I

Mikrobiologi
1. Streptococcus Pneumoniae & Streptococcus viridans

innonsienaeitive
sramoftaining.ca#gfasE-.Hgqgygseism.fsciffo9n'
Awrlden -

Coccus :& chains

.
.
.

s . Viridans
optochin resistant
5. Pneumoniae
I
makros blood agar mikros ⑦ coccus Sensitivities optochin
catalase
> :
.
gram , .

( draught man 's appearance ) to

Fermentasi .
Bile solubility
① lisislsernihl
( Koning )
5. viridans
↳ makros blood agar mikros ⑦ coccus Sensitivities optochin
catalase
:
.
gram , .

( draught man 's appearance ) ①

Fermentasi Bile solubility

Gins Burri
.

① tdklisislkeruhl
makros Capsul
( Merah ) I
quelling
i

Virulent :
05mm , ① I
stq.in
Streptococcus Pneumoniae l
l
,
avirulent 00.5 :
-2mm I -0 I
①
Mtkrobiologi
'

I
'

1. Corynebacterium Diphteriae

> a. Gravis

b. Intermedius

c. mitis

Gram ① Club shaped

3 -6mm
. Neisser ( granule ,
staining susunanhurof
Wku ran 0.6 0.8 granola t
kanji
-
x
 Loeffler 's medium → utkisolasi I membiakanmikrobapatogm
lngridients Protease peptone
:
,
extra kdaging ,
esp .

nose a throat
NaCl ,
Dextrose . Serum horse

2. diphteroids ( Corynebacterium Beudodiphteriae )

↳
gram ⑦ . bacilpendek . Susman Spt
Pagar .
0.8 -
I × I
-3mm

3. Mycobacterium Tuberculosis

mikros →
ziehl Nee Isen Kultur →
Lowenstein Jensen medium
Merah ( G ow ) -

tahan Asam

batang bengnok
bergeron bot
#

Molds us Yeast
makros I Mikos

multicellular dgn
/
thread like ,

→
bykwarna hifatabungberfilarnen

→
Bulat loral Pucat .
/ Uni sewer ( mostly )
monochromatic existing individual ldgn
I buds tumbuhdidmnya

aspergillus SP .

hifaberfilamen
↳ monomorphic fungi Mikos

(
:
,

septate hyalite
conidia
.
,

airborne
bercabang
aspergillus
fiamuigsat "

Niger
terre us
typo , mo
Cutaneus
.
para nasal

Alur
sputum -
Kultur SDA 26°C I 35°C
> hari
t t
Mikros
IKOH 10%1 Rolon i

X.
''
"

mirror
t fruiting Bodies
→

hifa Maura
.

bercabang ,

bergerturn berfilanen datar .

konidia powdery Putin lhijaul

,

Koning koalat
PATO LOGI KLINIK

①
Scant

min 50 Lp
I min 20
,
LP

transudate vs Eksodat

( info sit TBO Neutrofil Pramod

Riva Hato
seromuaosadlm asam
benton Kellerman

- Rival ta ①
Iensvdat)

easodat
Fisioogi
1. fisiologispirometri

yl
TLE
IRV
Iva
K

ERVIVCE

FRC
UR

Obstruksi us Restriksi
i
RASH ←
-

FEU
,
Obstruksi - se

•
* - Y - - '
d FEU ,
4705
.

= .

•
10.7

60 7g -

FVC @sedikit④
40 -

5g FEU ,
Sangat t
IRV f
440
FVC ERU t
> Po TLCT

FRET
60-79 Restriksi
ooo
÷ i

50 5g
-

Fred ÷: Fvct
<50 FEV , t

:@ ④
"art
ERVT
TLCL
RV t
FRU t
t t t t t t t

t t i t t t
Farmakdogi
"
-

am

*
Untukserangan
Pertemvan
SABA tspacertcsto ,
I :
① bat Asma
* Untuk Puking
Rlformoterol Inhaler KSI LABA TCS
( ABA →
idd
s Puff 1

Rl salbutamol inhaler no ,
SABA
.

I 3dd Puff I

Rl Budesonide Inhaler 200mg No I + spacer

1cg
-

S l dd Puff 1

Rl Symbicort turbo hater 16oly.s.mg

( ABA -
ICS →

I 2 dd I Semprot
"
desonidehformotero ,

Rlmetil Prednisone tab 8mg No xv

(s
.

I 3 dd tab I PC

Pertemuan I :
Bronko pneumonia & TB

A- HRZE
:

Rifampisin :
lnhibisienzim RNA Polimerase DNA dependent →
mencegahsintesis protein →
Bakterisidal *
kenoingmeran,

42 Dewasa :
lomglkgbb
( P 121
-
Max
600mg
Reset dewasa a
50kg anak bb 15kg
dptmenjadi MDR
Anak 15mg Ikgbb Rlfhifampisin tab 450mg NO xxx Rl Rifampisin tab 300mg No xxx
Max
600mg
: - .

110-201 I ldd tab I ac Sake I ldd tab I ace Saku

dewasa
50kg >

RI Rifampisin tab
600mg No xxx
.

Idle tab lac Sala

Isoniazid :
Inhibitor sintesis my colic acid →
komponendinding set
*
Hepatotoxic . neuritis Perier

H
Anak
dewasabb > 45kg 15kg
Dewasa 300mg 115MW kgbb Imax 900mg ) Rl Isoniazid tab No LX RI Rifampisin tab 300mg
txt
300mg No XV
: .

S l dd tab I ac sake I l dd tab 12 ac '

sake
Anak :
10 -

20mg I kgbb
lkgbb Sld
atau 20 -40mg
900mg Inari

Pirazinamid :
Inhibitor sintesis membranal
*
hiperuricemia .
hepatotoxic

Z 15 -

30 mglkgbb . Max 3000 mglhari

Sediaan tab 500mg

Dewas a anak 25kg

Rlpirazinamid tab
500mg NO XL
- Rl Pirazinamide tab
500mg No . Ix

S ldd tab 3 Pc mane Satu S ldd tab 1 Pc mane sake

Ethambutol Penghambatsintesisdinding kontra 6th

: set anak <

Dewas a 50kg Awal

Dewasa Rt Ethambutol tab NO .xxl
E I l dd
500mg
15mg lkgbbtunggal Max
1600mg tab 142 Pc mane sake
25
mglkgbblulang )
Dewasa
50kg ulang
Anak > 6th n Rl Ethambutol tab 500mg No . Xxl

25mg lkgbb 1×1 Go hari S l dd tab 1142 Pc mane sake

15mg lkgbb IN

bakteriostatik sediaan tab 250mg & 500mg

Streptomisin :
Inhibitor sinks is protein ( Ribosomal
*
absorbsibook , Manya mjeksi .
Oto toxic

S Dewasa : awal →
15mg lkgbb 12-3 mgg ) Rlstreptomisih Vial 1g NO I .

lanjutan →
25 351kg bb 13×1 mggl-
S l dd Pro
Mj

Anak :
Awal 20 -

40 mglkgbb 12 bln )
Lanjutan 25-30 mglaegbb 12×1 mgg → 4 -
10 bln )

Regimen OAT Dewasa

-

terkonfiftmeraisiiogis
-
terdiagnosis
Klin is
-

TB extra Parr

1-

kategori I : 2 IHRZEI 1411-11213

kategori I : 2 IHRZEIS I IHRZEI 1511-11213 E3
"
211-1122114 IHR ) KE'T LE,
t BB
:
anak a

Foaagmaibuphengobatanrat I 5-7 tab

'

I I
- .

Potus obat P H
-

2 2

12 -
16 3 3
17 -

22 4 9
23 30 -

5 5

Pneumonia
Bakteri gram ① →
DOC : -

Penicillin :
Amoxicillin 1 Inhibitor dining set lenzim trans Peptidase ) ) Dewasa 3×500
my
Anak 25-50 mglkgbb * 3

cephalosporin e Cefixime ( Inhibitor enzim trans peptidase Pem b. dining sell Dewasa 2×10 omg
-

: →

Anak 1.5--3 rnglkgbb +2

Quinton Respirator levofloksasin :( Inhibitor DNA gyrase )

Dpenwaapasa
as .no Heat
11500mg
:
-

'
-

Makrolide :
Azitromisin ( inhibitor Sint protein . Ribosome 505 ) Dewasa Ix
500mg
Anak 10mg lkgbb
-

tetrasiklin :
Doxycycline ( Inhibitor Sint protein Ribosome 3051 . Dewasa 2x
100mg
Anak -

Bakteri gram -0 → DOC :

Resister penicillin : →
makrolide ( Azitromisin)

sensitive Penicillin :
co amoxiclav

Contoh Resep Dewasa Anak 10kg

Rl Azitromicin Rt Azitromispn Syr RI

2oomglcthfls.li
tab co amoxiclav tab
625mg NO xxx
500mg NO . 111
mau
.

ldd tab I
l Yzhac Yeh I 3dd tab PC S dd Cth 12
I n l ac
'
.

- -

Rl Paracetamol tab 500mg NO .

X Atau

I 3 dd tab l Pc Prn Sulu RICO -

amoxidav Syr 125mg loth fb ) .

I 3 dd Cth 1 Pc
Rl patio nigra
-

Syr fts .
I

S 3dd Cth 1 Prn Sak R 1 Paracetamol Syr 120mg Eth FAI

s3ddCth1PCP#
-

R 1 Patio alba FIS I .

I 3dL cthl Pc Prn

Patologi Anatomi
"" en

Pulmo fetus

alveolus yg

-±÷÷÷
berkembang

1 ,
bakal Pneumocystis
Asbestosis Pulmonum
PMN

Yang
fibrosis

( O 0

!÷%
a
(T Club Shaped asbestos
bodies

Emphysema Pulmonom
lobar is
ytdkada Pneumonia
Fibrosis .

' "" "

"" "
""""

t.u.mn lumen alveolus

terisimakrofag
Neutrofil
&

Tuberculosis Polmonvm

qggggggggyaMAMMY
%e9aesipit.no
;D

's: rnoeisrotic
caseosa ,

qqµk

limfositsederdiantfiabgnnghaa.rs
Carcinoma Paro
"

adenocarcinoma
"

>
Sel Kanker Pleomorfik ,
hiperkromatis
mitosis tdkterkendali
 articolatiocosto
# transuersaria bucket
/
sternum
-
Processors transverses handle
handle
Costa pump

cartilage
Costa

vertebra
Spatium
Subcostal ,

Incisor
Jugularis
? ( Mciwcrfauicuiaris
I
Synchondrosis
-

Costa
-
Prima
Manubrium
art costovertebralis
✓
.

angulosslerniludovici art costotransversaria

.

incisor Symphisismanubriosternalis
Costain - corpus

synohondrosisxiphosternalis
- processes
xiphoideos

Facies articular is capitis Costa Superior

codowstmae tubercuwmcostae

Facies articular is '

,
( - -
¥ , anqscosi.aeIs
-

i
- -
- -

capitis costae Inferior

,
'
I
- -
- - -

caputcostae articular is
'
-
-

facies ⇐
tuberculicostae sulcus
Costae

Costa
typical

-
"
-
umcostae
,

→
/
/
-
Caput
i
Costa
/ '
P

Orso's.us#iierai
(
,

'

tueeariunmamerioi s
tuberosities
Mosconi Serrat
sulcus venae
anterior subclavian

art .

Sternoclavicularis
art Sternocostalis
.

art costochondralis
.
Soynchondrosiscostaeprimae

Synchondrosis Costa Secunda

. " "

Vera
Costa
Vertebra sternal

Hcumumnya, I
-
caput
-
n
i
- -
.

l l Costa

!
/ I
'
Vertebrochondral
/
18-10 ) umumnya
/

"

Costa fluctuates
"

ang In -121
floating
lnfrasternalis
 M -

Pectoralis m .
pectoralis

.tn?owracicamsaE9eYi8Y
minor
major
apertura

-
(
- -
-
T a

#Subclavian
-
.

-
\

↳
-
-
-
-
-

i
-

iaavia

I ln.pnrenic.us
n .
Vagus

mintercostalis
Infernos s
'

M
%
1/1/11
" " "

11
m .
intercostal 's
Externs 4( -

-
m
(y
me 11111
" th
'

intercostal is
-

m -

Externs

membranal intercostal
external

m .
Pectoralis
a .lv -
thoracic a minor
internal
MoD

mnienrceorsntgiis /
)

//
membranal -
is
intercostal external

me 'x9betin9Y"abdominis
"

mining;sta M Serratos
-

Anterior
 Gaviota
a. thoracic internal

Mlntercostalis
V. thoracic internal
{ a. thoracic

V. thoracic internal
Internal

interns
m .
intercostal is
lntimvs

Alvin .
} M - transverses
Intercostals thoracis

.lk/-horacica1nternaa.subClavioymscat\eannFerior
a

a.tyornferinaam.in/ercostalis1htimusm.intercostalis / m transverses
.

Infernus thoracis
y
O

ras .ae#racia/m.transverso m.lntercostalisthoraciSlntimos

M .
Scalenus
/ anterior

a. thoracic V
Internal
-

Subclavig

( .li?qnrg sm+qgi
sinister

I
Subclavian
a.
sinistral
-

intercostal's m ,
Interns Neurovascular
bundle .

Alvin . intercostals's
a -

thoracic
Internal
( apisan :

facial
endothoracica

trunchus
-
bronchus principal.is
sinister
Symphaticuj V
azygos
yarns
-

o
M Subcostal is
.

/
Alvin intercostals's
.

ductus
-

thoracicus

V.
azygos
1-
Y Intercostals
v.
I
Venaazygos
V. hemiazygos
 media sup

mr-y-iamrgeasg.jo Mf

f. /
i :c Ii :*
-

-
-
. .

]
.
I
r

¥
Recesses Pleura pars Pars
Recesses pleura
costodiapraghmatica mediastinal's
Diarraghmaticaplmeueriaapairsnaii , costars
-
apex
facies "
costa - sup
Fgs
SUP sup
"
% .

"
90g SUP jar
"
" Horizon do

Figura
media
Ob od
Horizontal is riss

qq.gg figura Inf 1nF 1nF

med , MF
-
✓
margo Inferior

apex

Arcus aorta (
a. Polmonalis

sinister

B
venaazygos bronchus
lobar is

aorta a. Pulmonalis get superior

thoracic bronchus Principal's

Dextro Eoe
on
- "

inferior
-

s
-
- sinister v. pulmonate's -
E
/
i
Dextra l l
l l
l S
l
en
t
's l
Cig Pulman
-

T
l
.

l V. Polmonall's 5
s n
i r sinister E 8
-
-
-
E

#
E

maioonferior Impression
Cardiac
EE
inferior
ligpulmonis
-
lingua

bronchus Principal's
Dextran

a. Pulmonalis
sinistral bronchus a. Pulmonate's
lobaris
Dextro
Bronchus superior
Principals
n
sinistral
- -

inferior
V. pulmonate's
V. Polmonalil Dextran
Silistra

Lig Pulmonate
.
 Bronchos lobar is
superior sinister

Bronchus lobar is superior

sinister
Bronchus lobar is
Bronchus lobar is
medius sinistral
inferior sinistral
Bronchos lobar is
inferior sinistral

B. l .

Superior
Dextro

B. P

Bjuperior Dex

Sinistral
p .

B.

I B. L Bronchos
Inferior intermedius
Bronchia
Lingo
B. L .

media

B. L .

Inferior

Bronchos lobar is
superior Dextro

Bronchus
intermedia
-

Bronchus lobar is
media D extra

Bronchus lobar is
Inferior pextra
 apical
✓

anterior anterior superior

✓

=\
Cingular

iieriooiar
'

1-
-
anterior es

bas
media anterior ,
tmedial

↳:
I

:i/
lateral
/ basal
basal
Year sat nmaeiai n
Posterior
basal

in

apical
µ apical
apical aproposterror or
'

er
eos nor posterior
posterior M et ameri
's

or
anterior
anterior cingular
superiors
superior

kterqeg.ge
Soperius
""
T sore Cingular
'

superior
go inferiors linger
basahe basal infernos ameromedldw
µ basalt
antero mediate takraw basal
anterior
medial
Posterior posterior
basal basal basal basal basal
lateral lateral cateran