Case Report Anak (1)

7/24/2019 Case Report Anak (1)

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AnemiaSupervisor: dr. Pertin Sianturi, M.Ked(Ped), Sp.A(K)

Presentator: Boris (110100076)

Try udia !amad"any (11010011#)

$AS% !%P&!T

Department of Pediatric Health

Faculty of Medicine Universitas Sumatera Utara

H. Adam Malik General Hospital

Medan 2!"


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#iterature $evie%

&hat is anemia'''

Anemia is a reduction in red cell mass or

H( and is usually defined as H( or Hct) 2standard deviations (elo% the mean for

a*e.


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Physiolo*ic AnemiaPhysiolo*ic anemia is the most common cause of anemia

in the neonatal period. +ormal physiolo*ic processes oftencause normocytic,normochromic anemia in term and preterm

infants. Physiolo*ic anemia do not *enerally re-uire etensive

evaluation or treatment.

/n term infants0 the increase in oy*enation that occurs%ith normal (reathin* after (irth causes an a(rupt rise in

tissue 1 2 level0 resultin* in ne*ative feed(ack on

erythropoietin production and erythropoiesis. his reduction in

erythropoietin0 as %ell as the shorter life span of neonatal

$34s 56 days vs !2 days in adults70 causes H(concentration to fall over the first 2 to 8 mo of life 5typical H(

nadir 6 to !! *9d#7. H( remains sta(le over the net several

%eeks and then slo%ly rises in the :th to ;th mo secondary to

rene%ed erythropoietin stimulation.


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Dia*nose

History


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Mana*ement

1(servation and Supportive 4are1(servation and Supportive 4are


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4ase $eport

&'etive: he o(=ective of this paper is to report acase of 8,month old *irl %ith a dia*nosis of Anemia.

*ame : S>PA+e:8 months old

Se:Female

-ate o Admission: 1cto(er ?th2!"

$"ie omp/aint: Prematurity

istory o disease:S>P %as reffered from @ina Hospital to Adam Malik General Hospitalto receive ade-uate treatment. 4hief complaint %as prematurity andS>P %as admitted to the perinatolo*y department.


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istory o mediation: unclear

istory o ami/y: unclear

istory o parents mediation:Antihypertensive a*entsprescri(ed (y o(stetrician

istory o pre+nany: he mother %as 8 years old %henpre*nant 5G2P2A7. S>P %as (orn %ith =ust 8 %eeks ofpre*nancy. History of hypertension in pre*nancy %asfound and %as treated %ith anti,hypertensive a*ents

prescri(ed (y o(stetrician. History of dia(etes inpre*nancy %as dinied.


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istory o 'irt": S>P %as (orn in @ina Hospital %ith only8 %eeks of pre*nancy and %as helped (y o(stetricianvia 4aesarean method. 3& %hen (orn is !*. 3# isunclear.

istory o eedin+: 3reastfeeded for2 months.istory o immuni2ation: unclear

istory o +ro3t" and deve/opment: unclear


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Physical


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hora B Symmetrical fusiform0 4hest retraction 5,7.

H$B !:(pm0 re*ular0 murmur 5,7$$B :9i0 re*ular0 ronchi 5,9,70 vesicular %ith no

additional sound.

A(domen B Soft0 non tender0 normal peristaltic0 liver

and spleen %ere not palpa(le0 Ascites 5,70 umor 5,7.


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#a(oratory Findin*sTest !esu/t 8nit !eerene

H( #.90 * !.?,!?.!$34 .07 !;9mm8 8.?",:.6"

#eucocyte 6.6; !89mm8 ;.,!?."

hrom(ocyte :"! !89mm8 2!?,:6?

Ht 97.60 8,"2

M4@ 6.6 f# 68,!!"

M4H 2;.? p* 26,8"

M4H4 26.? f# 2,8:

$D& 2." !:.6,!.?


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Follo% Up&to'er 7t"=#t"901>

S 4ryin* is loud0 suckin* is stron*.& Semsorium: 4M0 empB 8?.o40 reflees are *ood.

ead:


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P Place in incu(ator %ith temperature ran*e 8;.",8?."o4Fluid demand !?cc93&9day ParenteralB none


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A Unproven sepsisAnemia ec, 4hronic Disease

, A31 /ncompati(ility , 1$4H , G;PD Defficiency , 3acterial /nfection

Prematurity



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&to'er 10t"=11t"901>

S 4ryin* is loud0 suckin* is stron*

& Sensorium: 4M0 empB 8?.!o40 reflees are *ood.ead:


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A Unproven sepsis/UG$ 5/ntraUterine Gro%th $etardation7Anemia ec, 4hronic Disease

, A31 /ncompati(ility , 1$4H , G;PD Defficiency , 3acterial /nfectionPrematurity

P Place in incu(ator %ith temperature ran*e 8;.",8?."o4

Fluid demand 2cc93&9day ParenteralB none


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Discussion

T"eory $ase

Anemia has many causes0one of those are caused (ydecreased $34 production.

his may (e caused (ychronic disease0 irondefficiency0 poor diet0infection and also (yprematurity.

/n this case0 S>P %as (ornpreamature/yat the*estational a*e of 0 3ees

and %as present %ithrespiratory distress.

Dia*nosin* anemia can (eperformed (y history takin*0physical eamination0 and

also other dia*nostic tests.

/n this case0 dia*nosis ofanemia is done (yperformin* dia*nostic tests

such as omp/ete '/oodount.


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T"eory $ase

Mana*ement of anemiais done (y o(servational

and supportive care0medication and also irontherapy if needed.

1(servational andsupportive care %as

done (y placin* thepatient in an inu'ator%ith contolledtemperature0 eedin+

the patient %ith milk andkeepin* the /uid in'a/aneand also (y*ivin* iron.


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Summary

S>P0 8 months old %as admitted to H. AdamMalik General Hospital (ecause of prematurityand %as later dia*nosed %ith C Anemia ecchronic disease C /UG$ C Prematurity and %astreated %ith supportive care (y providin*incu(ator and feedin* and also (y *ivin* oraliron therapy and multivitamin

Apialys !.8cc

Ferri !.8cc

@itamin < !2"/U


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THANK

YOU

Documents

Case Report Anak (1)