1. Lower Respiratory Tract Disease
1.1. Obstructive Disease Restrictive Disease
1.1.1. Obstructive Pulmonary Disease
1.1.1.1. Asthma
1.1.1.1.1. Definisi
1.1.1.1.2. Clinical Sign
1.1.1.1.3. Patophysiology
1.1.1.1.4. Management
1.1.1.1.5. Jenis
1.1.1.2. COPD
1.1.1.2.1. Bronchitis
1.1.1.2.2. Chronic Bronchitis
1.1.1.2.3. Emphysema
1.1.1.3. Bronchiectasis
1.1.1.3.1. Definisi
1.1.1.3.2. Clinical Sign
1.1.1.3.3. Management
1.1.2. Restrictive
1.1.2.1. Definisi
1.1.2.1.1. Berkurangnya kemampuan ekspansi dari parenkim paru2 Berkurangnya total lung capacity
1.1.2.2. Diukur oleh FVC
1.1.2.3. Jenis
1.1.2.3.1. Chest wall disorders
1.1.2.3.2. Chronic interstitial and infliiltrative disease
1.1.2.4. Atelectasis
1.1.2.4.1. Incomplete expansion of the lungs
1.1.2.4.2. Collapse od previousl inflated lung
1.2. Pneumonia
1.2.1. Definisi
1.2.1.1. Inflamasi lung parenchyme as response to microorganism invasion
1.2.2. Jenis
1.2.2.1. Community acquires
1.2.2.1.1. Bronchopneumonia
1.2.2.1.2. Lobar pneumonia
1.2.2.2. Hospital acquired
1.2.3. Clinical Sign
1.2.3.1. General symptoms
1.2.3.1.1. 1. Irritable 2. Dcreased feeding 3. GIT symptoms 4. Malaise
1.2.3.1.2. If severe : convulsion decreased consciousness, convulsion
1.2.3.2. Respiratory symptoms
1.2.3.2.1. 1. Cough with fever 2. Takipne 3. CHest wall retraction 4. Nasal flaring 5. Head nodding and grunting
1.2.3.2.2. Auscultation : Fine crackle / RHALES BASAH
1.2.3.3. Pathophysiology
1.2.3.3.1. Kongesti
1.2.3.3.2. Hepatisasi merah
1.2.3.3.3. Hepatisasi abu
1.2.3.3.4. Resolusi
1.2.4. Management
1.2.4.1. Oksigenasi bila saturasi dibawah 90
1.2.4.2. Outpatient
1.2.4.2.1. Amoksisilin 80-100mg
1.2.4.2.2. Eritromisin 40-60mg
1.2.4.3. Rawat patient
1.2.4.3.1. Lini pertama
1.2.4.3.2. Lini Kedua
1.2.4.3.3. S. aureus
1.2.5. Pneumonia Aspiration
1.2.5.1. Definisi
1.2.5.1.1. Pneumonia akibat content stomach ke lower respiratory tract
1.2.5.1.2. Sering berhbungan dengan poor oral hygiene
1.2.5.2. Jenis
1.2.5.2.1. Posterior segment of upper lobe
1.2.5.2.2. Basal segment of lower lobes ketika anak dalam posisi duduk
1.2.5.3. CLinical sign
1.2.5.3.1. Onset insidious
1.3. Pleura
1.3.1. Pleural effusion
1.3.1.1. definisi
1.3.1.1.1. Adanya akumulasi fluid yang berlebihan di pleural space
1.3.1.1.2. Imbalance pleural fluid formation and removal
1.3.1.2. Clinical Sign
1.3.1.2.1. Pleuritic chest pain Dyspnea Dry non productive cough
1.3.1.2.2. shifting dulness
1.3.2. Pulmonary edema
1.3.2.1. Definisi
1.3.2.1.1. Extravasation of fluid from pulmonary vascular ke insterstitium dan alveoli
1.3.2.2. Jenis
1.3.2.2.1. Cardiogenic
1.3.2.2.2. Non Cardiogenic
2. Upper Respiratory Tract disease
2.1. Inflamatory disease
2.1.1. Nose and paranasal sinuses
2.1.1.1. Rhinitis
2.1.1.1.1. Rhinitis Akut
2.1.1.1.2. Rhinitis Kronik Allergika
2.1.1.1.3. Rhinitis Medikamentosa
2.1.1.1.4. Rhinitis Vasomotor
2.1.1.1.5. Septi
2.1.1.1.6. Valvulr collapse
2.1.1.1.7. Atresia Koana
2.1.1.2. Sinusitis
2.1.1.2.1. Lokasi
2.1.1.2.2. Waktu
2.1.1.2.3. Sumber infeksi
2.1.2. Pharyngitis
2.1.2.1. Acute Pharyngitis
2.1.2.1.1. weakness, fever, pharynx hiperemis uvula oedeme, hypertrofi tonsil, sore throat
2.1.2.2. Chronic Pharyngitis
2.1.2.2.1. rasa kering, nyeri dan iritasi dari pharynx iritasi ada granulasi tissue
2.1.2.3. Acute tonsilopharyngitis
2.1.2.3.1. Pain while swallowing tonsil enlargement
2.1.2.4. Acute Tonsilitis follicularis
2.1.2.4.1. fever weakness sore throat pain around neck headache, muscle pain episode 4-6 hari tanpa komplikasi leucocytosis
2.1.2.5. Chronic Tonsilitis
2.1.2.5.1. 1. febris subfebris 2. Weakness all day 3. Sleep Apnea
2.1.3. Adenoiditis
2.1.3.1. Acute Adenoiditis
2.1.3.1.1. 1. Purrulent rhinorrhea 2. Fever 3. Otitis Media 4. Nasal Obstruction
2.1.3.2. Recurrent adenoiditis
2.1.3.2.1. Kejadian akut di atas 4 kali selama periode 6 bulan
2.1.3.3. Chronic Adenoiditis
2.1.3.3.1. 1. Persisten nasal discharge 2. Malodorous breath 3. Post Nasal Drip 4. Otitis Media 5. Chronic Congestion
2.1.3.4. Obstructive Adenoid Hyperplasia
2.1.3.4.1. 1.Hyponasal voice 2. Rhinnorhea 3. CHronic nasal obstruction
2.1.4. Laryngitis
2.1.4.1. Acute Laryngitis
2.1.4.1.1. 1. Hoarseness 2. Aphonia 3. Stridor 4. Fever 5. Sore throat
2.1.4.2. Chronic Laryngitis
2.1.4.2.1. 1. Hoarseness Lebih dari 3 bulan 2. Aphonia 3. Stridor
2.1.4.3. Laryngeal neurologic problem
2.1.4.3.1. Abductor paralysis
2.1.4.3.2. Abductor paralysis
2.1.4.3.3. Combination
2.2. Tumors
2.2.1. Nose
2.2.1.1. Korpus Alienum / Benda Asing
2.2.1.1.1. Eksogen : masuk lewat nares anterios
2.2.1.1.2. Endogen : masuk dari dalam koana atau kavum nasi
2.2.1.2. Massa pada hidung atau nasofaring
2.2.1.3. Furunkel pada Hidung atau Abses Vestibulum Hidung
2.2.1.3.1. Peradangan pada vestibulum hidung yang berlanjut jadi abses
2.2.2. NAsofaring
2.2.2.1. Hidung
2.2.2.1.1. Polip, tumor
2.2.2.2. Nasofaring
2.2.2.2.1. Adenoid hipertrofi
2.2.2.2.2. Tumor benign
2.2.2.2.3. Angiofibroma
2.2.2.2.4. Tumor Ganas nasofaring
2.2.3. Larynx
2.2.3.1. Larynx Tumor / Malignancy
2.2.3.1.1. Benign
2.2.3.1.2. Carcinoma (Malignant)
2.2.3.2. Vocal Cord
2.2.3.2.1. Vocal Cord Nodule
2.2.3.2.2. Vocal Cord Polyp
2.2.3.2.3. Vocal Cord paralysis
2.3. Foreign body in the ear, nose , throat
2.3.1. Telinga
2.3.1.1. Otoscopy
2.3.2. Hidung
2.3.2.1. Nasal Congestion hanya pada satu sisi hidung
2.3.2.1.1. Anterior Rhinoscopy dan Nasoendoscopy
2.3.3. Tonsil dan lidah
2.3.3.1. Nyeri ketika menelan, dapat nunjuk lokasi
2.3.3.1.1. 1. Spatula lidah 2. Indirect/direct laryngoscopy
2.3.4. Larynx
2.3.4.1. 1. Sudden choking 2. Tidak bisa bernafas 3. Loss of voice
2.3.4.1.1. 1. Auscultation : Stridor 2. Laringoskopi
2.3.5. Esofagus
2.3.5.1. X ray dan fagoscopy
2.3.6. Traktus Trakeobronkial
2.3.6.1. Stridor dan Wheezing
3. Other disease
3.1. Pertussis in child
3.1.1. Definisi
3.1.1.1. Infeksi akut, sangat infeksius, dipanggil 100 days cough
3.1.1.2. disebabkan bordetalia pertussis, toxin, protactin
3.1.2. Clinical sign
3.1.2.1. Clinical Sign
3.1.2.1.1. Whooping cough
3.1.2.1.2. Spasmodic cough
3.1.2.1.3. Batuk terlihat intens dan keras wajah hingga memerah dan sianosis
3.1.2.1.4. paroksisimal : acute
3.1.2.1.5. Lymphositosis
3.1.3. Management
3.1.3.1. Ampicilin
3.1.3.2. Prevention
3.1.3.2.1. DPT atau DTAP
3.2. Diphteria
3.2.1. Definisi
3.2.1.1. Penyakit akut yang disebabkan oleh bakteri yang menimbulkan inflamasi pada membran mukosa membentuk PSEUDOMEMBRANE
3.2.1.1.1. Cornybacterium diphteria
3.2.2. Clinical Sign
3.2.2.1. Pseudomembrane
3.2.2.1.1. disentuh berdarah
3.2.2.2. Bull neck pembesaran kelenjar lymph
3.2.2.3. fever
3.2.3. Management
3.2.3.1. Penangan awal segera tanpa konfirmasi lab
3.2.3.2. Antibiotik
3.2.3.2.1. Procain
3.2.3.2.2. Penicilli
3.2.3.2.3. Metronidazol
3.2.3.2.4. Eritromycin
3.3. SARS-COV-2
3.3.1. Struktur
3.3.1.1. Spike glikoprotein
3.3.1.1.1. Untuk infeksius virion particle
3.3.1.2. Membrane Protein
3.3.1.3. Envelope glycoprotein
3.3.1.4. Nucleocapside protein Single stranded positive sense RNA Genome
3.3.1.5. Lipid Bilayer
3.3.2. Sifat virus
3.3.2.1. Droplet
3.3.2.2. bisa menjadi airborne bila dipecah menjadi partikel yang lebih kecil
3.3.2.2.1. aerosol
3.3.2.3. Virus ada 2 jenis
3.3.2.3.1. Antibody dependent
3.3.2.3.2. Non antibody dependent
3.3.3. Klasifikasi
3.3.3.1. Mild
3.3.3.1.1. No or Mild Pneumonia
3.3.3.2. Severe
3.3.3.2.1. Dyspenia Hypoxia 50% lung involvement
3.3.3.3. Critical
3.3.3.3.1. Respi failure shock mulitorgan dysfunction
3.3.4. Staging
3.3.4.1. Stage 1 Early infection
3.3.4.1.1. Mild constitutional symptoms Dry Cough Lymphophenia
3.3.4.2. Stage 2 Pulmonary Phase
3.3.4.2.1. Shortness of breath Hypoxia Abnormal Chest imaging Transaminitis Low normal procalcitonin
3.3.4.3. Stage 3 hyperinflamation
3.3.4.3.1. ARDS SIRS/SHock Cardiac Failure Elevated inflammatory markers
3.3.5. Diagnostic
3.3.5.1. RT PCR
3.3.5.1.1. Gold Standard
3.3.5.1.2. Rapid test - antigen detection
3.3.5.1.3. Serology dan culture
3.3.5.1.4. Other
3.3.5.1.5. Radiology
3.3.6. Patophysiology
3.3.6.1. 1. Spike glycoprotein berikatan dengan ace receptor
3.3.6.1.1. 2. endocytosis
3.3.6.1.2. 3. Uncoating di dalam cell
3.3.7. Jenis Pasien
3.3.7.1. Kasus Suspek
3.3.7.1.1. Gejala ISPA Riwayat Kontak
3.3.7.2. Kontak Erat
3.3.7.2.1. Tanpa gejala Riwayat Kontak
3.3.8. Management
3.3.8.1. Antibodies : Convalescent Plasma
3.3.8.2. Antiinflammatory
3.3.8.2.1. Dexamethasone
3.3.8.3. Anticoagulant
3.3.8.3.1. Mencegah coagulasi
3.3.8.4. Targeted immunotherapy
3.3.8.4.1. tocilizumab sarilumab anankira ruxolitin
3.3.8.5. Antifibrotics
3.3.8.5.1. Tyrosine Kinase Inhibitor