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Kelas UKMPPD > Neurologi II > Flashcards

Neurologi II Flashcards

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1
Q

Gejala
- refleks tendon turun
- artrofi otot (12-15 minggu permanen)
- rangsang meningeal +
- lesi asimetris (dd: GBS simetris)
- krn virus, penularan fecal oral
Dx?

A

poliomyelitis

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2
Q

poliomyelitis dx topis dimana

A

medula spinalis cornu anterior

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3
Q

Tx poliomyelitis

A

suportif, simptomatik, fisioterapi

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4
Q

pencegahan poliomyelitis

A

bivament oral polio vaccine
inactivated polio vaccine

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5
Q

** tipe poliomyelitis**
- minor illness, sembuh 3-10 hari

A

poliomyelitis abortif

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6
Q

** tipe poliomyelitis**
- meningitis aseptik
- nyeri kepala
- meningeal sign +

A

poliomyelitis non paralitik

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7
Q

** tipe poliomyelitis**
- spinal : kelemahan motorik LMN, asimetris
- bulbar: disfungsi respirasi
- bulbospial : kombinasi keduanya

A

poliomyelitis paralitik

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8
Q

gejala
- gloved and stocking phenomenon
- kelemahan simetris dan progresif
- ascending paralysis
- refleks tendon hilang
- diplegia fasial
- parese otot orofaring n respirasi
Dx

A

guillen barre syndrome

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9
Q

Gejala GBS paling tipikal di subtipe

A

acute inflammatory demyelinating polyneuropathy (AIDP)

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10
Q

trias oftalmoplegi, ataxia, areflexia
subtipe gbs?

A

Miller-fisher syndrome

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11
Q

Dx GBS

A

klinik
analisis LCS

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12
Q

Temuan LCS pada dx GBS

A

LCS : disosiasi sitoalbumin -> peningkatan protein, jumlah sel mononuklear turun (<10/mm3)

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13
Q

Tx GBS

A
  • ICU : gejala disautonomia (hipotensi, gagal napas, ileus)
  • plasmaferesis (plasma berisi antibodi yg autoimun, makanya plasmanya diganti
  • IV Ig 0.5 - 5 gr /kgBB (2-5 hari)
  • Rehabilitasi
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14
Q

patfis gbs

A

Molecular mimicry process. biasanya antigen myelin menyerupai antigen EBV yang serang saluran napas atau C. jejuni di saluran cerna

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15
Q

gejala
- kelemahan berfluktuasi pada otot skeletal
- semakin dipake aktivitas semakin lemah
- ptosis, diplopia
- mulai pelo siang, sulit menelan, postur kepala sulit dipertahankan
- gagal napas
dx

A

Myasthenia gravis

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16
Q

patfis myasthenia grafis

A

asetilkolin receptor diserang oleh IgG (autoimun) di SSP
type II hypersensitivity

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17
Q

sel imun sekolahnya di … untuk seleksi …

A

timus,
autoimun

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18
Q

tumor yang merupakan etiologi mistenia gravis

A

thymoma

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19
Q

Ddx Myasthenia gravis

A

Lamber-eaton myasthenis syndrome
berhubungan dengan small lung cell cancer
autoantibodi Ca2+ channel di sinaps
MEMBAIK SAAT AKTIVITAS
ADA GANGGUAN OTONOM

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20
Q

Tes provokasi khusus myasthenia gravis

A
  • Wartenberg : lihat ke atas selama >30s -> ptosis
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21
Q

Tes eliminasi myasthenia gravis

A
  • Ice pack test
  • Tensilon test
  • Neostigmin
    + -> gejala membaik
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22
Q

Px penunjang myasthenia gravis

A
  • Eletromiografi
  • Test serologis
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23
Q

biasanya abis infeksi

A

myasthenic crisis

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24
Q
A

cholinergic crisis

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25
Tx myasthenia gravis
Anticholinesterase inhibitor - pyridostigmine - neostigmine : jarang digunakan Immunosupressive Gagal -> phasmaresis, IVIG, thymectomy (hindari di anak)
26
**Gejala** - idiopatik - UMN dan LMN gejala - UMN : spastisitas, peningkatan releks fisiologis LMN : wasting, kedutan, flaccid - awal susah jalan, salah bicara
Amyotrophic lateral sclerosis
27
**gejala** - penurunan ketajaman penglihatan - Lhermitte's sign - gangguan sensorik, kelemahan - gangguan keseimbangan
multiple sclerosis
28
etiologi multiple sclerosis
autoimun menyerang demyelinisasi sel schwann di perifer
29
Dx multiple sclerosis
kriteria mcdonald 2017
30
Px penunjang multiple sclerosis
MRI otak + medulla spinalis dengan kontras --> sclerosis di servikal (enhancement)
31
**Gejala** - oculosympathetic palsy - gangguan persarafan simpatis ke mata - trias : miosis, partial ptosis, amnhidrosis **ipsilateral** (MIPAN HORENG)
Horner syndrome
32
etiologi horner's syndrome dibagi jadi
sentral preganglion postganglion
33
etiologi horner syndrome sentral
34
etiologi horner syndrome preganglion
35
etiologi horner syndrome postganglion
36
Pc penunjang horner syndrome
37
virus
38
dx poliomyelitis pencegahan: vaksinasi sesuai jadwal
39
Dx GBS autoimun
40
B
41
dx multiple sclerosis Lhermitt sign + MRI Kontras (cari skelrosis di servikal)
42
amyotropic lateral sclerosis ada lesi UMN dan LMN
43
Dx myasthenia gravis tensilon test
44
Dx: myasthenia gravis piridostigmin
45
**Gejala** - inflamasi meninges - tidak ada defisit neurologis - demam - nyeri kepala - kaku kuduk (rangsang meningeal +) **Dx**
meningitis
46
trias meningitis
- demam - nyeri kepala - rangsang meningeal +
47
**gejala** - inflamasi parenkim otak - berkaitan dengan inflamasi meningers - **terdapat defisit neurologis** - gejala: **demam, penurunan kesadaran, kejang** **Dx?**
ensefalitis
48
Trias meningitis + penurunan kesehatan **Dx?**
meningoensefalitis
49
Dx ensefalitis dan meningitis
Lumbal pungsi ambil CSF. nyoblos di bawah L2 biar di bawah sisi bawah medspin
50
Temuan lumbal pungsi CSF pada infeksi TB meningeal
xanthochrome (kuning jernih) dan spiderweb clot Limfosit meningkat (mononuklear)
51
Temuan lumbal pungsi CSF pada infeksi bakterial non TB
kekuningan keruh Neutrofil meningkat (PMN)
52
Temuan lumbal pungsi CSF pada infeksi virus
jernih
53
Temuan lumbal pungsi CSF pada infeksi fungal
keruh
54
tx meningitis ensefalitis
55
**Gejala, tipe meningitis?** - biasanya di menyerang individu imunokompromised AIDS, HIV stage 4 - Px penunjang: - Tinta india : sel jamur C. neoformans - Kultur Saburaud dextrose agar --> koloni kuning hingga krem - CT scan: non enhancing cyst **Dx?**
Meningitis kriptokokus
56
Tx meningitis kriptococcus
amfotorisin flukonazol
57
**Gejala, tipe meningitis?** - biasanya di menyerang individu imunokompromised AIDS, HIV stage 4 - lesi ring enhancement di ganglia basalis - CT scan: multiple ring enhancement - Kalsifikasi multiple di area dan plexus choroideus **Dx?**
Toxoplasma cerebri
58
Tx toxoplasma cerebri
pirimetamin klindamisin
59
**Deskripsi** - CT scan kontras: **massa hipodens** + ring enhancement SOLITER - Fokus infeksi: otitis media, sinusitis, endokarditis, selulitis, pnumonia
Abses serebri
60
Tx abses serebri
sefalosporin intravena (ceftriaxone, cefotaxome) antiedema : dexa atau mannitol indikasi op: diameter >2,5 cm, lesi deket ventrikel (risk hidrosefalus), gagal konservatif
61
Dx?
rabies
62
63
tingkat Risiko
tinggi
64
tx rabies farmako
vaksin anti rabies serum anti rabies
65
tx awal rabies
cuci air sabun 5-10 menit, bilas debridement, wound toilet dgn alkohol
66
ceftriaxone
67
JAMUR Criptococcus neoformanss warna jernih TB warna kuning jernih bakteri warna kuning keruh
68
Dx meningoensefalongitis Lumbal pungsi dikontraindikasikan pada pasien penurunan kesadaran. pasien harus stabil, gaada tanda peningkatan TIK
69

Kelas UKMPPD (26 decks)

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