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1)Why the man feel dyspneu and cough with green

sputum and fever ?

The phlegm is produced in the throat have chemicalsubstances which varies depending on the climate,

genetic and immune system conditions. Usually a

viscous solution containing gel which is a solution

glicoprotein, immunoglobulin, lipids, etc. Sputum color

to indicate the severity of the symptoms of cough:

1. A healthy Sputum clear or white color

2. yellow phlegm a sign of symptoms common cold

cough fever

3. green phlegm a sign of pneumonia indication

4. Sputum brown signs of heavy smokers and heavy

cough

5. bloody phlegm a sign of tuberculosis.

mechanism Fever

In response to pyrogenic stimuli, the monocytes,

macrophages, and Kupffer cells secrete a chemical

substance known as endogenous pyrogens IL-1

(interleukin 1), TNF (tumor necrosis factor ), IL-6

(interleukin 6), and INF (interferon) which works on the

hypothalamic thermoregulatory center to increase the

benchmark thermostat. The hypothalamus maintains

the temperature at which point a new benchmark and

not in normal temperature. For example, endogenous

pyrogens increase benchmark points to 38.9 C, the

hypothalamus feel that the normal temperature of 37

C prademam too cold, and this organ trigger cold

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response mechanisms to increase body temperature

(Ganong, 2002).

Various reports showed that the increase in body

temperature is directly related to the level of cytokinepyrogen produced to address a variety of stimuli.

Stimulation of endogenous like exotoxin and endotoxin

induce leukocytes to secrete endogenous pyrogens,

and the potent include IL-1 and TNF, in addition to IL-

6 and IFN. The endogenous pyrogens will work on the

central nervous system level OVLT (Organum

vasculosum laminae terminalis) surrounded by the

medial and lateral parts preoptic nucleus, anterior

hypothalamus, and septum palusolum. In response to

these cytokines occurs then the OVLT synthesis of

prostaglandins, especially prostaglandin E2 through

pathways of arachidonic acid metabolism COX-2

(cyclooxygenase 2), and raises the body temperature,especially fever (Nelwan in Sudoyo, 2006).

The mechanism of fever may also occur through non-

prostaglandin pathway through the vagus afferent

signals mediated by local products MIP-1

(machrophage inflammatory protein-1) can not be

inhibited by antipyretics (Nelwan in Sudoyo, 2006)

http://repository.usu.ac.id/bitstream/123456789/2144

5/4/Chapter%20II.pdf

2)Why in the lung examination the doctor get dim and

wet ronchi in the bronchial basis ?

3)What causes his RR increased until 32/minutes and HR

110/minutes?

http://repository.usu.ac.id/bitstream/123456789/21445/4/Chapter%20II.pdfhttp://repository.usu.ac.id/bitstream/123456789/21445/4/Chapter%20II.pdfhttp://repository.usu.ac.id/bitstream/123456789/21445/4/Chapter%20II.pdfhttp://repository.usu.ac.id/bitstream/123456789/21445/4/Chapter%20II.pdfhttp://repository.usu.ac.id/bitstream/123456789/21445/4/Chapter%20II.pdf

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4)Why in rontgen photo is found infiltrat in both og the

lung ?

5)Why the doctor ask the patient to do gram staining and

sputum culturing ?6)Why in routine blood examination get leukositosis ?

7)How to score the penumonia severity index ?

8)What is diagnosis and different diagnosis ?

9)What are the etiologies from the scenario ?

10) What are clasification of pneumonia ?

11) What are risks factor possible causes pneumonia ?

12)

What are additional examination ?

13) What are treatments ?