OPERAN RABU PAGI, 15 Januari 2020

NO NAMA DIAGNOSA PROBLEM TERAPI PLAN

1 Hariyanto Tetraparesis spastik ENMG lesi preganglionik Inj dexa 5 mg/6 jam SSEP?
dr.DS/dr. KD kronis progresif cum MRI cervical/cerebral?
gg kognitif ec 15/1 -> dbn
01.91.95.08 syrignomyelia dd
myelitis

2 Novida Aphasia global IgG HSV1 130.2 -> 86.2 IVFD NaCl 0,9% 16 tpm qEEG 21/1/19
RES kronis progresif cum IgM HSV1 15 -> 9 (N) Inj.Ranitidin 50mg/12 jam kardio: DUS elektif
dr. KD/dr. SK/dr. tanda lesi UMN e.c IgG HSV2 1.3 (N) Thiamine po 2x100mg Lapor dr AT jam 8
AT/ dr. TR/ dr. II encephalitis kronis IgM HSV2 8.3 (N) inj Zovirax 500 mg /8 jam H-11/21 GDBT dan GDP
34 tahun Inj Piracetam 3x3g
Trimulyo, Bantul RA, IGRA, AFP, Mulai ada respon Asam folat 3x1 Ulkus/DVT?
Ibu rumah CEA, Ca19-9, Ca inj. Citicolin 500mg/12 jam
125, Ca 15-3, ANA
tangga, mantan 15/1 UR (kontaminasi?) inj. Meticobalamin 1000mg/12 jam
(-)
sales kosmetik 14/1 Vip albumin 3x1 caps
DR dbn Semax
01.91.86.20 Vit D 10.4 (>=30)
3 Kasiana Cephalgia akut cum HT
dr. CT vertigo mix ec stroke
infark 15/1
01.06.60.56 Hb 9.9

HCTS infark pons

4 Satar Sirtaggang Sopor tanpa Pneumonia Inj. Ceftazidime 1g/8jam

YOS lateralisasi cum febris Penkes membaik -> CM Inj. Metronidazole 1 gr/8jam
dr. KD ec: NO ODS dbn Inf. PCT 1g/8jam kp
silent proses PTIK NB VaD IVFD RL 16tpm
01.87.06.11 (ventrikulomegali) Depakote 2x250 mg
Encephalopathy 14/1 Acetazolamide 2x250 mg
sepsis Na/K 123/3.0 -> 134/3.5 Fenitoin 2x200 mg
Metabolik 13/1 FR dbn, UR prot 2+
12/1 DR dbn
5 Rustiyani Riw. focal seizure ec 6/1 Hb 11.5 IVFD NaCl 0,9% 16 tpm Plan :
ELO meningioma residif Inj. Dexametasone 5 mg/24 jam Pro craniotomy tumor
dr.IS/dr.KD PA (15/05/2015) H1/2 removal (Jadwal diundur,
Meningioma Inj. Ranitidine 50 mg/12jam dr.IS advis untuk MRV
01.72.73.30 meningothelial WHO gr I terlebih dahulu  terjadwal
16/01/2020)

6 Ny. Sukirni Tetraparese flaccid 10/1 IVFD NaCl 0,9% 16 tpm PE 1 dari 3
ILA cum glove and Na/K/Cl/Mg/Ca Inj MP 62,5 mg/12jam H2 Cek lab post PE 1 (16/1/20)->
dr. YD stocking hipoestesia 133/3.1/97/2.1/2.1 Inj Ranitidin 50mg/12 jam Lacak hasil
ec CIDP as folat 2x1
01.79.87.20 vit B6 2x1 ENMG (+) lacak hasil
vit c 1x1
6 Ny. Tukiyem Disfagia/PN IX D cum t inverted pada v1-v3 inf nacl 0.9% 16 tpm EKG/24 jam
ANA PN XII D UMN cum TC 377/LDL 297 CPG 1X75 mg Cek alkali fosfatase
dr. IP hemiparese S ec susp HDL 54/TG 91 Candesartan 1x16 mg
SNH dd SH CKD?? -> riw HD Asam Folat 2x 400 mg
01.92.06.63 swallowing therapy
13/1 DR dbn (termasuk fisioterapi
ur/cre)
7 Mugijem somnolen cum tromboplebitis IVFD NaCl 0.9% 16 tpm raber cv dr.AG
ANA lateralisasi sinistra iatrogenic Inj citicholin 1000 mg/12 jam suction berkala?
dr PD cum tanda lesi UMN po vit B6 1 tab/12 jam
76 tahun bilateral ec ICH IVH 15/1 DR relatif dbn po vit B1 2x1
Panjatan, post EVD NT pro BNP 1033 (<624) Nebu combiven:pulmicort 2:2/8 j
Kulonprogo Amlodipin 1x10 mg
Mantan curcuma 3x1 mg
pedagang vipalbumin 3x2 cap
kapsul; garam 3x1000 mg
01.91.64.37 diet ept
inj. Ceftazidime 1gr/8 j H5?
inj. Moxifloxacin 400mg/24 j H4?
Kompres alkohol 3x sehari
7 Tuginem afasia global cum HCTS dbn - Nacl 0,9 % selang seling UPD nefro: kebutuhan cairan
NAF lateralisasi D cum Stress ulcer membaik aminofluid 1:1 30cc/kgbb/24 jam
SK/TY tanda lesi meningeal Kejang - inj. dexamethason 5mg/6jam H1 total daily 2000cc
ec metabolik dd CAP? (jumat) STOP MRI 20/1
01.92.02.21 meningoencephalitis ISK jamur - inj. omeprazole 1 amp/8 jam EEG 4/2
- inf. paracetamol 500mg/8jam
general clonic seizure 15/1 - inj. meropenem 1gr/8jam H2
APTT 44.5 (32.3) kapsul garam 3x500 STOP
13/1 PPT 16.7 (14.3) tranfusi albumin 25%
Hb 9/AL 11.5/N 84.4 INR 1.24 novorapid 10-10-10
AT 545/HbA1c 9 Na/K/Cl/Mg/Ca Combivent:pulmicort/8 jam
11/1 Alb 2.9 155/4.8/116/1.4/2.0 inj. asam tranexamat 500mg/8jam
BUN/cre 42/1.2
8 Karina Tetraparesis Flacid 14/1 Inf NaCl 3 % 8tpm ENMG
NIA onset subactue Na 126 inj Metylprednisolone 125mg/6jam lacak UPD nefro-gastro-
YD progresif suspek GBS Bun/cr 50.5/ 1.17 hari 1 pulmo-endokrin
cum PN VII Sinistra ot/pt 546/288 inj omeprazole 1vial/24 jam PE?
01.92.08.37 LMN vip albumin 3x1tab
Asidosis metabolik curcuma 3x1 tab
KAD? sulfas ferous 2x1 tab -> perlu?

9 Laginah Hemiparesis dextra Hipoglikemia Inf. NaCl 0.9 % 16 tpm Faktor resiko?
YOS cum disartria e.c
dr. PA Stroke Infark 14/1 DR dbn
Recurrent APTT 49.3 (31.4)
01.42.18.73 Bun/cre 39.7/1.41

10 Lendra Febris cum gangguan 14/1 AT 116 Inf NaCl 0.9% 16 tpm lacak lab evaluasi (DR/UR)
TRI perilaku cum riw SE ec Alb 2.6 -> 3.5 inj Omeprazole 1A/12 jam -> ?
SK/TY susp encephalitis Fenitoin 100mg tab 3x1
Asam valproat 2 x 1000 mg
01.26.64.15 Fenobarbital 2x50mg
Levofloxacin 1x500mg tab

10 Endri Afasia transkortikal 14/1 DR relatif dbn IVFD NaCl 0,9% 16 tpm Lacak Konsul Mata
ILA campuran Alb 2.7 Inj. Ceftriaxon 2 gr/12 jam Stop. Fraksi Na? osmolaritas?
SK/dr, AA Macroadenoma OT/PT 363/710 Inj. Dexametason stop EEG 31/1/20
27 tahun Hipofisis Na/K 120/3.7 PCT 3x500mg po MDT 16/1/20
Bantul Phenytoin 3x100 mg po
membantu di TSH/FT3/FT4/T3/T4 Omeprazole 2x40mg po
Badan rendah Clobazam 5 mg + CPZ 6.25 mg k/p
Pertanahan Inf. Nacl 3% 10 tpm
Nasional As folat 3x1
Piracetam 2x2 1200mg
01.91.85.54 Kapsul garam 3x1
Albumin 25% 100cc extra
10 Feri Kurniawan Paraplegia spastik 14/1 DR dbn IVFD NaCl 0.9% 16 tpm Lacak MRI, ENMG, SSEP
ERA onset kronis progresif OT/PT 95/193 Inj. dexamethasone 5 mg/12 jam
dr. AA/SK cum hipoestesi TORCH IgG rubela-CMV Inj. ranitidine 50 mg/12 jam
17 tahun segmental setinggi T8 naik (<100) Gabapentin 2x100mg
ke bawah e.c myelitis Dzp 3x2mg
01.92.00.97 dd SOP

10 Kushadi W Riw. Somnolens cum Penkes -> CM Inj Dexa 5mg/12 jam H1/3 MRI cerebral kontras 21 /1
RES tanda lesi n. II tanpa 13/1 Inj Ranitidin 50mg/12jam Co BM
dr. KD lateralisasi ec susp BUN/cre 102/2.1 -> Inf PCT 1g/8jam
brain infiltration dd 68/1.1 Inj ceftriaxone 1 gram/ 12 jam H7
01.89.16.57 brain metastasis pada AL 16.8 -> 7.6 IVFD NaCl 0.9%
pasien dengan massa Alb 3.1 -> 3.58
retroorbita D dan Novorapid 3-3-3
massa colli D Inj Tranex
10 Frans Rifai Syndrome PTIK cum 10/1 DR dbn IV Plug BLPL?
Manolo Riwayat monoparese Na 128 -> 140 Dexa 2x2
WAS Sinistra superior ec Paracetamol 3 x 650mg
dr.SK Cerebral CD 4 absolute 142 Pirimetamin 1x 50 mg H16
42 tahun toxoplasmosis pada CD4 percentage 16% Kotrimoxazol 1x 960 mg H16
Lubuk Pakam, B20, TB paru Fluconazole 1x400mg
Deli Serdang ARV 1x1
Pelaut Kapsul garam 3x500mg -> ?
01.89.63.12 diazepam 2x2 mg -> ?
10 Muh Lasin SDH subakut 15/1 DR dbn Post op
TR Pro US

01.92.08.63

11 Temunah LBP kronis progresif Penkes IVFD NaCl 0.9% 16 tpm: clinimix Paliatif – EOL care
UDA cum Riw ACS Echo elektif Assessment behaviour
dr. CT pseudoparaparesis ec Susp CAP Inj ceftazidine 1 gram/8 jam H5 -> harian (Bedside Cognitive
susp canalis stenosis, Susp syok sepsis (on mero? assessment) sudah ada di
01.91.98.47 vascon 1.00 cc/jam) Inj Moxifoxacin 400 mg/12 jam H5 - status paling depan, dapat
Acute renal failure dd > amikacin? dilaporkan malamnya ke dr.
acute in chronic renal 15/1 Bun/cre 34.8/1.3 inj. citicholine 500mg/12 jam AT
failure 14/1 inj.meticobal 500mg/12 jam
Alb 2.65 -> 2.4 As folat 3x1 mg bila elektrolit baik, jadwalkan
K 2.2 -> 2.9 -> 3.3 MRI cerebral lengkap 
12/1 jadwal sudah dapat 15/01
Hb 8.9; AL/N 9.8/89.2
PENGAWASAN
11 Duriyah Somnolen cum Penkes membaik -> E4 IVFD Nacl 0.9% : Clinimix 1:1 20tpm - rontgen thorax 14/01/2020
NIA Cephalgia Subakut HAP inj omz 2x1 amp -> post AB aja?
dr.YD cum Cerebellar sucralfat syr 3x10 cc
50 tahun syndrome ec Brain 14/1 pct 1 gr/8jam K/P K/S darah/urin?
Mantrijeron, Tumor dd Metastasis AL/N/L 21.8/93/3.9 Inj. Ondansetron 8mg/8jam
Yogyakarta Alb 2.6 Flunarizin 2 x 10 mg
Ibu rumah inj meropenem 1 gr/8jam H6 (7-10)
tangga inj gentamicin 240mg/24jaam H6
(7-10)
01.91.73.00 mp 31,25 mg/ 12jam hari 2
nebu combivent+ pulmicort / 8jam
metronidazole 50mg/8jam H5 (5)
Inj Furosemid 20mg/24 jam
Candesartan 1x8mg po
Extra albumin 25% 100cc
Pengawasan per 2 jam kesadaran. 4
jam ttv
11 Ny Eni Yuliati Sindroma PTIK Nyeri kepala membaik IVFD Nacl 0,9% 16 tpm Besok CTA
EMA Hidrocephalus Post 13/1 DR dbn Inj Omeprazole 40mg/24jam BLPL?
dr DS/dr AG EVD Riw ICH Post Diamox 1x250mg stop -> masuk
Craniotomy lagi?
01.91.60.19 Inf Manitol 2x125cc
12 Surtini Multicranial nerve 15/1 IVFD NaCL 0.9% 16 tpm FNAB, biopsi (+)
TRI palsy cum proptosis AL/N/L 15/79/16 Inf paracetamol 1 gram/ 12 jam  MSCT NPC kontras 16/01
dr. YD sinistra e.c malignant Alb 2.69 stop Lacak mata
neurofibroma?? OT/PT 81/40 Inj omeprazol 40 mg/24 jam
01.92.01.60 Bun/cre 28/1.2 Inj dexamethasone 5 mg/24 jam
Na/K 140/3.4 H3/3
Sumagesic 3x600 mg
Tramadol 3x25 mg -> penjaminan?

12 Wasiyem Afasia global cum Kejang terkontrol inf. nacl 0,9% 16 tpm K/S ulkus?
ERA lateralisasi sinistra Ulkus dekubitus inj. dexa 5mg/6 jam H1 (sabtu) Transfusi PRC
dr.KD/dr.TY cum riwayat focal to inj. omeprazole 40mg/12 jam
general tonic clonic 15/1 fenitoin 3x100mg
01.85.16.09 seizure ec Hb 7.6 -> 8 levitiracetam 2x250mg
glioblastoma WHO AT 465 -> 542 caco3 2x1
grade IV KED 41
Na 132 -> 124 koreksi NaCl 3% 8 tpm?
Alb 2.9 -> 2.0 koreksi inf. Albumin extra?
12 Jumiatun Lesi Nervus II Bilateral 13/1 inf. Nacl 0,9% 16 tpm Obat habis pulang
ERA Cum Chepalgia Kronis AL/N/L 14/78/7 inj. Dexametason 5mg/8 jam H3/3
dr.IS/dr.KD Progresif Cum Frontal AT 752 -> 490 inj. Ranitidin 50mg/12 jam
Realese Sign Cum Paracetamol 3x500mg
01.90.93.91 Gangguan Kognitif ec Asam folat 3x1mg
Menigioma Vip albumin 3x1
Post tumor removal Diet EPT
 OPERAN LUAR KOTA

NO NAMA DIAGNOSA PROBLEM TERAPI PLAN

Anggrek Trisno Pawiro LBP Mixed Type Onset Kronik 15/1 ivfd NaCl 0,9% 16 tpm RT simulasi
1/10 dr.DS/dr.SK Progresif Cum paraparese Tipe Na 136 diet TKTP Lacak bone survey -> susp
Spastik Ec Spondylitis DD K 3.7 -> 2.7 -> 2.59 -> 2.3 inj ranitidin 1A/ 24 j MM dd metas (cranium,
01.91.72.91 Metastase 10/1 paracetamol 3x600 mg mandibula, humerus S,
AL/N/L 10/85/6.7 tab dexamethasone 2x4 mg radius S, ulna S, pelvis)
CT abd -> susp massa pulmo S, Laminectomy kapan?
erector spina S-VL5, susp Zometa?? Cek Ca?
hepatal metas; nefrolith+ HOM?
vesicolith; metas VL4-5-ilium
S-femur bilateral
Anggrek Sri Sudalmi ICH onset hari ke- 9 6/1 DR dbn Inf. NaCl 20 tpm BLPL?
1/11C YOS hemiparesis dextra LDL 138 Inj. Omeperazole 40 mg/24
dr IP lesi UMN N VII et XII jam
Flunarizin 1x5 mg
01.91.96.49 Amlodipin 1x10 mg

Dahlia 4/12 Suryati Myasthenia Gravis dd Lambert 10/1 DR dbn Mestinon 3x60mg Lacak ENMG RNS
EMA eaton disease ec susp Inj Mecobalamin BLPL?
dr. BG autoimmune disease 500mcg/12jam
Inj MP 125mg/12jam H-1
01.92.02.73 CT thorak-nonK: thymoma (-) (sabtu)
Omeprazole 1x20mg

HCU Siti Kunzaenah Vertigo central cum HAP IVFD NaCl 0,9% 16 tpm Sudah trakeostomi per
NAF hemihipoestesi D cum ISK Inj dexamethasone 5mg/24 sabtu 11/1/2020
dr RG -> KD myoclonus S cum retensi urin jam (tidak masuk Alih leader BS
cum multicranial nerve palsy 14/1 DR relatif dbn NaCl 3% 8 tpm
01.90.03.62 ec brain tumor (susp albumin 25%
Vestibular schwannoma) premix KCL
amikasin
levofloxacin

SICU Sudilah Meningioma, post tumor GDS sering tinggi Inj Ceftriaxone 2 gr/ 24jam
Bed 17 ANA removal Inj Omeprazole 40 mg/24 jam
dr.IS/dr.KD ICH, post craniotomy 13/1 Inj Phenitoin 100 mg/8 jam
Hb 6.3 -> 10 Inf manitol 125 cc/12 jam h3
01.91.52.41 ROSC?? AL/N/L 5.4/84.7/9.8 Inj Paracetamol 1 gr/8 jam
AT 130 -> 87 -> 103 -> 77 inj asam traneksamat 50 mg/8
jam
15/1 Inj Dexametasone 5 mg/12
K 3.4 -> 3.00 -> 2.8 -> 3.9 jam h1/3

ICU Evi Yoga tetraparesis flaccid cum 14/1 Inj. Methylprednisolon 62,5 PE 1/6
BED 2 ELO parestesi stock and glove e.c AL/N/L 15.8/90/4 mg/24 jam H-1 Evaluasi post PE?
dr. YD susp GBS GDS sering tinggi Inj. Mecobalamin 1000 ug/12
gagal nafas mixed type, susp jam  tidak masuk fornas
01.92.02.28 HAP, on venti inj. Omperazole 40 mg/12 jam
Inj. Cefotaxim 1 gr/ 8 jam
 dari anestesi dapatya inj.
Meropenem
Yudhistira Soewar LBP mixed type cum nyeri (NPS 3) IVFD NaCL 0.9% 16 tpm OP siang
2 UDA paraparese spastic cum Pamol inf 1 gr/8 jam
dr.AA hipoestesi hingga setinggi 13/1 DR relatif dbn inj Dexamethasone 5mg/ 8 j
level T9 ec susp Schwannoma Dzp 1x5mg
01.91.37.16 et multiple HNP Baclofen 2x1
Tramadol 2x1 -> tidak perlu
IMC2/5 Tri Ernawati Cephalgia kronis progresif Nyeri NPS 9 Inf PCT
dr. IS cum focal aware tonic seizure Depakote 2x250
Syringomyelia 15/1 DR dbn Dzp?
Varicella zoster Na 132 Gabapentin?
Febris