PROGRAM PENDIDIKAN

ILMU KESEHATAN ANAK

VISI
MENJADI PUSAT PENDIDIKAN DOKTER SPESIALIS ANAK PILIHAN DI
TINGKAT NASIONAL YANG MENGHASILKAN DOKTER SPESIALIS ANAK
YANG KOMPETEN DAN BERKUALITAS INTERNASIONAL TAHUN 2020
MISI
1. MENYELENGGARAKAN PENDIDIKAN KEDOKTERAN BERBASIS
KOMPETENSI BERSTANDAR NASIONAL, MUTAKHIR, PROFESIONAL,
DAN BERLANDASKAN KEILMUAN BERBASIS BUKTI
2. MENYELENGGARAKAN PENELITIAN KEDOKTERAN DAN KESEHATAN
YANG INOVATIF, UNGGUL, KOMPETITIF DAN BERORIENTASI PADA
PENGEMBANGAN ILMU DAN BERMANFAAT BAGI MASYARAKAT
3. MENYELENGGARAKAN PELAYANAN KESEHATAN ANAK YANG
HOLISTIK DAN KOMPREHENSIF
4. BERPERAN AKTIF DALAM PENGEMBANGAN PENDIDIKAN,
PENELITIAN KEDOKTERAN, PELAYANAN KESEHATAN ANAK DAN
PENGABDIAN MASYARAKAT
 DOCTORS ON DUTY
2

Junior On Duty Madya On Duty

dr. Arif dr. Lilik Fitriana
dr. Tessa
dr. Herdanti
dr. Maria

Madya II On Duty Emergency on duty:

dr. Firman Syahbana dr. Ading Rohadi
dr. Diah Anggraini
dr. Nesi A Ramli

Onsite Supervisor Supervisor On Duty

dr. Denny Salverra Yosy, Sp.A (K) dr. Afifah Ramadanti, Sp.A (K)
CO-ASSISTANT ON DUTY

Jaga IKA – B Jaga IKA - C

Anugerah Rizka
Safira Mita
M Arif

Jaga IRD Jaga Neonatus

Fidzah Nopasari
Husnul Nurul
 TOTAL NUMBER OF INPATIENTS
Box Patients New Discharge Patient with Deceased Total
Patients Patients Problems

4
Gastroenterologi 11 1 - - - 12
Nutrition & metabolic disease 2 1 - - - 3

Endocrine - - - - -
Infection 4 1 - - - 5
Respirology 16 - - - 16
Al- Immunology 7 - - - 7
Neurology 15 1 - - - 16
Nephrology 4 - - - 4
Cardiology 7 - - - 75
Hemato-Oncology 35 1 - - - 45
Neonatology 28 - - - 28
PICU 6 - - - 6
NICU 15 - - - 16
Surgery/ophtalmology 1 - - -
DV -
 NEW PATIENTS DURING ON DUTY
Identity
No
1 An Nasya/ girl/ 4 yo
2 Eli santi / girl/ 16 yo
3 Syah jehan/ Girl/ 16 yo
4 Nadya binti Fajrul/ Girl
/ 16 yo
5 Mutia / girl / 14 yo
Diagnose/ Severity Division
Differential Diagnose Level
Tymoma + Rhinofaringitis Akut + 3 Hematoonkology
Candidiasis oral + hiperpirexia
Decompensatio Cordis NYHA V ec 3 Cardiology
susp PJR
Dehidrasi low intake + low intake + 3 Gastroenterohepat
B20 + Rhinofaringitis acute ology
TDBD grade 1 3 Infection
 DECEASED PATIENT
6

No. Identity Diagnose Box

Eli Santi/ girl/ 16 yo

Appearance Breathing
abnormal Normal

Normal Circulation

Appearance: Breathing :
T: normal tone NCH (-), retraction (-), tachipneu (-)
I: normal interaction ,
C: normal consalable
L: look or gaze (+) Circulation:
S: normal Pale (-) mottling (-)

7
ANAMNESIS
Identity :Eli Santi/ girl/ 16 yo
Time of Admission in ER : 01.10 am
Chief complain : shorthness of breath
Aditional complain : feeling palpitation
Present Illness History
Shorthness of breath was getting worst since 1 month before admission. It was affected
by activity and position of the patient. The patient feel more comfort when he get lay
down. The patient also complain about fever but not so high and it was not measured.
Patient complained about palpitation since 1 week before admission. Cough (-) cold (-)
Patient complained about shorthness of breath since 3 years before , she have seen
cardiologist before and echocardiography was done, patient was getting treated but
she didn’t remember her medication.
The patient got routine controlled to cardiologist for 1 years, first year when she knew
that she got heartache but after that she didn’t control anymore.
At the mean time shothness of breath were getting worstened then get referred to
RSMH
 0

9
• Physical Examination

• General Condition • Weight : 20 kg

• General Condition : E4M6V5 • Height : 120 cm
• Pulse : 125 x/m • WAZ : Z< -3SD
• Temp : 36,80C • HAZ : Z< -3 SD
• RR : 35x/m • WHZ : Z< -3 SD
• SpO2 : 98 %
Spesific Condition
Head : Anemic conjunctiva (+), icteric sclera (-), nasal flare (-),normal light reflex,
Thorax : Symmetric, retraction (-), prominent ribs (-),
Lungs : Normal vesicular breathe sound, rhales (-), wheezing (-)
Heart : Normal heart sound, murmur (+) split in all valves gallop (-)
Abdomen : flat, souple, liver was palpable 3cm bac and spleen not palpable, bowel
sound
Extremities : warm extremities, CRT <3
 Laboratory Finding (5/3/2019)
Result Normal
11

23-02-19
Haemoglobin 10.5 11.3 – 14.4 g/dL
Eritrocyte 4.04 4.75-4.85 103/mm3
WBC 3.59 4.5 – 13.5 103/mm3

PLT 430 217 – 497 103/µL

Ht 32 37-41 %
MCV 80 75-87 fL
MCH 26 25-31 Pg
MCHC 33 33-35 g/dl
LED 55 <5 mm/hour
DC 0/3/45/33/19
Reticulocyte 0.7 0.5-1.5 %
ASTO NON EACTIVE
 FOTO KLINIS
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 PROBLEMS ASSESSMENT
- Shortness of breath Susp NYHA IVV + PJR
- Increasing of JVP

DIFFERENTIAL DIAGNOSIS WORKING DIAGNOSIS

Decompensatio cordis

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 PLAN EXAMINATION THERAPY
Routine blood Count - Oxygen nasal 2lpm
- Furosemide 2x40mg
ECG - KSR 2x1 tab
Ro Thorax
Plan for Echocardiography

DIET MONITORING
• Vital sign
• Pain

ADMISSION Cardiology Division

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THANK
YOU