Group 27 D

Putri Ramadhani 1210311001 Fitri Yani 1210312001 Suci

SKENARIO 1 : PAK PESTO DAN PEKERJAANNYA

Pak Pesto,56 tahun, seorang petani palawija datang ke puskesmas dengan keluhan sering mencret sejak 1 tahun yang lalu. Pak Pesto bercerita bahwa dia sering merasa sakit perut disertai mual dan muntah terutama sesudah menyemprot tanamannya dengan pestisida. Hal ini terjadi berulang kali dan hanya diatasi dengan minum obat tradisional. Pak Pesto juga mengeluh mudah sakit-sakitan walau hanya terkena angin dan gerimis sedikit saja. Enam bulan yang lalu Pak Pesto pernah mengalami nyeri dada yang menjalar ke leher dan lengan kiri, terasa seakan tertindih benda berat. Nyeri berkurang setelah pak Pesto beristirahat. Sejak sebulan yang lalu buang air kecil juga tidak lancar. Pada pemeriksaan fisik ditemukan kesadaran komposmentis, kooperatif, BB 45 kg, TB 170 cm, konjungtiva anemis, sklera subikterik. Kulit wajah banyak bercak-bercak hitam. Pemeriksaan toraks ditemukan tanda kardiomegali. Ditemukan pula limfadenopati di regio colli sinistra,1 buah, diameter 1 cm dan mobile. Pemeriksaan rectal toucher ditemukan pembesaran prostat. Dokter menyarankan untuk melakukan pemeriksaan penunjang seperti rontgen foto, EKG dan biopsi aspirasi. Dokter Puskesmas merasa prihatin dengan keadaan Pak Pesto, dia teringat dengan hal yang dipelajarinya dulu tentang perubahan pada sel akibat pengaruh berbagai agen atau sebagai mekanisme adaptasi seperti yang dialami oleh Pak Pesto. Bagaimana anda menjelaskan apa yang terjadi pada Pak Pesto?

terminology
Pesticides: Pest = pests, Sida = murder, all materials chemicals or bacteria or virus used to eradicate pests 2. Komposmentis cooperative: fully conscious can follow instructions well and can respond to stimuli from outside and from within. Clear minded, reacted immediately with the perfect cover-oriented place, time, and person. 3. Anemic conjunctiva: a state that is pale eye conjunctiva. 4. Sclera subikterik: slightly yellow-colored sclera 5. Cardiomegaly: an enlarged heart due to thickening of the heart muscle or enlargement of the heart chambers. 6. Lymphadenopathy: disease enlarged lymph nodes in both the size, consistency and amount of cell mass. 7. Mobile: moving 8. Toucher rectal (rectal): internal rectal examination by inserting a finger (index finger) into the rectum. 9. Regio Colli Sinistra: left neck area 10. Aspiration biopsy: taking a small portion of tissue for microscopic examination using a fine needle.
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Why Mr. Pesto frequent diarrhea since 1 year ago? Why pesticides can cause abdominal pain, nausea and vomiting? How the effects of traditional drugs taken Mr. Pesto? Why Mr. Pesto get sick? Why pee is not fluent Pak pesto? why Mr. Pesto experiencing chest pain radiating to the neck and left arm? why the pain has subsided after Mr. Pesto rest? why cardiomegaly could happen to Mr. Pesto? why Mr. Pesto skinny?

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why Mr. Pesto suffer lymphadenopathy? why Mr. Pesto experiencing anemic conjunctiva, sclera subikterik and dark patches on her face? why Mr. Pesto have an enlarged prostate? how the relationship cardiomegaly with chest pain Pak Pesto? how the cell changes due to various influences agent? how aspiration biopsy in Pak Pesto? what is the function of X-ray photos examination, ECG and aspiration biopsy? adaptation mechanisms how cells perform? Any agent who is able to affect change in the cell?

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Pesticides can cause irritation of the intestinal tract so that the excretion of water, electrolytes and mucosal lot, then an increase in intestinal motility so can diarrhea. pesticides: organosfosfat that can cause diarrhea : Arsenic, carbamates, organokolon => poisoning => diarrhea pesticides => EXOGENOUS Endogenous: age = decrease in cholinesterase enzyme and decreased intestinal motility gender = enzyme cholinesterase in males slightly

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Because organophosphates => cholinesterase enzyme inhibitory (modifier acetylcholine => acetate + choline) => acetylcholine + => + muskorinik and nicotinic => Central nervous system => poisoning => nausea, vomiting and salivation Traditional medicine: symptomatic = symptomatic or supportive course 1. Herbal Remedies: no side effects, has not been extracted and tested 2. Standardized herbal medicine: is extracted and tested 3. fitofarmaka: already extracted and tested

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4. - There are chemicals in pesticides that affect the immune system so that infections occur easily, and get sick more easily and more dangerous impact -weight is too small and a little food intake (due to nausea and vomiting) age-old factor 5. due to the narrowing of the enlarged prostate urination impaired + 12. hormonal effects of pesticides and disrupted the reproductive hormone. decreased androgen and testosterone increases resulting cell hyperplasia which is an adaptation hypertrophy: cardiac cells: cell frame and nerve cells (permanent) hyperplasia: the cell is not permanent

6 + 7 + 13 chest pain can be due disebkan 1. heart: angina pectoris, cardiomegaly and myocardial infarction 2. G I tract
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- Pesticides can increase heart rhythm so the heart is heavier, larger myocardial cells is an adaptation of heart muscle cells. - Pesticides can inhibit blood vessel - Trichloro ethylene can disrupt heart rhythms will respond so that there will be a stimulus cells and pathological enlargement of the heart muscle cells occurs => pathological hypertrophy physiological hypertrophy: when pregnant
- Lymphadenopathy can cause weight loss of less than 10% - Pattern of appetite due to pesticide - Nausea and vomiting - diarrhea age-factor - Traditional medicine (not bad)

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10. destructive pesticides contain carcinogens, maintained by the immune system and can affect the lymph 11. - The conjunctiva anemis: in pesticide containing benzene which can damage red blood cells, causing hemolytic anemia. red blood cells quickly dilisis, bilirubin so much into the sclera sclera become yellow - Sclera subikterik: Urination is not smooth, bilirubin lot, look at the eyes. - Black spot: exposure to direct sunlight (damaging the epidermis), pesticides can damage skin pigmentation, age. 14 + 18 agents Physics, Chemistry and Biology 15. tumor cells in the diseased organ 16. ECG and chest X-ray photograph to see contraindications and indications cardiomegaly 17. if the cells get stressed it will be handled by the immune cells. If the stress is more severe, causing cell death.

Learning Objective :