IRON DEFICIENCY ANEMIA

jd nggk bs produce enough hemoglobin

lead to tired and short of breath
Symptoms :
extreme faigue, pale skin, weakness, shortness
of breath, headache,
dizzinesss/lightheadedness, cold hands and feet,
irritability, inflammation/soreness dr tongue,
brittle nails (koilonychia), fast heartbeat,
unusual craving untuk non-nutritive substances,
poor appetite, restless legs syndrome, angular
cheilosis
Causes :
- Blood loss darah contain iron di
RBCnya. Kalo lose blood brrti lose bbrp
iron.
*women dgn heavy periods
*slow, chronic blood loss peptic ulcer,
hiatal hernia, colon polyp/colorectal
cancer
*gastrointestinal bleeding bs karena
terus2an gunain pain relievers (esp
aspirin)
- Lack of iron diet meat, eggs, green
vegetables
- Inability to absorb iron diabsorb di
small intestine. Klao ada disorder (co.
celiac disease autoimmune, damage
lining dr small intestine) jd ga bs nge
absorb nutrients
- Pregnancy karena iron stores need to
sere their own increased blood volume as
well as be a source of hb for the growing
fetus
RF
Women (menstrutation), infants and children (yg
premature atau low birth weight, ga dpt enough
iron dr breast mil/formula), vegetarian, frequent
blood donors
Complications
- Heart problems lead to rapid/ireegular
heartbet krn heart hrs nge pump more
blood untuk nge compensate lack of
oxygen. Lead to enlarged heart/heart
failure
- Problems during pregnancy severe iron
deficiency bs linked to prematuritas
births dan lbw
- Growth problems
Test
- microcytic hypochromic anemia, pencil
cell
- Hematocrit << (normal = 34,9-44,5)
- Hemoglobin <<
- Ferritin << (protein yg help store iron)
Additional :
- Endoscopy check bleeding dr hiatal
hernia, ulcer dr stomach
- Colonoscopy buat liat source dr
bleedingnya
- Ultrasould untuk pelvic, liat pnybb
excess menstrual bleeding (co. uterine
fibroids)
Treatment

Iron supplemets biar di absorb dgn

baik, minumnya pas stomach kosong,
minum jg vitamin c (improve absorption
of iron)
S.E = constipation

HEPATITIS C
Infeksi oleh HCV (flaviviridae family) lead to
inflammation no symptoms smpe liver
damage show up (cirrhosis)
Virusnya RNA, made up dgn envelope dan
contain enzyme dan protein biar bs reproduce di
cells of the body
Menular mll exposure thdp infected blood (IV
drug abuse paling sering), mother to unborn
child, sexual intercourse (small number cases)
Symptoms
Fatigue, fecer, nausea/poor appetite, muscle and
joint pains, yellowing of the skin and whites eyes
(jaundice)
Kalo udh sirosis :
- weakness
- Loss of appetite
- BB <<
- Breast enlargement in mn
- Rash di palms
- Difficulty with clotting blood
- Spider-like blood vessel di skin
Advance siroris confusion, coma
(encephalopathy) krn toxic, <<produksi dr
clotting factors, portal hypertension nyebabin
ascites esophageal varices tear easily
* portal hipertensi jg bs nyebabin kidney
failure dan enlarged spleen krn anemia,
trombocitopenia yg bs promote bleeding
Complication
- Cirrhosis stlh 20-30 tahun dr hepatitis
C
- HCV bs nybabin body produce unusual
antibodies (cryoglobulins) nyebabin
vasculitis (inflamasi dr arteri) damage
skin, joint, kidney. Dan bs nyebabin
raynauds phenomenon
- Chronic infection HCV lichen planus,
porphyria cutanea tarda
- Low platelet count tjd krn destruction
dr platelet oleh antibody
- Associated sm V cell lymphoma (cancer
dr lymph system)
Test
- Enzyme immune-assays (EIAs) test
blood untuk antibody (butuh bbrp
minggu buat antibody develop stlh initial
infection dgn HCV
- Recombinant immunoblot assay (RIBA)
digunain untuk confirm positif result dr
EIA
- RNA testing untuk orng yg recently
exposed thdp HCV, more sensitive
karena munculnya 1-3 minggu dr
exposure

liver biopsy nentuin staging (tau brp

banyak inflamasi dan scarringnya)dan
terapi
Treatment
- kombinasi antiviral + interferon dan
ribavirin
PULMONARY TUBERCULOSIS
Cause : mycobacterium tuberculosis (slow
growing bakteri yg grow bet di daeralh yg bnyk
darah dan oxygen, krn itu di lung) mll inhalasi
dr infected people
Symptoms
- Asymtpomatik (pd latent)
- Ada sputum >2 minggu
- Breathing problems
- Chest pain, shortness of breath (rare
case)
- Wheezing
- Night sweats and fever
- Rapid heart beat
-

- Fatigue
- Weight loss
- Swelling di neck
- Coughing up blood
Klasifikasi :
- Latent TB = ada TB bacteria tp immune
system nge defense, keeping it from
turning into active TB. Jd nggk ada
symptoms. Bakal jd active TB
- Active TB = TB bacteria growing dan
nyebabin symptoms. Dan easy buat
spread the disease tp others
RF
- HIV, imunodepressant
- Close contact sm orng yg active TB
- Ngerawat pasien
- Tinggal atau se kantor
- Abuse drugs/alcohol
- Travel ke daerah epidemic
Diagnsois
- Tuberculin test inject TB antigens
dibawah skin kalo ada TB bakteri, dlm
2 hari bakal ada red bump di tempat
needle
- Sputum cek bakteri
- X ray untuk liat pulmonary TB
- Untuk extrapumonary biopsy, CT, MRI
Treatment
Take medicine slm 6 bulan. Kalo msh aktif,
continue 2 bulan/3 bulan
Kalo smpt ke putus start dr awal lg
Kalo latent cuma one drug. (INH slm 9 bulan)
(untuk yg
Kalo aktif : isoniazid, rifampin, ethambutol,
pyrazinamide (liat catetan)
* sering metastasis ke brain, liver, heart