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Transcript of Teaching Bangsal
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TEACHING BANGSAL
HERPES ZOSTER
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Group Nameo MUHAMMAD ADIYATH S.o NUR ULUL AMRANo A. TENRI SYAHIRAH S.o ARMIN ABAS S.o EVY MISELVY T.o FIRGHANA ATTAMIMIo MULIANA KHAERUNIZAH N.o MUHAMMAD IQBAL T.o ANDI MUHAMMAD LATE R.o ANDI DIRHAN TAKDIRo MUHAMMAD AKAHRIHWAN A. GALIGO
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PATIENT IDENTITY
Name : Ampa DG NgaiGender : MaleAge : 53 y.oAddress : Rannaya GowaMarital Status : MarriedReligion : MoeslemAdmission Date : 1st August 1961Medical Record Number : 679677
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History Taking
Anamnesis : AutoanamnesisChief complaint : Watery pimples scars
Further Anamnesis : Patient complain about itchy and
burn on the left chest that spread to the left back that hefeels 5 days ago. After a few days appear reddish spotthen appear spots that filled with transparent liquid,spot that filled with liquid is appear that accumulatedon the one area and can crush if it scratched, Fever (+)Malaise (+), Anorexia (+)Latest disease : varicella (+) 3 years ago
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History Taking
Treatment history : (-) Family History with the same complaint : (-)
History of allergy : (-) Medical history : (-)
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Physical Examination
Anemic (+), icterus (-), cyanose(-) Cor/Pulmonal : S1 S2 normal, reguler, Rh -/-
Wh -/- Abdomen : Normal, peristaltic (+) Extremities : Edema (-)
Lymph nodes : Enlargement (-)
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Current Status Consciousness : Concious (E4V5M6) General Condition : Severe Hygiene : Medium
Vital Sign BP : 100/60 mmHg
PR : 92 x/minutes RR : 20x/minutes T : 38,4 C
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DERMATOLOGY STATUS
Location : Regio Thoracalis Anterior et Posterior
Efflorescence : vesicles, eruption, crust
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BEFORE TREATMENT
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AFTER TREATMENT
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Laboratory Result RBC : 3,4. 10 6 /uL WBC : 16,05 10 3 uL HGB : 9,3 g/dL HCT : 28,0 % PLT : 318. 10 3 /mm 3 GDS : 128 mg/dl Ureum : 24 mg/dl
Creatinin : 0,60 mg/dl SGOT : 42 U/I SGPT : 33 U/I
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Diagnosis
Herpes zoster
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Treatment
R/ IVFD NaCl 0,9% 28dpmAcyclovir 5x 400 mg
Neurodex 2x1Cetirizine 10 mg 1x1 (if itchy)Mefenamat Acid 3x500mg (if pain)
MBO Talk (morning-afternoon)
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Dermatology status :Location : Regio Thoracalis Anterior et Posterior
SinistraEfflorescence : Vesicles, Eruption, Crust
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Discussion
Herpes zoster : Segmental (dermatomal) painful skin
disease caused by reaction of VZV
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Epidemiology
1.5 3.0 per 1,000 person-years in allages and 7 11 per 1,000 per year in personsover 60 years of age in European and NorthAmerican studies.
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Clinical Manifestation
1. Dysesthesias or pain in distribution of theaffected nerve without visible skin changes.Typically burning or lancinating pain
2. Eruption of grouped vesicles and thenpustules on an erythematous base
3. Healing with drying, crusting, and usuallysome scarring (7 days)
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Clinical Diagnosis
Varicella can usually be diagnosed readily onthe basis of the appearance and evolution ofits characteristic rash particularly when thereis a history of exposure within the preceding2 3 weeks
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Complication
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Treatment
Antiviral therapy :- Acyclovir 5 x 800 mg/day (7 days)
- Valacyclovir 3 x 1000 mg/day- Famciclovir 3x500 mg/day (7 days)
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Prevention
Vaccination
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REFERENCE Straus S, Oxman M, Schmader K. Varicella and herpes Zoster.
Wollf K, Goldsmith LA, Katz SI, Gilchrest BA, Paller AS, LeffelDJ. In Fitzpatricks Dermatology In General Medicine. 7thEdition. McGraw-Hill; New York 2008
Handoko R. Penyakit Virus.Djuanda A, Hamzah M, Aisah S.Dalam Ilmu Penyakit kulit dan Kelamin. Edisi ke 5. Jakarta:Balai Pustaka FKUI;2009
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Thank You
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