ASMA BRONKIALE

Definitions
Asthma is a condition in which the channel breath because constringency
hiperaktivitas against a particular stimulus, which causes inflammation and
constringency a while.
Causes
According to The Lung Association, there are two factors that a spark asthma:
1. Triggers (trigger) that cause respiratory tract and terganggunya
tauten menyempitnya or cause respiratory tract
(bronkokonstriksi) but does not cause inflammation, such as:
- Changes in weather and temperature.
- Irritated something that is alergen, such as cigarette smoke, pollen,
dust, fur, smoke, cold air, and sports, insecticides, dust,
air pollution and pets.
- Respiratory tract infection.
- Disturbances emotions.
- Work Sports physical or excessive.
2. The cause (inducer) in the mast cells release the material along bronki
histamin and leukotrien such as the response to foreign substances (alergen),
such as pollen, dust, which is fine in the house or fur,
the cause:
- Smooth muscle contraction
- Increase the formation of mucus
- Transfer of certain white blood cells to bronki.
that lead to inflammation (inflammation) in the respiratory tract
where this will reduce the diameter of the airways (called
bronkokonstriksi) and refinement of this should cause
exert every effort in order to breathe.
Clinical picture
-Difficult breath on asthma typically accompanied voice mengi due to difficulties expiration
- On auskultasi hear wheezing and ekspirasi sweep.

- The state of chock-marked with great musculature giatnya help
respiratory and sianosis known to the status that can asmatikus
fatal consequences.
- Dispnoe in the morning and throughout the night, after physical exercise (especially
when the cold weather), related to the infection channels of breath up,
associated with exposure to alergen such as pollen and fur
animals.
- Coughing that long in the morning and late at night, dealing with
iritatif factors, batuknya can be dry, but often there is a clear mukus
ekskresi channel of breath.
Diagnosis
Asthma diagnosis sometimes can ditegakkan on the basis of anamnesis and
auskultasi. Wheezing in the end ekspirasi almost always a sign of disease
paru obstruktif such as asthma. In the mild asthma, auskultasi almost always normal
when patients asimtomatik.
treatment
- The spark attacks wherever possible eliminated.
- In the light of attacks can be given injections adrenalin 1: 1000 0.2 - 0.3
ml subkutan that can be repeated several times with intervals of 10 - 15
minutes. 0.01 mg dose of the child / kgBB that can be repeated with
attention to blood pressure, pulse and respiration function.
- Bronkodilator is selected teofilin 100 - 150 mg x 3 a day on people
and adults 10 - 15 mg / day for children kgBB.
- Other options: Salbutamol 2 - 4 x 3 mg a day for adults
- Efedrin 10 - 15 mg x 3 a day can be used to add property
theofilin.
- Prednison only when needed medicines and above does not help
given only a few days to prevent asmatikus status. But
pemberiannya should not be delayed.
- People with status asmatikus require oxygen, and parenteral therapy
so that intensive care should be referred to the action as early
following:
People diinfus glucose 5%
Aminofilin 5 - 6 mg / kgBB injected iv slowly when the patient has not been
teofilin obtain oral.

Prednison 10 - 20 mg x 2 a day for several days, and then
derived dose as soon as possible so that it can be stopped.
If it has not tried to overcome adrenalin, it can be used
first adrenalin.

ARTRITIS

Definitions
Artritis is a general term for inflammation (inflamasi) and swelling in
joint area.
Causes
Artritis can be osteoartritis (oa) or artritis reumatoid (AR), but the
most often encountered in the osteoartritis. On the main factors oa
is a trauma or pengausan joints, while the immunological factors that AR
a role.
Clinical picture
- Artritis Symptoms vary depending on which joints are involved. Oa more often
the joint patron of the body. Therefore, the need to Obesity
avoided. Meanwhile, the AR first attack more often hinge-joint
small joints such as wrists or legs, but in advanced
can also attack joints such as large-joints and shoulder joints pinggul.
- Complaints that artritis is similar to the actual reumatism
network software comes from outside the joints. Which is known as a common rheumatism
most are reumatism.
- joints who fell ill usually swollen, red and painful.
- AR attack usually starts with prodromal symptoms such as body weakness,
lost appetite, stiff and sore all over the body. Symptoms usually in the joints
gradually emerged after several weeks or months.
- joints pain are missing in the AR-relief, there is the Remisi, are symmetrical
bilateral, and associated with cold air.
- Oa attacks usually sesisi. Main symptom is a painful joints
related to the movement. People also feel stiff in the joints
fell ill.
- On Radiology oa checks usually shows widening joints
at the initial stage, osteofit, sklerosis constringency hollow bones and joints between
go on stage.
- Deformitas can occur oa and AR occurred after destruksi joints.

Diagnosis
Pain and swelling in the joint area.
treatment
- Complaints on the joints or the network software in the surrounding areas can be take
painkillers or with nonsteroid anti inflamasi given after
eat.
Asetosal 1 gram a day x 3
Fenilbutason 200 mg x 3 a day
Ibuprofen 400 mg x 3 a day
- Spell joints needed in critical condition. Next on oa,
may need to improve the attitude of the body, reducing body weight,
or doing physiotherapy.

Antraks

Definitions
Antraks is a disease in wild animals, and pets, that is
animal-ruminant animals (herbivora), such as cows, buffaloes, goats, sheep,
pigs and horses. The disease is spread to humans, especially in people who
always related to work / adjacent to the livestock such as
cattle farmers, shepherds, veterinarians, laboratory workers, factory workers stuff
skin and bones.
Causes
Antraks bacteria (Bacillus anthracis)
Ways of transmission
This disease is usually transmitted to humans by the entrance or spore
basil antraks into the body through various ways, namely through the skin abrasions
or injury that caused skin antraks, through the mouth because the food material contamineted
food, causing intestinal antraks (digestion), inhalation
cause respiratory tract antraks pulmonal. Antrak brain inflammation
(meningitis) in general is a form of continuity antraks skin, intestinal or
pulmonal. Antraks pulmonal meningitis and very rarely been reported in Indonesia.
Going the way of direct contact with the animal people, for example,
contact with the blood out of the holes kumlah dead animals because
antraks or materials that come from animals that tercemar by spore
antraks, such as meat, offal, skin, flour, wool, and so forth. Beside
that, penularannya other sources of potential ligkungan is, among other lands,
plants (vegetables) and water tercemar by spore antraks.
Clinical picture
1. Clinical picture Antraks Skin
- Incubation period of 7 days (average 1-7 days)
- Gatal place lesi
- Papel
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- Vesikel
- Ulkus (tukak) in the middle there is a network-shaped scab nekrotik
black (the patognomonik antraks) and is usually found
eritema and oedema around tukak. In the palpability, udema is not
software and does not dent (non-pitting) when pressed. Not be here
pus unless followed by secondary infection.
- It can happen lymph gland enlargement regional
- The current fever, headache, malaise rarely have
- Predileksi antraks skin usually on the open places, such as face,
neck, arms, hands, and feet
- Antraks skin that is not treated will grow worse with the
limfe spreading to the gland, and blood continues to flow, so that
septikemia cause mortality and 5 - 20%
- Bacteriological examination of eksudat in the skin obtained lesi
the bacillus that sediaan on clear and positive culture.
2. Clinical picture Antraks intestinal
- Incubation period varies between 2 - 5 days
- The early symptoms nausea, no appetite and increased temperature
- Vomiting
- Health intense stomach
- Constipation
- It can also occur acute gastro-enteritis which sometimes bloody,
hematemesis, general weakness, fever, and there is the exposure history
with animals or food products.
- Bacteriological examination of specimens obtained feces of basil
sediaan on a clear and positive culture.
Diagnosis
1. Suspect antraks skin
When the case or the "explosion" in the animal or antraks history
the exposure to animals / animal origin of the materials and the environment tercemar
by spore / basil antraks and aberration found in the skin form of tukak
network with dead-shaped black scab in the middle (eskar),
around tukak redness, swollen, on the swollen area palpability
is not soft and does not dent and is usually not available unless the pus
followed by secondary infection.
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2. People with skin antraks (definitive diagnosis)
If the suspect is already antraks skin with diagnosisnya
bacteriological examination.
3. Suspect antraks intestinal
When the case or the "explosion" in the animal or antraks history
the exposure to the animals or food products and found the heat
with stomach pain and vomiting.
4. People with intestinal antraks (definitive diagnosis)
If the suspect is already antraks skin with diagnosisnya
bacteriological examination.
Penatalaksanaan
- Drugs choice (drug of choice) for people with skin is antraks penicillin.
Procain with a dose of penicillin 1.2 million IU im x 2 a day for 5 - 7 days
or benzilpenisilin with 250,000 IU dose every 6 hours. Before giving
do penicillin skin test. People who hipersensitif against penicillin
tetrasiklin can be given with the dose of 500 mg, 4 x day for 5 - 7 days.
Should not be given to children under age 6 years. Another drug of choice
is kloramfenikol.
- In the intestinal antraks be given penicillin G 18 - 24 million units per day
the intravena, can be added tetrasiklin 1 gram per day.
- Simtomatis medicine and drug-suportif if necessary
- Refer to the hospital when needed.
Prevention
- People are requested to report to the local health clinic when a suspect
antraks and report to the Farm when there is a sick animal with symptoms
antraks
- Not allowed to slaughter animals sick antraks
- Not allowed to consume meat derived from animals
sick antraks
- Not allowed to make goods that originate from animals such as
craft's horn, leather, fur, bones that come from animals sick / dead
because antraks disease.
- Mandatory health Health Department to report to the district when
meet people / antraks suspects.

ANGINA PEKTORIS

Definitions Angina is the clinic pektoris marked with malaise or pain in the chest due to heart muscle iskemia network. The clinical forms of angina divided in two forms, namely stable angina and unstable. Angina is an unstable form of a more serious that can be become and / or is a form of early infark so miokard people need to be examined further and diobservasi in the hospital. Causes Iskemia this occurred because the supply of oxygen carried by the coronary blood flow not sufficient oxygen miokardium needs. This occurs when the demand miokardium increased oxygen (for example, because of physical, emotional, tirotoksikosis, hypertension), or when the coronary blood flow is reduced (for example, or on spasme trombus coronary) or when they occur. Clinical picture - People complain of chest pain and various forms of location. - Nyeri started feeling as terhimpit, feeling squeezed or feel the burn spread to the inside of the left arm and sometimes up to the neck, shoulder neck and left, even to the left pinkie. - The same can be spread to the waist, throat, teeth and jaw also have to submit the right arm. - Men do not feel can be felt also in the Ulu heart, but rarely felt in the region apeks kordis. - Pain may be accompanied by painful beberapan or one of the following symptoms: sweating cold, nausea and vomiting, feeling weak, feeling the pulse and fainting (fainting). - Usually angina occur when physical activity (stable angina). - The attack will be lost if patients stop the physical activity is and rest. - The attack lasted only a few minutes (1 - 5 minutes) but can be up to more than 20 minutes. - Nyeri angina is constant. When changes occur, for example long attacks increased, more intense pain, the incidence of attacks threshold Basic guidelines Medicine Clinic in 2007 17 - Decreased or when the attack came up to bed, then the interference is necessary to diwaspadai. This change may be a sign prainfark (angina not stable). - A form of change (variant), which is called angina Prinzmetal usually arise when people are resting. - Angina said gain weight when the attack occurred after the next physical work that is lighter, for example, after eating. This is also classified unstable angina. - Check out the physical attack does not generally show a deviation means. At the time of attacks, increased heart rate, blood pressure and increased in the region prekordium hard jolt the heart feels. - On auskultasi, the voice sounded much the heart, the sound noisy sistolik mid or late sistol and heard the sound of the fourth. - Usually found risk factors: hypertension, or diabetes melitus Obesity. Diagnosis - Retrosternal chest pain - Checking EKG Penatalaksanaan - Aberration preference angina pektoris be searched, then reduced or treated. Factors that aggravate such as smoking, body weight excessive, drinking habits and coffee should be avoided. - High blood pressure treated. - Stress is - Angina is not stable, it is treated in the hospital. 1. Treatment of acute - Acute attacks with the rest in order to overcome the heart of activity is reduced. Vasodilator work to improve the provision of oxygen and reduce oxygen consumption, heart. - Sublingual nitroglycerine 0.15 - 0.6 mg is very effective. Tablet can be used several times each day without side effects except headaches. 1 When the tablet has not been repeated may help, but when repeated after 3 times symptoms do not diminish the possibility has occurred infark. - Isosorbid dinitrat (ISDN) sublingual 2.5 - 5 mg can also be repeated oral tablet or 5 - 30 mg. Basic guidelines Medicine Clinic in 2007 18 2. Prevention of attacks - Propranolol for angina pektoris effective because it can reduce the work heart muscle so that the heart needs oxygen. Effect clinic propranolol achieved when the heart rate in the rest 60 - 70 times / minute. Initial dose: 20 mg x 2 a day. Maximum dose: 120 mg a day. This medicine should not be used in angina Prinzmetal. - Nitrate working long: ISDN oral tablet 10 - 20 mg x 2 a day. - Nifedipin 10 - 20 x 4 mg a day, or diltiazem 30 - 60mg x 3 a day, verapamil or 40 - 80mg x 3 a day. - Angina unstable: need special care. - Angina variants: strong dilator: nitrate, calcium antagonis, prazosin 0.5 - 1mg X 3 a day with titrasi.
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anemia

	Definition Anemia can be classified according to several criteria, but the most is a practical way of grouping based on the occurrence of post-Anemia bleeding, anemia hemolitik, defisiensi anemia, anemia and anemia aplastik because of violence. CAUSE Production of blood that is not enough (because defisiensi or bone marrow failure), excessive blood loss, excessive destruction of blood or a combination from these factors. Loss of blood and chronicles the secret, for example, in ankilostomiasis, cause anemia defisiensi Fe, while the other occurred between hemolisis defisiensi on G6PD and talasemia. Clinical Overview - Anemia due to the sudden loss of blood and many will homeostatis compensation body. Acute blood loss as much as 12 - 15% will give the symptoms of pale, takikardia with normal blood pressure or low. Lost 15 - 20% cause blood pressure to drop shock, and 20% loss can result in death. - Anemia defisiensi marked with a limp, often pulse, tired and grouchy headaches. Papil appear atrofi tongue. Heart swell and sometimes sounds murmur sistolik. At the edge of the blood picture appear anemic and hipokrom mikrositer, while low serum iron content. - Defisiensi acid and vitamin B12 anemia folat cause megaloblastik which may be accompanied by neurological symptoms. - Anemia hemolitik be followed by an increase in blood bilirubin (ikterus). Spleen is generally limited. - Anemia aplastik visible from the low rate of Hb and other systemic symptoms, without enlarging the organ. Diagnosis Inspection rate and blood Hb edge. general Hb <12 g / dl. Treatment guidelines in the Basic health 2007 15 Dealing - Successful treatment depends greatly on the ability to enforce on the level of early diagnosis. - Anemia pascaperdarahan overcome by transfusion of 10 - 20 ml / kgBB, or plasma expander. If there is no both, intravenous fluids the other can also be used. - Impact of slow can be overcome with packed red cell transfusion. - Anemia defisiensi iron overcome with adequate food, sulfas ferosus 10 mg / day kgBB 3 x Iron or shut 1mg/kgBB/hari - Anemia megaloblastik specific treatment, therefore, must be distinguished cause, defisiensi vitamin B12 or defisiensi acid folat. Doses of vitamin B12 100 mcg / day im, for 5 - 10 days as initial therapy followed by therapy rumat 100-200 mcg / be achieved remisi until months. Dose of acid folat 0.5 - 1mg/hari in oral for 10 days, resumed with 0.1 to 0.5 mg / day. The use of oral vitamin B12 is not no use in anemia pernisiosa. In addition, the thin oral more expensive. - Hemolisis autoimun overcome by prednison 2 - 5 mg / kgBB / day and peroral testosteron 1 - 2 mg / kgBB / day iv, for the long term. - Blood transfusion given only when it is needed. - Refer to the hospital
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VARISELA

Varisela or chickenpox, which is marked with vesikel in the skin and mucous membrane of this
very easily spread through saliva and contact spray. Transmission can be
occurred since 24 hours before arising aberration skin to 6 - 7 days later.
CAUSE
Varicella zoster virus.
The clinical picture
- The period of incubation 13 - 17 days.
- Symptoms of early form of dizziness, headache, fever and that is not so high.
This phenomenon is not so clear in children under five, but prominent in children age
over 10 years.
In adults, this complaint can be violent.
- Aberration skin appear initially morbili as in, and form makula
papula that became clear vesikel contain liquids. This change
take place within 24 - 48 hours.
- Rash usually more in the body than with members of the movement.
The typical on varisela this is a rash of various kinds can be found
in a moment.
- In the form of the weight difference arises in the skin throughout the body.
Diagnosis
Based on the clinical picture of Tracy with the characteristics (fluorosensi
that are papulo vesikuler that multiforme and centrifugal process penjalarannya)
Dealing
- Medicine, which provided only a simtomatis: parasetamol when fever
is very high. Do not give asetosal in children, because it can cause
reye syndrome.
- Patients are encouraged with the bath water and soap. Potassium Permanganate and
Other antiseptic is not recommended.
Then give salisil powder 1%. Try to vesikel not broken and
experienced a secondary infection.
- When there is secondary infection: Inject penicillin prokain 50,000 IU / kgBB / day
for 3 days or give Amoksilin 25 - 50 mg / kgBB / day peroral.
- Collaboration re-examined after a week.
- When you need the asiklovir 200 - 400 x 5 mg a day early in the disease
for 7 days.

XEROFTALMIA

Definition
Xeroftalmia eye aberration is due to vitamin A deficiency, especially in the
Young children and children are often found in people with malnutrition and lack of nutrition.
CAUSE
The factors that cause the high Xeroftalmia cases in Indonesia are:
- Consumption of foods that are less / does not contain enough vitamin A or
pro-vitamin A for long time
- Babies are not breastfed get Exclusive
- Disturbances of the absorption of vitamin A
- The high number of infection in children (Gastroenteritis / diarrhea)
Clinical Overview
1. Reversible symptoms:
- Blind dusk (Hemeralopia)
- Xerosis konjungtiva: namely konjungtiva dry, thick,
berkeriput, and muddy because many spot
pigment
- Xerosis corneas: konjungtiva corneas dry, thick,
berkeriput and muddy because many spot
pigment
- Bitot spot: benjolan the form of dry deposition and foamy
The silvery-gray color contains remnants
epitel konjungtiva damaged.
2. Symptoms irreversible: ulserasi cornea and sikatriks (scar)
Diagnosis
The diagnosis was based on the symptoms and the results of the eye.

- Then give salisil powder 1%. Try to vesikel not broken and
experienced a secondary infection.
- When there is secondary infection: Inject penicillin prokain 50,000 IU / kgBB / day
for 3 days or give Amoksilin 25 - 50 mg / kgBB / day peroral.
- Collaboration re-examined after a week.
- When you need the asiklovir 200 - 400 x 5 mg a day early in the disease
for 7 days.
Treatment guidelines in the Basic health 2007
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Dealing
- Provide 200,000 IU Vitamin A in oral or 100,000 IU Vitamin A injection
- Next Day, give 200,000 IU Vitamin A in oral
- 1 - 2 next week, give 200,000 IU Vitamin A in oral
- Medical diseases that accompany the infection
- Medical aberration eye, occurs when the
- Improve the nutrition status