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    Mengapa Didapatkan Keluhan Sakit Kepala Dan Panas Tinggi?: LBM 5 Demam Dan Kejang

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    Vivie Tirany Soediro
    This document discusses a patient presenting with high fever and seizures. It provides 14 questions about the case including: 1) Why the patient has headache and high fever; 2) How infection occurs in the CNS; 3) Types of CNS infections; 4) Why the patient is sleepy and unable to wake; 5) Why the patient had a 5 minute seizure and remained unconscious; 6) Relationship between the patient's condition and ear drainage; 7) Why the patient has coma, high fever and neck stiffness; 8) Indications and contraindications for lumbar puncture; 9) Clinical signs and symptoms; 10) Physical exam and diagnostic tests; 11) Differential diagnosis and diagnosis; 12) Pathophysiology,

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    Mengapa Didapatkan Keluhan Sakit Kepala Dan Panas Tinggi?: LBM 5 Demam Dan Kejang

    Uploaded by

    Vivie Tirany Soediro
    30 views14 pages
    This document discusses a patient presenting with high fever and seizures. It provides 14 questions about the case including: 1) Why the patient has headache and high fever; 2) How infection occurs in the CNS; 3) Types of CNS infections; 4) Why the patient is sleepy and unable to wake; 5) Why the patient had a 5 minute seizure and remained unconscious; 6) Relationship between the patient's condition and ear drainage; 7) Why the patient has coma, high fever and neck stiffness; 8) Indications and contraindications for lumbar puncture; 9) Clinical signs and symptoms; 10) Physical exam and diagnostic tests; 11) Differential diagnosis and diagnosis; 12) Pathophysiology,

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    This document discusses a patient presenting with high fever and seizures. It provides 14 questions about the case including: 1) Why the patient has headache and high fever; 2) How infection occurs in the CNS; 3) Types of CNS infections; 4) Why the patient is sleepy and unable to wake; 5) Why the patient had a 5 minute seizure and remained unconscious; 6) Relationship between the patient's condition and ear drainage; 7) Why the patient has coma, high fever and neck stiffness; 8) Indications and contraindications for lumbar puncture; 9) Clinical signs and symptoms; 10) Physical exam and diagnostic tests; 11) Differential diagnosis and diagnosis; 12) Pathophysiology,

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    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    30 views14 pages

    Mengapa Didapatkan Keluhan Sakit Kepala Dan Panas Tinggi?: LBM 5 Demam Dan Kejang

    Uploaded by

    Vivie Tirany Soediro
    This document discusses a patient presenting with high fever and seizures. It provides 14 questions about the case including: 1) Why the patient has headache and high fever; 2) How infection occurs in the CNS; 3) Types of CNS infections; 4) Why the patient is sleepy and unable to wake; 5) Why the patient had a 5 minute seizure and remained unconscious; 6) Relationship between the patient's condition and ear drainage; 7) Why the patient has coma, high fever and neck stiffness; 8) Indications and contraindications for lumbar puncture; 9) Clinical signs and symptoms; 10) Physical exam and diagnostic tests; 11) Differential diagnosis and diagnosis; 12) Pathophysiology,

    Copyright:

    © All Rights Reserved
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    of 14

    LBM 5

    Demam dan Kejang

    Step 7

    1. Mengapa didapatkan keluhan sakit kepala dan panas tinggi?


    Sumber : Color Atlas Pathophysiology Thieme

    2. Bagaimana mekanisme infeksi pada SSP ?


    3. Macam – macam infeksi pada SSP ?

    4. Mengapa pasien tampak mengantuk terus dan pagi ini penderita tidak dapat di
    bangunkan?
    Sumber : Color Atlas Pathophysiology Thieme

    5. Mengapa di Igd pasien mengalami kejang kurang lebih 5 menit dan setelah kejang
    penderita tetap tidak sadar? Patfis, etiologi kejang?
    6. Apa hubungan penyakit penderita dengan keluhan penderita sering sakit telinga dan
    keluar cairan sejak 1 thun terakhir?
    Sumber : Netter’s Neurology

    7. Mengapa didapatkan kesadaran koma, dan suhu tinggi, dan kaku kuduk positif?
    8. Indikasi dan kontraindikasi di lakukan lumbal pungsi ?
    9. Gejala klinis dari skenario?

    Symptom Sign Mechanism

    Chills, rigors Fever (T>38°) Endogenous cytokines (released during


    the immune response to the invading
    pathogens) affect the thermoregulatory
    neurons of the hypothalamus, changing
    the central regulation of body
    temperature.

    Invading viruses or bacteria produce


    exogenous substances (pyrogens) that
    can also re-set the hypothalamic
    thermal set point.
    Nuchal Brudzinski sign and Flexion of the spine leads to stretching
    rigidity(neck Kernig sign of the meninges.
    stiffness)
    In meningitis, traction on the inflamed
    meninges is painful, resulting in limited
    range of motion through the spine
    (especially in the cervical spine).

    Altered Decreased Glasgow ↑ ICP → brain herniation → damage to


    mental status Coma Scale (GCS) the reticular formation (structure in the
    brainstem that governs consciousness)

    Focal Examples: cranial nerve Cytotoxic edema and ↑ ICP lead to


    neurological palsies, hemiparesis, neuronal damage.
    deficits, e.g. hypertonia, nystagmus
    vision loss Signs or symptoms depend on the
    affected area (cerebrum, cerebellum,
    brainstem, etc.)

    Seizures Inflammation in the brain alters


    membrane permeability, lowering
    the seizure threshold. Exact seizure
    pathophysiology is unknown.

    Headache Jolt accentuation of Bacterial exotoxins, cytokines, and ↑


    headache: headache ICP stimulate nociceptors in the
    worse when patient meninges (cerebral tissue itself lacks
    vigorously shakes head nerve endings that generate pain
    sensation).

    Photophobia Due to meningeal irritation.


    Mechanisms unclear; pathways are
    thought to involve the trigeminal nerve.

    Nausea and ↑ ICP stimulates the area


    vomiting postrema (vomiting centre), causing
    nausea and vomiting.

    Petechial rash Meningococcemia (due to N.


    meningitidis)

    10. Pemeriksaan fisik dan penunjang ?


    11. DD dan diagnosis ?
    12. Patofisiologi, patogenesis, etiologi dan faktor resiko ?
    13. Penatalaksanaan dari diagnosis?
    14. Komplikasi dari diagnosis?

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