WEEK 2

Question 1

Tetanus

Answer 1

toksemia akut karena neurotoksin tetanospasmin dihasilkan oleh Clostridium tetani (bakteri gram positif)
–>spasme otot yang periodik dan berat

Question 2

Eksotoksin Clostridium tetani

Answer 2

Tetanolisin = menghancurkan sel darah merah BIKIN LINGKUNGAN OPTIMAL
Tetanospasmin =  toksik thd sel saraf, bikin spasme

Question 3

Baby tetanus

Answer 3

infeksi tali pusat oleh Tetanus Neonatorum

Question 4

Characteristics of clostridium tetani

Answer 4

obligat anaerob, sensitif terhadap panas
spora sangat resistant trhdp panas dan antiseptik, also relatively resistant to phenol, ethyl propol alkohol tapi mati di disinfektan yg berat kek formaldehyde

Question 5

General Tetanus Patophysio

Answer 5

Diawali kaku otot maseter → ggn membuka mulut (trismus),→ timbul opistotonus ( regangan otot belakang )krna kaku.
Timbul defanse muskuler → ddg perut spt papan; 
Risus sardonikus ( muka setan ) krn kaku otot wajah dan kekakuan otot ektremitas.; penderita susah menelan
prolonged = gangguan simpatis, anoksia krna otot kaku

Question 6

Tetanus scale (ablett)

Answer 6

I = mild ada trismus dan rigidity 
II = moderate ada trismus, rigidity dan spasm, dysphagiam npaas ningkat
III = severe (basically like II tapi severe)
IV = very severe involving cardiovascular (hyper tachy or hypo brady)

Question 7

Tetanus test and therapy

Answer 7

no test, purely clinical tapi bisa kasih spatula kalo digigit brarti dia tetanus, atau suruh siul (tp ni jarng)
kasih penicilin and metronidazole, imunoglobin tetanus and anti serum for tetanus

Question 8

Rabies

Answer 8

• Acute, progressive viral (Genus Lyssavirus, Enveloped bullet-shaped virus) encephalitis

Question 9

Rabies patophysio

Answer 9

digigit –> virus masuk dan membanyak di otot –> masuk dan bind dengan neuron post synaps –> gerakan axon retrograde (ke pusat) –> terus spread kemana2
extra : negri body, eosinofilik inclusion bodies

Question 10

Hydrophobia

Answer 10

sakit dan kontraksi kalo minum air (kek dia responsnya lebai ke orang minum, padahal kalo minumyg pasti ga masuk ke respiratory tract kan)

Question 11

diagnosis rabies & treatment

Answer 11

CSF, serology, negri body, spesific antibodies, DFA test (antigen test)
no definite treatment

Question 12

Leprosy

Answer 12

mycobacterium leprae (M.Leprae)

Question 13

M. Leprae

Answer 13

parasit intraseluler
menginvasi dan bertumbuh dalam saraf perifer
berkembang biak di dalam sel Schwann saraf dan makrofag kulit

Question 14

Lepra patology

Answer 14

M.leprae → inokulasi kulit&droplet → makrofag in dermis & sel Schwann → sel target → gangguan imunitas → kuman migrasi&aktivasi → reaksi tubuh (+) → makrofag → fagositosis → sel epiteloid inaktif → sel Datia Langhans → granuloma → aktivitas regenerasi saraf ↓ & kerusakan saraf progresif

Question 15

Kerusakan saraf di lepra

Answer 15

sensoris = anastesi
motoris = paresis or paralisis
otonom = kulit kering

other symptom = dingin, hypopigmentasi or merah,

Question 16

tipe lepra

Answer 16

pausi (tuberkuloid) vs multibasiler (lepramatosa)

Question 17

terapi lepra

Answer 17

rifampisin,
DDS (Diamino Difenil Sulfon)
Klofazimin (Lamprene)

Question 18

diagnosis lepra

Answer 18

BTA test, skin prick, biopsi, bercak2, pembesaran nervus

Question 19

Infeksi brain (kunci : MEMAN)

Answer 19

Meningitis : inflamasi pada meninges
Ensefalitis : inflamasi pada parenkhim otak
Myelitis : inflamasi pada medula spinalis
Abses serebri/spinal cord : akumulasi material infeksius
Neuritis : inflamasi pada neuron

Question 20

Cause of Meningitis

Answer 20

viral : DNA (herpes) RNA (HIV, Influenza)
Bakterial : Gram NEG (Neisseria meningitidis, Haemofilus influenza) Gram POS (strep, staph)
TB : MTB and non MTB (complex, kansas)
Parasit : toxoplasma gondi, malaria
Fungi : Cryptococcus neoformans

Question 21

Meningeal signs

Answer 21

Neck rigidity / kaku kuduk
Brudzinski 1, 2, 3, 4
Kernig sign
Lasegue sign bilateral
Guillain
Edelmann
Bikele’s sign
Amoss sign

Question 22

Encephalitis symptoms

Answer 22

(demam)+penurunan kesadaran - kejang - defisit neurologis fokal
Gold standard diagnosis : analisis cairan serebrospinal dan kultur

Question 23

Spinal abcess vs transverse myelitis

Answer 23

bisa punya masalah gerak, pusing, sakit dkk tapi si transverse ada tambahan bladder problems

Question 24

Acute flaccid paralysis

Answer 24

intinya pelemahan otot napas dan nelan

karena guilen bare syndrome (GBS) atau krna post polio (poliomyelitis), transverse myelitis

Question 25

Guillan Bare Syndrome

Answer 25

kelemahan progresif di kedua tungkai, refleks menurun atau gaada, bisa ada ganguan sensoris akibatnya krna si immune system pikir sel kita jahat krna si infectous agent yg pernah masuk sebelumnya (molecular mimicry)

Question 26

Penting tau si GANGLIOSIDE

Answer 26

``` On the cell surface: • cell to cell recognition • adhesion • signal transduction tambahan : dalam sel bantu homeostasis calcium GM1 ganglioside banyak di axolemma ```

Question 27

Tipe GBS

Answer 27

Acute Inflammatory Demyelinating Polyradiculoneuropathy = jadi ga bermyelin, sensory loss > motor Acute Axonal Neuropathy, motory loss > sensory Miller Fisher Syndrome = di mata biasanya

Question 28

Malaria

Answer 28

``` TRIAS MALARIA: paroxysmal fever, anemia, and splenomegaly Paroxysmal fever: 3 stages COLD stage HOT stage SWEATING stage ```