Scenario A Blok 12 Batch 2018

“Periculum in mora”
Mrs. A, a 48 years old woman, brought to the emergency department of RSMP by her family with a chief
complain of shortness of breath that keeps on worsening since 4 hours ago. The shortness of breath were not
triggered by activity or weathers change, and were not followed with wheezing. Mrs. A also complains of
productive cough accompanied with pain while swallowing and fever since one weeks ago, she went to the
Puskesmas and was given an antibiotic but she didnt take it. Her blood sugar level also being checked at the
Puskesmas, and the result was 280 mg/dl, and she also claimed that she often feels thirsty, famished, and urinate
a lot, then she was given an oral anti diabetic but she didnt take it regularly.
According to her family, Mrs. A had a medical history of Diabetes Mellitus since the age of forty, but she
didnt take her medicine regularly, and seldomly control her condition to the Puskesmas.
Physical Examination :
General Appearance: Looks severely sick, apathic, BH: 154 cm, BW 40 kg
Vital Sign : BP 100/60 mmHg, HR 120x/mnt, Temp 38,8°C, RR: 38x/menit (deep and fast breathing)
Head : Pale conjungtive (-/-), icteric sclera (-/-)
Neck : JVP 5-2 cmH2O
Thorax : Heart and lung within normal limits
Abdoment : flat, supple, bowel movement (+), hepar and lien were not palpable
Extremities : cold extremities (-), edema (-/-). Turgor return slowly.
Laboratory Examination:
Blood Chemistry: Hb 13g/dl, Leukocyte 18.000/mm3, thrombocyte 250.000/ mm3
BSN 300 mg/dl
Urinalysis: Keton urin +3, glukose urin +3

Skenario A Blok 12 Batch 2018

“Periculum in mora”
Ibu A, seorang wanita berusia 48 tahun, dibawa ke departemen darurat RSMP oleh keluarganya dengan
seorang kepala mengeluh sesak napas yang terus memburuk sejak 4 jam yang lalu. Sesak nafas tidak dipicu oleh
aktivitas atau cuaca berubah, dan tidak diikuti dengan mengi. Ibu A juga mengeluh batuk produktif disertai
dengan rasa sakit saat menelan dan demam sejak satu minggu yang lalu, dia pergi ke Puskesmas dan diberi
antibiotik tetapi dia tidak meminumnya. Kadar gula darahnya juga diperiksa di Puskesmas, dan hasilnya 280 mg
/ dl, dan dia juga mengklaim bahwa dia sering merasa haus, kelaparan, dan banyak buang air kecil, kemudian
dia diberi oral anti diabetes tetapi dia tidak meminumnya. secara teratur.
Menurut keluarganya, Ny. A memiliki riwayat medis Diabetes Mellitus sejak usia empat puluh, tetapi ia
tidak minum obat secara teratur, dan jarang mengendalikan kondisinya ke Puskesmas.
Pemeriksaan fisik :
Penampilan Umum: Terlihat sangat sakit, apatis, BH: 154 cm, BW 40 kg
Tanda Vital : BP 100/60 mmHg, HR 120x / mnt, Temp 38,8 ° C, RR: 38x / menit (pernapasan dalam dan
cepat)
Kepala : Pung konjungtif (- / -), sklera icteric (- / -)
Leher : JVP 5-2 cmH2O
Thorax : Jantung dan paru-paru dalam batas normal
Abdoment : rata, kenyal, buang air besar (+), hepar dan lien tidak teraba
Ekstremitas : ekstremitas dingin (-), edema (- / -). Turgor kembali perlahan.
Pemeriksaan Laboratorium:
Kimia Darah: Hb 13g / dl, Leukosit 18.000 / mm3, trombosit 250.000 / mm3
BSN 300 mg / dl
Urinalisis: Keton urin +3, glukose urin +3