Medicine in Our Life

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Sumber :  medicallinkgo   Penyuntikan Adrenalin 0,3 – 0,5 ml SC / IM bila pasien mengalami reaksi / syok setelah penyuntikan ( dengan tanda-tanda : sesak, pingsan, kelainan kulit ). LANGKAH-LANGKAH KEGIATAN     :   A.     Penanganan Utama dan segera  : Hentikan pemberian obat / antigen penyebab. Baringkan penderita dengan posisi tungkai lebih tinggi dari kepala. Berikan Adrenalin 1 : 1000 ( 1 mg/ml )   segera secara SC / IM pada otot deltoideus, dengan dosis 0,3 – 0,5 ml (anak : 0,01   ml/kgbb), dapat diulang tiap lima menit,   pada tempat suntikan atau sengatan dapat diberikan 0,1 –  0,3  ml ­Pemberian adrenalin IV apabila terjadi tidak ada respon  pada pemberian secara SC / IM, atau   terjadi kegagalan sirkulasi dan syok, dengan dosis ( dewasa) : 0,5 ml adrenalin 1 : 1000 ( 1 mg / ml ) diencerkan dalam 10 ml larutan garam faali dan diberikan selama 10 menit. Bebaskan jalan napas dan awasi vital sign ( Tensi, Nadi, Respirasi ) sampai syok teratasi. Pa

rtPA tPA can be manufactured using recombinant biotechnology techniques; tPA produced by such means are referred to as recombinant tissue plasminogen activator ( rtPA ). Specific rtPAs include alteplase , reteplase , and tenecteplase . They are used in clinical medicine to treat embolic or thrombotic stroke . The use of this protein is contraindicated in hemorrhagic stroke and head trauma. The antidote for tPA in case of toxicity is aminocaproic acid .  Caranya: 100 mgr terbagi dalam 1. 50 mgr bolus IV 2. 20 mgr bolus IV pada jam ke-2 3. 30 mgr bolus IV pada jam ke-3 atau alternatif 1. 60 mgr bolus IV 2. 20 mgr bolus IV 3. 20 mgr bolus IV https://www.researchgate.net/publication/8358453_The_Neurotoxicity_of_Tissue_Plasminogen_Activator/figures?lo=1 http://americanhistory.si.edu/collections/search/object/nmah_1000953

Sediaan Lasix (Furosemide); 20 mg/ 2 cc ampul Cara 12,5 amp lasix (250 mg) dalam 200 cc Dextros 5% habis dalam 1/2- 1jam (133 gtt/menit)  From: onlinesmedicines Cedinalid Bolus Sediaan a. Deslanoside 400 ugr/ 2 cc (ampul) b. lanatosid C 250 ugr (tablet salut) Deslanoside https://xudonghaipu.en.ecplaza.net/products/deslanoside-injection_1315996 Cedilanid-d - General Information dari: MinClinic Deacetyllanatoside C. A cardiotonic glycoside from the leaves of Digitalis lanata. Pharmacology of Cedilanid-d Cedilanid-d is a cardiac glycoside used to treat congestive heart failure and supraventricular arrhythmias due to reentry mechanisms, and to control ventricular rate in the treatment of chronic atrial fibrillation. Additional information about Cedilanid-d Cedilanid-d Indication: For the treatment and management of Congestive cardiac insufficiency, arrhythmias and heart failure. Mechanism Of Action: Cedilanid-d inhibits the Na-K-ATPase membrane pump,

Murmur grading  https://jamanetwork.com/journals/jamapediatrics/fullarticle/485985 Murmur  Sumber: Healio Murmurs are described by their timing in the cardiac cycle, intensity, shape, pitch, location, radiation and response to dynamic maneuvers. Using the aforementioned criteria, a clinician can accurately characterize the nature of a murmur and communicate their findings in a precise manner. Timing The timing of a murmur is crucial to accurate diagnosis. A murmur is either systolic, diastolic or continuous throughout systole and diastole. Remember: Systole occurs between the S1 and S2 heart sounds, while diastole occurs between S2 and S1. With the knowledge of the possible cardiovascular conditions that cause systolic or diastolic murmurs, the clinician can narrow their differential diagnosis. Thus, it is important to remember which lesions result in systolic murmurs and which result in diastolic murmurs. Stenosis of the aortic or pulmonic valves wi

The cardiac output is simply the amount of blood pumped by the heart per minute. Necessarily, the cardiac output is the product of the heart rate , which is the number of beats per minute, and the stroke volume , which is amount pumped per beat. CO = HR X SV The cardiac output is usually expressed in liters/minute. For someone weighing about 70 kg (154 lbs), the cardiac output at rest is about 5 liters/minute. In this case, if the heart rate is 70 beats/min, the stroke volume would be a little more than 70 ml/beat. But of course this changes dramatically as a person begins to exercise. For a typical, fit young person, the cardiac output might go up to about 20 liters/min at the peak of exercise. However, for a world-class athlete in an endurance sport, the maximum cardiac output might be around 35 liters/min. https://courses.washington.edu/conj/heart/cardiacoutput.htm The overall blood pressure as measured in the brachial artery is maintained by the cardi

Different Types of Abnormal Pulses Anacrotic Pulse Anacrotic pulse is a slow rising, twice beating pulse where both the waves are felt during systole. The waves that are felt are the anacrotic wave and the tidal wave. It is best felt in the carotids in aortic stenosis. Pulsus Bisferiens Pulsus bisferiens is a rapid rising, twice beating pulse where both the waves are felt during systole. Here the percussion wave is felt first followed by a small wave. It is seen in: Idiopathic hypertrophic subaortic stenosis –  Here initially there is no obstruction to the outflow and about 80 percent of the stroke volume is ejected in the early part of systole. The obstruction occurs in midsystole when aortic valve approximates the hypertrophied septum. Hence, there is a dip, as suddenly the flow ceases, followed by a secondary rise as the L.V. overcomes the obstruction. Severe A.I. with mild A.S.: The volume flow is initially increased due to severe. A.I. mild A.S. causes an ex

Left Ventricular Hypertrophy ECG Criteria Through many studies, multiple criteria have been developed to diagnose LVH on an ECG; they are listed below. Cornell criteria: Add the R wave in aVL and the S wave in V3. If the sum is greater than 28 millimeters in males or greater than 20 mm in females, LVH is present. Modified Cornell Criteria: Examine the R wave in aVL. If the R wave is greater than 12 mm in amplitude, LVH is present. Sokolow-Lyon Criteria: Add the S wave in V1 plus the R wave in V5 or V6. If the sum is greater than 35 mm, LVH is present. Romhilt-Estes LVH Point Score System: If the score equals 4, LVH is present with 30% to 54% sensitivity. If the score is greater than 5, LVH is present with 83% to 97% specificity. Amplitude of largest R or S in limb leads ≥ 20 mm = 3 points Amplitude of S in V1 or V2 ≥ 30 mm = 3 points Amplitude of R in V5 or V6 ≥ 30 mm = 3 points ST and T wave changes opposite QRS without digoxin = 3 points ST and T wave changes oppo

KILLIP untuk prognosis STEMI https://drsvenkatesan.com/tag/killip-classification/

S1= normal redup atau meningkat tergantung kausa S2= komponen P2 meningkat yang menungjukkan tanda hipertensi Pulmonal S3= atau protodiastolik gallop , umumnya berasal dari ventrkel kiri (kdg-kdg dari ventr. kanan) merupakan tanda gagal jantung. S3 umumnya ditemukan pada anak-anak dewasa muda yang sehat Bunyi jantung akibat aktifitas jantung: BJ 1= getaran menutupnya katup AV terutama katup mitral , getaran kontraksi otot miokard serta aliran cepat saat katup semilunar mulai terbuka. pada keadaan normal terdengar tunggal BJ 2= getaran menutupnya katup semilunar aorta maupun pulmonal , Pada keadaan normal terdengan pemisahan (splitting) dari kedua komponen yang bervariasi dengan pernapasan pada anak atau anak muda BJ3= krn getaran cepat dari aliran darah saat pengisian cepat (rapid filling phase) dari ventrikel. Terdengar pada anak dan dewasa muda atau keadaan komplain yang menurun (hipertrofi atau dilatasi) BJ4= krn kontraksi atrium yg mengalirkan darah ke ventr. yang kompl

Hiponatremia menyebabkan hipoosmolaritas dalam sel rendah tjd osmosis makan air bergerak dari tekanan rendah ke tinggi Cairan ekstraseluler x BB x 10-12% NaCl 0,9% = 135 Meq NaCl 3% = 500 Meq Contoh:  0,6 x BB x 12%                           24 jam Gejala : penurunan kesadaran hipotensi/mengantuk usia tua 80% Muntah Komplikasi akut hiponatermia: Edema cerebri

Pengobatan Toxic Tifoid Dexametason 3 mg/kgBB dibolus dalam D5% 50cc Drip dexametason 1 mg/kgBB tiap 6-8 jam Dosis maksimal 10 mg/kgBB Diberikan ranitidin injeksi

1.Abortus 2.Anemia def besi ec ascariasis 3.Benda asing pada konjungtiva 4.tifoid 5.skizofenia 6.depresi 7.anxietas 8. Osteoarthritis genu 9. Cluster headache 10. Stroke 11. Iskemik st depresi/ st elevasi 12. Insect bite 13.vesicolitiasis 14. BPH Sindrom metabolik Pielonefritis Ejakulasi dini Syok anafilaktik Tension headache Ves Asma 15. Nefrolitiasis

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Genitalia Pria 1. Prostat Gambar 1. Anatomi prostat  The prostate gland is composed of different types of tissue, divided into zones: The peripheral zone (PZ) contains the majority of prostatic glandular tissue. The largest area of the peripheral zone is at the back of the gland, closest to the rectal wall. When a doctor performs a digital rectal exam (DRE) it is the back surface of the gland he is feeling. This is important because about 70-80% of prostate cancers originate in the peripheral zone. The central zone (CZ) is the area that surrounds the ejaculatory ducts. Only a very small percentage of prostate cancers begin here (less than 5%) and are thought to be more aggressive and more likely to invade the seminal vesicles. The transition zone (TZ) surrounds the urethra as it enters the prostate gland. It is small in young adults, but it grows throughout life, taking up a bigger percentage of the gland, and is responsible for benign prostati