MARIANI,50 YO,HCU

Cc : breathlessness since a week ago

Present illness history : Breathlessness since a week ago due to activity, was not influenced by food nor climate Left Chest pain since 15 hrs before going to the hospital, not decrease when rest Has been inpatient in cvcu a day ago

Physical examination: VS/ cmc, BP:110/70 mmHg, HR: 100x/i, RR: 24x/i, T: 36,80 C Eye :Conjungtiva anemic (-), sclera icteric (+) Neck : JVP 5+3 cmH20 Chest: bronchovesiculer, rales +/+ on base, wheez (-) Cardiac : irreguler rhythm Abdomen: Liver palpable 2 finger under arcus costarum, spleen was not palpable Shifting dullness (+) Ext: edema(+)/ (+)

Laboratorium
Hb : 7,4 g % Leucocyte ; 5400/mm3 Ht : 22 % Thrombocyte : 166.000/mm3 Na : 132 K :5 Cl :112 Ureum :194 Creatinin : 10,6 Protein urine (++)

Blood gass analyze pH : 7,15 pCo2: 29 pO2 : 118 HCO3-: 10.1 BE ecf : -18,8 So2 : 97

WD : CHF fc II LVH RVH AF rhythm normorespon ec HHD Congestive hepatopathy

Th : Rest/heart diet II,low protein/ o2 2 l/I Ivfd easpfimmer: D 5 500cc/24 hrs Lasix 5 amp in 50 cc Nacl 0,9% in syringe pump 5cc/hr Folic acid 1x5 mg sodium bicarbonat 3x500mg Osteocal 1x1 tab Curcuma 3x1 tab Alprazolm 1x0,5 mg Dulcolax 1x2 tab PRC transfusion till Hb > 10g% Meylon correction 150 meq in 150 cc Nacl

ARLINDA,47 YO,HCU

Cc : breathlessness since a week ago

Present illness history Breathlessness since a week ago,increase by activity, was not influenced by food nor climate Fever since a week ago, no shake,no sweat Cough since a week ago, no mucous Nausea (-), vomit (-) Fatigue (+)

Physical examination: VS/ cmc, BP:180/100 mmHg, HR: 122x/i, RR: 26x/i, T: 36,80 C Eye :Conjungtiva anemic (-), sclera icteric (+) Neck : JVP 5-2 cmH20 Chest: bronchovesiculer, rales -/+ on left base, wheez (-) Cardiac : reguler rhythm Abdomen: Liver and spleen were not palpable Ext: edema(+)/ (+)

Laboratorium
Hb : 10,3g % Leucocyte ;26.000 /mm3 Ht : 31% Thrombocyte : 290.000/mm3 Na : 126 K : 3,3 Cl :97 Ureum :166 Creatinin : 9,4 Protein urine (++)

Blood gass analyze pH : 7,39 pCO2 : 16 pO2 : 81 HCO3: 9,7 Beecf : 15,3 SO2 : 96

WD : St V CKD cb hypertension nefroschlerosis with metabolic acidose Sinistra bronchopneumonia

Th : rest/ low salt II,low protein diet/ O2 2 l/I IVFD easpfimmer : Nacl 0,9 % 12 hrs/kolf Lasix 1x1 amp Ceftriaxone 1x2 g As folat tab 1x5 mg Sodium bicarbonat 3x 500 mg Amlodopin 1x5 mg Candesartan 1x8 mg Fluid balance

THOMAS SAPUTRA,16 YO,TI

Cc : fever since 6 days ago

Present illness history Fever since 6 days ago,continously,no shake, no sweat Vomit once, volume glass,consist of food eaten Headache (+) Fatigue (+) No bleeding manifestation

Physical examination: VS/ cmc, BP:100/60 mmHg, HR: 97x/i, RR: 20x/i, T: 36,80 C Eye :Conjungtiva anemic (-), sclera icteric (+) Neck : JVP 5-2 cmH20 Chest: vesiculer, rales -/-,wheez (-) Cardiac : reguler rhythm Abdomen: Liver and spleen were not palpable Ext: edema-/ -

Laboratorium
Hb : 16,1g % Leucocyte ; 3500 /mm3 Ht : 46% Thrombocyte : 27.000/mm3 Na : 126 K :3 Cl :97

Ig G anti anti dengue (+) Ig M anti dengue (-)

WD : Dengue fever

Th / rest/ soft diet IVFD RL 6 hrs/kolf Pct 3x1 NTR 3x1 Domperidon 3x1