DS GLYCOPHORIN 2017

GASTROINTESTINAL SYSTEM
 RULES :
1. UCAPKAN BASMALLAH
2. NIATKAN BELAJAR KARENA
ALLAH
3. DIANJURKAN BERWUDHU
TERLEBIH DAHULU
4. KALAU ADA HAMBATAN
DALAM MENGHAPAL ISTIGFAR
5. JANGAN LUPA MINTA MAAF
SAMA ORANG TUA DAN TEMAN
ATAS KESALAHAN

DS Glycophorin 2017 Gastrointestinal System

 REVIEW CASE SINGKAT BANGET [baca ya, biar ga salah diagnosis. Hehe ^_^ ]

Dental Infection and Angina Ludwig Upper Gi Bleeding due to Peptic Ulcer Disease (PUD) Hepatitis B chronic active, Cirrhosis, Portal Hypertension
Diagnosed : Phlegmone e.c Seconf Molar Mandible Infection Diagnosed:Chirosis Hepatis with pre coma (Hepatic Encephalopathy)
Ms. N, 18 y.o Mr. A 66 y.o Mr. Irsyad, 30 y.o
1. CC: Kesulitan membuka mulut dengan lebar, dan menelan sejak 1. CC : Tarry Stool 1. CC : Dark Urine & Yellow tint of eyes since 2 days ago
2 hari yang lalu 2. Vomitied 2. Past History : 4 thn lalu, ada jaundice
2. Kesulitan bernafas dan berbicara 3. Epigastric tenderness (+) 3. Riwayat keluarga : Ibu & Ade di diagnosis chronic hepatitis
3. Mengeluarkan banyak air liur 4. Endoscopy : Ulcer ar pyloric &duodenum 4. Serologic Markers : HBsAg (+) , Ig-G anti-HBV (+)
4. Bengkak pada mulut dan kelua sisi area mandibula sejak 5. Histophatological : Helicobacter Pylori (+) 5. Jarang follow up, 3 year later : gynecomastia, spider naevi dll
kemarin
SKDI : karies gigi (3A) SKDI : Ulkus (Gaster , duodenum) 3A SKDI : Hepatitis A (4A) , Hepatitis B (3A), Hepatitis C (2),
Sirosis Hepatis (2)

Acute Cholangitis due to Choledocholithiasis owing to Cholelithiasis Right Indirect Incarceration Inguinal Hernia Diffuse Peritonitis e.c Perforated Appendicitis
with Cholecystitis
Mrs. C, 43 y.o Mr. D, 40 y.o construction labourer Miss D,20 y.o
1. Right Upper Abdominal Pain since last night 1. CC : Right groin lump, (tenderness & redness sourunding lump) 1. CC : Abdominal pain sejak 6 jam lalu
2. Icteric & fever 4 hari lalu, diikuti mual muntah 2. Colicky pain and obstipation Kronologi :
3. T↑, BP↓, PR↑, RR↑, CRT >2 second 3. Kronologi : -7 hari lalu, epigastric pain
4. Urine : dark brown -15 tahun lalu, ada benjolan juga tapi kalo batuk, meregang atau -2 hari lalu, pain at the right lower abdomen
5. Magnetic Resonance Cholangio-Pancreatography : Filling angkat beban tapi masih bila di masukin kedalem -Now , pain at all region terutama RLQ
defect in the gall bladder and biliary tract -1 hari yg lalu, dia angkat air seember ada benjolan dan semakin 2. High fever dan Obstipasi sejak kemarin
6. Endoscopic Retrograde Cholangio-Pancreatography: membesar dan ga bisa dimasukin lagi.di sekitar benjolannya juga 3. Tenderness, rebound tenderness at all region terutama kanan
Stones at the ampulla of vater, common bile duct, and gall nyeri sama kemerahan. bawah abdomen, mucular rigidity (+) → tanda peritonitis
bladder 4. Trendelenburg position, Herniotomy exploration dan McVay 4. Diffcount : shift to the left → tanda infeksi akut
Herniography repair 5. Plain X ray : free air appearance → tanda perporasi
SKDI : Kolesistisis (3B), Kole(doko)litiasis (2), pankreatitis (2) SKDI : Hernia (Inguinalis, femoralis, scrotalis ) reponibilis, SKDI : Peritonitis (3B), Perforasi usus (2), Apendisitis akut (3B)
irreponibilis (2), Hernia (Inguinalis, femoralis, scrotalis )
strangulate, inkarserata (3B)

Acute Diarhea Non Dysentry With Severe Dehidration Helminthiasis Sigmoid Colon Carcinoma & Internal Hemorrhoid grade II
T, 22 month baby girl Son, 4 y.o Mr. H , 50 y.o
1. CC : Loose stool (lunak), AC : Watery stool more frequent 1. CC: Bloody-mucoid diarrhea sejak 1 minggu lalu 1. CC: Bleeding from anus, biasanya setelah defekasi
2. Lethargic, very sunkes eyes, no tears, dry oral mucous 2. Slight abdominal discomfort, no fever 2. Difficulty in defecation
membrane →tanda tanda dehidrasi berat 3. Diffcount : eosinophil ningkat 3. Weight loss, in LLQ lump as big as duck egg, solid, hard,
3. Stool exam : acidic odor 4. Stool exam : (+) ascariasis lumbricoideus & trichuris trichiura regular, shape &fixed
4. Plan C dulu → terus dikasih Plan A 4. Barium enema : apple core like appereance
SKDI : Malabsorbsi (3A), Intoleransi makanan (4A) SKDI :Askariasis (4A) SKDI : Karsinoma colom (2), Hemoroid grade 1-2 (4A),
Hemoroid grade 3-4 (3A)

DS Glycophorin 2017 Gastrointestinal System

 MINDLIST GASTROINTESTINAL (GIS)

Dental Infection and Angina Ludwig Upper Gi Bleeding due to Peptic Ulcer Disease (PUD) Hepatitis B chronic active, Cirrhosis, Portal Hypertension
Diagnosed : Phlegmone e.c Seconf Molar Mandible Infection Diagnosed:Chirosis Hepatis with pre coma (Hepatic Encephalopathy)
1. Anatomi 1. Anatomi (Struktur, Topografi, Vaskularisasi, Innervasi) 1. Anatomi Hepar (definisi, surface, recessus, ligament, lobus,
a. Oral Region : Oral Cavity, Salivary Gland, Gigi, a. Batas upper Gi & Lower GI vaskularisasi, innervasi)
Nomenklatur (FDI) b. Esophagus*** 2. Histologi Hepar (Mucosa, Submucosa, Muscularis, Serosa)
b. Leher : Fascia dan Spasium c. Lambung 3. Fisiologi Hepar
c. Mandible d. Duodenal a. Fungsi Hepar
2. Histologi 2. Histologi (Mucosa, Submucosa, Muscularis, Serosa) b. Metabolisme Bilirubin (Pre, Intra, Post Hepatic)
a. Gigi a. Esophagus *** 4. Mikrobiologi : Virus Hepatitis A,B,C,D,E (focus di B)
3. Fisiologi b. Lambung
a. Membuka Mulut c. Duodenal
b. Mastikasi dan menelan 3. Fisiologi
c. Mekanisme drooling a. Lambung
4. Mikrobiologi : Flora normal -Fase Sekresi Lambung
-Mixing and Propulsi
-Stomach Emptying
-Secretion HCL
b. Small Intestine
-Mixing & Propulsive
-Sekresi
-Digestive
-Absorpsi
c. Gastroduodenal Mucosal Defense
d. Regulasi Sekresi Sel Sekretagogeus
e. Digestie Enzyme (mention apa saja)
4. Mikrobiologi (Lokasi, Karakteristik, Morfologi, Factor virulensi)
Helicobacter Pylory
1. Dental Caries 1. GI Bleeding (Definisi, Derajat dan klasifikasi upper & lower GI 1. Patofisiologi : Jaundice / Ichterus
2. Odontogenic Infection Bleeding) 2. Hepatitis Viral B (All about)
3. Selulitis Fascia 2. Peptic Ulcer (All about, tekankan perbedaan Gastric ulcer dan 3. Cirrhosis Hepatis (All about)
4. Phlegmone (ALL ABOUT) Duodenal Ulcer di klasifikasi) 4. HEPATIC ENCEPHALOPATHY ***
NOTES:
1. ***Anatomi dan Histologi Esofagus
Cek di kasus, kalo ada kelainan di kasus jelasin, kalo ga ada
ga usah kyknya. Atau kalau mau cari aman, terus pgn jelasin
esofagus padahal esofagusnya ga ada kelaianan, manga aja.
Paling nyambungin kenapa harus ngejelasinnya :” karena
peptic ulcer biasanya terjadi pada esofagus, lambung dan
duodenum. Maka disini saya akan menjelaskan itu. Tapi
tekankan pada kasus terjadinya dimana aja!)

DS Glycophorin 2017 Gastrointestinal System

Acute Cholangitis due to Choledocholithiasis owing to Cholelithiasis Right Indirect Incarceration Inguinal Hernia Diffuse Peritonitis e.c Perforated Appendicitis
with Cholecystitis
1. Anatomi 1. Anatomi 1. Anatomi
a. Gallbladder a. Quadran & Regio Abdomen a. Quadran & Regio Abdomen
b. Billiary b. anterolateral abdominal wall b. Large Intestine (Appendix)
c. Pankreas *** c. Inguinal region c. Peritoneum (mesenteri, omentum, ligament)
2. Histologi d. Inguinal canal 2. Histologi
a. Gallbladder e. Small intestine & fungsinya ***sekilat aja ya, a. Large Intestine (Appendix)
b. Billiary ngejelasinnya jgn panjang2 ^_^ hehe. Dibahas karena 3. Fisiologi
c. Pankreas *** “pada kasus small intestinenya terjepit sehingga a. Large Intestine (Appendix)
3. Fisiologi Asam Empedu (Bile Salt) menurunkan fungsinya.” b. Peritoneum
a. Sekresi 2. Embryologi penurunan testis c. Nyeri
b.Storage -cepat lambat
c. Pemekatan -somatic, visceral, referred pain
d.Pengosongan gall bladder 4. Mikrobiologi
e. Sirkulasi enterohepatic (daur ulang garam empedu) a. Flora Normal
f. Metabolisme Bilirubin *** Pada pasien terdapat obstruksi di b. E.Coli
bile ductnya, sedangkan bilirubin normalnya harus ke biliary c. Bacteriodes fragilis
system terlebih dahulu, karena ada obstruksi tersebut
menyebabkan adanya jaundice pada pasien. Dimana
metabolisme bilirubin adalah blablabla
1. Obstructive jaundice 1. Hernia & type hernia 1. Abdominal Pain
2. Cholangitis 2. Inguinal Hernia (all about) 2. Appendicitis (All about)
3. Choledhocolhitiasis 3. Peritonitis (All about)
NOTES:
***Anatomi dan Histologi Pankreas
Cek di kasus, kalo ada kelainan di kasus jelasin, kalo ga ada ga usah

Acute Diarhea Non Dysentry With Severe Dehidration Helminthiasis Sigmoid Colon Carcinoma & Internal Hemorrhoid grade II
1. Anatomi 1. Anatomi 1. Anatomi & Histologi (jelasinnya sesuai tumorya atau
a. Small & Large Intestine a. Small & Large Intestine hemorhoidnya dmn)
2. Histologi 2. Histologi a. Large Intestine
a. Small & Intestine a. Small & Large Intestine b. Rectum
3. Fisiologi (tekenin di mekanisme absorbsi laktosa, elektrolit,air) 3. Fisiologi c. Anal canal
a. Small Intestine a. Small Intestine 2. Fisiologi defekasi
b.Large Intestine b.Large Intestine 3. Cell cycle *** (Ini the ga tau dijelasin atau engga, disebagian
4. Mikrobiologi 4. Parasit tutor disuruh jelasin, tapi sebagian lagi engga)
-Bakteri, Virus, Parasit (contah & perbedaan manfes) a. Cacing STH dan STH 4. Patofisiologi : karsinogenesis (inisiasi, promosi, progresi)
-Rotavirus b.Ascaris Lumbricoideus
c. Trichuris Trichiura
1. Diare (definisi, epidemiologi, etiologic, FR, klasifikasi) 1. Helminthiasis (Rumah besar, epidemio, etiolo, klasifikasi) 1. Carcinoma Colon
2. Akut Diare (All about) (Tekenin Lintas Diare) 2. Ascariasis (all about) 2. Adenocarcinoma sigmoid colon
3. Trichuriasis (All about) 3. Hemorrhoid
4. Internal Hemorrhoid grade II*** Case 9: hemoroid internal
stage 3 harusnya, karena dia manual reduction
DS Glycophorin 2017 Gastrointestinal System
CASE 1 PHLEGMONE E.C SECONF MOLAR MANDIBLE INFECTION

DS Glycophorin 2017 Gastrointestinal System

CASE 2 UPPER GI BLEEDING DUE TO PEPTIC ULCER DISEASE (PUD)

DS Glycophorin 2017 Gastrointestinal System

CASE 3 CHIROSIS HEPATIS WITH PRE COMA (HEPATIC ENCEPHALOPATHY)

DS Glycophorin 2017 Gastrointestinal System

CASE 4 ACUTE CHOLANGITIS DUE TO CHOLEDOCHOLITHIASIS OWING TO CHOLELITHIASIS WITH CHOLECYSTITIS

DS Glycophorin 2017 Gastrointestinal System

DS Glycophorin 2017 Gastrointestinal System
CASE 5 RIGHT INDIRECT INCARCERATION INGUINAL HERNIA

DS Glycophorin 2017 Gastrointestinal System

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CASE 6 DIFFUSE PERITONITIS E.C PERFORATED APPENDICITIS

DS Glycophorin 2017 Gastrointestinal System

DS Glycophorin 2017 Gastrointestinal System
CASE 7 ACUTE DIARHEA NON DYSENTRY WITH SEVERE DEHIDRATION

DS Glycophorin 2017 Gastrointestinal System

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CASE 8 HELMINTHIASIS

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CASE 9 SIGMOID COLON CARCINOMA & INTERNAL HEMORRHOID GRADE II

DS Glycophorin 2017 Gastrointestinal System

DS Glycophorin 2017 Gastrointestinal System