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TROPMED case #4.pdf

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  cAsE f,EVrEt' tl tEr.tGUE mrrroRnHAGtc DEVER ANAMNETU JuIelV 6od rs my Jolv olion; . I wi[ ]T.rJt md not be ofrojd. Ihe DR0 ,Ih€LoPD himsell iJmy Jfr€rrqth qnd nry d4q$0r lle lrs b*.otne rny &1vohon. -I,nioh 12:2 Mv DennY. tt1-yeor - 0ld J d Pil., 51 CAI ETATVI INAToN : 'nodemelril, - nF z8rlmir@ ';ffi[lY'f.',',,',,[,. *, n .' H#{$rj$}:d'x ' : ?tr;.g5ffi''' *' - ohe of chl€o ncr-rrbor deod ofter 6 doYt of owre ferer - moserlitos @ Orlng doyii m€ - ureody ili}cd OP, g'ryen onipyreDc tGrlib'lohc - How crccstttoodtuthe hb: wBc +, PlaElel r Are b PNt),Ytg a lingert Loclole lV - 0reloninophen 290 rng /{{hr J <fc,reo bholsy rest be(oyp odffipd rwrpero+ure@to asrs C hdpolettsvr, ** r,Hffiq, rulse iotg r\Or trn-hOu80RAfon{ sYPMlMEmq\t - 89forechq^k:-ptqietel- qSooolm3@ - PcvE)'[ - Cr(R + pleurol€ffusnn on rlghilurg - Pf+errhoctr -Pkilelet s>bo/mIh'O - P(,v sg% - 196 orrndeng eO 19M onlidengve@ DlbGr€lrs: DENGTG rtErtOSEiA6lL FIYEP / DlJ, ,ECOnDARY 'MECT'ON I rFEErinEN f.' -8ol\rr Loctoteo chgs lr(f,/EgBw/hr - hoiclet cqrnl r ?CV tevgl grom ev€r, t }'r I lsdo$ stoue, O.rctrqrged rn SPd condiron v'ttit LvePr rcter &r&low-up r &nvoleJ[gh(E H ,e]t PBO6NolIJ: -Orro qd vfrotn: od barom -guo od im$orrorn. od b$orn -OrlOod uanoliorUm; d,rh-o Od bornmCrol$olsscQh(€ renrn ) r/,yOo) ct{lgFcDMPLR,rvrj highfeverfor Sdoyl w/ obruPl onsg}  IUICJC C]{G a rilGt,E VIRVJ - lwolnyo ddlctosi{irqjixon tc€ dlm grvp B Al}hropod-Born€ Vilus CArbovitur)vO sglorongterbogi rnlU Arenavividoe, &rnyqviridop. tlqviv iridoP, fleovfrido0, 6sn rogavirido€. - D€^gue virus + tomrli Plovlvirid0e, genvs Plov)virur' - ,Jhuklvr t. morfol o9i ; - rsBNA ,30- 50nm 0 - vilioo terdiri dori nvdcocqprid 99 murniliti ehveloPe' - gehorhe nYo lgrurr,rn qlor : r protein 5lrutturor lJ.*,BffiBl:,(#:{;:}ll,.fnt?r r J rn.u,:ll IlglJg^l,,o,ypmeneontrol en.retopl p.otelo - -/ tvrosuxnyo v'r ,J kp dlm sel o I prolein non-r*.ultt,.rrol . NJ r, Ni2A.N528, Ns3, NJq^, N5rlB, NJ5 + vl reoil.ori yrrv.l \ memifixi pungs, potologis Oon diagnos{rl'' - Strotype r - 'l selofyeI -, gENv.t, D[,NV-2. DENV-3, DtNV.l - Ih{eKJi JeKunder d9n rerorype loin otouihf€,qi rnrltiple d9n serotype berbedo ; N4l IDSJ - D€Nv'1:3subtlPe DgNY -2 -r 6 subtiP€ OEN\I -J -r gsubliP0 0ENy- '{ ', q svbtipe OENY- 1 - monrfeJ+osiUi nis poling poroh + DENV -: ' potrng rihgon Di Indoneliq poling bonYol DENV'3 - Li(e t90e i Bind;n9 vrfvs kP Jel -+ recePtor.medislpd endocytorij e nr)on'endolomP merhbrohe fuJiOt -, unroot,ng + trontl0+ion t polyprctein processiog { lnelllbronQ -olsocio}ed nNA rcplicoiOn ,norphogenesis'in inliorellulor veliclpl -r v)iron tronspor| J vetiole fvrion o| p,oJmo ')e -i vi(loO 'eleotg   Iro i Vi o ny omult h€ der ' hvm on-tu hurnoo Adq J siKtutr'i ' o en ? ooholi ( : monye+' DedOJ 'rnon9e' ', €Prtordic : hoD-hurnon pr'lmote.l ,,;;,Jlili:; l;T?1il:11,;,i. .TT n)., u* ? pd,ione hori f* -i;,flf, iS:'#;i?f;, Jglotnoedesoeg)Pti,odoAe.q|[oplc*vllA€.polynerignsirCropipofinjbnyrRe.oegyph) . AEOES OEGYPT - Ioxonom) , - Pilum: Ar+hroPodo -lubfomity: tulicrnse - clotJ, lnre.io' 6envs: Aedes - ordeY, u',pieto - Jubgenvs I slegsrnyt 6 - lornrt , qrr1,6d oe - Jp€cles j oe'yPt' - Polo moKoh: ontropophihc' SioDg hor' ['(olqu nolorrl horut o<lo cohoyo lornpv) rronv q vs I y g rnenggig i) mc'n\'sr o - [qbilol, o.eoiiop,, i'tiulttpu', dol orn rvrnoh ( olrh Boleng' v05J - hele, oegYpti + vecto' utorno d?'a9us fgvsr . ilKlus hid.p : Iglur tON O .--+ Pt'pO t oeuoll c oeuofiC \_.- 4 Deworo +errorlriol?EIEN a dto{r d OENGgE SE\GF (oje definil i'on : p16 obrr , ,,HlliiiJ,:r;,i:6i.%i Hl $ilf,'J,1'#;;'l ,#rl,:;] i ^,*t#t o*r .(,onorm€d , tfilfr.ffi ;irru,ur::': .f^ ,i nTJil:?JJ:Jl,:,iiH;'fl,J;J;i;T'',', '^ -Efro}ogrioeng\'evlnciDedOgoegJp}iipenodeinEubosiE.lohori)- potologi : qbnorvno buluh doroh' to(diri doO pcmbengFok66 endolhel' edefiO Pcrrvqsc qn6nu6lgqr 1Qll5' t crreSfii a I  - Clinicol feo+urs:o Eoyi r onoxr : demom 0.659 deworo I onorryg lbl,beJori dtrnorrr de.l9ve l.losix,;oxi-l pd 6lgi,rendi,tulong . Jetel;h periode ;6lvb0:i 5-t hori d; org dewos0 j dely,om tibq',.roti*lePolo lotoh. m€n99i9il, rolro-orbltol poin, soxil pungrvhg t p;Sefiian toroktertrtix etm0m: ri^99i ( 39_ r1o,t), s_b j.rari, b;phoic Di ohhrr demom e gentrol;tpd rojb memudor . odo,oiOli?ed clus.tgT r€tech,se di dorstrrh xoti, +ongoh, teng1D Iorl ouOlnrol€rlihol dj woj(h,hher, dqdo -, exrrerh;i95, od o Jo+o) r LOb flhdrngr j le\rhopehio i)-3 hori rgreroh dPrr)orn Ud fqe demlrr, rgJe.roiJ rni ld -' rnod erd te +h rom bo [Ytopenlo OCNGI'C EEIT,INI A6I C }EYER - tose deshihon (horur odo temvo); l. Oernom olou riw0Yq+ demom q[vt , ]'? hori , br'plt osrc r. ,Qrderohoh / I'ehden(i u, berdoroh drn odonJo ; - rQrl iorrrnr0uel @ - ,el€6iqe, ecchgmosr.lr f urpuf6 - hdorohon dori rruioso, Gl irocl, tempo.l )ruer(ri lloltsn totn - [emqlg netLt I mU€oO 3. throrrbocylopeniO T tdoaro r€locorqn Ptosrnc qKiboI peniogltotoo Perrheobilit0r vOrhvror dil,rnjvffon drn ,olngrirbl I dori ; - ico _ rto - Adcrn e{ust Plet'rs, olcilel' hypoprol€ingnri<tHothroorl Drlf . ppsrrn leFoge + hernosfosir yg qbnorrnol - \+ *erOprho, top;ler: i<lvmi auei E thrombopo *rry d9n fun$r, plotelei(t) lr rhrorpSq6r]open,O Koogvlopo lhv - p er u b o hon hr ro b ei r v os.o d.t r r,, . n jo'Jrl sH'ftt raffi:J;- #i#T,lllil ** proliftrori jell BES d9n orfrvitor &gos,lit tg-oepd okJu'rqr D ty mplrocyre QJFOcot hecro,u di hgpdscyte 9. JelrKvppfor 0€{€lop|Irt tt} D{f i odo ih{exsi den9u0 s6Qiufnhyo , odo ontrbOdi dengue rnolerno) - Cl,n,col co\rrjg.' iqse febrile -r dernqm irnggr ibo'. pociot PhrJhing..rqKi+.kepolq, orrcr?xrQ. mynlsh, obdomurcrl porn. dsr i'erect'riqe 19 rnsnyeboi, trepotomegolg lonpo joundice, dr okhir kqto:it I rrombolilg n rg5e crihcol + ,.rhu@cqlol, berkeringol, rolqu poroh r pujle prpJsv , Fort ronvole\tehct ' i:?Or.t t::Jrfl?;i, - D)5eqSQ .5qvsrilv: non rhocl {' r1de- l='tr )6hock iyoO'e U ,. E ,grode p +or le'oio nod ) OENGUE JHOCh ,',NDRS{E -lio,. d€finrtron, u 'lr;,,'^lJ-tr[r;nrrf l'le ff' ' Pu)l e p r ejsure J grnp 11 ( < )O mm }l9 ) . Hgpo,enlion Ct,,io1,c prels*rre <do mmtig v1 <5 thrt,olov ( 9o mmHg ) t:-tt') (vlit dlngio, domrny, reslles5 - hrileiro diJeojg Jevgri+y,i * 0F + delnom + 2qtoulebi h;sohitLgpqtq,retroorb'lal Poro, + leur0PPhrO,rfirornbo2lopeno'myolgio, a hrotgiq 'eriserologR dengue( oHf godP I ; 9{olo tPi r ;**::: :',# 'l r i'I;' :T: ' ropenior (Dss ) Yq''q' Plosrho teohoge p0fgrode E, + shoc1 d9n dg6yr1 nod, /ieXonon doroh fdt rerosd IhrornbucyloPeni' & C05r., . -,.,_.._r piormo leorrogg  ,lo9n otit, OW. Diogaoril. ilbnogerfnt r Drognosi.r . - HI : onjei, 0dq e.1 ol 6r DF / lql /aJJ afon td'r - Pt- ; hemoa.1no*,i Jistjj' iod, JPneo I pl )uro) el{uion ' JouInt0us} - Lob; biood iort + leuhofenio' lilrorpUoiy-op€hig' Ht 0) >/LOlo Rr-PcB + \ori 3-$ ' det9rtri DENv'RND EtUl,n e bedoio inFehsi primer I stkunder Jg6;erolog9, r,SM M A('ELlsA Inhibrrr r,,.i gi,r',,^;r, ; O xo)oir: singls ierl > Dbo.pairedtero oda@ >'tr E1_154 v7 NJ-l Cul'l,rr€ -r hql^, p}rtona rawOlr soKr ) r oi{ {. diogno'tJ - Pd {ose fQbrrle , flo, compoh, chrhvn vogo ( €lu 'Jrlte Jyhdlomp) t,rbeI)q, rcorlef {erer, in{pk<i rvrfn)ngococcol ( odo roJb ) - Pd Iqtetrifi cql : 0cul-esqoltroen]eri tiJ,rholario,lep]o.lpiroJU,typhot' ,typhvt,bocllry,o) tppsis r Manogemqnl ' 0e n9v e F€l er iv cryJtqflord 1-3 nl/ kg/h , reuiewje +e,oh 2iam (.,1 irnprov PmenJ rnprov rmeDJ -- O iv crystqltoid loml I kg/h V crystqlloid ,Omt t K9rh -lj t,r, r, t.t.;r1'', l;'o11) J O lrprorereni im orovQrntn) (;,i[;;; &'ur;ne ovtPrrl irdhl) ' 'no'inlo)n rV crvstqlloid d9n r doijs ierop + Ooninv€d rmprovernen I = ;top pd 2ljom ) I 'lo ,evere dengrre,/ D 5J : lV trysrql)ojd l0-2o rnl/rcglh f, evrgl H g, B ?,88 4tiqp30-60 mnl ,/ ,t* ienqp tjorn \d. @ i rnprovemeoJ lrrr pf o\rPmPh, = (,; lv c Do;d a-6nltrglh ul . 2-ttjOh ^J 0) ir provgrnenj = lVcoilojrt 34rr,l)lglh iolu rtop pd utjon thARt00tnLo6, o, pnneGtrDnot dtvtehc 9: {:'9 )'pyrelicnyo ok; bot efeh )gJg tecdYety 'Sweolingr heolQ) ,tto'lq6/;iiit /l,doh. vzvol, sokif perti ' 90lgl ' i:,:',3'; 1;%:;l*ffi,iB E me / ts po sehope$JohD ilROr$ooGYTE r PHrsloro6l ot 'lEMo'rAsl' = drofl llfJ il 3rI Efl P, PHOP , CBP - il9: JeLond oprnion -' Posi€h btrhox mendoPotkonny0 docior -doclo.i.rot,*ri',p r trl lt uoleh m eDjeleft tloh lc'h oD J Pj owo'tOistfosrre of mlstohe : lesolohonJg rnoyol 'Posten berhok t66' - pllop ; Pence gohon Per+urnbvh0n nyorun denguo + 3M ( he hgurOJ ' lhengubur' m€nulup) pencesohon gigitqnneomuk t i8l:l :'j;.';i:ilii,?,:')r:::iliJ,;Hl'' K00r r0rr pelcJp0roo korvs dengue rec0P0rnJo lcol0u odo v9 demorD otcuJ di hnikvnlofi - CRP l' rpid pmiolqee , .,t .iilj:,0;?fl;r, olJj;:; [1,,' 1, ;ull-,,^rt,o,oLZ.p ]grlg,lilO.,nol.1^- R0. Apohah ,lorn pepoyo mem,l,hi eJ'Qk gntf'Xon u/ mehi ngf,ol(on rrornbosil pd deoluel g'ogoirn qnq prevqlenli DH F /DJJ di |orot I improverne nJ tHl/perfusrsn /pdse PrPS i.J re / At I : @ crysrollord sglomo 6iom re dpn m)d lo,lolu 5,lol,r Itnl/k9lh I Con'lr nv P d i mgoverngnt -- .ilop pd lf jorn = lV collord to nl /kg / ln ] review 3;;5 'l eom (_; improverneat :02, inleDJrygCofe centrolvencui lJn€ bioo{ 6q65fur en a I

AM - FM lecture

Sep 22, 2019

D3Prefs

Sep 22, 2019
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