Infeksi Tropis

Question 1

lepto vs weil’s

Answer 1

lepto: ikterik -, anuria -
weil’s: ikterik +, anuria +

Question 2

penunjang awal dan gold Leptospirosis

Answer 2

awal: RFT, LFT, dark field microscopy
lanjut: Microscopic Agglutination Test (MAT)

Question 3

Tx Leptospirosis

Answer 3

1. Doxycycline 2x100mg 7 hari
2. Ampicillin 3x500mg 7 hari

Question 4

Tx Weil’s Disease

Answer 4

IV
1. Penisilin G 4x1,5jt unit 7 hari
2. Ceftriaxone 1x1gram

Question 5

Tx Leptospirosis

Answer 5

PER ORAL
1. Doxycycline 2x100mg 7 hari
2. Ampicillin 3x500mg 7 hari

Question 6

DF vs DHF

Answer 6

DF: plasma leakage (-)
DHF: plasma leakage (+)

Question 7

tanda plasma leakage

Answer 7

1. HCT >= 20>
2. efusi pleura
3. asites

Question 8

grading DHF

Answer 8

Gr. 1: rumple leed (+), perdarahan spontan (-)
Gr. 2: perdarahan spontan (+)
Gr. 3: syok + hipotensi
Gr. 4: syok + tensi tidak teraba

Question 9

grading DHF

Answer 9

Gr. 1: rumple leed (+), perdarahan spontan (-)
Gr. 2: perdarahan spontan (+)
Gr. 3: syok + hipotensi
Gr. 4: syok + tensi tidak teraba

Grade 1&2 = DHF
Grade 3&4 = DSS

Question 10

Tatalaksana DHF Grade 1&2

Answer 10

awal: kristaloid 7cc/kg/jam

membaik: turunkan jd 5cc/kg/jam -> 3cc/kg/jam
memburuk: naikkan jd 10cc/kg/jam -> 15cc/kg/jam -> koloid 10cc/kg/jam

Question 11

Tatalaksana DSS

Answer 11

awal: kristaloid 20cc/kg/jam

membaik: diturunkan perlahan
memburuk:
- HCT naik diganti koloid 10cc/kg/jam
- HCT turun diganti transfusi (PRC/WB)

Question 12

Tatalaksana HIV

Answer 12

2 NRTI + 1 NNRTI

NRTI: Tenofovir, Lamivudine, Zidovudin, Emtricitabine
NNRTI: Efavirenz, Nevirapine

TELEk (tenofovir, lamivudine, efavirenz)

Question 13

grading HIV

Answer 13

Gr. 1: limfadenopati general
Gr. 2: penyakit mukokutan + ISPA berulang. BB turun <10% / bulan
Gr. 3: penyakit GIT & pulmo. BB turun >10% / bulan
Gr. 4: TB extra paru, sarcoma kaposi, toxo ensefalitis

Question 14

Skrining HIV

Answer 14

ELISA
Rapid test

Question 15

Gold standard HIV

Answer 15

Western Blot

Question 16

Penunjang monitoring HIV

Answer 16

CD4 + viral load

Question 17

Efek samping ARV

Answer 17

Zidovudine: anemia
Tenofovir: ginjal
Evafirenz: toksisitas SSP

ZiAn TenGil Eva Toksik

Question 18

spesimen demam tifoid & minggu ke berapa

Answer 18

Darah: mgg 1
Feses: mgg 2
Urin: mgg 3

DFU

Question 19

5F Thypoid

Answer 19

Food
Finger
Feces
Fly
Fomites

Question 20

Klinis Tifoid Minggu 1

Answer 20

• demam step ladder
• rose spot
• nyeri perut & kepala
• dewasa konstipasi, anak diare
• splenomegali

Question 21

Klinis Tifoid Minggu 2

Answer 21

• demam continuously
• bradikardi relatif
• lidah kotor
• hepatomegali

Question 22

Klinis Tifoid Minggu 3

Answer 22

Komplikasi
- perdarahan usus
- perforasi usus
- meningitis tifosa
- hepatitis tifosa

Question 23

First line tx Thypoid

Answer 23

Gol. Fluoroquinolone (-xacin)
1. Ciprofloxacin 2x500mg 7-14 hari -> utama
2. Ofloxacin 2x400mg 7-14 hari

Question 24

Second line tx Thypoid

Answer 24

Gol. Cephalosporin gen. 3
1. Ceftriaxone 1x3-4gr/hari

Question 25

Tx Thypoid u/ bumil dan anak

Answer 25

Bumil: Ampicillin 3x500mg Anak: Chloramphenifol 250mg/hari

Question 26

etio Schistosomiasis letak spina?

Answer 26

1. Schistosoma mansoni: spina di samping (margin) 2. Schistosoma hematobium: spina di bawah 3. Schistosoma japonicum: spina rudimenter

Question 27

manifestasi klinis Schistosomiasis

Answer 27

S. mansoni & japonicum: diare S. hematobium: hematuri

Question 28

FR Schistosomiasis

Answer 28

berenang di danau Sulawesi

Question 29

Tx Schistosomiasis

Answer 29

S. mansoni & hematobium: Praziquantel 40mg/kg dibagi 2 dosis S. japonicum: Praziquantel 60mg/kg dibagi 3 dosis

Question 30

Profilaksis Leptospirosis

Answer 30

Doxycycline 200mg/minggu 1-2 hari sebelum exposure

Question 31

Enterobiasis

Answer 31

GaBur MaRi Gatal duBur Malam haRi

Question 32

Pemeriksaan Enterobiasis

Answer 32

Anal swab -> Graham scotch adhesive test

Question 33

Sepsis Hour 1 Bundle

Answer 33

- hitung kadar laktat - kultur darah sebelum antibiotik - antibiotik broad spectrum - resusitasi cairan kristaloid 30mg/kg dalam 3 jam - vasopressor bila TD tidak membaik

Question 34

etio Filariasis

Answer 34

Wuchereria bancrofti Brugia malayi dan Brugia timori

Question 35

Perbedaan klinis W. bancroft dan Brugia (Filariasis)

Answer 35

W. banCROfti: limfedema sampai paha, sampai sCROtum Brugia: tidak sampai paha

Question 36

Pemeriksaan penunjang Filariasis

Answer 36

apusan darah teli malam hari

Question 37

hasil SADT W. bancrofti

Answer 37

cephalic space 1:1 infi kasar, teratur, inti di ekor (-)

Question 38

hasil SADT Brugia malayi dan timori

Answer 38

malayi 1:2 ; Timori 1:3 (Tiga) infi halus, tidak teratur, inti di ekor (+)

Question 39

Tatalaksana dan Profilaksis Filariasis

Answer 39

Terapetij DEC (dietilcarbamazine) 6mg/kg/hari (3 dosis) 12 hari Profilaksis DEC / Ivermectin 150mg + Albendazol 400mg SD

Question 40

Trias Malaria

Answer 40

demam menggigil berkeringat

Question 41

etio Malaria

Answer 41

Plasmodium vivax & ovale Plasmodium malariae Plasmodium falciparum

Question 42

Malaria Tertiana gejala dan etio

Answer 42

bebas demam 2 hari (tertiana 3 - 1 =2) P. vivax & ovale

Question 43

Malaria Kuartana gejala dan etio

Answer 43

bebas demam 3 hari etio: Plasmodium malaria

Question 44

Malaria Tropikana gejala dan etio

Answer 44

demam kontinyu Plasmodium falciparum

Question 45

Khas P. Falciparum

Answer 45

Maurer's spot ringform, accole ring, bulan sabit, pisang

Question 46

khas P. vivax

Answer 46

vivakS = Schuffner's dot

Question 47

khas P. ovale

Answer 47

James dot (JOvale)

Question 48

Khas P. Malariae

Answer 48

Ziemann Dot piTA, rectangular, BUnga Zieman kena Malaria sampe BuTa

Question 49

tatalaksana M. tertiana

Answer 49

ACT 3 + Primakuin 14 hari 2nd line: Kina + Primakuin

Question 50

tatalaksana M. kuartana

Answer 50

ACT 3 2nd line: Kina + Primakuin + Doxy / Tetra

Question 51

tatalaksana M. tropikana

Answer 51

ACT 3 + Primakuin SD 2nd line: Kina + Primakuin + Doxy / tetra