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CUE AND CLUE PL Idx PDx PTx PMo

Female/17 yo 1. Acute 1.1 DHF Gr II Bed rest Subj


Fever since 4 days prior to febrile 1.2 Dengue fever Soft diet HCHP 2100 ccal/day CBC/8
admission Illness 5th 1.3 Chikungunya IVFD RL 30-40 dpm hours
Headache day+ 1.4 Ricketsiosis
Nausea thromboc
ytopenia
PF :
BP: 110/70
PR:108 bpm
RR: 24 tpm tax 386 C
RL (+)

Lab:
Trombocyte
960005000036000
14000
Leucocyte 1420
PCV 45,5
AST 310
ALP 97
APTT 54,3 s
Antidengue IgM positif
Antidengue IgG positif
CUE AND CLUE PL IDx PDx PTx PMo
Female/17 yo 2. Tb on AFB at the end Joint care with pulmonology Subj,
-FDC at month 6 treatment of treatment department AFB
-6 months ago months 6th Po : FDC 3 tablets, 3 times per after
diagnosed has TB week end of
(cough with yellowish tx,
sputum, low grade
fever, loss of
bodyweight, and cold
sweating at night for
2 months)
-CXR:
fibrocalcification lung
D/S

Female/17 yo 3. Dyspepsia 3.1 dt no 1 Po : Omeprazole 2x20 mg Subj


Nausea syndrome 3.2 PUD
Decrease of appetite
Epigastric pain (+)

Female/17 yo 4. Increased 4.1 Drug induced Bil T/D/I Monitoring Lab


AST 310 of (anti tuberculosis result
ALT 97 transaminas drugs)
e 4.2 dt viral
On chronic
Lung TB Increased of
drugs
transaminase
treatment

Immunocom
Infected Viral
promised
neighborhood virulance

Increase
Dyspepsia vector
syndrome
DHF

Thombocitopenia Rumple
leede +
Risk factor

DHF
Dense population
Chronic infection
Viral virulence
TB
Dense population
Infected neared neighborhood
Management Analysis
Emergency : -
Urgency : DHF gr II
Evaluate VS and bleeding sign
Surface cooling
Rehidration with cristalloid to maintain haemodynamic
stabillity
Non urgency :
Dyspepsia syndrome
Soft diet
Anti emetic and oral PPI
TB on tx : continue tx FDC
Condition this morning
Subj: epigastric pain (+)
BP: 100/70
PR: 108 bpm
RR: 24 tpm
T: 36
Petechiae (+) from rumple leed
Thank you
Fluid therapy

Cairan Kristaloid yang diberikan per hari :


1500 + 20 X (berat badan dlm kg-20)
Pada pasien ini :
1500 + 20X(50-20) = 2100 ml/24 jam = 30 tpm