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SGD 3 LBM 6

Coughing up blood with rapid weight loss STEP 1 horner s syndrome suatu syndrome terdiri dri kelainan 4 gejala( ptosis, miosis, enoftalmus, anhidrosis) ptosis abnormal face with palpebra is down miosis the pupil smaller than the normali size. STEP 2 MASS 1. definition of cancer ? 2. the caracteristic of cells cancer ? 3. the clacification of cancer ? 4. patogenesis of cancer ? 5. risk factor of cancer ? 6. etiologi of cancer ? 7. clinical manifestation of cancer ? 8. the conduct other diagnosis ? 9. complication of cancer ? 10. why this cancer can distributed in our body ? 11. what the tumor is same with cancer? 12. why the patient have hoaerse voice ?

SGD 3 LBM 6

STEP 3 MASS

1. definition of mass? mass cancer - Abnormal mass of - A neoplasma this resulting from maligna (mass) autonomous disordes growth that persist after the intiating stimulation has been removed. Characteristic cant Can metastasis, metastasis, Clasificated benigna, Sarkoma and maligna karsinoma

2. What is the differential diagnosis of opac mass? - Bronkogenic carsinoma - Lungs cancer

SGD 3 LBM 6

3. the caracteristic of carsinoma of lungs? self suficiency or the cells is produced growth signal alone Menghindari apoptosis Insensitifitas of the growth inhibitor sign The cells can differensiasi infinity 4. the clacification of mass lungs? Based on the location : bronchomucos we can find epitel cell, membrana basalis cells, broncho glandula cells, bronchiolus mucos alveolar cells the other tissue of lungs based on patologi : small cells lungs cancer non small cells lungs cancer 5. etiologi of mass lungs? Tobacco smoking cigarrete composition of tobacco Radiasi

SGD 3 LBM 6

polution genetic the abnormal of genetic difuse lungs radiasi asbestos exposure 6. clinical manifestation of lungs cancer? Cought with pleghm, anoreksia, decrease appetite, dispnea, The secondary symptoms : hoarse voice(press of laryngeus recurrens) when supress in intrathoracal it can calls vena cava superir syndrom, the symptoms is edem and upper chest Clasificated based the growth the cancer : - growth of tumor in to airway breathing in lungs find cought, cougt with plaghm, pneumonia, and the other simptoms because of bronchus obstruction. - growth supression of tumor at the besides organs if the tumor supress vena cava superio it can make facial edem, cervical, the superior of thorax and arm (vena cava superior syndrome), this

SGD 3 LBM 6

tumor can supress esofagus, that tumor can make simptomps disfagia, the tumor supress the nervus, laryngeus recurrens it can hoarse voice. Than in thoraco cervical (syndrome horner) - far metastasis - the other

7. patogenesis of mass lungs? - Carsinogen to the lungs with aspirasion make it iritasion it amke change carsinogenik hipertrofi cells the cells funtion more active hipersecretion bronchus mucosa epitel sel goblet cells than make it change of bronchial mucosahave phase we can precancer carsinoma insitu and invasive karsinoma or metastasis. (ditributed by limphogen or hematogen )

8. risk factor of mass lungs? - Smoker (severe smoker), more than twenty cigarrets in the day

SGD 3 LBM 6

- Life in industri area - Chronic inflamtion and infection mayor - The age more than 40 years - Gender - Genetic - Decrease of immune 9. Penegakan diagnosis (physical examination) - Inspeksi ptosis, miosis, enoftalmus,the thorac is not simetris, - Palpasi sterm fremitus decrease, pain the area mass - Perkusi pekak, - Auscultation hemithorac dextra disappear, cracle, Px. Penunjang : Radiograf CT scan Bronkoskopi Biopsi TNM - Tumor, find location the tumor with radiologic and endoscopi,

SGD 3 LBM 6

Find the maligna or to make sure diagnosis we can sitologic there are sputum, fluid pleura , beside the sitologic we can hitopatologic from the biopsi - Nodul , we can tomografi and CT scan - Metastase , group again with thoracal (biopsi) and ekstra thoracal (CT scan if metastase in the brain), but the metastase in bone we can bone scanning or biopsy. In the liver, we can use USG, CT scan of liver, - and than the another, we can use test faal of lungs, px. Tumor marker, 10. complication of cancer ? - atelektasis 11. how this cancer can distributed in our body ? distributed by : - hematogen - limphogen - direct local extension - trans bronchial spread 12. 13. the prognosis of lungs cancer? The principal management of lung cancer?

SGD 3 LBM 6

STEP 4