study guide infection semester iii 11 nov 2014

8/9/2019 Study Guide Infection Semester III 11 NOV 2014

http://slidepdf.com/reader/full/study-guide-infection-semester-iii-11-nov-2014 1/59

Study Guide Infection and Infectious Diseases

CONTENTS

Table of contents ………..……………………………………………………………. 1

Introduction ……………………………………………………………………………………. 2

Curriculum ……………………………………………………………………………………… 3

Block Team ………………………………………………………………………................... 7

Facilitators ……………………………………………………………………………………… 9

Time Table Regular Class …………………………………………………………………… 1

Time Table !nglis" Class …………………………………………………………………….. 1

#eeting of $tudents re%resentati&es ………………………………………………………… 2

#eeting of T"e Facilitators…………………………………………………………………. 2

'ssessment met"od …………………………………………………………………………... 2

(earning )rogram …………………………………………………………………………….. 2*

(ecture …………………………………………………………………………………. 2*

(earning Task and $elf 'ssessment……………………………………………………. 2*

Curriculum #a%%ing …………………………………………………………………………... *7

Reference ……………………………………………………………………………………… *+

Facult, of #edicine --/0#!- 1




INTRODUCTION

/ue to t"e a%%lication of integrated curriculum at t"e Facult, of #edicine -da,ana

-ni&ersit,0 t"e disci%linebased subects of t"e %re&ious curriculum suc" as Biolog,0 'natom,0 )",siolog,0 Internal #edicine0 etc "a&e been integrated and incor%orated intose&eral blocks. ne of t"ese blocks is Infections and Infectious /iseases. In t"is block 4illbe e5%lained in general about %at"ogenesis0 %at"o%",siolog,0 sign0 s,m%toms0 clinicalfeatures0 diagnosis0 and management of certain infectious diseases commonl, occur incommunit,.

T"is guide book aims to gi&e general information for medical students about infectionsand infectious diseases and im%ortant for facilitators and resource %erson 4"ile facilitate or guiding t"e students in learning %rocess. T"is stud, guide consists of general information onlearning time table0 block team members0 facilitators0 and t"e core curriculum includinglearning outcomes0 learning situations0 learning tasks and selfe&aluation items.

T"e block Infection and Infectious /iseases "as t"e e6ui&alent of si58 credits. 's ablock of si5 credits0 t"e learning %rocesses 4ill be carried out for 3 da,s starts from 27 t" ofo&ember 213 as s"o4n in t"e Time Table. T"e final e5amination 4ill be conducted on 13 t"

of unuari 21:. /uring t"e 3 da,s of learning acti&ities0 t"e students 4ill discuss se&eralto%ics in &aried forms of learning situations suc" as inde%endent learning0 small grou%discussion0 lecture0 and skill lab.

#ore t"an "alf of t"e learning material must be learned inde%endentl, and in smallgrou% discussions. ' lecture is gi&en onl, to em%"asi;e crucial t"ings or obecti&es of material and to %re%are t"e students before discussion. For small grou% discussion0 t"estudents 4ill be gi&en learning tasks to sol&e and discuss. 'fter discussion0 students also"a&e to e&aluate t"eir learning %rogress inde%endentl, self evaluation8.

From t"is block0 4e "o%e e&er, medical student "a&e kno4ledge and skill to diagnoseand manage infections and certain infectious diseases commonl, occur in communit,0 as afrontline in communit, "ealt".

$ince t"e integrated curriculum of t"e Facult, of #edicine -da,ana -ni&ersit, is still in%rogress0 t"is $tud, <uide 4ill also0 naturall,0 "a&e some re&isions in t"e future. T"erefore04e kindl, in&ite readers to gi&e an, comments or suggestions for its im%ro&ement andde&elo%ment.

)lanners





CURRICULUM OF THE BLOCK

AIMS

♣ To com%re"end t"e biolog, of t"e infectious diseases

♣ To a%%l, and inter%ret common laborator, diagnosis of infectious diseases

♣ To diagnose and manage common infectious diseases

♣ To carr, out basic immuni;ation in c"ildren and adults

LEARNING OUTCOMES

Com%re"end t"e %ractical and clinical im%lications of t"e biolog, of infection

'%%l, t"e general %rinci%les of a%%roac" to %atients 4it" infectious diseases

'%%l, and inter%ret common laborator, diagnosis of common infectiousdiseases

'%%l, t"e basic %rinci%les of immuni;ation in c"ildren and adults

/iagnose and manage common bacterial infections common <ram %ositi&e

and negati&e0 s%iroc"etal8

/iagnose and manage common %arasitic infections common nematode0

trematode0 cestode0 and %roto;oal infections8

/iagnose and manage common fungal infections

Clinicall, diagnose and manage common &iral infections caused b, common

res%irator, &irus0 "er%es&irus0 arbo&irus8

Clinicall, diagnose and manage %uer%erial Infection

CURRICULUM CONTENT

1. T"e biolog, of infection= bacterial0 &iral0 fungal and %arasitic.

a. )rinci%les of bacterial infections suc" as Staphylococci, Streptococci,Neisseria, Salmonella, Vibrio, anaerobic bacteria> Leptospira, Mycobacteria,<ram %ositi&e bacilli8

b. )rinci%les of &iral infections suc" as res%irator, &irus influen;a &irus0

mum%s0 measles80 retro&irus ?I@80 "er%es&irus ?$@ 10 ?$@ 20 @A@0arbo&irus dengue &irus0 a%anese B ence%"alitis &irus8.

c. )rinci%les of fungal infections suc" as Candida, Pneumocytis jiroveci,Histoplasma, Cryptococcus

d. )rinci%les of %arasitic infections suc" as Plasmodium, Tooplasma !ondii,"ntamoeba histolytica and soil transmitted "elmint"es.

2. <eneral a%%roac" to t"e %atients 4it" infection suc" as=

a. Clinical manifestations local and s,stemic infections8

b. (aborator, e5amination to su%%ort diagnosis of infections i.e. #icrobiological

e5amination0 )arasites e5amination0 Clinical %at"olog, e5amination0)at"olog, e5amination and Imaging e5amination





3. #anagement %atients 4it" infection suc" as=

a. Common bacterial infections suc" as bacterial meningitis0 t,%"oid fe&er0

diarr"ea0 endocarditis0 di%"t"eria0 tetanus0 food %oisoning0 genital

gonorr"oeae0 non gonococcal uret"ritis0 etc.

b. Common %arasitic infections suc" as malaria0 amoebiasis0 to5o%lasmosis.

c. Common fungal infection suc" as dermato%",tosis0 s,stemic candidiasis0

"isto%lasmosis0 cr,%tococcosis0 %neumoc,tis iro&eci %neumonia.

d. Common &iral infections suc" as mum%s0 measles0 influen;a es%eciall,

?*180 $'R$0 &aricella0 "er%es labialis0 "er%es genitalis0 dengue fe&er0

a%anese B ence%"alitis0 and ?I@.

:. Immuni;ation in c"ildren and adults0 and general ad&ice to international tra&eler

*. )uer%erial Infection





STANDAR KOMPETENSI DOKTER





PLANNERS TEAM

No Name Departement Phone

1)rof. /r. dr. Tuti )ar4ati #erati0 $%)/0)TI Coordinator8

Internal #edicine+123+2

2/r. dr. Bagus omang $atri,asa0#.Re%ro $ecretar,8

)"armacolog,+12371+

3/r. dr. /e4a #ade $ukrama0 #.$i0$%#

#icrobiolog, +133+2919*

: )rof. /r. dr. Raka $ude4i0 $%.$ 8 eurolog, +1712::

* dr. I< /armada0 $%/ermatolog, and

@enereolog,+133+::921

dr. I.B. gura"0 #.For )"armacolog, +123+72++

7 dr. 'gus $omia0 $%.)/ Internal #edicine +1239+93*3

+ dr. #ade $udarmaa0 #.es )arasitolog, +1239*39:*

LECTURER

NO NAME DEPT PHONE

1)rof. /r. dr. Tuti )ar4ati #erati0 $%)/0)TI

Internal #edicine+123+2

2 )rof./r. dr. Raka $ude4i0 $%.$ 8 eurolog, +1712::

3 )rof./r.dr. I.B. Rai0 $%) 8 )ulmonolog, +123+:*79

: dr. 'gus $omia0 $%)/ Internal #edicine +1239+93*3

* dr. '.'.<.). Diraguna0 $% /ermatolog, E@enereolog,

+133+:*2++

)rof.dr. #. $4astika 'diguna0 $% 8/ermatolog, E@enereolog,

+123+2+*:+

7 dr. I<'. $umed"a )ind"a0 $% 8/ermatolog, E@enereolog,

+1**73*977

+dr. /4i (ingga0 $%' 8dr D.<usta4an0#.$c.0 $%.'

C"ild ?ealt"+12*+:*+123+:+2:1

9dr. I<. /armada0 $% dr. /arma%utra0$%.

/ermatolog, E@enereolog,

+133+::921

1 dr. i #ade 'ditarini $%. # #icrobiolog, +133+7*3::

11 dr. (u" 'ri4ati )arasitolog, +1232311

12 dr. ,oman #a"artini0 $%) Clinical )at"olog, +13371**77

13 dr. I.B. gura"0 #. For )"armacolog, +123+72++

1: /r. dr. Bagus omang $atri,asa0 #.Re%ro )"armacolog, +12371+

1* dr. adek $4astika0 #.es )arasitolog, +12::92

1)rof. dr./e4a )utu Didana0 /')E!0$%.)ar.

)arasitolog, +113+:*

17 )rof. dr. I<#. 'man0 $%F )"armacolog, +133+77*

1+ dr. $ri Buda,anti0 $%.# #icrobiolog, +*+371139+

19 dr./e4a ',u '. $ri (aksmi0#.$c )arasitolog, +13921717

2 dr. #ade $usila -tama0 $%.)/ Internal #edicine +123+1*2*





21 dr.#ade 'gus ?endra,ana0 #.ed #icrobiolog, +123921*9

22 dr.(el, Ra"a,u0 $%.T?T( !T +113+9++2

23dr. I <usti #ade $ur,a Candra Tra%ika0

#.$c

)"armacolog, +1337991177

2: dr. . anuart"a0 #.es #icrobiolog, +123+3171

2* dr. #ade a4i0 #.es )"armacolog, +1797+7972

2 dr. I ,oman Ba,u #a"endra0$%.<bstetrics E<,necolog,

+1339**:23

27 I.B. ,oman )utra /4ia0 $.$i0 #.Biotec" #icrobiolog, +1797:7*2

2+ dr.)utu ',u 'sri /ama,anti0#.es )arasitolog, +*33+**7+3

29 dr.#ade $udarmaa0#.es )arasitolog, +1239*39:*





~ FACILITATORS ~

REGULAR CLASS

NO NAME GROUP DEPT PHONE VENUE1

dr. #ade Did"i 'si"0 $%.Rad1

Radiolog, +191::223nd floor=R.3.1

2dr. #uliani 0 # Biomed

2 'natom, +1239377

3nd floor=R.3.2

3dr. i <usti ',u )utri #a,uni0 $.ed

3 'ndrolog, +19331133

3nd floor=R.3.3

:dr. ,oman $ur,a4ati 0 #.es0 $%.

:/ermatolog, +17::7279

3nd floor=R.3.:

*dr. i (u" 'ri4ati

*)arasitolog, +1232311

3nd floor=R.3.*

dr. i (u" )utu Rati" @ibri,anti arna0

$%.

/ermatolog, +1337+++::

3nd floor=

R.3.7

dr. i #ade 'di Tarini0 $%.#7

#icrobiolog, +133+7*3::3nd floor=R.3.7

+ dr. i #ade /e4i /ian $ukma4ati0$%.)/

+Interna +1+***1

3nd floor=R.3.+

9dr. I <.'. Inda" 'rdani0 $%.

9)s,c"iatr, 31 G ++1::

3nd floor=R.3.2

1 dr. i enga" /4i Fatma4ati 0$%.#0 )"./

1#icrobiolog, +7+22+1:

3nd floor=R.3.21

11dr. i ,oman #argiani0 $%.Rad

11Radiolog, +1337:12:

3nd floor=R.3.22

12dr. i )utu $ri4id,ani 0 $%.)'

12 'natom,)at"olog,

+133711*123nd floor=R.3.23

ENGLISH CLASS

NO NAME GROUP DEPT PHONE VENUE1 dr. I <usti #ade <de $ur,a C"andra

Tra%ika 0 #.$c1

)"armacolog, +13379911773nd floor=R.3.1

2 dr. 'nak 'gung Dirade4i (estari 0 $%)

2 Clinical)at"olog,

+1**2379373nd floor=R.3.2

3dr. ,oman )aramita ',u0 $%.)/

3Interna +123+37372

3nd floor=R.3.3

:dr. i adek #ul,antari 0 $% )

: Clinical)at"olog,

+123:7:133nd floor=R.3.:

*dr Da,an Citra Dulan $uci%ta )utri

*)ublic ?ealt" +21:*1731

3nd floor=R.3.*

dr. '.'.gura" $uba4a 0 #si

Clinical)at"olog,

+1**73*3:3nd floor=R.3.

7 /r. dr. Bagus omang $atri,asa0#.Re%ro

7)"armacolog, +12371+

3nd floor=R.3.7

+dr. )ontisoma,a )arami0 $%.'n

+ 'nast"esi

+1231312+113+17

3nd floor=R.3.+

9 dr. )rati"i4i )rimad"arsini0 #.Biomol0$%.)/

9Interna +1+**319

3nd floor=R.3.2

1dr. )utri 'riani0 $%.

1)s,c"iatr, +123+397

3nd floor=R.3.21

11dr. I <usti ',u Didianti 0 #.Biomed

11 'natom, +1239217*

3nd floor=

R.3.2212

dr. i )utu $ri 4id,ani 0 $%.)'12 'natom,

)at"olog,+*33+**7+3

3nd floor=R.3.23





TIMETABLE !B"o#$ In%e#t&on an' &n%e#t&o() D&))*+

DAY/ DATETime

Topic Learning

situation Place PIC

RegularClass

EnglishClass

,

T(e)'a-No.* ,,th ,/

+.+.3 9.9.3 Le#t(re ,Intro'(#t&on to the0"o#$ !A1ent 2Ho)tEn.&ronment2 an'&n%e#t&onman&%e)tat&on+

Introduction tot"e Block

Class room )rof. /r. dr. Tuti)ar4ati #erati0$%)/0 )TI

+.39. 9.31. Le#t(re 3 0a#ter&a"#"a))&%&#at&on

dr. . anuarta0#.es

9.1.3 12.13.3 Indi&iduallearning

1.312. 13.31*. $mall grou%discussion

/isc. Room Facilitator

12.31:. 1.11.3 $tudent)roect

)rof. /r. dr. Tuti)ar4ati #erati0$%)/0 )TI dr. .anuarta0 #.es

1:.1*. 1*.1. )lenar,$ession

Class room )rof. /r. dr. Tuti)ar4ati #erati0$%)/0 )TI dr. .anuarta0 #.es

3

4e'ne)'a-No.* ,3th ,/

+.9. 9.1. Le#t(re 5 Me#han&)m o%

0a#ter&a"Patho1ene)&)

Le#t(re Class room dr. 'gus?endra,ana0 #.ed


1.312. 13.31*. $mall <rou%/iscussion

12.31:. 1.11.3 $tudent)roect

ClassRoom

dr. 'gus?endra,ana0 #.ed

1:.1*. 1*.1. )lenar, ClassRoom

dr. 'gus?endra,ana0 #.ed

5

Th(r)'a-No.* ,5th,/

+.+.3 9.93. Le#t(re /V&ra" #"a))&%&#at&on

Le#t(re ClassRoom

/r. dr. $riBuda,anti0 $%.#

+.39. 9.31. Le#t(re 6

Me#han&)m o% V&ra"Patho1ene)&)

Le#t(re Class room /r.dr. $ri Buda,anti0

$%.#

9.1.3 12.13.3 Indi&idual(earning


/isc. Room

12.31:. 1.11.3 $tudent)roect

/r. dr. $riBuda,anti0 $%.#

1:.1*. 1*.1. )lenar, Class room /r. dr. $riBuda,anti0 $%.#

/ +.+.3 9.93. Le#t(re 7Man&%e)tat&on o% .&r()

Le#t(re ClassRoom

dr.'gus somia0$%.)/





DAY/ DATETime

Topic Learning

situation Place PIC

Regular

Class

English

Class

Fr&'a-No.* ,/th,/

an' 0a#ter&a" &n%e#t&on

+.39. 9.31. Le#t(re 8Ba)&# #on#ept o%Para)&t&# In%e#t&on)

Le#t(re Class room )rof. dr. /.).Didana0 /')E!0$%.)ar.



/isc. Room

12.31:. 1.11.3 $tudent)roect

dr.'gussomia$%.)/)rof. dr. /.).Didana0 /')E!0$%.)ar.

1:.1*. 1*.1. )lenar, Class room dr.'gussomia$%.)/)rof. dr. /.).Didana0 /')E!0$%.)ar.

6

Mon'a-No.* ,8th,/

+.9. 9.1. Le#t(re 9 Treatment o% V&ra"In%e#t&on !PK:PD+

(ecture Class room )rof. I<# 'man0$%.F




12.31:. 1.11.3 $tudent

)roect

)rof. I<# 'man0

$%.F1:.1*. 1*.1. )lenar,$ession

Class room )rof. I<# 'man0$%.F

7

T(e)'a-No.* ,9th,/

+.9. 9.1. Le#t(re ; Treatment o%M&#ro0a#ter&a"In%e#t&on) I !T-pe o%ant&m&#ro0a#ter&a"+!PK:PD+

(ecture Class room/r.dr. B..$atri,asa0#.Re%ro



/isc. Room

12.31:. 1.11.3 $tudent)roect

Class room /r.dr. B..$atri,asa0#.Re%ro


Class room /r.dr. B..$atri,asa0#.Re%ro

84e'ne)'a-No.* ,;th,/

+.+.3 9.1. Le#t(re ,< Treatment o%M&#ro0a#ter&a"In%e#t&on) II!Re)&)tan#e2 rat&ona"treatment2 an' 'r(1#om0&nat&on+

(ecture dr. #ade a4i0#.es

+.39. 12.13.3 Le#t(re ,,Ant&m&#ro0&a")()#ept&0"-

Indi&iduallearning

dr. i #ade adiTarini0 $%.#





DAY/ DATETime

Topic Learning

situation Place PIC

Regular

Class

English

Class

9.1.3 13.31*. $mall grou%

discussion


1.312. 1.11.3 $tudent)roect

Class room dr. i #ade adiTarini0 $%.# dr.#ade a4i0 #.es

12.31:. 1*.1. )lenar,$ession

Class room /r. #ade a4i0#.es

9

Th(r)'a-No.* 3<th,/

+.+.3 9.93. Le#t(re ,3=Re)pon' Ho)t a1a&n)tpara)&t&# an' #"&n&#a"man&%e)tat&on

Le#t(re Class room dr. I #ade $usila-tama0$%.)/

+.39. 9.31. Le#t(re ,5 Treatment o%para)&t&# &n%e#t&on

!PK:PD+

Le#t(re Class room dr. I <usti #ade$ur,a CandraTra%ika0 #.$c




12.31:. 1.11.3 $tudent)roect

Class room dr. I #ade $usila-tama0$%.)/dr. I <usti #ade$ur,a CandraTra%ika0 #.$c


Class room dr. I #ade $usila-tama0$%.)/

dr. I <usti #ade$ur,a CandraTra%ika0 #.$c

;

Fr&'a-No.* 3,th,/

+.+.3 9.93. Le#t(re ,/=The Ro"e o% Imm(n&t-to &n%e#t&on !Ba)&#+

Le#t(re Class room /r.dr. /e4a #ade$ukrama0 #.$i0$%.#

+.39. 9.31. Le#t(re ,6= In%e#t&ono% M-#o0a#ter&(m!TBC+

Le#t(re Class room )rof /r.dr. IBRai0$%.)


1.312. 13.31*. $mall grou%

discussion

/isc. Room

12.31:. 1.11.3 $tudent)roect

Class room /r.dr. /e4a #ade$ukrama0 #.$i0$%.#)rof /r.dr. IBRai0$%.)


Class room /r.dr. /e4a #ade$ukrama0 #.$i0$%.#)rof /r.dr. IBRai0$%.)





DAY/ DATETime

Topic Learning

situation Place PIC

Regular

Class

English

Class

,<

Mon'a-No.* 3/th,/

+.+.3 9.93. Le#t(re ,7= In%e#t&on

o% M-#o0a#ter&(m!Lepro)-+

Le#t(re Class room dr. /"arma %utra0

$%.

+.39. 9.31. Le#t(re ,8=Ant&m-#o0a#ter&a"Dr(1) ! ant& TBC2 Ant&"epra+ !PD:PK+

Le#t(re Class room dr. IB gura"0 #.For




12.31:. 1.11.3 $tudent)roect

Class room dr. /"arma %utra0$%.dr. IB gura"0 #.For

1:.1*. 1*.1. )lenar, Class room dr. /"arma %utra0$%.dr. IB gura"0 #.For

,,

T(e)'a-No.* 36th,/

+.+.3 9.93. Le#t(re ,9=Contro" o%m&#roor1an&)m!&n%e#t&on #ontro"+

Le#t(re Class room dr. /4iFatma4ati0 $%.#0)"./

+.39. 9.31. Le#t(re ,;=Imm(n&>at&on &n #h&"'

Le#t(re Class room dr. /4i (ingga0s%.' dr. D.<usta4an0$%.'

9.1.3 12.13.3 Le#t(re 3< = &n%e#t&on)&n (pper re)p&rator-tra#t !%ar&n1&t)2ton)&""&t&)2 "ar&n1&t)2ot&t&)2 ma)to'&t&)2rh&n&t&)2 )&n()&t&)2%(r(n$e"&t&)+

(ecture /r (el,



12.31:. 1.11.3 $tudent)roect

Class room dr. /4iFatma4ati0 $%.#0)"./dr. /4i (ingga0s%.' dr. D.<usta4an0$%.'

1:.1*. 1*.1. )lenar, Class room dr. /4iFatma4ati0 $%.#0)"./dr. /4i (ingga0s%.' dr. D.<usta4an0$%.'

,3

4e'ne)'a-

+.+.3 9.93. Le#t(re 3<Ant&)ept&# an''&)&n%e#tant

(ecture Class room /r.dr.B..$atri,asa0#.Re%ro





DAY/ DATETime

Topic Learning

situation Place PIC

Regular

Class

English

Class

No.* 37th,/ +.39. 9.31. Le#t(re 3,

Un&.er)a" Pre#a(t&on

(ecture Class room dr 'gus

$omia0$%.)/




12.31:. 1.11.3 $tudent)roect

Class room /r.dr.B..$atri,asa0#.re%rodr 'gus

$omia0$%.)/1:.1*. 1*.1. )lenar, Class room /r.dr.B..

$atri,asa0#.re%rodr 'gus$omia0$%.)/

,5

Th(r)'a-No.* 38th,/

+.9. 9.1. Le#t(re 33Proto>oa In%e#t&on I!Ma"ar&a2 Amoe0&a)&)2Le&)man&a)&)2Tr&pano)om&a)&)2To?op"a)mo)&)2 Tr&#homon&a)&)+

(ecture Class room dr./e4a ',u '. $ri(aksmi0#.$c0#.esdr. )utu 'stri/ama,anti0#.es

9.1.3 12.13.3 Indi&idual

learning


12.31:. 1.11.3 $tudent)roect

dr./e4a ',u '. $ri(aksmi0#.$c0#.esdr. )utu 'stri/ama,anti0#.es

1:.1*. 1*.1. )lenar, dr./e4a ',u '. $ri(aksmi0#.$c0#.es

dr. )utu 'stri/ama,anti0#.es

,3*<<,5*5< M&''"e 0"o#$ meet&n1

,/

Fr&'a-No.* 39th,/

+.+.3 9.93. Le#t(re 35Proto>oa In%e#t&on II!Mana1ement o%proto>oa In%e#t&on)+

(ecture Class room dr Huli <a,atri0$%.)/

+.39. 9.31. Le#t(re 3/In%e#t&on o%Entero0a#ter!Th-po&'2 C*0ot("&n(m+

(ecture Class room dr 'gus$omia0$%.)/





DAY/ DATETime

Topic Learning

situation Place PIC

Regular

Class

English

Class

9.1.3 12.13.3 Indi&idual

learning



12.31:. 1.11.3 $tudent)roect

Class room dr Huli <a,atri0$%.)/dr 'gus$omia0$%.)/

1:.1*. 1*.1. )lenar, Class room dr Huli <a,atri0$%.)/

dr 'gus$omia0$%.)/

,6

Mon'a-De)* ,)t ,/

+.+.3 9.93. Le#t(re 36Sep)&) an'Ba#terem&a

(ecture Class room dr. #ade $usilautama0 $%.)/

+.39. 9.31. Le#t(re 37C(taneo() V&ra"In%e#t&on !Var&#e""a2@o)ter2 Herpe)+

(ecture Class room dr.I<' $umed"a)ind"a0 $%.dr.!lis Indira0$%.




12.31:. 1.11.3 $tudent)roect

Class room dr. #ade $usilautama0 $%.)/dr.I<' $umed"a)ind"a0 $%.dr.!lis Indira0$%.

1:.1*. 1*.1. )lenar, Class room dr. #ade $usilautama0 $%.)/dr.I<' $umed"a)ind"a0 $%.dr.!lis Indira0$%.

,7

T(e)'a-De)* 3n' ,/

+.+.3 9.93. Le#t(re 38Retro.&ra" In%e#t&on!HIV+

(ecture Class room )rof. /r. dr. Tuti)ar4ati #erati0$%)/0 )TI

+.39. 9.31. Le#t(re 39In%"(en>a

(ecture Class room )rof. /r. dr. Tuti)ar4ati #erati0$%)/0 )TI




12.31:. 1.11.3 $tudent

)roect

Class room )rof. /r. dr. Tuti

)ar4ati #erati0$%)/0 )TI





DAY/ DATETime

Topic Learning

situation Place PIC

Regular

Class

English

Class

1:.1*. 1*.1. )lenar, Class room )rof. /r. dr. Tuti

)ar4ati #erati0$%)/0 )TI

,84e'ne)'a-De)* 5th,/

+.+.3 9.93. Le#t(re 3;In%e#t&on &n #h&"'ren!DBD2 D&%ter&2 )ep)&)2Campa$+

(ecture Class room dr. /4i (ingga0s%.' dr. D.<usta4an0$%.'

+.39. 9.31. Le#t(re 5<&n%e#t&on) &n (pperre)p&rator- tra#t!%ar&n1&t)2 ton)&""&t&)2"ar&n1&t)2 ot&t&)2ma)to'&t&)2 rh&n&t&)2)&n()&t&)2 %(r(n$e"&t&)+

(ecture Class room dr. (el,0 $%.T?T



/isc. RoomFacilitator

12.31:. 1.11.3 $tudent)roect

Class room dr. /4i (ingga0s%.' dr. D.<usta4an0$%.'dr. (el,0 $%.T?T

1:.1*. 1*.1. )lenar, Class room dr. /4i (ingga0s%.' dr. D.<usta4an0$%.'dr. (el,0 $%.T?T

,9

Th(r)'a-De)* /th,/

+.9. 9.1. Le#t(re 5,@oono)&) In%e#t&on!Ra0&e)2Lepto)p&ro)&)+

(ecture Class room )rof./r. dr. Raka$ude4i0 $%.$ 8/r. dr. $riBuda,anti0 $%.#




12.31:. 1.11.3 $tudent)roect

Class room )rof./r. dr. Raka$ude4i0 $%.$ 8/r. dr. $riBuda,anti0 $%.#

1:.1*. 1*.1. )lenar, Class room )rof./r. dr. Raka$ude4i0 $%.$ 8/r. dr. $riBuda,anti0 $%.#

,;

Fr&'a-De)* 6th,/

+.3. 9.9.3 Le#t(re 53Pr&n#&p"e) o% F(n1a"In%e#t&on !Morpho"o1-o% F(n1a"+

(ecture Class room dr. (u" 'ri4ati

+.39. 9.31. Le#t(re 55=)(per%&#&a" %(n1a"In%e#t&on) !T&nea2T&nea .er)&$o"or2$a'&'&a)&)m($o$(taneo()+

(ecture Class room )rof. #. $4astika 'diguna





DAY/ DATETime

Topic Learning

situation Place PIC

Regular

Class

English

Class

9.1.3 12.13.3 Indi&idual

learning1.312. 13.31*. $mall grou%

discussion/isc. Room

12.31:. 1.11.3 $tudent)roect

Class room dr. (u" 'ri4ati)rof. #. $4astika 'diguna

1:.1*. 1*.1. )lenar, Class room dr. (u" 'ri4ati)rof. #. $4astika 'diguna

3<

Mon'a-De)* 9th,/

+.+.3 9.9.3 Le#t(re 5/Deep F(n1a" In%e#t&on

Le#t(re Class room )rof./r.dr Tuti)ar4ati0$%.)/

+.39. 9.31. Le#t(re 56Treatment o% F(n1a"In%e#t&on !PD:PK+

(ecture Class room dr.I B.gura"0#.For dr. I <usti#ade $ur,a CandraTra%ika0 #.$c




12.31:. 1.11.3 $tudent)roect

Class room )rof./r.dr Tuti)ar4ati0$%.)/dr.I B.gura"0#.For dr. I <usti#ade $ur,a Candra

Tra%ika0 #.$c1:.1*. 1*.1. )lenar, Class room )rof./r.dr Tuti)ar4ati0$%.)/dr.I B.gura"0#.Fordr. 4i4iekIndra,ani0 #.es

3,

T(e)'a-De)* ;th,/

+.+.3 9.9.3 Le#t(re 57He"m&nthe) In%e#t&on

Le#t(re Class room /r. dr. I #ade$udarmaa0 #.es

+.39. 9.310 Le#t(re 58In%e#t&on o%Nemato'a2 Ce)to'aan' Tremato'a

(ecture Class room dr. adek$4astika0#.es

9.1.3 12.13.3 Indi&idual


discussion/isc. Room Facilitator

12.31:. 1.11.3 $tudent)roect

Class room dr. I #ade$udarmaa0 #.esdr. adek$4astika0#.es

1:.1*. 1*.1. )lenar, Class room dr. I #ade$udarmaa0#.es$taff

33

+.+.3 9.9.3 Le#t(re 59F&"ar&a)&)

Le#t(re Class room dr. . 'gus $omia0$%.)/

+.39. 9.31. Le#t(re 5;Den1(e V&ra" In%e#t&on

(ecture Class room dr. #ade $usila-tama0 $%0)/





DAY/ DATETime

Topic Learning

situation Place PIC

Regular

Class

English

Class

4e'ne)'a-

De)* ,<th,/

9.1.3 12.13.3 Indi&idual


discussion/isc. Room Facilitator

12.31:. 1.11.3 $tudent)roect

Class room dr. . 'gus $omia0$%.)/dr. #ade $usila-tama0 $%0)/

1:.1*. 1*.1. )lenar, Class room dr. . 'gus $omia0$%.)/dr. #ade $usila-tama0 $%0)/

35

Th(r)'a-De)* ,,th,/

+.9. 9.1. Le#t(re /<Treatment o%

He"m&nthe) In%e#t&on!PK:PD+

(ecture Class room /r.dr.B..$atri,asa0#.Rre

%ro


Class room


Facilitator

12.31:. 1.11.3 $tudent)roect

Class room /r.dr.B..$atri,asa0#.Rre%ro


Class room /r.dr.B..$atri,asa0#.Rre%ro

3/

Fr&'a-De)* ,3th,/

+.9. 9.1. Le#t(re /,O.er.&e o% P(erpera"In%e#t&on

(ecture Class room dr. ?ari,asa$ana,a0$%.<




12.31:. 1.11.3 $tudent)roect

Class room dr. ?ari,asa$ana,a0$%.<


Class room dr. ?ari,asa$ana,a0$%.<

36

Mon'a-De)* ,6th,/

+.9. 9.1. Le#t(re /3O.er.&e o% Se?(a""-Tran)m&tte' In%e#t&on

(ecture Class room /r. dr. '.'.<.).Diraguna0 $%.80 FI$/@



/isc. Room Facilitaor





DAY/ DATETime

Topic Learning

situation Place PIC

Regular

Class

English

Class

12.31:. 1.11.3 $tudent

)roect

Class room dr. '.'.<.).

Diraguna0 $%.


Class room dr. '.'.<.).Diraguna0 $%.

37

Fr&'a-De)* ,;th,/

+.1*. 9.1. Pra#t&#e , =La0orator- '&a1no)&)o% M&#ro0&a" &n%e#t&on

(aborator, I.B. ,oman )utra/4ia0 $.$i0#.Biotec"

38

Mon'a-De)* 33th,/

+.1*. 9.1. Pra#t&#e 3 =La0orator- '&a1no)&)o% M&#ro0&a" &n%e#t&on

(aborator, I.B. ,oman )utra/4ia0 $.$i0#.Biotec"

39

T(e)'a-De)* 35th,/

+.1*. 9.1. Pra#t&#e 5 =La0orator- D&a1no)&)o% C"&n&#a" Patho"o1-

(aborator, /r ,oman#a"artini $%)

3;

4e'ne)'a-De)* 3/th,/

+.1*. 9.1. Pra#t&#e / =La0orator-E?am&nat&on o%para)&t&# &n%e#t&o()

dr. adek $4astika0#.es

5<

Mon'a-De)* 3;th,/

+.1*. 9.1. Pra#t&#e 6 =La0orator-E?am&nat&on o%para)&t&# &n%e#t&o() !+

dr. adek $4astika0#.es

5,T(e)'a-

De)* 5<th,/

S&"ent Da-

534e'ne)'a-De)* 5,th,/

EAMINATION BLOCK TEAM

MEETING OF STUDENT REPRESENTATIVES

In t"e middle of block %eriod0 a meeting is designed among t"e student re%resentati&es of

e&er, small grou% discussion0 facilitators and source %erson of t"e block. T"e meeting





discuss about t"e ongoing teac"ing and learning %rocess0 6ualit, of facilitator and lecturesas a feedback to im%ro&e t"e ne5t %rocess.

MEETING OF THE FACILITATORS

'll facilitators are in&ited to discuss all block acti&ities 4it" block contributors 1 4eek after meeting of student re%resentati&es.

ASSESSMENT METHOD

1. 'ssessment 4ill be "eld on 2*t" da, of t"e block %eriod. T"e time %ro&ision is 1

minutes. T"e number of #C is 1 4it" %assing %oint ≥ 7.

2. 'ssessment in t"is block consists of=$</ = *J

$tudent )roect )a%er8 = 1JFinal e5am = +*J

STUDENT PROECT

TIT(!

$ubectto%ic= c"oose from com%etenc, list8

ame=I#=

Facult, of #edicine0 -da,ana -ni&ersit,211

1. Introduction )enda"uluan82. Content Isi sesuai dengan udul %a%er83. $ummar, Ringkasan8:. References /aftar %ustaka8= @anCou&er st,le

*. )ages= 10 $%asi= 1.*0 Time e4 Roman=12





St('ent Proe#t

No Top&# Kompeten)&

1 $ta%",lococcus bacteremia

1. $ta%",lococcus= microbiologis as%ect2. Clinical s%ectrum of sta%",lococcusinfection

3. ?o4 are sta%",lococcus infectiondiagnosed

:. Com%lication of sta%" infection*. Treatment and %re&ention of sta%"

infection

2

2 $inusitis1. etio%at"ogenesis of sinus infection2. clinical s,m%toms and sign of sinus

infection

3. management of sinus infection:. com%lication of sinus infection

2

3 titis #edia1. titis media acute= etio%at"ogenesis2. titis media acute= management3. titis media %urulenta:. titis media k"ronic su%%urati&e*. Com%lication of acute titis media

2

: #astoiditis1. etiologi2. %at"ogenesis3. diagnosis:. management*. com%lication

2

* )eritonsilar abses1. etio%at"ogenesis2. clinical manifestation3. diagnosis:. management

2

R"eumatic fe&er 1. etiologi2. %at"ogenesis

3. diagnosis:. management*. com%lication

2

7 R"eumatic disease1. etio%at"ogenesis2. clinical manifestation3. management:. com%lication

2

+ #eningitis )urulenta1. et"io%at"ogenesis2. clinical manifestation3. diagnosis

:. management*. com%lication

1





9 #eningitis serosaet"io%at"ogenesis

clinical manifestation diagnosis management com%lication

2

1 )la6ue )es8 !tiologi Transmisi #anagement Com%lication

2

11 'ctinom,cosis /iagnosis microbiolog,8 Clinical manifestation #anagement

1

12 C"romoblastom,cosis

/iagnosis microbiolog,8 Clinical manifestation #anagement

1

13 #adurom,cosis /iagnosis microbiolog,8 Clinical manifestation #anagement

1

1: Fe&er - )atogenesis of fe&er- #etabolic res%on of fe&er - ?o4 to measure bod, tem%erature and

fe&er %attern- 'lgorit"m management of acute fe&er

illness- #anagement of fe&er

1* C#@- C#@= &irolog,- Clinical s%ectrum of C#@- C#@ in immunocom%etent- C#@ infection in immunocom%romi;ed- #anagement of C#@

3'

1 #alaria- etio%atogenesis of se&ere malaria- clinical s%ectrum of se&ere malaria- malaria cerebral- clinical a%%roac" management of se&ere

malaria- malaria in %regnant

:

17 /engue infection- ?o4 to kno4 4arning sim%tom and sign- se&ere dengue- management of se&ere dengue- management

:

1+ T,%"oid fe&er - t,%"oid to5ic

:





- T,%"oid fe&er= intestinal com%lication

19 ?I@'I/$- stigma of ?I@'I/$- @CT- )ICT- C$T care su%%ort treatment8- 'R@

3'

2 Influen;a- seasonal influen;a- s4ine influen;a- '&ian influen;a- #anagement- )re&ention

:

21 'cute <astroenteritis- 4ater, diarr"ea=- inflammator, diarr"ea

- "o4 to assement of se&erit, of de",dration

- "o4 to do re",dration- "o4 to do rectal s4ab

:

22 Ha4s %atek8- etio%atogenesis- clinical %icture- laborator, confirmation- #anagement- )re&ention

:

23 Rabies- etio%atogenesis of rabies

- clinical %icture of rabies- laborator, confirmation of rabies- "o4 to manage dog bite- "o4 to gi&ing &accination I# and

subcutans8

:

2: Candidiasis- clinical s%ectrum of candida infection- (aborator, confirmation- #anagement

2* (e%tos%irosis- etio%atogenesis

- clinical %icture- laborator, confirmation- #anagement- )re&ention

3B

2 !merging and reemerging disease= legionalle Clinical manifestation /iagnosis microbiolog, #anagement

27 !merging and reemerging disease= !ntero&irus71 ?F#/8 Clinical manifestation

/iagnosis microbiolog, #anagement





2+ !merging and reemerging disease= Corona&irus$'R$8 Clinical manifestation /iagnosis microbiolog, #anagement

29 !merging and reemerging disease= Bun,a&iruses?anta&irus8 Clinical manifestation /iagnosis microbiolog, #anagement

3 Infeksi nosokomial /efinition #anifestation #anagement )re&ention

31 'ntibiotic resisten #ec"anism of resistence

Rationale of using antibiotica )re&ention

32 ?o4 to using %rudent antibiotic )rofile of antibiotic





LEARNING PROGRAM

LECTURE ,

Intro'(#t&on to the 0"o#$ !A1ent 2Ho)t En.&ronment2 an' &n%e#t&onman&%e)tat&on+

O"eh=Pro%* Dr* 'r* T(t& Parat& Merat&2 SpPD2 KPTI

KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK

Le#t(re 3=Ba#ter&a" #"a))&%&#at&on

O"eh='r* K*an(artha P* P&nat&h2 M$e)

1. /escribe relations"i% bet4een microbes and "uman in "ealt" and disease2. !5%lain normal "uman flora and o%%ortunistic infections3. /escribe t"e establis"ment of microbial infection:. !5%lain t"e difference bet4een <ram%ositi&e and <ramnegati&e bacterial cell 4all L*. Classif, t"e s%"erical bacteria cocci8 into <ram%ositi&e and negati&e grou%. (ist

t"eir &irulence factors and related diseases caused b, t"em L. Classif, t"e rod bacteria bacilli8 into <ram%ositi&e and negati&e grou%. (ist t"eir

&irulence factors and related diseases caused b, t"em L7. (ist t"e im%ortant enteric bacteria !nterobacteriaceae80 t"eir &irulence factors and

related diseases L+. Classif, t"e anaerobic bacteria according to t"eir ca%abilities to form s%ores. (ist

t"eir &irulence factors and related diseases caused b, t"em L9. !5%lain t"e s%esific c"aracteristic of #,cobacteria cell4all and t"e im%lication to

t"eir natural resistance L1. !5%lain t"e &irulence factors and %at"ogenesis of infection caused b, #,cobacteria L

Le#t(re 5=PATHOGENESIS OF BACTERIAL INFECTION

Ma'e A1() Hen'ra-ana

ABSTRACT

T"e %at"ogenesis of bacterial infection includes initiation of t"e infectious %rocessand t"e mec"anisms t"at lead to t"e de&elo%ment of signs and s,m%toms of disease.C"aracteristics of bacteria t"at are %at"ogens include transmissibilit,0 ad"erence to "ostcells0 in&asion of "ost cells and tissues0 to5igenicit,0 and abilit, to e&ade t"e "ostMs immunes,stem. #an, infections caused b, bacteria t"at are commonl, considered to be %at"ogensare ina%%arent or as,m%tomatic. /isease occurs if t"e bacteria or immunologic reactions tot"eir %resence cause sufficient "arm to t"e %erson.

Bacteria and ot"er microorganisms8 ada%t to t"e en&ironment0 including animalsand "umans0 4"ere t"e, normall, reside and subsist. In doing so0 t"e bacteria ensure t"eir





sur&i&al and en"ance t"e %ossibilit, of transmission. B, %roducing as,m%tomatic infection or mild disease0 rat"er t"an deat" of t"e "ost0 microorganisms t"at normall, li&e in %eo%leen"ance t"e %ossibilit, of transmission from one %erson to anot"er.

$ome bacteria t"at commonl, cause disease in "umans e5ist %rimaril, in animalsand incidentall, infect "umans. t"er bacteria %roduce infection of "umans t"at isinad&ertent0 a mistake in t"e normal life c,cle of t"e organismN t"e organisms "a&e notada%ted to "umans0 and t"e disease t"e, %roduce ma, be se&ere.

T"e clinical manifestations of diseases eg0 diarr"ea0 coug"0 genital disc"arge8%roduced b, microorganisms often %romote transmission of t"e agents.#an, bacteria are transmitted from one %erson to anot"er on "ands. ' %erson 4it" Saureus carriage in t"e anterior nares ma, rub "is nose0 %ick u% t"e sta%",lococci on t"e"ands0 and s%read t"e bacteria to ot"er %arts of t"e bod, or to anot"er %erson0 4"ereinfection results. #an, o%%ortunistic %at"ogens t"at cause nosocomial infections aretransmitted from one %atient to anot"er on t"e "ands of "os%ital %ersonnel.

T"e most fre6uent %ortals of entr, of %at"ogenic bacteria into t"e bod, are t"e sites4"ere mucous membranes meet 4it" t"e skin= res%irator, u%%er and lo4er air4a,s80gastrointestinal %rimaril, mout"80 genital0 and urinar, tracts. 'bnormal areas of mucous

membranes and skin eg0 cuts0 burns0 and ot"er inuries8 are also fre6uent sites of entr,.ormal skin and mucous membranes %ro&ide t"e %rimar, defense against infection. Tocause disease0 %at"ogens must o&ercome t"ese barriers.nce in t"e bod,0 bacteria must attac" or ad"ere to "ost cells0 usuall, e%it"elial cells. 'fter t"e bacteria "a&e establis"ed a %rimar, site of infection0 t"e, multi%l, and s%read directl,t"roug" tissues or &ia t"e l,m%"atic s,stem to t"e bloodstream. T"is infection bacteremia8can be transient or %ersistent. Bacteremia allo4s bacteria to s%read 4idel, in t"e bod, and%ermits t"em to reac" tissues %articularl, suitable for t"eir multi%lication and cause t"ediseases.

Learn&n1 Ta)$Ca)e =

' 3* ,ears old female0 a secretar, at %ri&ate com%an, come to general %racticiancom%lained t"at s"e "as unreasonable %ain 4"en urinate since * da,s. $"e feels %ain tooat lo4er abdominal. T"e urine color is dark ,ello4 and little bit cloud,. t"er %",sicale5amination results are normal. T"e %ractician ask for laborator, e5amination for urineanal,sis and urine culture. 'fter fe4 da,s0 t"e urine anal,sis s"o4n t"at s"e "as urinar,tract infection. T"e urine culture s"o4n colonies of "scherichia coli bacteria and significantas agent of infection.

(e)t&on) =1. In t"is case0 "scherichia coli as a %at"ogen bacteria. D"en is "scherichia coli called

as coloni;ation bacteriaO

2. !5%lain t"e differentiation bet4een true %at"ogen and o%%ortunistic %at"ogenL

3. !5%lain t"e %at"ogenesis "o4 "scherichia coli can infect t"e urinar, tract fromtransmission until infection and cause t"e disease8 L

:. D"at are "scherichia coli#s &irulence factors t"at can cause urinar, tract infectionO

*. !5%lain t"e microbial &irulence factors t"at ,ou kno4L

. !5%lain t"e differentiation bet4een e5oto5ins and endoto5in L

7. /escribe "o4 se&eral %at"ogens are able to sur&i&e inside t"e macro%"ages L

+. !5%lain t"e routes of transmission t"at ,ou kno4 and gi&e e5am%les of eac" L





Se"% A))e))ment1. !5%lain t"e meaning of t"is term abo&e =

'. ContaminationB. Coloni;ationC. In&asion

/. Infection!. )at"ogenF. Carrier <. on%at"ogenic?. %%ortunistic %at"ogen=I. )at"ogenicit,=. To5igenicit,=. @irulence=

(. $,mbiosis

#. Commensalism

. )arasitism

. Aoonoses

2. <i&e e5am%les of attac"ment mec"anism L

Re%% =a4et;0 #elnick0 'delberg. 21. C"a%ter 9. )at"ogenesis of Bacterial Infection in #edical#icrobiolog,0 2*t" !dition b, @is"al . T"e #c<ra4?ill Com%anies. (ange #icrobiolog,.

Le#t(re /V&ra" #"a))&%&#at&on

O"eh=

'r* Sr& B('a-ant&2 Sp*MK

Le#t(re 6

Me#han&)m o% V&ra" Patho1ene)&)O"eh=

'r* Sr& B('a-ant&2 Sp*MK

KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK

Le#t(re 7Man&%e)tat&on o% .&r() an' 0a#ter&a" &n%e#t&on

dr.'gus somia0 $%.)/

KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK





Le#t(re 8Ba)&# #on#ept o% Para)&t&# In%e#t&on)

le"=

)rof. dr. /.). Didana0 /')E!0 $%.)ar.

KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK

Le#t(re 9Treatment o% V&ra" In%e#t&on !PK:PD+

)rof. dr. I<# 'man0 $%.F

#ost of anti&iral agents e5erts t"eir actions on &iral re%lication0 at t"e stage of nucleic acids,nt"esis ot t"e stage of late %rotein s,nt"esis and %rocessing. #ost of anti&iral agentsacti&e against "er%es &iruses and against t"e ?uman Immunodeficienc, @irus ?I@8 areantimetabolites0 so t"at it must first undergo con&ersion to acti&e forms0 usuall, tri%"os%"atederi&ati&es. ne of t"e most im%ortant recent trends in &iral c"emot"era%, "as beencombination t"era%,0 4"ere treatment 4it" combination result in greater effecti&eness and%re&ent or dela, t"e emergence of resistance0 es%eciall, in t"e treatment of ?I@ disease.$uc" combination usuall, include t4o ucleoside Re&erse Transcri%tase In"ibitor RTIs8%lus )rotease in"ibitor. In some combination regimens0 a non nucleoside re&ersetranscri%tase in"ibitor RTI8 "as been used %lace of )rotease in"ibitor. ?ig"l, acti&e

antiretro&iral t"era%, ?''RT8 is recommended for 'I/$ %atients.

Learn&n1 Ta)$

' male %atient0 3 ,ear old0 is ?I@%ositi&e0 "as a C/: count 3ul and a &iral R' load* co%iesml. T"e %",sician gi&e "im anti&iral drug. T4o 4eeks later "e com%lainedanore5ia0 nausea0 &omiting0 and abdominal %ain. ?is abdomen 4as tender in t"e e%igastricarea. Finall, t"e %",sician diagnose "im as acute %ancreatitis.

1. (ist drugs t"at "a&e cross resistance 4it" ac,clo&ir0 and e5%lain t"e reason 4",cross resistance "a%%enedO at;ung %.+2:8

2. (ist and describe t"e drugs %reser&ed for ac,clo&ir resistant strain. at;ung %.+2:8

3. In t"e treatment of ?I@ disease0 t"e combination of anti&iral is needed. !5%lain t"ead&entages of drug combination. In t"e case 4"atPs likel, anti&iral drug gi&en b, t"edoctor.

:. ?o4 do ,ou manage t"is %atientO

$elf assessment=1. ' %atient suffering from "er%es sim%le50 treated 4it" ac,clo&ir. But ?$@ is resistant

to ac,clo&ir. T"e alternati&e drug can c"oose=1. <anciclo&ir 2. @alaciclo&ir

3. Famciclo&ir :. Cidofo&ir





2. 's anti&iral0 t"e clinical use of ac,clo&ir are as follo4=1. @aricella2. Retinitis b, C#@ c,tomegalo&irus83. ?er%es ;oster :. Reccurent "er%es labialis

3. T"e anti&iral t"at are good for treating "e%atitis %atient are=1. (ami&udin2. Riba&irin3. Interferon:. $ta&udin

:. For treated 'I/$ %atient a combination of anti&iral are needed. T"e combination t"atare effecti&e for t"is %atient are=

1. Indina&ir Q /idanosine Q (ami&udin2. 'c,clo&ir Q 'mantadine Q Aido&udine3. Aido&udine Q /idanosine Q e&ira%ine

:. <anciclo&ir Q $ori&udine Q Cidofo&ir

Le#t(re ;Treatment o% M&#ro0a#ter&a" In%e#t&on) I !T-pe o% ant&m&#ro0a#ter&a"+

!PK:PD+

O"eh=

/r.dr. B.. $atri,asa0#.Re%ro

A0)tra#t

#an, of microorganism are classified as eit"er <ram%ositi&e or <ramnegati&e. Bot" of t"em could be differentiated b, se&eral res%ect0 not least in t"e structure of t"e cell 4all04"ic" "as im%lications for t"e action of antibiotics. T"e cell 4all of <ram%ositi&e organismsis a relati&el, sim%le structure and it consist of *J %e%tidogl,can. T"e cell 4all of <ramnegati&e organisms is muc" com%le50 so more difficult in %enetrating b, some antibiotics. 'ntibiotic for 4"ic" %enetration is a %roblem include ben;,l%enicillin0 met"icillin0 macrolides0&ancom,cin0 bacitracin0 and no&obiocin. T"ere are man, mec"anisms of action of antibiotics or antimicrobial drugs in killing or in"ibited t"e bacterial gro4t" suc" as= in"ibitcell 4all s,nt"esis0 in"ibit %rotein s,nt"esis0 as a antimetabolites0 and in"ibit microbialnucleic acid metabolism. T"e emergence of microbial resistance %ose a constant c"allenge

to t"e use of antimicrobial drugs. #ec"anism of underl,ing microbial resistance to t"e cell4all s,nt"esis in"ibitors include t"e %roduction of antibioticinacti&ating en;,mes0 c"ange int"e structure of target rece%tors0 increased efflu5 &ia drugs trans%orters0 and decreases int"e %ermeabilit, of microbes cellular membranes to antibiotics. $trategies designed tocombat microbial resistance include t"e use of aduncti&e agents t"at can %rotect againstantibiotic inacti&ation0 t"e use of antibiotic combination and a&oid t"e misuse of antibiotic.

Learn&n1 Ta)$ '3,ear old 4oman recentl, treated for leukemia is admitted to t"e "os%ital 4it" malaise0c"ills0 and "ig" fe&er. Bram stain of blood re&eals t"e %resence of <ram negati&e bacilli.T"e initial diagnosis is bacteremia. T"e records of t"e %atient re&eal t"at s"e "ad a se&ereurticarial ras" after oral %enicillin @.

a. If ,ou a medical doctor 4"at antibiotic 4ould ,ou c"oose for t"is 4omanOb. !5%lain t"e mec"anism of action and ad&erse reaction of t"e drugs t"at ,ou c"oosed





c. In ,our o%inion is t"ere a%%ro%riate if t"at %asien treated b, C"loram%"enicolO !5%lain,our ans4er.

$elf assessment=1. D"ic" one of t"e follo4ing item is beta lactamase in"ibitors=

a. #afenideb. )enicillin @c. Cla&ulanic acidd. 'mo5,cilline. flo5acin

2. Ci%roflo5acin and t"e ot"er fluoro6uinolone mec"anism of action is b,=a. In"ibiting t"e s,nt"esis of bacterial %roteinb. In"ibiting an en;,me deo5,ribonucleic acid /'8 g,rasec. Interfering cell 4all s,nt"esisd. In"ibiting t"e %roduction of m,colic acide. In"ibiting en;,me de",drofolate reductase

3. T"e follo4ing antibiotics in"ibit bacterial %rotein s,nt"esis and are considered asbacteriostatic=

a. ';it"rom,cina. flo5acin

b. C"larit"rom,cinc. Ci%roflo5acin

:. T"e follo4ing drugs are used for to%ical a%%lication=a. #afenide b. $ulfasala;inec. $il&ersulfadia;ine

d. )enicillin

*. D"ic" ones are t"e contraindication of tetrac,cline=a. )roducing a ,ello4 discoloration of teet" b. <ro4t" retardation in relation to infant skeletal de&elo%mentc. /e%ression of bone gro4t"d. Cr,stalluria

. T"ese statements are true about c"loram%"enicol=a. It is a %otent in"ibitor of microbial %rotein s,nt"esis

b. It binds re&ersibl, to t"e %:* as sub unit of bacterial ribosomalc. It in"ibits t"e %e%tid,l transferase ste% of %rotein s,nt"esis

d. It is a bacteriostatic broad s%ectrum antibiotic

7. 'ntibiotic t"at "as ototo5ic and ne%"roto5ic effect is=a. !r,t"rom,cinb. $tre%tom,cinc. C"loram%"enicold. 'mo5,cilline. Clindam,cin

Te5tbook$ource =

1. at;ung0 B.<. 21. Basic and Clinical )"armacolog,. !ig"t !dition. (ange #edicalBooks#c<ra4 G?ill.





2. at;ung and Tre&orPs. )"armacolog, !5amination and Board Re&ie4. $i5t"!dition.(ange #edical Books#c<ra4?ill.

Le#t(re ,<Treatment o% M&#ro0a#ter&a" In%e#t&on) II !Re)&)tan#e2 rat&ona"

treatment2 an' 'r(1 #om0&nat&on+

O"eh= /r. #ade a4i0 #.es

KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK

Le#t(re ,,

Ant&m&#ro0&a" )()#ept&0"-

le"= dr. i #ade 'di Tarini0 $%.#

KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK

Le#t(re ,3=Re)pon' Ho)t a1a&n)t para)&t&# an' #"&n&#a" man&%e)tat&on

dr. I #ade $usila -tama0$%.)/

KKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKKK

Le#t(re ,5

Treatment o% para)&t&# &n%e#t&on !PK:PD+

'r* I G()t& Ma'e S(r-a Can'ra Trap&$a2 M*S# 'bstract

#alaria is t"e most im%ortant %roto;oal disease in tro%ical medicine. It is res%onsiblefor 2 million deat"s %er ,ear and muc" morbidit, in t"e 2 million %eo%le 4orld4ide 4"oare infected. #alaria is caused b, four s%ecies of %lasmodial %arasites t"at are transmittedb, female ano%"elene mos6uitoes. 'nti malarial drugs are usuall, classified in terms of t"eir action against different stages of t"e %arasite. T"e, are used to %re&ent transmission or cure malaria. T"e aim of %ro%",lactic use is to %re&ent t"e occurrence of infection in a%re&iousl, "ealt", indi&idual 4"o is at %otential e5%osure risk. $u%%ressi&e %ro%",la5isin&ol&es t"e use of blood sc"i;onticides to %re&ent acute attacksN causal %ro%",la5isin&ol&es t"e use of tissue sc"i;onticides or drugs against t"e s%oro;oite to %re&ent t"e%arasite establis"ed in t"e li&er. 'nti malarial drugs can be used curati&el, t"era%euticall,8against an establis"ed infection. $u%%ressi&e treatment aims to control acute attacks0usuall, 4it" blood sc"i;onticidesN radical treatment aims to kill dormant li&er forms0 usuall,

4it" a ",%no;onticide0 to %re&ent rela%sing malaria. $e&eral classes of antimalarial drugssuc" as c"loro6uine0 amodia6uine0 6uinine0 6uinidine0 meflo6uine0 %rima6uine0 fansidar0%roguanil0 artemisin0 and ato&a6uone%roguanil. T"e effecti&eness of anti malarial agents





&aries bet4een %arasite s%ecies . In addition0 drug resistance is an im%ortant t"era%eutics%roblem0 most notabl, 4it" P falciparum$

'moebic d,senter, is caused b, infection 4it" "ntamoeba histolytica, 4"ic" isingested in a c,stic form. /,senter, results from in&asion of t"e %arasite in t"e intestinal4all. ccasionall,0 t"e organism insists in t"e li&er0 forming abscesses. !. ?istol,tica cancause as,m%tomatic intestinal infection0 mild to moderate colitis0 se&ere intestinal infection0ameboma0 li&er abscess and ot"er e5tra intestinal infections. T"e c"oice of drugs for amoebiasis de%ends on t"e clinical %resentation. /rugs of c"oice for as,m%tomaticintestinal infection are luminal agent suc" as dilo5anide furoate0 iodo6uinol and%aromom,cinN for mild to moderate intestinal infection are metronida;ole %lus luminal agentNfor se&ere intestinal infection and "e%atic abscess are metronida;ole %lus luminal agent .

To5o%lasmosis is an infection caused b, to5o%lasma gondii %arasite. #ost %eo%le"a&e no s,m%toms because t"eir immune s,stem kee%s t"e %arasite from causing illness.?o4e&er0 in %eo%le 4"o "a&e a 4eak immune s,stem0 to5o%lasmosis can cause seriousmedical %roblems0 suc" as damage t"e e,es and brain. T"e immune s,stem can become4eak for a number of reasons.T"e drug of c"oice for to5o%lasmosis are %,rimet"amine %lusclindam,cin %lus folinic acid

(earning Task1. #s. /e4i0 a 2* ,ear old student0 %resents 4it" a four da, "istor, of "ig" fe&er :

C80 general malaise 0 feeling intensel, cold and s"aking follo4ed b, %rofuses4eating. ?e returned from (ombok island 3 4eeks ago. $"e takes drugs for malaria. Toda, s"e feel di;;iness0 nausea0 diarr"ea0 tinnitus0 blurred &ision 0flus"ed0 s4eat, skin and im%aired "earing.

uestions =1. D"ic" of t"e follo4ing antimalarial drugs causes a dose de%endent to5icit, O

2. /escribe t"e %"armacod,namic and %"armacokinetic %ro%erties of t"e maor antimalarial drugs c"loro6uine0 meflo6uine0 6uinine0 %rima6uine0 and t"eantifolate agents8L

T"e fi&e star "otel usuall, "as screening t"eir food "andler s e&er, si5 mont"s. #r. 'ndi"ad %ositi&e c,sts amoebiasis 4it"out d,senter, s,m%tom.uestions

1. D"ic" of t"e follo4ing anti amoebiasis drugs can use to treat #r. 'ndi O

2. /escribe t"e %"armacod,namic and %"armacokinetic %ro%erties of t"e maor amebicides dilo5anide0 emetine0 iodo6uinol0 and metronida;ole8 L

#rs Ratna0 a 2+ ,ears old0 come to "os%ital %oliclinic 4it" c"ief com%laints "ad abortus for 3

times. $"e usuall, eat steak or sata, and "as man, cat in "er "ouse. /octor sus%ect s"e"ad infected b, to5o%lasma gondii.uestions

1. Identif, t"e drugs useful for %ro%",la5is and treatment to5o%lasmosis and kno4t"eir to5ic effects L

$elf Gassesment 6uestions1. D"ic" of t"e follo4ing antimalarial drugs s"ould be used for %ro%",la5is for tra&el to

t"e !ast of (ombok island O

'. C"loro6uine

B. )rima6uine





C. #eflo6uine

/. ?,dro5,c"loro6uine

!. ),rimet"amine

2. D"ic" of t"e follo4ing drugs "as a maor side effect of "emol,sis in %ersons 4it"<)/ deficienc,O

'. C"loro6uine

B. )rima6uine

C. #eflo6uine

/. ),rimet"amine

!. /o5c,cline

3. D"ic" of t"e follo4ing drugs is recommended as a single agent for oral treatment of uncom%licated malaria due to c"loro6uineresistent P falciparum strains O

'. /o5,cline

B. Iodo6uinol

C. )rima6uine

/. )roguanil

!. uinine

:. D"ic" of t"e follo4ing drigs is effecti&e against !. "istol,tica and ot"er %roto;oa t"atli&e under anaerobic conditionsO

'. #etronida;ole

B. )entamidine iset"ionate

C. uinine

/. !flornit"ine

!. C"loro6uine

*. D"ic" one of t"e follo4ing statements about amebicides is least accurateO

'. /ilo5anide furoate is a luminal amebicide

B. !metine is contraindicated in %regnanc, and in %atients 4it" cardiac disease

C. #etronida;ole "as little acti&it, in t"e gut lumen

/. )aromom,cin is effecti&e in e5traintestinal amebiasis

!. $,stemic use of iodo6uinol ma, cause t",roid enlargement and %eri%"eralneuro%at",





Te5tbook$ource =

3. at;ung0 B.<. 21. Basic and Clinical )"armacolog,. !ig"t !dition. (ange #edicalBooks#c<ra4 G?ill.

:. at;ung and Tre&orPs. )"armacolog, !5amination and Board Re&ie4. $i5t"!dition.(ange #edical Books#c<ra4?ill.

Le#t(re ,/=

The Ro"e o% Imm(n&t- to &n%e#t&on !Ba)&#+

O"eh=

Dr*'r* Dea Ma'e S($rama2 M*S&2 Sp*MK

Le#t(re ,6=

In%e#t&on o% M-#o0a#ter&(m !TBC+

Pro% Dr*'r* IB Ra&2Sp*P

Le#t(re ,7=

In%e#t&on o% M-#o0a#ter&(m !Lepro)-+

Dr* Dharma p(tra2 Sp*KK

#orbus ?ansen is an infectious disease %rimar, affected t"e %eri%"er, ner&e andsecondar, affected skin and t"e ot"er organ caused b, Mycobacterium leprae. Readle, ando%%ing classification is TuberculoidTuberculoid TT80 BorderlineTuberculoid BT80BorderlineBorderline BB80 Borderlline(e%romatous B(80 and (e%romatous(e%romatous

((8. T"e : cardinal sign of (e%ros, are= 1. #acula ",%o%igmented or er,t"ematous skin02. 'naest"esi0 3. !nlargement of %eri%"er, ner&e0 :. 'cid Fast Bacilli 'FB8 found from slitskin smear. /iagnosis of le%ros, is based on finding t4o from t"ree cardinal sign of le%ros,or if onl, cardinal sign number :.

T"ere are t4o kind regimen t"era%, for le%ros, i.e. t"e t"era%, for %auc, bacillar,le%ros, TT0 BT 4it" 'FB 8 are rimfa%icin mg a mont" and dafsonJ //$8 1 mg ada, continuous for si5 mont" and for multi bacillar, le%ros, are rifam%icin mg a mont"0clofacimin lam%rene8 3 mg a mont" continuous 4it" lam%rene * mg a da, and dafson//$8 1 mg a da, continuous t"era%, for 12 mont"s.





e%ustakaan

1. 'ndre4s /iseases of t"e skin. ine !d2. (e%ros,. T"ird edition. 'nton, Br,ceson

Intoroduction of (e%ros,

1. !5%lain t"e etiolog, of le%ros, #, cobacterium le%rae82. !5%lain t"e test for detection of # le%rae = Aei"leilsen staining test0

"isto%at"ological e5amination0 le%romin test0 <una4an test and anaest"etic test insu%%orting t"e diagnosis of le%ros,

3. !5%lain t"e classification of le%ros,:. !5%lain t"e clinical sign and s,m%tom of le%ros,*. !5%lain t"e com%lications of le%ros,. !5%lain t"e management of le%ros, and t"e com%lications

Ka)()

$eorang 4anita0 3* ta"un mengelu" ada bercak mera" %ada %unggung kiri dan kanandengan batas tidak tegas0 selain itu uga dium%ai bercak mera" di 4aa" dan dada ,gtersebar simetris0 kecilkecil. Bercak mera" tersebut tidak gatal. $elain itu dium%ai%enebalan %ada cu%ing telinga kanan dan kiri serta alis mata rontok.)ertan,aan =

a. '%a ,ang %erlu ditan,akan lagi %ada %enderita tersebutOb. )emeriksaan a%a saa ,ang di%erlukan Oc. '%a diferensial diagnosis $audara Od. '%a diagnosa $audara O

Bagaimana %enatalaksanaann,a O

Le#t(re ,8=Ant&m-#o0a#ter&a" Dr(1) ! ant& TBC2 Ant& "epra+ !PK:PD+

'r* IB N1(rah2 M*For

T"e c"emot"era%, of infection caused b, Mycobacterium tuberculosis is com%licatedbecause= limited information about t"e mec"anism of drugs action0 t"e de&elo%ment of resistance0 t"e intracellular site of m,cobacterial0 t"e c"ronic m,cobacterial disease and

man, drug drug to5icities0 and %atient com%liance. C"emot"era%, of tuberculosis al4a,st"e use of drug combinations to dela, of resistance and increased antituberculosis efficac,.

T"e : cardinal sign of (e%ros, are= 1. #acula ",%o%igmented or er,t"ematous skin0 2. 'naest"esi0 3. !nlargement of %eri%"er, ner&e0 :. 'cid Fast Bacilli 'FB8 found from slitskin smear. /iagnosis of le%ros, is based on finding t4o from t"ree cardinal sign of le%ros,or if onl, cardinal sign number :.

T"ere are t4o kind regimen t"era%, for le%ros, i.e. t"e t"era%, for %auc, bacillar,le%ros, TT0 BT 4it" 'FB 8 are rimfa%icin mg a mont" and dafsonJ //$8 1 mg ada, continuous for si5 mont" and for multi bacillar, le%ros, are rifam%icin mg a mont"0clofacimin lam%rene8 3 mg a mont" continuous 4it" lam%rene * mg a da, and dafson//$8 1 mg a da, continuous t"era%, for 12 mont"s.





Case 1= ' :,ear old man got coug" since one mont"0 lost of a%%etite and s4eating e&er, nig"t. 'fter e5amination t"e %",sician diagnosed t"e %atient as tuberculosis.

1. /escribe t"e combination t"era%, for tuberculosis 4"ic" used best2. !5%lain t"e mec"anism of action of eac" drugs3. T"e t"era%, of tuberculosis need long time. !5%lain 4"at is t"e reason.:. !5%lain t"e interaction of isonia;id 4it" %"en,toin*. /escrie t"e to5ic effect of drugs for tuberculosis

. (ist all drugs for le%ros,7. /escribe t"e mec"anism of action da%sose for le%ros,+. /escribe 4", ,ou use combination da%sone 4it" rifam%in and clofa;imine

for le%ros,9. /escribe t"e to5ic effects of da%sone and treatment for er,t"ema nodosum1./escribe t"e %"armacological as%ects of rifam%in for le%ros,11. /escribe t"e %"armacological as%ects of clofa;imine for le%ros,

$elf assessment=

1. Com%are t"e fate of isonia;id in slo4 asetilator %atient and ra%id asetilator %atient.2. Isonia;id for tuberculosis is usull, combined 4it" &itamin B. /escribe t"e reason3. D", do ,ou c"oose %,ra;inamide as %rimar, drug for tuberculosis.

Le#t(re ,9=

Contro" o% m&#roor1an&)m !&n%e#t&on #ontro"+

'r* N& Ma'e A'&tar&n& Sp* MK

ABSTRACT

#icroorganism like &iruses0 bacteria0 fungi and %roto;oans re%roduce directl, 4it"int"e "ost. T"e, are usuall, small and "a&e a s"ort generation time. Reco&er, from infectionusuall, gi&es immunit, against reinfectionN in t"e case of &iral infections t"is ma, belifelong. De kno40 t"e source of infection can be from communit, and "os%ital0 4"ile t"etransmission of infection &aries to de%ending from microorganism. T"e %rinci%le %re&entionof infection must to kno4 t"e kind of microorganism0 transmission met"od and %o%ulation of infection. 'mong &arious maor factors contributing to t"e emergence of infectious diseases0t"e im%ortant ones are "uman demogra%"ics and be"a&ior0 industr, and tec"nolog,0economic de&elo%ment and land use0 globali;ation and international tra&el0 microbialada%tation and c"ange0 breakdo4n of %ublic "ealt" measures0 and economic dis%arit, of

"a&e and "a&enotsne of t"e great ac"ie&ements of a%%lied medical researc" "as been its success in

controlling so man, infectious diseasesN small%o5 "as been eradicated and ot"er infectionsare no4 controlled effecti&el, in man, %arts of t"e 4orld. T"is control "as beenaccom%lis"ed in t"ree main 4a,s b, t"e use of c"emot"era%,0 immuni;ation and im%ro&ingt"e en&ironment e.g. better sanitation0 nutrition8

In general0 c"emot"era%, is used to control infectious diseases in indi&iduals04"ereas immuni;ation and en&ironmental im%ro&ements are used for control in %o%ulations.-nderstanding t"e 4a,s in 4"ic" t"ese diseases arise0 s%read and can be controlledre6uires detailed e%idemiologic studies to %ro&ide an accurate basis for assessment of risksand for %lanning inter&ention. T"ese studies are based on kno4ledge of t"e infectiousagents and t"eir %atterns of association 4it" t"eir "osts0 but re6uire t"e collection and

anal,sis of data0 in conunction 4it" t"e use of mat"ematical models0 to %roduce useful%ictures of disease transmission and control. D"ere t"e causal links bet4een a clinical





condition and an infectious agent or its mode of transmission are unkno4n0 e%idemiologicin&estigations can establis" t"is link and t"us determine a%%ro%riate control strategies.Learn&n1 Ta)$

1. /escribe risk factors are influence to communit, infection and "os%ital infection2. /escribe "o4 infections flo4 t"roug" a "ost %o%ulation .3. /escribe some strategies for control of infectious diseases.:. /escribe some factors are influence to s%read of infection.*. /escribe some factors are influence t"e success of &accination.

Se"% A))e)ment1. Com%arison of c"emot"era%, and &accination2. !5%lain t"e meaning of t"is term abo&e =

a. $usce%tible "ostb. Incubation %eriodc. (atent %eriodd. <eneration time

3. #ention some factors are im%ortant at &accination gift

Re%eren#e =#ims. #edical #icrobiologi0 :t" !dition0 #osb, !lse&ier. 2+. %.::*:*7 E %. **1*+

(ecture 19=

Imm(n&>at&on &n #h&"'

dr. /4i (ingga0 s%.' dr. D. <usta4an0$%.'

A0)tra#t

Immuni;ation is t"e %rocess of artificiall, inducing immunit, or %ro&iding %rotection fromdisease. 'cti&e immuni;ation is t"e %rocess of stimulating t"e bod, to %roduce antibod, andot"er immune res%onses t"roug" administration of a &accine or to5oid. )assi&eimmuni;ation0 t"e %ro&ision of tem%orar, immunit, b, administration of %reformedantibodies deri&ed from "umans or animals. Biologic agents used to induce acti&eimmuni;ation include &accines and to5oids. ' &accine is defined as a sus%ension of li&eusuall, attenuated8 or inacti&ated microorganisms0 or fractions t"ere of0 4"ic" isadministered to induce immunit, and %re&ent infectious disease or its se6uelae. T"ere aresome diseases t"at can %re&ent 4it" immuni;ation. )olio0 di%"t"eria0 tetanus0 %ertusis0tuberculosis0 measles0 "e%atitis B0 "e%atitis '0 influen;a0 meningitis caused b, "emo%"ilusinfluen;a t,%e B. 'll &accines ma, cause side effects0 and immuni;ation safet, is a realconcern. -nlike most ot"er medical inter&entions0 &accines are gi&en to "ealt", %eo%le0 and

%eo%le are far less 4illing to tolerate &accinesM ad&erse effects t"an ad&erse effects of ot"er treatments. 's t"e success of immuni;ation %rograms increases and t"e incidence of disease decreases0 %ublic attention s"ifts a4a, from t"e risks of disease to t"e risk of &accination0 and it becomes c"allenging for "ealt" aut"orities to %reser&e %ublic su%%ort for &accination %rograms.

Learn&n1 ta)$T"e bab,0 bo,0 * mont"s old accom%anied b, "is mot"er come to clinic to get immuni;ation.?is mot"er told to doctor t"at "er bab, "ad fe&er after t"e first /)T immuni;ation. ?er bab,"ad fe&er until 3+C. ?e "as no sei;ure0 no "ig" cr,ing but "is mot"er 4orried about t"ate5%erience.1. D"at is t"e e5%lanation t"at ,ou must tell to "is mot"erO

2. ?o4 about t"e ne5t immuni;ation sc"eduleO3. D"at is contraindication for ne5t immuni;ationO





Le#t(re 3<

Ant&)ept&# an' '&)&n%e#tant

Dr*'r*B*K* Satr&-a)a2M*Repro

A0)tra#t=/isinfectants are c"emical agent t"at in"ibit or kill microorganism in an inanimateen&ironment. 'ntise%tics are disinfecting agent 4it" sufficientl, lo4 to5icit, for "ost cells t"att"e, can be used directl, on skin0 mucous membranes or 4ound. 'ntise%tics anddisinfectants are e5tensi&el, used in "os%itals and ot"er "ealt" care settings for a &ariet, of to%ical and "ardsurface a%%lications. ' 4ide &ariet, of acti&e c"emical agents biocides8are found in t"ese %roducts0 man, of 4"ic" "a&e been used for "undreds of ,ears0 includingalco"ols0 %"enols0 iodine0 and c"lorine.

' 4ide &ariet, of acti&e c"emical agents or biocidesS8 are found in t"ese %roducts0 man, of 4"ic" "a&e been used for "undreds of ,ears for antise%sis0 disinfection. /es%ite t"is0 less iskno4n about t"e mode of action of t"ese acti&e agents t"an about antibiotics. In general0biocides "a&e a broader s%ectrum of acti&it, t"an antibiotics0 and0 4"ile antibiotics tend to"a&e s%ecific intracellular targets0 biocides ma, "a&e multi%le targets. T"e 4ides%read useof antise%tic and disinfectant %roducts "as %rom%ted some s%eculation on t"e de&elo%mentof microbial resistance0 in %articular crossresistance to antibiotics. T"e %rocess of disinfectants %re&ent infection b, reducing t"e number of %otentiall, infecti&e organismeit"er b, killing0 remo&ing0 or diluting t"em.

'ntise%tics are disinfecting agents 4it" sufficienc, lo4 to5icit, for "ost cells t"at can useddirectl, in skin0 mucous membrane0 or 4ound. /isinfectants are strong c"emical agents t"at

in"ibit or kill microorganisms in an inanimate en&ironment. /isinfectant and antise%tics donot "a&e selecti&e to5icit,0 and t"eir clinical use are t"erefore limited. #ost antise%tics dela,4ound "ealing. -ser of antise%tics and disinfectants need to consider t"eir s"ortterm andlongterm to5icit, since t"e, ma, general biocidal acti&it, and ma, accumulate in t"een&ironment or t"e bod, of t"e %atients.

Learn&n1 Ta)$

1. (ist t"e /isinfectants and antise%tics at;ung E Tre&orPs0 at;ung0 B<82. !5%lain t"e mec"anism of action disinfectants and antise%tics at;ung E Tre&orPs0

at;ung0 B<8

3. /escribe t"e clinical use of disinfectants and antise%tics for nosocomial infection:. /escribe t"e side effect of disinfectants and antise%tics at;ung E Tre&orPs0

at;ung0 B<8

Se"% a))e))ment1. D"ic" one t"e follo4ing antise%tics %romote 4ound "ealingO

'. IodineB. 'lco"olC. ?e5ac"loro%"ene/. C"lor"e5idine!. one of t"e abo&e

2. . D"ic" one t"e follo4ing antise%tics and disinfectant deri&ates of o5idi;ing 'gentO

'. IodineB. 'lco"ol





C. ?e5ac"loro%"ene/. C"lor"e5idine!. ?,drogen %ero5ide

3. 'lco"ols are not used as sterilants because t"e, are. !C!)T= '. T"e, are s%oricidal B. /o not %enetrate %roteincontaining organic material C. #a, not be acti&e against ",dro%"ilic &iruses /. (ack residual action !. T"e, e&a%orate com%letel,:. #ec"anism of action of %o&idoneiodine is to

'. In"ibitor of arabinos,l tranferaseB In"ibitor of t",midilate s,ntetaseC In"ibitor of %rotein kinase/ /enature of %rotein!. /enature of li%id

Le#t(re 3,Un&.er)a" Pre#a(t&ondr 'gus $omia0$%.)/

(earning taskCase 1 ' 22,earold male0 4ork as an interns doctor in emergenc, care unit0 "ad a %atient 4it"sus%ected of ?I@ infection stage I@ and (ung TB and c"ronic diarr"ea. T"is doctor 4ill dot"e "istor,taking0 %",sical e5amination and gi&ing first aid to t"e %atient

(earning Task=1. D"at is t"e t,%e of e5%osure risk t"at ma, "a%%en to t"is doctorO2. D"at is s%ecific %recaution t"at t"is doctor "a&e to do to %re&ent cross

transmissionO3. D"at are t"e kind of bod, %rotector t"at t"is doctor "a&e to 4ear O:. If t"is doctor "a&e to take blood s%ecimen 4it" s,ringes needle to laborator,

e5amination0 "o4 to reca%%ing needles in order to %re&ent t"e infectionO

$elf assessment=1. /escribe about=

a. osocomial infection

b. inds of nosocomial infectionc. ?o4 to do ",gienic "and 4as"ingd. ?o4 is t"e %re%aration and %rocedure of using sterile glo&esOe. ?o4 is t"e %re%aration and %rocedure unleas"ing sterile glo&esO

2. !5%lain %at"ogenesis of=a. osocomial blood stream infection





Le#t(re 33Proto>oa In%e#t&on I !Ma"ar&a2 Amoe0&a)&)2

Le&)man&a)&)2Tr&pano)om&a)&)2To?op"a)mo)&)2 Tr&#homon&a)&)+O"eh=

'r*Dea A-( A* Sr& La$)m&2M*S#2 M*Ke)'r* P(t( A)tr& Dama-ant&2M*Ke)

ABSTRACT

)roto;oa are unicellular organisms t"at "a&e tro%"o;oite form 4it" one or more nucleicontaining nucleoli or kar,osome and bounded b, a nuclear membrane and t"e usualeukar,otic c,to%lasmic organelles including mitoc"ondria ribosomes and endo%lasmicreticulum. Tro%"o;oite "a&e a cell membrane but not cell 4all. #ost intestinal )roto;oa alsode&elo% c,st t"at are more resistant t"an t"e fragile tro%"o;oite to dr,ing0 cold or ot"er en&ironmental stresses.

#alaria and To5o%lasmosis 4ell kno4n as %arasitic disease and "a&e great im%actdue to t"eir 4orld4ide distribution. ?uman malarial %arasite 4ere first seen in 1++ andt"eir de&elo%ment bot" in t"e ano%"eline mos6uito and in t"e "uman blood stream 4as 4ellunderstood b, 190 "o4e&er $e&eral clinical s,ndromes kno4n to be caused b, infectionof malaria %arasites 4ere first recogni;ed centuries before t"e disco&er, of t"eir %at"ogens.Conse6uentl, t"e diseases 4ere referred to t"e t,%e of febrile c,cle. uotidian0tertian and 6uartan fe&ers denoted res%ecti&el, 2:0:+ and 72 "our c,cles of fe&er. T"emodern tendenc, is to refer t"e &arious t,%es of malaria b, t"e name of t"e agent.

To5o%lasma is caused b, a coccidian %arasite0 Tooplasma !ondii . It "as a4orld4ide distribution and s"o4s a broad "ost range from 4arm blooded animals to birdsand re%tiles. #an ac6uires t"e infection indirectl, b, ingesting ooc,sts from contaminateden&ironments0 b, consuming To5o%lasma c,sts from tissues of ot"er intermediate "ostssuc" as co40 goat0 c"icken0 duck0 rabbit0 b, blood transfusion or trans%lantation0 or directl, b, trans%lacental infection

?uman infection is generall, asim%tomatic and self limited e5ce%t inimmunocom%romised "ost0 infection can disseminated and fatal. T"e %re&alence of antibod, to to5o%lasma in "uman and animal ranged from 2J to 7*J in $out"east 'sianCountries. Cats are t"e definiti&e "ost of T$ !ondii N t"e, are t"e onl, animals t"at %assooc,sts in t"eir feces .

LEARNING TASKS PROTO@OA INFECTION

1. Ca)e=

' 3* ,ear old man %resent to %rimar, %ublic "ealt" ser&ice 4it" one 4eek "istor, of "eadac"e0 fe&er0 c"ills0 s4eats and m,algia. )atient "istor, re&eals t"at "e ust returnedfrom Dest )a%ua after 2 mont"s li&ed t"ere. ?e took c"loro6uine malarial %ro%",lacticirregularl,. )",sical e5amination s"o4ed raised bod, tem%erature :C80 a ra%id %ulserate0 and generali;ed s4eating. Com%lete Blood Count 4as ordered and demonstratedintra er,t"roc,te organism.

a. /escribe t"e laborator, e5aminations to define t"e diagnosis

b. D"en in blood smear demonstrate normal si;e er,t"roc,te containing crescents"a%e gametoc,tes and multi%le ring form 4it"in t"e blood cell0

D"at is t"e most likel, diagnosed in t"is %atientO





4"at is et&o"o1- of t"is cases and describe t"is para)&te "&%e #-#"e

c. /escribe t"e %at"ogenesis of t"is disease

2. )lease com%are t"e mor%"olog, c"aracteristic of : t,%e of %lasmodium in "uman.3. /escribe briefl, about c"agasP disease.

:. /escribe t"e life c,cle of Trypanosoma cru%i and Leishmania donovani 6* Ca)e

' %re&iousl, "ealt", 2+,ear old man0 4"o "ad recentl, returned from a tri% to(ombok0 4as seen b, "is famil, %",sician for cram%, abdominal %ain0 malaise0 slig"tfe&er and blood,0 mucoid diarr"ea. (i6uid stool s%ecimens 4ere collected andsubmitted for culture for enteric bacterial %at"ogens as 4ell as %arasites. $tool cultures4ere negati&e for bacterial %at"ogens0 e5amination for o&a and %arasites 4as %ositi&efor motile tro%"o;oites in t"e saline 4et amount0 and ameboid tro%"o;oites 4it" finel,granular c,to%lasm and ingested red blood cells in t"e %ermanent tric"rome stain.

a. /escribe t"e life c,cle of %arasites abo&e L

b. !5%lain t"e %at"ogenesis of %arasite abo&eL

c. /escribe infecti&e stages of %arasite abo&eL

. /escribe t"e life c,cle of Trichomonas va!inalis

7. /escribe infecti&e stages of Trichomonas va!inalis

+. !5%lain 4"at t"e differences of "ntamoeba histolytica and &iardia lamblia life c,cleO

9. /escribe t"e life c,cle of Tooplasma !ondii

1. !5%lain transmission of Tooplasma !ondii infection

11. !5%lain 4", to5o%lasma infection became latenc,O

Le#t(re 35Proto>oa In%e#t&on II !Mana1ement o% proto>oa In%e#t&on)+

'r ("& Ga-atr&2 Sp*PD

O0e#t&.e)

• To describe name t"e : im%ortant members of t"e <enus Plasmodium

• To kno4n 4"ic" from of #alaria is most dangerous and 4",.• To describe disease t"at #alaria most commonl, mimic

• To understand "o4 #alaria is diagnosed

• To describe t"e current recommendation for #alaria treatment and 4"at factors

dictate t"e regimen of c"oice

• Recogni;ed 4"en s"ould c"emo%rofila5is be begun and "o4 long after com%letion

of a tri% to an endemic area s"ould %re&enti&e t"era%, be continued

• To describe clinical %resentation of 'moebiasis To5o%lasmosis Tric"omoniasis

• To kno4 "o4 'moebiasis To5o%lasmosis Tric"omoniasis

Is diagnosedO

• To describe 4"at are t"e treatment of c"oice of 'moebiasis To5o%lasmosis

Tric"omoniasis





Case 1= ' 21,earsold man com%lained 4it" fe&er for da,s %rior to admission0 rela%sing c"ills0muscle ec"es and lost of a%%etite. ?e took se&eral da, tri% to (ombok island. T"e, notedsome mos6uito bites and ate some fruits on t"e island. 'bout 3 da,s into t"e illness ?ebecame aundice and began %assing dark urine. T"e, soug"t treatment from local (ombok%",sician0 4"o diagnosed "e%atitis secondar, to ingestion of to5ic food. T4o da,s later ?e4as referred to $angla" ?os%ital for intensi&e treatment. Based on an initial e5amination0%atient 4as conscious0 look %ale and icteric0 bod, tem%erature 4as 3+0* UC.(earning task=

1. Find ke, 4ords related to t"is case2. /escribe condition related to ke, 4ords3. /efine organ s,stem t"at in&ol&ed in t"is condition and find %robabl, cause of

t"e ke, 4ords:. /efine differential diagnosis and ot"er e5aminations to su%%ort t"e diagnosis*. /escribe kinds of laborator, e5amination to diagnose malaria e.6. blood

smear0 t"ick smear0 ra%id test0 etc. /efine management of t"is case

7. /efine com%lication and %rognosis+. /efine %re&ention based on indi&idual0 famil,0 and communit,$elf assessment=

1. /escribe kinds of %lasmodium2. /escribe %at"ogenesis of malaria3. /escribe diagnosis of malaria:. /escribe %at"ogenesis of com%lication*. /efine management of uncom%licated malaria. /efine management of malaria 4it" se&ere com%licatio

Le#t(re 3/In%e#t&on o% Entero0a#ter !Th-po&'2 C* 0ot("&n(m+

dr 'gus $omia0$%.)/

Ca)e , ' 22,earold male0 4it" feeling generall, un4ell 4it" fe&er0 "eadac"e0 malaise anddiarr"ea. t"e onset of fe&er since 7 da,s ago. ?is bod, tem%erature 4as 39 degree celcius0blood %ressure 12+ mm?g0 )ulse rate 1 beat %er minute.

(earning Task=*. /efine and describe ot"ers s,m%toms related to t"e %atients t"at s"ould be

asked to t"is %atient. /escribe %",sical e5amination to su%%ort diagnosis of t"is %atient.7. D"at is %ossibl, diagnosis of t"is %atientO+. /escribe differential diagnosis of t"is case9. /escribe laborator, and ot"er e5amination to su%%ort t"e diagnosis1. /escribe management of t"is %atient11. /escribe "o4 to e5%lain to t"is %atient about %rognosis of %atientVs disease

Ca)e ,= ' :2,earold man com%lained 4it" diarr"ea since last nig"t. ?is diarr"ea 4as 1 times.

/iarr"ea "as accom%anied 4it" nausea0 abdominal %ain0 and malaise. o "istor, of fe&er and stomac"ac"e. ?e is a salesman. ?e took medicine to retrie&e "is diarr"ea0 but it doesnot 4ork.





(earning task=1. /efine ot"er sign and s,m%toms from t"is %atient2. /escribe %",sical e5amination must be done to t"is %atient3. /escribe laborator, e5amination and ot"er e5amination must be done to su%%ort

diagnosis:. /escribe management of t"is %atient*. /escribe %lan of t"era%, based on %riorit, on t"is %atient

$elf assessment=3. !5%lain %at"ogenesis of=

a. Bacillare /,sentriaeb. T,%"oid fe&er c. C"olerad. Clostridium difficile associated diarr"ea

:. /escribe and inter%ret cerebros%inal fluid C$F8 e5amination in bacterial meningitis0&iral meningitis0 tuberculous meningitis0 and stre%tococcal meningitis.

*. /efine signs and s,m%toms of=

a. T,%"oid fe&er b. Bacillare d,sentriaec. C"olerad. Clostridium difficile associated diarr"ea

. /ifferentiate clinical sign and s,m%toms of diarr"ea caused b, bacillare d,sentriae0c"olera and Clostridium associated diarr"ea

7. /escribe ste%s for "o4 4e doing re",dration

+. /efine management of t"ese %atients=a. T,%"oid fe&er b. Bacillare d,sentriaec. C"olera

d. Clostridium difficile associated diarr"ea9. /escribe about com%lication of

a. T,%"oid fe&er b. Bacillare d,sentriaec. C"olerad. Clostridium difficile associated diarr"ea

Le#t(re 36

Sep)&) an' Ba#terem&a

dr. #ade $usila utama0 $%.)/

KKKKKKKKKKKKKKKKKKKKKKKKKKKK





Le#t(re 37

C(taneo() V&ra" In%e#t&on !Var&#e""a2 @o)ter2 Herpe)+

O"eh=

dr.I<' $umed"a )ind"a0 $%.dr. !lis Indira0$%.

Learn&n1 ta)$

'n adult 4oman0 :* ,ears old came to clinic 4it" c"ief com%laints grou% of small blister inrig"t side of t"e back since 3 da, ago t"en t"e lession s%read to t"e rig"t 4aist and rig"tc"est. T"is com%lain is accom%anied 4it" burning sensation. ne da, before t"e blistera%%eared %atient "ad fe&er. ?istor, of t"e same disease 4as denied. ?istor, of takingmedicine before 4as denied.

1. D"at s"ould 4e asked to t"e %atient in t"e anamnesis O2. /escribe t"e effloresensi in %",sical e5amination.3. D"at are t"e differential diagnosis in t"is %atient O:. D"at (aborator, tests is needed to confirm diagnosis of t"is caseO*. D"at is t"e diagnosis of t"is %atient O. #ention about com%lication of t"is disease7. D"at is t"e %rognosis of t"e disease O+. D"at is t"e treatment of t"is caseO9. D"at ad&ice 4e can gi&e to t"e %atient O

$elf 'ssasement

1. D"at kind of diseased t"at can caused b, t"e "er%es &irus grou% and 4"at is t"e nature &irus of t"is grou%O2. D"at is t"e maorit, c"aracteristic of t"ese grou% of &irusO3. D"at is clinical manifestation of &aricella O:. ?o4 is %at"ogenesis of ?er%es Aoster infectionO*. #ention about trigger factor t"e emergence of lesions in "er%es sim%le5. D"at are t"e com%lication t"at occurs in ?er%es AosterO7. #ention about com%lication t"at could occur "a%%ens 4"en %regnant 4omen suffer from&aricella+. D"at is t"e management of skin diseases caused b, &irusesO

Le#t(re 38

Retro.&ra" In%e#t&on !HIV+

O"eh=

)rof. /r. dr. Tuti )ar4ati #erati0 $%)/0 )TI





Le#t(re 39

In%"(en>a

O"eh=

)rof. /r. dr. Tuti )ar4ati #erati0 $%)/0 )TI

INFLUEN@A

A0)tra#t

Influen;a &irus infection0 one of t"e most common infectious diseases0 is a "ig"l,contagious airborne disease t"at causes an acute febrile illness and results in &ariabledegrees of s,stemic s,m%toms0 ranging from mild fatigue to res%irator, failure and deat".T"ese s,m%toms contribute to significant loss of 4orkda,s0 "uman suffering0 mortalit,0 and

significant morbidit,. 'ccuratel, diagnosing influen;a ' or B infection based solel, on clinicalcriteria is difficult because of t"e o&erla%%ing s,m%toms caused b, t"e &arious &irusesassociated 4it" u%%er res%irator, tract infection -RTI8. In addition0 se&eral serious &iruses0including adeno&iruses0 entero&iruses0 and %aram,5o&iruses0 ma, initiall, cause influen;alike s,m%toms. T"e earl, %resentation of mild or moderate cases of fla&i&irus infections eg0dengue8 ma, initiall, mimic influen;a. For e5am%le0 some cases of Dest ile fe&er ac6uiredin e4 Hork in 1999 4ere clinicall, misdiagnosed as influen;a. )atients 4it" influen;afre6uentl, %resent 4it" &arious s,m%toms s"ared b, man, ot"er &iral infections. In t"enort"ern and sout"ern "emis%"eres0 t"ese s,m%toms are more common in t"e 4inter mont"s.Influen;a &irus is a singlestranded R' &irus0 di&ided into t,%e '0 B0 and C 4"erestructurall, and biologicall, similar but &ar, antigenicall,. It is famil, of rt"om,5o&iridae.T"e most common %re&ailing influen;a ' subt,%es t"at infect "umans are ?11 and ?32.

!ac" ,ear0 t"e tri&alent &accine used 4orld4ide contains ' strains from ?11 and ?320along 4it" an influen;a B strain. Influen;a &irus infection occurs after transfer of res%irator,secretions from an infected indi&idual to a %erson 4"o is immunologicall, susce%tible. If notneutrali;ed b, secretor, antibodies0 t"e &irus in&ades air4a, and res%irator, tract cells.nce 4it"in "ost cells0 cellular d,sfunction and degeneration occur0 along 4it" &iralre%lication and release of &iral %rogen,. $,stemic s,m%toms result from inflammator,mediators0 similar to ot"er &iruses. Influen;a ' is generall, more %at"ogenic t"an influen;aB. Recentl,0 mutation of influen;a ' &irus cause t"e emergence of ne4 strain of &irus 4"ic"cause s%ecific influen;a suc" as Birds flue ?*18 and $4ine flue or o&el ?11.

Ca)e=

' man of : ,earold came to "os%ital com%laining fe&er0 "eadac"e0 sore t"roat andm,algia since : da,s . ?e ust come from ?ong ong about a 4eek ago. ?e also "adcoug"0 and feeling &er, 4eak.

Le#t(re3;

In%e#t&on &n #h&"'ren !DBD2 D&%ter&2 )ep)&)2 Campa$+

dr. /4i (ingga0 s%.' dr. D. <usta4an0$%.'

Case 1


http://emedicine.medscape.com/article/211738-overview















' bo,0 ,ears mont"s "as come to our clinic 4it" s4elling and %ain on t"e c"eek under rig"t ear since 2 da,s ago. ?e "as fe&er since : da,s ago. ?e "asnPt cor,;a0 coug" andcold. ?is a%%etite 4as decrease. ?is friends on t"e sc"ool "a&e t"e same com%laint.

1. D"at is t"e close diagnosis of t"is caseO2. D"at is t"e differential diagnosisO3. D"at is t"e laborator, su%%ort neededO:. D"at is t"e t"era%,O*. D"at are t"e com%lications of t"is caseO

Case 2 ' bo, comes to m, clinic 4it" fi&e da,s of fe&er as t"e c"ief com%laint. ?e 4as currentl, ,ears and 1 mont"s old and a first grade of elementar, sc"ool student. Fe&er 4ass%eaking immediatel, and "as resol&ed one da, before t"e doctor &isited. T"is morning t"efe&er rea%%ears0 gi&ing a %attern of saddle back fe&er0 4"ic" is accom%anied 4it""eadac"e0 muscular %ain0 articular and &ertebra %ain0 retro orbital %ain0 nausea0 &omitingand skin ras"es. T"e skin ras" a%%eared at t"e beginning of t"e disease0 but subse6uentl,

&anis"ed 4it"out an, marks. In %",sical e5amination0 t"e c"ild looked com%os mentis0mildl, ill 4it" fe&er of 3+.+ C. /ermatological e5amination re&eals skin ras"0 mainl, on t"elegs0 foot soles and %alms0 t"e %"ar,n5 4as slig"tl, ",%eremic and t"ere is no %al%ableenlarge l,m%" nodes on t"e neck. 'uscultator finding of t"e "eart and lungs 4ere 4it"innormal limits. 'bdominal e5amination re&ealed e%igastrial and rig"t u%%er 6uadranttenderness on %al%ation. T"ere 4as no li&er enlargement. o significant finding e5isted ont"e e5tremities0 e5ce%t for t"e %ositi&e tourni6uets test.

1. D"at is t"e close diagnosis of t"is caseO2. D"at is t"e differential diagnosisO3. D"at is t"e laborator, su%%ort neededO:. D"at is t"e t"era%,O*. D"at are t"e com%lications of t"is caseO

Case 3 ' girl0 2 ,ears0 comes to clinic 4it" fe&er and ras" as t"e c"ief com%laint. Fe&er 4as a%%ear from * da,s ago and ras" a%%ear since ,esterda,0 4"ic" is accom%anied 4it" "eadac"e0coug"0 muscular %ain0 nausea0 &omiting and red of "er e,es. T"e ras" %"ase isaccom%anied b, "ig" fe&er. T"e macular ras" begins on t"e "ead abo&e t"e "airline8 ands%reads o&er of t"e bod, in 2: "ours in a descending fas"ion.

1. D"at is t"e close diagnosis of t"is caseO2. D"at is t"e differential diagnosisO3. D"at is t"e laborator, su%%ort neededO:. D"at is t"e t"era%,O

*. D"at are t"e com%lications of t"is caseO

Case : ' bo,0 3 ,ears0 comes to emergenc, de%artment 4it" unconsciousness since 2 "ours ago.T"is com%laint suddenl, occurs 4"en "is mot"er talk to "im. ?e is no res%onse to talk0 nomo&e0 and "is e,e look o%ened. ?e "ad fe&er since * da,s ago and still "ig" until no4. ?istem%erature 4as unstable0 it 4as decrease after drink %arasetamol0 and increase again fe4"our after t"at. T"e earliest s,m%toms are 4eakness0 nausea or abdominal %ain0 and"eadac"e.

1. D"at is t"e differential diagnosisO2. D"at is t"e ot"er data needed to com%lete t"is caseO3. D"at is t"e laborator, su%%ort neededO:. D"at is t"e t"era%,O*. D"at are t"e com%lications of t"is caseO





Le#t(re 5<

@oono)&) In%e#t&on !Ra0&e)2 Lepto)p&ro)&)2 L&)ter&o)&)+

)rof./r. dr. Raka $ude4i0 $%.$ 8

dr. $ri Buda,anti0 $%.#

Infections in central ner&ous s,stem "a&e certain uni6ue c"aracteristics. First0 t"e,occur 4it"in an anatomic closed s%ace. $econdl,0 t"e natural "istor, of illnesses due toC$ infection often differs strikingl, from t"at of t"ose due to infection at ot"er sites0 e&en4"en caused b, t"e same organism. T"irdl,0 man, C$ infections cause "ig" mortalit, t"e%atients sur&i&es0 serious se6uelae after resolution of t"e acute infections.

T"ere are four cardinal manifestation of $ infection are= fe&er0 "eadac"e0 alteration

of mental status0 and focal neurologic signs. $ometimes0 t"ese signs can be found innoninfectious C$ s,ndromes. T"e time course of disease is es%eciall, im%ortant in t"ee&aluation of disease affecting t"e C$. T"e date of onset0 tem%oral relations"i% to%resdi%osing factors0 rate of %rogression0 time to reac" t"e %eak of se&erit,0 time needed tores%ond to treatment0 and rate of resolution are all "ig"l, informati&e.

Infections of C$ can be caused b, bacteria %,rogenic infections80 fungal0s%iroc"etal0 %arasitic0 and sarcoid. ),rogenic infections of C$ suc" as bacterial meningitis0se%tic t"rombo%lebitis0 brain abscess0 e%idural abscess0 and subdural em%,ema. T"egranulomatous infections of C$ suc" as tuberculosis0 s,%"ilis0 and ot"er s%iroc"etalinfections0 and fungal infections.

Case 1 ' 27 ,earold man0 Balinese0 ?indu 4it" unconciousness in emergenc, room $angla"?os%ital. From "is famil, told t"at it 4as con&ulsion at least for 3 "ours before arri&ed in"os%ital. From %",sical e5amination0 a5illar, tem%erature 390*C.

(earning Task=12. /efine and describe ot"ers s,m%toms related to t"e %atients t"at s"ould be

asked to "is famil,13. /escribe %",sical e5amination to su%%ort diagnosis of t"is %atient.1:. D"at is %ossibl, diagnosis of t"is %atientO

1*. /escribe differential diagnosis of t"is case1. /escribe laborator, and ot"er e5amination to su%%ort t"e diagnosis17. /escribe management of t"is %atient1+. /escribe "o4 to e5%lain to "is famil, about %rognosis of %atientVs disease

$elf assessment=1. /escribe about=

a. #eningitisb. !nce%"alitisc. #eningoence%"alitisd. #,elitise. Cerebral abscess

11. !5%lain %at"ogenesis of bacterial meningitis





12. /escribe and inter%ret cerebros%inal fluid C$F8 e5amination in bacterial meningitis0&iral meningitis0 tuberculous meningitis0 and stre%tococcal meningitis.

13. /efine signs and s,m%toms of=a. #eningitisb. Cerebral abscessc. 'cute 'nterior )oliom,elitisd. 'I/$ /ementia Com%le5e. Cerebral c,sticercosis

1:. /ifferentiate clinical sign and s,m%toms of bacterial meningitis0 &iral meningitis0tuberculous meningitis0 and stre%tococcal meningitis

1*. /efine management of t"ese %atients=a. ?er%es $im%le5 !nce%"alitisb. Tuberculous meningitisc. Cerebral abscess

1. /efine %rognosis of=a. 'cute anterior %oliom,elitisb. Tuberculous meningitis

c. Cerebral abscess17. /escribe kinds or t,%es of neuros,%"ilis1+. /escribe about tabes dorsalis

Le#t(re 5,

Pr&n#&p"e) o% F(n1a" In%e#t&on !Morpho"o1- o% F(n1a"+

dr. (u" 'ri4ati

A0)tra#t =Fungi are eukar,otic microorganism0 "a&e a nucleus containing t"eir /' and a

R' nucleolus0 and c,to%lasma. $urrounding t"em is %lasmalemma 4"ic" containingergosterol and out side %lasmalemma is a rigid cell 4all. Fungi do not contain c"loro%",land cannot s,nt"esi;e macro molecules from carbon dio5ide and energ, deri&ed from lig"tra,s0 t"erefore all fungi lead a "eterotro%"ic e5istence in nature as sa%robes0 commensalsor %arasites.

Fungi can be di&ided into t4o basic mor%"ologic form= ,east and ",%"ae.

Heast are unicellular and re%roduce ase5uall, b, budding and most fungi "a&e branc"ing0t"readlike tubular filaments called ",%"ae. /imor%"ic fungi e5ist in bot" form. 'll fungire%roduce b, ase5ual %rocesses and most can re%roduce b, se5ual mec"anism.

T"e fungi contribute to food s%oilage0 destro, te5tile0 etc. 's sa%robe0 t"e, s"are4it" bacteria in t"e deca, of com%le5 %lant and animal remains in t"e soil. Fungi used in%roduction of antibiotics0 %roducts of fermentation suc" as be&erages0 so, sauce etc. Fungiare free li&ing and abundant in nature and a fe4 li&e in normal flora of "umans. T"ousandsof s%ecies "a&e been kno4n0 but less t"an 1 are cause diseases in "umans. T"e effectsof fungi on "umans are numerous suc" as m,coto5icosis0 ",%ersensiti&it, and coloni;ationof fungi 4it" resultant diseases.

?umans "a&e good barriers against fungal infection suc" as intact skin0 mucosalsurfaces0 sali&a0 normal bacterial flora etc. ?ealt",0 immunocom%etent %eo%le "a&e a "ig"

innate resistant to fungi e&en t"oug" t"e, are constantl, e5%osed to t"e %ro%agules of fungi.Infections and diseases occur 4"en t"ere are disru%tions in t"e %rotection barrier of skin





and mucus membrane or defect in immunit, s,stem. T"e c"aracteristic of fungal %at"ogenscategori;ed into grou%s according to tissue t"at t"e, coloni;e= su%erficial0 cutaneous0subcutaneous and s,stemic m,cosis. Fungal infections t"at occur onl, because of com%romising situations are categori;ed as o%%ortunistic m,cosis.Learn&n1 ta)$=

1. /escribe t"e structure of fungi2. !5%lain terms used in medical m,colog, = ,east0 ",%"ae0 m,celium and dimor%"ic

fungi.3. /escribe t"e mec"anisms of fungal %at"ogenesis:. /escribe t"e effect medical im%ortance8 of fungi on "umans*. /escribe t"e laborator, diagnosis of fungal diseases

Le#t(re 53=

)(per%&#&a" %(n1a" In%e#t&on) !T&nea2 T&nea .er)&$o"or2 $a'&'&a)&)

m($o$(taneo()+

)rof. #. $4astika 'diguna

#ale 3* ,ears old came to /ermatolog, Clinic 4it" c"ief com%lain itc"ing in t"e sites of neck0 u%%er0 lo4er e5tremitas0 trunk0 and inner surfaces of t"e t"ig" es%eciall, during t"e"ot climate. It began as a small er,t"ematous and scaling or &esicular and crusted %atc"t"at s%reads %eri%"erall, and %artl, clear in t"e centre. T"ese lesion ma, be slig"tl,ele&ated %articularl, at t"e border0 4"ere t"e, more inflamed and scal,.

1. )lease e5%lore anot"er "istor, to com%lete anamnesis2. D"at kind of clinical e5amination 4ill ,ou doO

3. D"at kind of laborator, e5amination 4ill ,ou do.:. D"at 4as t"e diagnosis of t"is %atientO*. /escribe ,our %lanning t"era%, for t"is %atient.. /escribe ,our %lanning education for t"is %atient.

$elf assessment=1. D"at in t"e definition of dermato%",tosis tinea or ring 4orm82. )lease0 describe t"e fungi of dermato%",tes3. 4"at is t"e differential diagnosis of dermato%",tosis

)lease describe t"e antifungal t"era%,

Le#t(re 55Deep F(n1a" In%e#t&on

O"eh=Pro%*Dr*'r T(t& Parat&2Sp*PD

A0)tra#tFungal infections "a&e become increasingl, fre6uent es%eciall, in immune com%romised"ost suc" as 'I/$0 cancer %atients0 organ trans%lantation 0 and also as a conse6uent of t"e a&ailabilit, of ad&anced medical tec"nolog, 4"ic" allo4 to do more in&asi&etreatment using more in&asi&e instruments. $,stemic fungal infections $FI8 or in&asi&efungal infection are a significant cause of morbidit, and mortalit, among immunecom%romised %atients0 suc" as ?I@infected indi&iduals0 cancer %atients0 neonates and%atients in t"e intensi&e care unit.





T"e infections considered as nosocomial infections in t"e "os%ital for %atients 4"o "a&e riskfactors suc" as immune com%romised %atients. T"e aetiolog, are = )redominant fungi =Candida C8= suc" as C. 'lbicans0 C. !labrata0 C. tropicalis and C. parapsilopsis0 'sper!illus s%%.and Cryptococcus s%%.0 !merging fungi = (usarium s%%.0 and )hi%opuss%%. and !ndemic fungi = Histoplasma capsulatum, *lastomyces dermatitidis andCoccidioides immitis

Clinical /iagnosis= T"ere is no s%ecific sign and s,m%toms of s,stemic fungal infection.T"at is 4", sus%ected clinical diagnosis of s,stemic fungal infection is fre6uentl, late. Itsresemble bacterial infections0 suc" as se&ere se%sis0 se%tic s"ock and multi organ failure. 'lertness to t"is infection 4ill comes late t"oug" sign and s,m%toms a%%ear earl,. In man,cases t"e diagnosis 4as done %er e5lusionem. /iagnosis s"ould be considered in %atient4it" risk factors "as t"e signs of s,stemic infection des%ite ade6uate antibiotics.Risk Factors = )atients at t"e Intensi&e Care -nit IC-80 Coloni;ation of skin and mucousmembranes 4it" Candida, 'lteration of natural "ost barriers 4ounds0 surger,80 T"ecoloni;ed Candida mig"t enter t"e blood stream 4"en microbes balance disturbed b,antibiotics and t"e barrier altered0 eg. Ind4elling central%eri%"eral cat"eter0 eutro%enia

"ematolog, disorders80 #alignanc,0 )ost c"emoradiation t"era%,0 rgan Trans%lant%atients0 ?I@ infection.)ortal entr, = <astro Intestinal tract0 skin0 urogenital tract0 Cat"eter related

Case stud,=

Female * ,earold consulted from a %ri&ate "os%ital 4it" c"ief com%lain = fe&er since *da,s ago. t"er com%lain= coug"ing 7 da,s0 "as been treated 4it" 'B inection0 im%ro&ed 0but 4orsening in t"e last 2 da,s. ?istor, of c"ronic diarr"oea0 but not no4. (oss of a%%etiteand $lig"t odino%"agia. )",sical e5amination = decreased of consciousness0 "ig" fe&er 390+ C80 B)= 1 mm ?g0 )ulse 1+min0 RR 2:min. ?eart = D(0 Ronc"i QQ

(earning Task

D"at is // of t"is %atientsO

C"est ra, = infiltrates on bot" middle and lo4er lung0 increased "ilar marking andem%",sematous lung. (ab. Test = CBC = ?b 702 gdl0 )(T 1:0 T(C 07 5 13 ml0 DBC :0*5 1ml0 t"er %",sical e5amination re&ealed = oral mucosa LL 0 tounge = coated.

D"at lab test do ,ou suggest O





Le#t(re 5/

Treatment o% F(n1a" In%e#t&on !PK:PD+

'r*I B*N1(rah2 M*For: 'r* I G()t& Ma'e S(r-a Can'ra Trap&$a2 M*S#

'bstract

C"emot"era%, t"at are used as antifungal agents difficult to treat fungal infection%articularl, in t"e immunocom%romised or neutro%enic %atient. /rugs for s,stemic fungalinfections are am%"otericin B0 fluoc,tosine0 and a;ole antifungal agents. $,stemic drugs for su%erficial fungal infections are griseoful&in0 terbinafine0 and a;oles. To%ical drugs for su%erficial fungal infections are n,statin0 micona;ole0 clotrima;ole0 "alo%rogin0 tolnafnate0and undec,lenic acid. nl, fe4 drugs are a&ailable for tretament of s,stemic fungal

infections. !rgosterol is a sterol t"at is uni6ue to t"e fungal cell membrane. T"e%redominant sterol of "uman cells is c"olesterol.

' 2*,ear old 4oman 4it" s"e feel itc", since 2 4eeks ago and c"anges bro4n nail colour.T"e %",sician diagnosed as dermato%",tes of t"e nail.

1. D"at kind of antifungal t"e best to be used.2. ?o4 is t"e mec"anism of action of t"e drugO3. /escribe t"e %"armacokinetic of t"e drug:. D"at 4ill be "a%%ened if t"e drug is gi&en concomitanl, 4it" coumarinO

$elf assessment=1. (ist t"e s,stemic antifungals for s,stemic fungal infections and su%erficial fungal

infections2. (ist t"e to%ical drugs for su%erficial fungal infections3. !5%lain t"e mec"anism of action s,stemic antifungals and su%erficial antifungals:. !5%lain t"e %"armacokinetics of am%"otericin B0 fluoc,tosine0 flucona;ole0

itracona;ole0 ketokona;ole0 griseoful&in0 and terbinafine.*. describe t"e clinical uses of s,stemic antifungals and su%erficialis antifungals.. /escribe t"e to5ic effects of s,stemic antifungal and su%erficial antifungals.

Le#t(re 56He"m&nthe) In%e#t&on

'r* I Ma'e S('armaa2 M*Ke)

In t"e ational $tandard of Com%etenc, of -ndergraduate #edical !ducation0 t"e corecontent of curriculum related to "elmint"ic infections "as been identified. T"is core must be4ell mastered b, t"e students. 'lt"oug" "undred or more s%ecies are identified as a"elmint"es of medical im%ortance0 "o4e&er0 onl, a fe4 of t"ose are considered as core.T"e core s%ecies are= 18 'scaris lumbricoides 28 Tric"iuris tric"iura0 38 ?ook4orm s%%0 :8

$trong,loides stercoralisN *8 !nterobius &ermicularisN 8 $%ecies causing cutaneous lar&amigrantN 78 Filaria s%%N +8 $c"istosoma s%%N and +8 Taenia s%%. For t"ose s%ecies0 t"efourt" le&el of studentPs com%etenc, "as been formulated0 in 4"ic" students must be able to





%erform clinical diagnosis based on %",sical e5amination and ot"er additional e5aminationssuc" as sim%le laborator, and ra, e5amination8. Instead of ust making clinical diagnosis0t"e students s"ould also be able to manage all related %roblems com%letel, and indi&iduall,.T"e students must t"erefore be familiar 4it" t"e life c,cle0 e%idemiolog,0 %at"ogenesis0clinical manifestations0 diagnosis as 4ell as treatment %rocedures of all t"e abo&ementioned "elmint"ic infections0 ot"er4ise t"e four le&el of student com%etenc, can not beac"ie&ed.

(earning Tasks

1. /ifferentiate t"e mor%"ological c"aracteristics of t"e class ematode0 Cestode andTrematode

2. /escribe t"eir life c,cles and identif, eac" of t"eir infecti&e stages3. /efine t"eir e%idemiological stand%oints and list t"e factors t"at are closel, related

to t"e transmission of t"e infections:. Identif, t"eir stages of de&elo%ment 4"ic" are useful from t"e &ie4%oint of diagnosis

%ur%ose and tr, to figure t"eir mor%"ological c"aracteristics*. /escribe t"eir %at"ogenesis and clinical manifestations

. #anage a%%ro%riatel, t"e diagnosis0 treatment0 and %re&ention measures.

$elf e&aluation

i #ade 'rtini0 a %re&iousl, "ealt", 2 ,ear old female medical student of t"e Facult, of #edicine -ni&ersit, of -ada,ana 4as admitted to t"e emergenc, room of $angla" ?os%italdue to sei;ure. $"e 4as born in t"e @illage of ete4el0 $ubdistrict of $uka4ati0 district of <ian,ar. and attended %rimar, and secondar, "ig" sc"ool at t"e same &illage. ?er "istor,4as ot"er4ise unremarkable0 alt"oug" s"e re%orted t"at s"e "ad been suffering fromse&ere "eadac"e for a cou%le of mont"s. ?er neurological e5amination re&ealed no clear abnormalities. ?o4e&er0 a com%uteri;ed tomogra%", scan CT scan8 of t"e "ead s"o4edmulti%le calcified lesions in bot" cerebral "emis%"eres.

uestions1. If it is a disease caused b, %arasitic infection0 4"at %arasite 4ould ,ou consider to

be res%onsible for t"e %atientPs conditionO2. ?o4 does man ac6uire t"is infectionO3. D"at are t"e factors t"at ma, %redis%ose to t"is infectionO:. ?o4 4ould ,ou diagnose t"is %atient %ro%erl,O*. ?o4 4ould ,ou treat t"is %atient a%%ro%riatel,O

Le#t(re 58

F&"ar&a)&)

'r* K* A1() Som&a2 Sp*PD

(,m%"atic filariasis is t"e commonest l,m%"atic s,stem infection t"at is occurred incommunit, es%eciall, in eastern %art of Indonesia. (,m%"atic filariasis0 onc"ocerciasis0 andloiasis are t"e t"ree most im%ortant filarial infections of "umans. (,m%"atic filariasis iscaused b, %arasite transmitted b, biting art"ro%ods mos6uitoes8. 'lmost 9J are causedb, +uchereria bancrofti, 4"ose onl, in "uman and most of t"e remainder are caused b,*ru!ia malayi . T"e maor &ectors for +$ bancrofti are culicine mos6uitoes in most urban andsemiurban areas0 ano%"eline mos6uitoes in t"e more rural areas of 'frica and 'edes spp inmna, of t"e endemic )asific island.

'3*,earold 4oman com%laints "er leg is s4elling. T"e s4ollen is getting 4orstand %ain since 2 4eeks ago. ?alf of "is s4ollen leg looks redness and felt %ain. T"e %atient





li&es in Bali and s"e comes from u%ang. $"e "as been like t"is before and it is t"e 3 rd

times. $"e gets fe&ers0 fati6ue0 and "eadac"e.

(earning task=1. /efine ot"er t"ings t"at s"ould be found from "istor, taking of t"is

%atient.2. /escribe %",sical e5amination to diagnose t"is %atient3. /efine ot"er e5amination in&estigation to su%%ort t"e diagnosis:. /efine t"e in&asi&e treatment s"ould be done to t"is %atient*. /escribe management treatment of t"is %atient

$elf assessment=

C"oose RI<?T or DR< of t"ese statement1. T"e %ossibl, diagnosis is limfangitis2. T"e most %ossibl, diagnosis is filariasis 4it" inflammation

3. It needs cell blood count and t"ick smear e5amination:. (,m%"ogra%, e5amination s"o4ed obstruction0 atresia0 or dilatation can"el%s to diagnose t"is disease

*. /iet",lcarbama;ine 23 mgkg0 3 times a da, is gi&en for 23 4eeks.

Le#t(re 59Den1(e V&ra" In%e#t&on

'r* Ma'e S()&"a Utama2 Sp2PD

A0)tra#t/engue fe&erdengue "emorr"agic fe&er caused b, dengue &iruses t,%e 10203 and

:80 transmission from "uman to "uman is b, t"e mos6uito 'edes ae!ypti . Clinical s%ectrumof dengue &iral infections are 4ide &ariation0 from undifferentiated fe&er0 dengue fe&er0dengue "emorr"agic fe&er and dengue s"ock s,ndrome. T"ere is %lasma leakage indengue "emorr"agic fe&er0 so differentiated 4it" dengue fe&er.

/engue fe&er s"ould be treated su%%orti&el,. /engue "emorr"agic fe&erdengues"ock s,ndrome is life t"reatening and re6uires immediate e&aluation of &ital sign0"emoconcentration0 de",dration0 urine out%ut0 electrolit imbalance.

Re%eren#e

?alstead $B. /engue fe&er /engue ?aemorr"agic fe&er. )o4derl, D<.!d8. Infectiousdisease. $econd ed. 2:. ). 1+1:

Den1(e &n%e#t&onCase= ' #ale0 3: ,ears old0 Balinese0 came to t"e $angla" ?os%ital. T"e c"ief of com%lain 4asfe&er since 2 da,s ago0 "e also com%lain about "eadac"e0 oint %ain0 ras" on t"e skin. T"eneig"bored 4as admitted in t"e "os%ital 4it" /?F

(earning task=1. D"at t"e some s%ecific factor in t"e "istor, and e5amination suggest t"e need for

making diagnose2. 4"at t"e laborator, e5amination t"e need for t"is %atients3. 4"at t"e management for t"is %atients





$elf assessments1. describe t"e clinical s%ectrum of dengue infection1. describe t"e %at"ogenesis of /?F2. describe t"e management a%%roac" for t"e dengue infections

References1. ?alstead $B. /engue fe&er /engue ?aemorr"agic fe&er. )o4derl, D<.!d8.

Infectious disease. $econd ed. 2:. ). 1+1:

Le#t(re 5;Treatment o% He"m&nthe) In%e#t&on !PK:PD+

/r.dr. B..$atri,asa0#.Rre%ro

Anthe"m&nt&#

?elmint"ic infections still as a %roblem on t"e 4orld. T"ere are man, of ant"elmint"icdrugs t"at can be used to eradicate t"e %arasite in t"e intestinal tract or in t"e tissue of t"ebod,. #ost ant"elmint"ics in use toda, are acti&e against s%ecific %arasites0 and some areto5ic. T"erefore %arasites must be identified before treatment is started. In t"is to%ic 4ill beintroduced t"e drugs for ant"elmintic so after t"is %rogram all of student be able to c"ooseant"elmintic drugs for t"e %atients in rationall,.

Anthe"m&nt&#1. /iscuss ant"elmintic drugs t"at use to eradicate or reduce t"e number of "elmint"ic

%arasites in t"e intestinal tract or tissue of t"e bod,2. /iscuss drugs of c"oice for t"e es%eciall, %arasite and side effect of t"at drugs of

t"e bod,3. /iscuss t"e mec"anism of action of ant"elmintic drugs t"at ,ou kno4:. /iscuss t"e %rinci%le of treatment of %atient according to t"e %arasite t"at 4ill be

eradicated

$elf assessment=1. /rug of c"oice for 'scaris lumbricoides is=

a. ),rantel %amoateb. 'lbenda;olec. )i%era;ined. (e&amisolee. )ra;i6uantel

2. /rug of c"oice for cutaneus lar&a migran is=a. ),rantel %amoateb. 'lbenda;olec. )i%era;ined. T"iabenda;olee. )ra;i6uantel

3. ' %atient suffered from taenia solium. /rug t"at can be used as drug of c"oice of t"is4orm is=

a. ),rantel %amoateb. 'lbenda;ole

c. )i%era;ined. (e&amisole





e. )ra;i6uantel

Le#t(re /<

O.er.&e o% P(erpera" In%e#t&on

dr. ?ari,asa $ana,a0$%.<

1. 'bstract=)uer%eral Infection G is a general term used to describe an, bacterial infection of t"e genital tract after deli&er, along 4it" %reeclam%sia and obstetrical"emorr"age %uer%eral infection formed t"e let"al triad of causes of maternaldeat"s because of effecti&e antimicrobials0 maternal deat"s from infection "a&ebecome uncommon

2. (earning task=2.1. To understand definition of %uer%erial infection.2.2. To understand definition and management of %uer%erial fe&er 2.3. To understand definition0 %redis%osing factors0 bacteriolog, and

management of uterine infection.2.:. To understand t"e com%lication of %el&ic infection2.*. To understand t"e %at"ogenesis0 clinical course and treatment of

infections of %erineum0 &agina and cer&i5.2.. To understand t"e to5ic s"ock s,ndrome2.7. To understand t"e %re&ention of %uer%erial infection

3. Case

' 2* ,ear old 4oman <1)18 %resents to ,our clinic eig"t da,s %ost%artum0com%laining of a tem%erature of at least 3+.* degrees Celsius o&er t"e %ast 3da,s0 and a foulsmelling &aginal disc"arge. $"e is in ot"er4ise good "ealt"0and "er bab,0 4"o 4as born b, emergenc, Caesarian section in a rural clinic0 isdoing 4ell. )",sical e5amination of ,our %atient re&eals an oral tem%erature of3+. degrees Celsius0 a clean and non4ee%ing abdominal 4ound0 and %ain of%al%ation of "er uterus.

D"at is t"e differential diagnosis of t"e site of infectionO D"at 4as most likel,

t"e source of t"is infectionO D"at features of ,our %atientPs "istor, and deli&er,%ut "er at "ig"er risk for %uer%eral infectionO

:. $elf assessment=

1. ?o4 t"e student understand about definition0 risk factors0 %at"ogenesis0com%lication and management of %uer%erial infectionO

2. ?o4 t"e student understand t"e definition of %uer%erial fe&er and t"edeferential diagnosis of %uer%erial fe&erO

3. ?o4 t"e student understand t"e %re&ention of %uer%erial fe&erO





Le#t(re /,O.er.&e o% Se?(a" Tran)m&tte' D&)ea)e)

dr. '.'.<.). Diraguna0 $%.

Case 1= ' 27,earold man "ad single %ainless ulcer on "is glans %enis 3 ,ear ago. T"is ulcersdisa%%ear 4it"out treatment. ne ,ear ago0 "e got married 4it" a 23,earold 4oman andno4 "is 4ife is %regnant for : mont"s. ?is 4ife com%lain of "a&ing &aginal disc"arge 4it"itc", and odor. T"is man no4 "as ras" on 4"ole bod, and muco%urulent uret"ral disc"arge0

t"e, alread, 4ent to a &enereologist. T"e result of laboratories e5aminations s"o4s @/R(1=: and doctor referred t"is cou%le to go to t"e /e%artment /ermato@enereolog, $angla"?os%ital.

(earning task 6uestions=1. D"at ot"er "istor, ,ou need to find out from t"ese %atientsO2. D"at laboratories e5amination needs to be done for t"is cou%leO3. D"at is ,our diagnosis for t"is manO:. D"at is ,our diagnosis for "is 4ifeO*. D"at could %ossibl, "a%%en 4it" "er %regnanc,O. D"at could %ossibl, "a%%en 4it" t"eir bab,O7. ?o4 4ould ,ou treat t"is man0 "is 4ife0 and t"eir bab, based on t"eir conditionsO

$elf assessment=1. /escribe t"e stages clinical manifestation of s,%"ilis.2. /escribe t"e causes of genital ulceration.3. /escribe microorganism %at"ologic of uret"ral disc"arge.:. /escribe t"e risk factors of se5uall, transmitted infection %atient*. ?o4 to %re&ent management of $TI.. /escribe microorganism %at"ologic of &aginal disc"arge and t"e clinical manifestation7. ?o4 to treat clinical manifestation of &aginal disc"arge0 t"e dose0 and for "o4 long.





~ CURRICULUM MAP ~

Smstr Program or curriculum blocks

1 Senior Clerkship

! Senior Clerkship

" Senior clerkship

#

Medical

Emergency(3 weeks)

BCS (1 weeks)

Special Topic

-Tra!el medicine(" weeks)

Elec#i!e S#$dy %%%

(& weeks)

Clinic 'rien#a#ion

(Clerkship)(& weeks)

$

The espira#ory

Sys#em and

isorders

(* weeks)

BCS (1 weeks)

The

Cardio!asc$lar

Sys#em and

isorders

(* weeks)

BCS (1 weeks)

The +rinary

Sys#em and

isorders

(3 weeks)

BCS (1 weeks)

The eprod$c#i!e

Sys#em and

isorders

(3 weeks)

BCS (1 weeks)

%

Elec#i!e S#$dy

%%

(1 weeks)

,limen#ary

hepa#o-

biliary sys#ems

disorders

(* eeks)

BCS (1 weeks)

The Endocrine

Sys#em/

Me#abolism and

isorders

(* weeks)

BCS (1 weeks)

Clinical 0$#ri#ion

and isorders

(" weeks)

BCS (1 weeks)

Special Topic

- allia#i!e

medicine

-Compleme

n#ary

,l#erna#i!e

Medicine

- 2orensic

(3 weeks)

Elec#i!e

S#$dy %%

(1 weeks)

&

M$sc$loskele#al

sys#em

connec#i!e

#iss$e disorders

(* weeks)

BCS (1 weeks)

0e$roscience

and

ne$rological

disorders

(* weeks)

BCS (1 weeks)

Beha!ior Change

and disorders

(* weeks)

BCS(1 weeks)

The is$al

sys#em

disorders

(" weeks)

BCS(1 weeks)

'

4ema#ologic

sys#em disor-

ders clinical

oncology

(* weeks)

BCS (1 weeks)

%mm$ne

sys#em

disorders

(" weeks)

BCS(1 weeks)

%n5ec#ion

in5ec#io$s

diseases

(6 weeks)

BCS (1 weeks)

The skin hearing

sys#em

disorders

(3 weeks)

BCS(1 weeks)

(

Medical

ro5essionalism

(" weeks)

BCS (1 weeks)

E!idence-based

Medical rac#ice

(" weeks)

4eal#h Sys#em-

based rac#ice

(3 weeks)

BCS (1 weeks)

Comm$ni#y-based

prac#ice

(* weeks)

Special Topic

- Ergonomi

- 7eria#ri

(" weeks)

Elec#i!e

S#$dy %

(" weeks)

1 S#$di$m Medical The cell 7row#h





7enerale and

4$maniora

(3 weeks)

comm$nica#ion

(3 weeks)

BCS (1 weeks)

as bioche-

mical machinery

(3 weeks)

BCS(1 weeks)

de!elopmen#

(* weeks)

BCS (1 weeks)

endidikan ancasila 8ewarganegaraan (3 weeks)

REFFRENCES

1. $%icer D. 28= Clinical Bacteriolog,0 #,colog,0 and )arasitolog,0 'n IllustratedColour Te5t. C"urc"ill (i&ingstone0 1:19.

2. Clinical Bacteriolog,0 #,colog, and )arasitolog, = 'n Illustrated Colour Te5t. D.o"n $%icer. C"urc"ill(i&ingstone

3. Brooks et al. %at"ogenesis and Control of @iral /iseases. In= (ange #edical#icrobiolog,. 23rd ed. #c<ra4 ?ill. International !d. 2:. %. 39: G :13.)rinci%lesof @iral Infection8

:. (e&inson et al. (ange #edical #icrobiolog, E immunolog,. !5amination E Boardre&ie4. +t" ed. #c<ra4 ?ill. International !d. 2:. %. 1+ G 220 2*9290 2::2*.)rinci%les of @iral Infection8

*. Roitt. I.0 Brostoff..0 #ale. /. Immunolog,. /urack /T0 D"itle, R0 and $c"eld D#. Introduction= '%%roac" to t"e )atient 4it"

Central ner&ous $,stem Infection. In = $c"eld D#0 D"itle, R0 /urack /T0 eds8.Infections of T"e Central er&ous $,stem. Ra&en )ress. e4 Hork. 1991 %. 1:.

7. @ictor # and ro%%er '?. Infections of t"e er&ous $,stem Bacterial0 Fungal0s%iroc"etal0 )arasitic8 and $arcoid. In= 'dams and @ictorsP %rinci%les of t"eeurolog,. 7t" ed. #c<ra4?ill. e4 HorkToronto. ). 73:7+.

+. ttesen !'. Filariasis.in )o4derl, D<. ed8. Infectious /iseases. 2nd ed. ).1713.9. Ringsrud #0 (inne . -rinal,sis and Bod, Fluids ' Colorte5t and 'tlas. 1st ed.

#osb,. $t. (ouis Toronto. 199*. %. 9*2.1. Burtis C'. Tiet; Fundamentals of Clinical C"emistr,. :t" ed. DB $aunders Com%an,.

)"iladel%"ia Tok,o. 199. %. **+*1.11. $immons '. $tatland B!. ?ematolog, ' combined T"eoritical and tec"nical

'%%roac". 2nd ed. Buuter4ort"?einemann. Boston $inga%ore. 1997. %. 1291:2.12. $tites /)0 Terr 'I0 )arslo4 T<. #edical Immunolog,. 9t" ed. )rentice?all

International. 1997. %. 2:29.13. as%er /(0 Fauci '$0 (ongo /(0 Braun4ald !0 et al. ?arrisonPs )rinci%les of Internal

#edicine. 1t" ed. @ol 1. #c<ra4?ill. e4 Hork Toronto. 2*. %. 9+1113.1:. $utton /. Radiolog, and Imaging for #edical $tudents. C"urc"ill (i&ingstone. 7t" ed.

199+.1*. <rainger R< and 'llison /. /iagnostic Radiolog,. C"urc"ill (i&ingstone. 2nd ed.

1993.1. #c'dam ' and umar $. Infectious /iseases in umar @0 Contran R$ and Robbins

$(0 Robbins Basic )at"olog,. ). 3::39+.17. 'ndre4s. /iseases of T"e $kin. 9t" ed.1+. Br,ceson '. (e%ros,. 3rd ed.19. ing E icole. $e5uall, Transmitted /iseases. 232. ?olmes 0 $%iring )F0 #ird" ). $e5uall, Transmitted /iseases. 3 rd ed. #c<ra4

?ill. 1999.21. #c#illan '0 Houng ?0 gil&ie ##0 $cott <R. Clinical )ractice in $e5uall,

Transmissible Infection. $aunders. 22.22. Braun4aldPs ?eart /isease. $ubacute bacterial endocarditis.


study guide infection semester iii 11 nov 2014

Documents