7/28/2019 PD LAGI
1/4
PLENARY DISCUSSION OF URINARY SYSTEM BLOCK
Time schedule: March 18, 2010 14.00-17.00 AM
Objective
After plenary discussion the students are able to:1. Explain the
organ or part of the body that abnormal related the symptom
(patient
complaint), the changes process from normal into pathologic
condition.
2. Explain the etiology and risk factor of kidney disorder
related the symptom andsign.
3. Explain the pathogenesis of kidney disorder related the
symptom and sign.
4. Explain the pathophisiology of kidney disorder related the
symptom and sign.
5. Explain the diagnosis of kidney disorder related the symptom
and sign.6. Explain the management of kidney disorder related the
symptom and sign.
7. Explain the complication of kidney disorder related the
symptom and sign.
8. Explain the prognosis of kidney disorder related the symptom
and sign.
9. Explain the role of family doctor in the management of kidney
disorder relatedthe symptom and sign.
10. Explain the adjustment of drug treatment for the patient
with kidney functiondisorder.
A 76-year-old man referred to the center hospital because
decrease of consciousness. He
had open surgical resection of Colon Carcinoma as long as 20 cm
in central hospital one
year ago and continued by radiotherapy for 3 month. After
radiotherapy he often
experience of nausea and diarrhea. 1,5 month ago he take care at
center hospital to beconducted colostomy. He discharge from the
hospital but still have low serum potassium
problem and obtain the treatment Aspar K 3x2, Tyarid 2x200 mg?,
ISDN 3x5 mg,Aloclair gargle 3x1, Elkana 2x1, and valsartan 1x80 mg.
10 days ago the patientcondition worse so he take care in a private
hospital Magelang, he obtain the treatment:
NaCl infuse 20 drop/mnt, Broadcet inj 2x1g, Rantin 3x1 amp,
Antrain inj if necessary,
Transfusion 500 cc PRCand oral treatment: CaCO3 3x1, Q ten 2x1,
B Comp Vitamin 2x1,Analsik 3x1, Imboost 2x cth I, CPG 1x1, ISDN
1x1. When the doctors allow him to
discharge his consciousness suddenly decrease then the doctor
referred him to the center
hospital. No history of heart, lung, and kidney disease. He has
mild hypertension. He has
habit drink of tea but no smoking. He had not urination problem
until he take care inprivate hospital Magelang but information for
the condition at the last time before he
refer to the center hospital not clear.
Glasgow Coma Scale: E2V1M2Vital Sign
BP: 125/85 mmHg, Pulse: 78 beat per minute, RR: 28 x/min, t:
38,5 0 C
First day
Laboratory
7/28/2019 PD LAGI
3/4
Laboratory 09:11 AM
Blood Glucose 291
Laboratory 01:36 PM
Total Protein 5,7
Albumin 1,9Globulin 3,8
Na+ 123 K+ low Cl- 102
Laboratory 10:49 PM
Urine laboratory:
Urine Protein: +3
Reduction: +Leucocytes >60
Red Blood Cell full
Laboratory 07.40 PMPLT 59
Total Protein 4,9Albumin 1,8
Globulin 3,1
Ureum: 141 Creatinin 4,7 As Urat 7,1
Na+ 105 K+ low Cl- 90 Mg+ 1,7
Laboratory 08:32 PMNa+ 114 K+ low Cl- 91
Urine Volume 150 cc/24 jam
Third days
Tx: change Broadcet into Tripanem 500mg/24 hrLaboratory 09:25 PM
(Pre HD)
Hb 9,8 AT 81 HBsAg negative
WBC 18,5 Blood Type A
Ureum: 178 Creatinin 4,2 As Urat 7,8Na+ 1132 K+ 2,8 Cl- 111
Urine Volume: 200cc/24 hr
Fourth days
Laboratory 00:26 AMBlood Glucose 312
Ureum: 93 Creatinin 1,8
Urine Volume: (-)
