 140/90
mmHg, nadi 56 x/mnt dan suhu 36,80C. Pada funduskopi didapatkan kesan edema papil dengan
perbandingan arteri : vena adalah 1 : 3. Keesokan harinya dilakukan pemeriksaan Brain CT Scan
dengan hasil lesi hipodens yang berbatas tegas, dan pada pemberian kontras tampak ring
enhancement di regio frontotemporal kiri. Wandi dikonsulkan ke Bagian Bedah Saraf dan
direncanakan untuk tindakan operasi.
Kepada dokter yang merawat, ibu Wandi bertanya, apakah kejang yang dialami Wandi sekarang
berhubungan dengan riwayat kejang saat demam yang dialaminya beberapa kali di waktu
kecil.Setelah mendapat keterangan dari dokter, barulah ibunya tahu bahwa kejang yang sekarang
berbeda dengan kejang yang dialaminya saat masih bayi.
Pada ruangan yang sama dirawat juga seorang laki-laki sekitar 65 tahun dengan keluhan resting
tremor, face mask, jalan susah dengan langkah kecil-kecil dan posisi badan sedikit membungkuk.
Walaupun sudah minum obat secara teratur, penyakitnya dirasakan makin berat. Melihat berbagai
macam penyakit yang dirawat di bangsal saraf, ibu Wandi jadi bingung sendiri
Bagaimanakah anda menjelaskan berbagai kasus di atas ?
TERMINOLOGY 8. Resting Tremor
tremor yang terjadi pada saat otot
1. Kejang
rileks/istirahat dan menghilang ketika otot
Disebut konvulsi; merupakan perubahan fungsi
digunakan
otak mendadak dan sementara sebagai akibat
dari aktivitas neuronal yang abnormal dan
9. Face mask
pelepasan listrik serebralyang berlebihan.
Wajah kaku, kurang ekspresi, kurang senyum
dan mata jarang kedip
2. Tekanan intrakranial
jumlah total dari tekanan yang mewakili
volume jaringan otak, volume darah
intrakranial dan cairanserebrospinalis.
3. Diazepam
kelompok obat benzodiazepine yang
memengaruhi sistem saraf otak dan
memberikan efek penenang
4. Funduskopi
tes untuk melihat dan menilai kelainan dan
keadaan pada fundus okuli (retina mata dan
pembuluh darah khoroidea keseluruhannya)
5. Edema papil
pembengkakan discus saraf optik sebagai
akibat sekunder dari peningkatan tekanan
intracranial
6. Ring enhancement
Lingkaran terang yang muncul pada tomografi
yang timbul setelah dilakukan peyuntuikan
media kontras, menunjukan adanya abses.
7. Regio frontotemporal
Bagian frontal (depan) dari tulang kepala yang
mengandung bagian dari saluran telinga,
telinga tengah dan telinga dalam
1. Adakah hubungan usia dengan apa yang dialami Wandi?
2. Mengapa Wandi mengalami kejang pertama pada 2 bulan yang lalu dan yang kedua kemarin
sore?
3. Mengapa pola kejang yang dialami oleh Wandi sama yaitu dimulai dari lengan dan kaki kanan
kemudian mengenai seluruh tubuh? Adakah pola kejang yang lain? Serta mungkinkah pola kejang
berubah?
4. Mengapa Wandi mengeluhkan sakit kepala, awalnya pada malam da pagi hari akan tetapi
sekarang sepanjang hari?
5. Bagaimana melakukan pemeriksaan tekanan intracranial? Apa yang terjadi jika tekanan
intracranial meninggi?
6. Apa saja pemeriksaan penunjang yang mungkin dilakukan pada Wandi?
7. Mengapa Wandi diberikan satu ampul diazepam intravena? Bagaimana cara kerja diazepam
sehingga membuat kejang berhenti & Wandi tertidur?
8. Apa interpretasi dari pemeriksaan tanda vital tekanan darah 140/90mmHg, nadi 56x/menit dan
suhu 36,8C?
9. Bagaimana cara pemeriksaan funduskopi? Apa interpretasi dari ditemukannya edema papil
dengan perbandingan arteri : vena 1:3?
10.Mengapa perlu dilakukan Brain CT Scan? Apa interpretasi dari hasil lesi hipodens yang berbatas
tegas?
11.Mengapa pada pemberian kontras tampak ring enhancement di regio frontotemporal kiri?
12.Apa tindakan operasi yang mungkin dilakukan terhadap Wandi?
13.Adakah hubungan kejang yang dialami Wandi sekarang dengan riwayat kejang saat demam yang
dialaminya beberapa kali waktu kecil?
14.Mengapa pada pasien berikutnya terdapat resting tremor, face mask, jalan susah dengan
langkah kecil-kecil dan posisi badan sedikit membungkuk?
15.Mengapa penyakitnya dirasakan semakin berat padahal sudah diberi obat secara teratur?
16.Adakah hubungan usia pasien tersebut dengan apa yang dialaminya?
17.Bagaimana penatalaksanaan dan prognosis dari kedua kasus tersebut di atas?
BRAINSTORMING
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MODUL 3
SKENARIO 3 : FITRI DAN KAKINYA
Fitri (18 tahun) seorang mahasiswi, datang ke puskesmas dengan keluhan, sejak satu minggu
mengalami kelemahan pada kedua kakinya, walaupun ia masih bisa berjalan dengan berpegangan.
Kesulitan ini lebih dirasakan bila ia harus berjalan mendaki atau naik tangga. Fitri juga mengeluhkan
parestesia pada semua jari tangan dan kakinya.Dari pemeriksaan dokter didapatkan kekuatan
tungkai bawah 3/3/2, dan kekuatan lengan dan tangannya 5/4/4. Ditemukan adanya hipoestesia
dengan pola stocking and glove, reflek biceps dan triceps +/+, KPR +/+ dan APR -/-. Dari anamnesis
diketahui bahwa sebelum mengalami kelemahan ada riwayat demam.
Dokter Puskesmas merujuk Fitri ke rumah sakit. Fitri juga melaporkan bahwa sejak satu tahun
terakhir ia berobat ke Poliklinik Saraf dengan keluhan sakit kepala berdenyut, berpindah-pindah,
disertai mual dan kadang-kadang sampai muntah, sering juga disertai fotofobia dan sonofobia,
sehingga mengganggu aktivitas kuliahnya. Ia menanyakan apakah kelemahan kakinya ini merupakan
akibat dari obat sakit kepala yang sering diminumnya?
Bagaimanakah anda menerangkan penyakit yang diderita Fitri?

TERMINOLOGY
1. Parastesia
sensasi kulit abnormal, seperti terbakar atau
menusuk-nusuk, yang terjadi tanpa stimulus
dari luar.
2. Hipoestesia
turunnya sensitifitas terhadap rangsang nyeri
3. Pola stocking and glove

Kesemutan yang biasa dirasakan di kaki dan
tangan
4. Refleks Biceps & Triceps

Refleks trisep: pengujian untuk lesi di tingkat
C6-C7 di mana pasien menekuk lengannya atau
menempatkannya di pinggul.
Refleks bisep: tes dengan mengetuk tendon
otot bisep. Biasanya ada kontraksi dari otot-
otot bisep disertai dengan kedutan lengan
bawah.
5. Fotofobia
sensitivitas terhadap cahaya
6. Sonofobia
Ketakutan pada suara
1. Adakah hubungan usia Fitri yang tergolong masih muda dengan kelemahan pada kedua kakinya?
Adakah kemungkinan jika nantinya Fitri tidak mampu berjalan lagi?
2. Mengapa kesulitan tersebut lebih dirasakan jika ia harus berjalan mendaki atau naik tangga?
3. Mengapa terjadi paraestasia pada jari tangan & kaki Fitri?
4. Bagaimana cara melakukan pemeriskaan kekuatan tungkai bawah? Apa maksud dari kekuatan
tungkai bawah 3/3/2?
5. Bagaimana cara melakukan pemeriksaan kekuatan lengan dan tangan? Apa maksud dari
kekuatan lengan dan tangan 5/4/4?
6. Apa interpretasi dari ditemukannya hipoestesia dengan pola stocking and glove, reflex bisep &
triceps +/+, KPR +/+, dan APR -/-?
7. Apa hubungan kelemahan yang dirasakan Fitri dengan riwayat demam?
8. Adakah hubungan sejak satu tahun terakhir Fitri mengalami sakit kepala berdenyut, berpindah-
pindah, disertai mual dan kadang sampai muntah serta sering disertai dengan fotofobia dan
sonofobia dengan apa yang dialaminya saat ini? Mengapa dapat terjadi hal demikian?
9. Apakah kelemahan kakinya merupakan akibat dari obat sakit kepala yang diminumnya? Jika ya,
kira-kira apa obat yang diminum Fitri dan bagaimana sampai terjadi hal tersebut?
10.Bagaimana penatalaksanaan dan prognosis Fitri?
BRAINSTORMING
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MODUL 4
SKENARIO 4 : PETAKA BAGI JASMINA
Jasmina, seorang pelajar berusia 18 tahun dibawa ke dokter oleh karena orang tuanya menduga
bahwa dia telah diperkosa oleh supir angkot yang ditumpanginya.Dua hari yang lalu Jasmina
menumpang angkot sepulang bimbel.Menurut keterangan Jasmina, dia merupakan penumpang
terakhir yang belum turun dan dirayu oleh supir dan kenek angkot yang ditumpanginya, selain itu dia
tidak mengingat apa-apa lagi.Jasmina diantar pulang malam itu oleh petugas ronda/polisi yang
menemukannya dalam keadaan bingung di tepi jalan.
Pada pemeriksaan terlihat seorang wanita dewasa muda bertubuh langsing dengan gejala
kebingungan, ansietas dan depresi.Pada pemeriksaan didapatkan lebam bekas gigitan pada
mammae kanan dan bagian lateral kiri leher.Ketika ditanya dan diberi kesempatan bercerita Jasmina
tampak ketakutan dan tidak mampu bercerita selain menangis. Keluarga sangat khawatir Jasmina
akan hamil, ketularan penyakit kelamin, dan stres yang berkepanjangan. Menurut dukun, Jasmina
tasapo dalam perjalanannya dari bimbel ke rumah.
Menurut keterangan orang tua Jasmina di sekolah ia dikenal sebagai anak yang pintar, banyak
teman, walaupun pendiam. Bagaimana pendapat Anda mengenai keadaan yag dialami oleh Jasmina
dan penanganannya?
TERMINOLOGY
1. Ansietas
kondisi yang ditandai dengan kecemasan dan
kekhawatiran berlebihan atas peristiwa
kehidupan sehari-hari tanpa alasan yang jelas
untuk mencemaskan/ mengkhawatirkannya.
2. Depresi
gangguan mental umum yang ditandai dengan
kesedihan, kehilangan minat atau kesenangan,
perasaan bersalah, kesulitan berkonsentrasi,
tidur terganggu, nafsu makan berubah dan
energi rendah.
3. Stres
bentuk ketegangan dari fisik, psikis, emosi
maupun mental.
4. Tasapo
Demam yang disebabkan sebagai gangguan
makhluk halus
1. Mengapa Jasmina tidak mengingat kejadian yang dialaminya? Apa yang menyebabkan Jasmina
dalam keadaan bingung saat diantar pulang?
2. Mengapa pada pemeriksaan ditemukan gejala ansietas dan depresi serta lebam bekas gigitan
pada mammae kanan dan bagian lateral kiri leher? Adakah hubungan luka tersebut dengan apa
yang dialaminya?
3. Mengapa Jasmina tidak mampu bercerita dan menangis? Adakah hal yang bisa dilakukan untuk
membuat Jasmina bercerita?
4. Adakah kemungkinan Jasmina hamil, tertular penyakit kelamin serta stress yang berkepanjangan?
Bagaimana penanganan yang tepat?
5. Apakah sifat Jasmina yang tergolong pendiam merupakan salah satu factor resiko akan stress
yang berkepanjangan?
6. Bagaimanae penatalaksaanaan yang tepat pada Jasmina?
BRAINSTORMING
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MODUL 5
SKENARIO 5: MINUM SEDIKIT TAPI MABUK SEBOTOL
Tuan Graha , 42 tahun, pramugara pada penerbangan komersil, dibawa ke dokter di sebuah
poliklinik oleh karena mengamuk di suatu pesta tahun baru yang diadakan teman sesama karyawan.
Menurut istri dan beberapa teman yang mengantarkannya, pasien mendadak marah-marah setelah
meneguk sedikit champagne.Istrinya mengatakan, selama beberapa bulan terakhir, beban pekerjaan
pasien lebih meningkat, tampak lebih irritable, pemarah, sampai memukul keluarga, mengalami
insomnia, dan resah.Dia khawatir kalau suaminya seperti tetangganya yang selalu memukuli istrinya
hanya karena masalah sepele.
Selama ini pasien kadang-kadang merokok dan meminum alkohol, akan tetapi tidak pernah mabuk.
Istri mengkhawatirkan suaminya akanaddiction dengan resiko di grounded. Dia juga menginginkan
suaminya untuk tidak terlibat dengan NAPZA.
Bagaimana anda menjelaskan dan mengatasi masalah pada Tn.Graha?

TERMINOLOGY
1. Champagne
minuman anggur putih bergelembung, yang
mengandung kadar CO2 dan alkolhol yang
tinggi.
2. Irritable
Keadaan mudah marah dan tersinggung
3. Insomnia
gejala kelainan dalam tidur berupa kesulitan
berulang untuk tidur atau mempertahankan
tidur walaupun ada kesempatan untuk itu
4. Grounded
Pengurungan
5. NAPZA
Narkotika, Alkohol , Psikotropika dan Zat adiktif
lain; bahan / zat yang dapat mempengaruhi
kondisi kejiwaan / psikologi seseorang ( pikiran,
perasaan dan perilaku ) serta dapat
menimbulkan ketergantungan fisik dan
psikologi.
1. Adakah hubungan usia Tn. Graha serta pekerjaannya dengan apa yang dialaminya?
2. Mengapa Tn. Graha mendadak marah-marah setelah meneguk sedikit champagne?
3. Apakah hubungan beban pekerjaan Tn. Graha lebih meningkat dengan Tn.Graha yang mudah
marah sampai memukul keluarganya, irritable, insomnia, dan resah?
4. Apakah kelakuan Tn. Graha yang seperti ini dapat memberikan pengaruh kepada istri dan
keluarganya? Jika ya, apa pengaruhnya?
5. Apakah kebiasaan merokok dan meminum alcohol menjadi factor resiko terhadap apa yang
dialami Tn.graha?
6. Mengapa biasanya Tn.Graha tidak pernah mabuk ketika minum alcohol namun sekarang hanya
minum seteguk menjadi seperti ini?
7. Mengapa istri Tn.Graha mengkhawatirkan suaminya akan addiction dengan resiko di grounded?
8. Apa yang terjadi jika Tn.Graha terlibat dengan NAPZA?
9. Apa yang sebaiknya dilakukan untuk menangani kasus Tn.Graha?
BRAINSTORMING
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MODUL 6
Ny. Sansara (41 tahun) telah dirawat tiga hari di puskesmas dengan keluhan demam turun naik sejak
10 hari yang lalu, sangat letih dan apatis.Diagnosis kerja dokter Puskesmas adalah tifus abdominalis
sedangkan menurut dukun pasien tasapo karena berhujan-hujan satu hari sebelum sakit di bawah
pohon besar yang terkenal angker.Sejak satu hari ini, pasien kadang-kadang terlihat bingung,
meracau dan kadang-kadang agak baikan.Keluarganya khawatir penyakit lama pasien kambuh, sebab
tiga tahun yang lalu pasien pernah dirawat inap di bagian psikiatri rumah sakit dengan diagnosis
Gangguan afektif bipolar tipe manik dengan gejala psikotik.
Pada pemeriksaan, didapatkan suhu berkisar 38-39,2 C, kesadaran berkabut (clouding of

consciousness), terdapat disorientasi, perhatian kurang, kadang-kadang marah tanpa alasan, sleep-
wake disturbance dan terlihat sangat lemah. Ketika suami membicarakan dengan dokter, dokter
berpendapat tidak perlu dikonsultasikan ke psikiater karena keadaan ini adalah komplikasi yang
lazim pada tifus abdominalis dan dapat diatasi dengan pemberian antibiotika, diet dan bed rest.
Bagaimana Anda menjelaskan apa yang terjadi pada Ny. Sansara dan bagaimana
penatalaksanaannya ?
TERMINOLOGY
1. Apatis
keadaan kesadaran yang segan untuk
berhubungan dengan sekitarnya, sikapnya acuh
tak acuh.
2. Tifus abdominalis
penyakit infeksi yang terjadi pada usus halus
yang disebabkan oleh Salmonella thypii
3. Meracau
berbicara tidak karuan
4. Gangguan afektif bipolar

dikenal juga dengan gangguan manik depresi,
yaitu gangguan pada fungsi otak yang
menyebabkan perubahan yang tidak biasa pada
suasana perasaan, dan proses berfikir. Disebut
Bipolar karena penyakit kejiwaan ini didominasi
adanya fluktuasi periodik dua kutub, yakni
kondisi manik (bergairah tinggi yang tidak
terkendali) dan depresi.
5. Clouding of consciousness
Penurunan kesadaran yang disertai dengan
gangguan persepsi dan sikap
6. Disorientasi
Tidak memiliki arah; kacau
7. Sleep-wake disturbance
Ketidakteraturan pola tidur, dimana biasanya
seseorang lebih banyak menghabiskan tidur di
siang hari daripada di malam hari.
1. Mengapa Ny. Sansara terlihat sangat letih dan apatis?
2. Mengapa dokter mendiagnosa Ny. Sansara mengalami tifus abdominalis?
3. Adakah hubungan Ny.Sansara yang kehujanan dengan apa yang dialaminya?
4. Mengapa sejak satu hari ini Ny.Sansara terlihat bingung, meracau, dan kadang agak baikan?
5. Apakah hubungan antara kondisi Ny.Sansara sekarang dengan penyakit gangguan afektif bipolar tipe
manik dengan gejala psikotik yang dulu dialaminya?
6. Apakah ada kemungkinan penyakit Ny.Sansara 3 tahun lalu dapat kambuh?
7. Mengapa pada pemeriksaan didapatkan suhu berkisar antara 38-39,2C, kesadaran berkabut, terdapat
disorientasi, perhatian kurang, kadang marah tanpa alasan, sleep-wake disturbance, dan terlihat
sangat lemah?
8. Mengapa dokter berpendapat tidak perlu dikonsultasikan ke psikiater? Bagaimana keadaan yang tepat
untuk dikonsultasikan ke psikiater?
9. Bagaimana tifus abdominalis dapat mempengaruhi kondisi mood seseorang?
10.Apa penatalaksanaan yang tepat terhadap kondisi Ny.Sansara?
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Modul 1

Diunggah oleh

Informasi Dokumen

Judul Asli

Hak Cipta

Format Tersedia

Bagikan dokumen Ini

Bagikan atau Tanam Dokumen

Opsi Berbagi

Apakah menurut Anda dokumen ini bermanfaat?

Apakah konten ini tidak pantas?

Hak Cipta:

Format Tersedia

Modul 1

Diunggah oleh

Hak Cipta:

Format Tersedia

Blok 3.

SKENARIO 1 : STROKE BERULANG

4. Paresis dilakukan secara pasif (dengan bantuan bukan

suatu kondisi ditandai oleh lemahnya gerak dengan dirinya sendiri)

badan, atau hilangnya sebagian gerakan badan

berkurang) pemendekan permanen dari kulit dan atau

5. Hemiparesis deformitas dan keterbatasan gerak.

kelemahan pada satu sisi tubuh

Bagaimanakah anda menerangkan penyakit yang diderita Fitri?

3. Pola stocking and glove

4. Refleks Biceps & Triceps

Bagaimana anda menjelaskan dan mengatasi masalah pada Tn.Graha?

Pada pemeriksaan, didapatkan suhu berkisar 38-39,2 C, kesadaran berkabut (clouding of

4. Gangguan afektif bipolar

Anda mungkin juga menyukai