K6B1

Ramlah
27/4/1959
715026
DPJP: HY

K6 B2
ROSMAWATI
11/11/1991
715811
MRS : 24/11/2015
DPJP : DJF

Ca mammae dextra
Post rehecting
(23/11)
Rencana kemoterapi

Soft Tissue Sarcoma

Dextra
Efusi Pleura Dextra
POH 5 Chest tube

Lab 18/11/15
WBC 7.73
RBC 3,28
Hb 9,2
HCT 27,3
PLT 396
GDS 104
Ur/Cr 15/0,60
SGOT/SGPT 30/22
Alb 3,2
As urat 5,0
Na/K/Cl 132/3,5/100
Lab 21/11/15
PT/APTT/INR 9,8/26,2/0,94
Lab 27/11/2015
Wbc 7.7
RBC 4,29
HB 12,3
HCT 36,5
PLT 282
PT 9,9
APTT 25,9
INR 0,9
GDS 104
Ur/Cr 23/0,6
GOT/GPT 23/9
Na/K/Cl 136/4,1/104
As.Urat 4,2
Foto pelvis (AP) 20/11/15
Tumor metastase ke tulang disertai
fraktur patologis ramus superios
ossis pubis sinistra
LAB 26/11/2015
WBC 9,2
RBC 3,76
Hb 10,8
HCT 32,4
PLT 337
Foto Thorax 24/11/2015
-Efusi Pleura Massive Dextra
-Suspek tumor metastasis ke paru
-soft tissue mass extrathoracal
dextra

Cefadroxyl 500
mg/12jam / oral
Ranitidin 50 mg/ 12
jam/ oral
Asam mefenamat 500
mg/ 8 jam/ oral
rencana kemoterapi
(Hari senin)
GV + rawat luka

IVFD RL 20 tpm
Ketorolac
30mg/8jam/iv
Ranitidin
50mg/8jam/iv
Rencana
kemoterapitunggu
diskusi keluarga

K6 B3
Hamsina
721454
30/12/1957
MRS 27/11/2015
DPJP: DJF

CA MAMMAE
SINISTRA

K6 B4
Andi Nuraeni
732818
14/11/1955
MRS 27/11/15

Tu buccal

DPJP : SPT

Lab 23/11/15
Wbc 5,4
Rbc 3,53
Hb 10,5
Hct 32
Plt 311
Ur Cr 14/0,50
GOT/GPT 18/12
As urat 6,5
Na K Cl 143/4,2/107
Lab 2/11/15
Wbc 5,4
Rbc 4,73
Hb 12,5
Hct 32
Plt 325
Ur Cr 16/0,70
GOT/GPT 18/12
Albumin 3,9
Na K Cl 143/4,2/107
Lab 12/11/2015
WBC 5,36
RBC 4,73
Hb 12,5
HCT 38,5
PLT 325
PT/APTT 10,5/27,1
INR 0,99
GDS 140
Ur/Cr 16/0,7
GOT/GPT 19/9
Albumin 3,9
Na/K/Cl 145/3,8/110
CT kepala 3D tanpa kontras
16/11/15
Massa jaringan lunak regio
mandibula sisi kanan yg
mendestruksi sisi anan dan
mendesak lingua ke kiri
Foto thorax 17/11/15
Cardiomegali dgn tanda
bendungan paru
Atherosklerosis aortae

-Rencana Pro MRM

(SENIN)

-Rencana biopsi insisi

(SELASA)
-Diet bebas

Tidak tampak tanda metastasis