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Skenario A Blok 8

Skenario
Miss A 36 years old. Her BW is 85 kg and height is 165 cm. Since a month
ago, she always exercises (aerobic, running and swimming) around 2
hours (one hour in the morning and one hour in evening), and she does
not eat fat and protein, she only eat fruits and vegetables and a little rice.
She also drinks slimming tea everyday 2-3 cups, her BW decreases 10 kg
a months (formerly her BW = 95 kg). Now she always feels tired and
always suffers from common cold.
Both of her parents are obese. She went to a family doctor for
consultation. The result of Physical exams : BP : 140/90 mmHg ; RR =
26X/minute ; Pulse rate 100X/minute
The doctor asked her to check up the blood in laboratory
The result : Hb : 9,7 g/dl, MCV = 75 fl MCH = 26 pg
Ureum : 50 mg/dl, creatinine 1,1 mg/dl ; uric acid : 5 mg/dl
BSN : 80 mg/dl, HbA1c : 5%
Total kolestrol : 80 mg/dl, HDL : 60 mg/dl , LDL : 60 mg/dl, trigliserida : 90
mg/dl
Na (sodium) : 115 meq/L ; K (potassium) : 2 meq/L
The doctor diagnoses Miss A with Hypochromic Microcytic Anemia with
hypopotasium and hyponatremia ec drastically reducing body weight.

II

Klarifikasi Istilah
a Exercises :
b Slimming tea : teh yang khusus untuk melangsingkaan tubuh
(mengandung laksatif (memperlancar buang air besar) dan diuretic).
c Common cold : demam yang disebabkan oleh infeksi virus yang
menyerang traktus respiratorius bagian atas yaitu hidung dan
tenggorokan
d Tired : kehilangan kemampuan atau tenaga untuk merespon stimulus
e Obese : berat badan melebihi indeks massa tubuh
f Hb : metaloprotein pada sel darah merah yang membawa oksigen dari
paru-paru ke seluruh tubuh.
g MCV : Mean Corpuscular Volume ;adalah volume corpuscular (badan
sel) rata yaitu ukuran dari volume sel darah merah rata-rata sebagai
data darah lengkap
h MCH : Mean Corpuscular Hemoglobin ; adalah masa hemoglobin ratarata dalam satu sel darah merah
i Hypochromic microcytic anemia : suatu jenis anemia yang sel darah
merahnya di dalam sirkulasi berukuran lebih kecil dari normal dan
hemoglobin berkurang.
j Hypopotasium : kondisi saat level kalium di dalam darah kurang dari
normal.

III

Hyponatremia : kondisi saat level natrium di dalam darah kurang dari


normal.

Identifikasi Masalah
a Miss A 36 years old. Her BW is 85 kg and height is 165 cm. her BW
decreases 10 kg a months (formerly her BW = 95 kg). Both of her
parents are obese.
b Since a month ago, she always exercises (aerobic, running and
swimming) around 2 hours (one hour in the morning and one hour in
evening), and she does not eat fat and protein, she only eat fruits and
vegetables and a little rice. She also drinks slimming tea everyday 2-3
cup. Now she always feels tired and always suffers from common cold.
c She went to a family doctor for consultation. The result of Physical
exams : BP : 140/90 mmHg ; RR = 26X/minute ; Pulse rate
100X/minute. The doctor asked her to check up the blood in laboratory
The result : Hb : 9,7 g/dl, MCV = 75 fl MCH = 26 pg
Ureum : 50 mg/dl, creatinine 1,1 mg/dl ; uric acid : 5 mg/dl
BSN : 80 mg/dl, HbA1c : 5%
Total kolestrol : 80 mg/dl, HDL : 60 mg/dl , LDL 60 mg/dl, trigliserida :
90 mg/dl
Na (sodium) : 115 meq/L ; K (potassium) : 2 meq/L

IV

Analisis Masalah
a Miss A 36 years old. Her BW is 85 kg and height is 165 cm. her BW
decreases 10 kg a months (formerly her BW = 95 kg). Both of her
parents are obese.
A. Bagaimana penghitungan BMI ?
B. Bagaimana BMI Miss A sekarang dan sebulan yang lalu?
C. Berapa banyak kalori yang dibutuhkan Miss A dalam 1 hari ?
D. Aktifitas ringan, sedang dan berat ?
E. Apa saja faktor penyebab obesitas ?
b

Since a month ago, she always exercises (aerobic, running and


swimming) around 2 hours (one hour in the morning and one hour in
evening), and she does not eat fat and protein, she only eat fruits and
vegetables and a little rice. She also drinks slimming tea everyday 2-3
cup. Now she always feels tired and always suffers from common cold.
A. berapa banyak kalori yang hilang saat exercise selama 2 jam ?
B. Apa kaitan tidak makan lemak dan protein dengan kasus?
C. Berapa kalori buah, sayur dan sedikit nasi ?
D. Apa kaitan minum slimming tea dengan kasus?
E. Apa penyebab munculnya tired dan common cold ?

She went to a family doctor for consultation. The result of Physical


exams : BP : 140/90 mmHg ; RR = 26X/minute ; Pulse rate
100X/minute. The doctor asked her to check up the blood in laboratory
The result : Hb : 9,7 g/dl, MCV = 75 fl, MCH = 26 pg
Ureum : 50 mg/dl, creatinine 1,1 mg/dl ; uric acid : 5 mg/dl
BSN : 80 mg/dl, HbA1c : 5%
Total kolestrol : 80 mg/dl, HDL : 60 mg/dl , LDL 60 mg/dl, trigliserida :
90 mg/dl
Na (sodium) : 115 meq/L ; K (potassium) : 2 meq/L

A. Bagaimana interpretasi pemeriksaan fisik ?


B. Bagaimana interpretasi pemeriksaan lab ?
V

Learning Issue
a Anabolisme karbohidrat
b Katabolisme karbohidrat
c Gluconeogenesis
d