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PLENARY DISCUSSION16 B Group

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Annisa Anggraini

Indria Asrinda

Kartika Julia

Maghend

Muhammad Reza N

Nur Aini Rahmah

Regina Veriska

Ayedia

Rey Mas Fakhrury

Rifan Ahadi Rizki

Rizkha Amalya

Wirza Rahmania

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SCENARIO 1: Pest exterminator caused

disastrousFarhan, 42, was taken to a hospital emergency room because he was

found unconscious in his field vegetables. Farhan was found still wearing

boots and carrying pest control equipment. From the anamnesis it is

known that Farhan did not like to use personal protective equipment

when spraying crops.

On physical examination found signs of acute poisoning and

immediately given action to save Farhan. At the time of treatment in

emergency department the doctor also treat another patients, a lecturer

with complaints of shortness of breath and pain in the gut. From the

results of X-ray photo of the piston, found signs of left ventricular

hypertrophy and long infarction. Laboratory tests found

hypercholesterolemia. The lecturer had been suffering from hypertension

and rarely control. Doctors advised to make changes to his lifestyle and

control regularly.

How do you explain what happened to Farhan and lecturer?

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Terminology

Unconsciousness : the decrease of ability tosee and respond the stimulation by the

environment

Acute poisoning Poisoning : undesireable substance entry the

human body and caused a damage to organs

function

Acute : the direct influenced by the poison to the

human body in a short time but relatively

dangerous

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Hypertrophy : excessive organ enlargement

because of cell size increase

Asphyxiate : the difficult to take a breath(dyspnea) because of respiratory disturbance

Hypercholesterolemia : high cholesterol levels

in the blood due to the accumulation ofcholesterol and lipids in the blood vessels, and

high LDL in the blood.

Hypertension : diseases caused by disordersof blood circulation so that the blood pressure

above normal

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Infarct : local area of ischemic necrosis

produced by occlusion of blood vessels either

arterial or venous drainage

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Identify the Problems

1. Why farhan unconscious and how the effectof using personal protective equipment

when spraying crops?

2. What is the signs of intoxication3. What is first aid for the person who poisoned

by pesticide?

4. Why are acute toxins occurred on Farhan?5. Why there is shortness of breath and pain in

the gut ?

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6. What causes left ventricular hypertrophy and infarction?

7. What are the causes and consequenses of

hypercholesterolemia?8. What is the relationship of hypertension and rarely

control the disease suffered by the patient?

9. Why doctors recommend lifestyle changes and control

regularly?

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Brainstorming

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1. Why farhan unconscious and how the effect of using

personal protective equipment when spraying crops?

There are 3 components of insecticide, one of which is

the organophosphates, these substances can reduce

awareness. Organophosphates inhibit acetylcholinesterase

going to break acetylcholine, and then acetylcholineaccumulate in your body. The number of acetylcholine

receptors that will bind to muscarinic receptors and

nicotinic will be exposed for longer, thus arises excitation

(excessive arcing nerve impulses). Due to continuous

excitation, the ATP will run out, thus decreasing the ability

of the cell to homeostasis, and cell injury occurs in the

cerebral cortex area, so he was not aware.

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2. What is the signs of intoxication

Intoxication can be classified into 3 groups mild acuteintoxication , severe acute and chronic.

1.) mild acute Intoxication :

Dizziness ,headache , skin mild irritation, the body

feels pain, and diarrhea.2.) severe acute :

Nausea, chills, abdominal cramps, difficulty breathing,

salivation, shrinking the eye pupil, and increased pulse

rate/blood preasure.

Very severe poisoning can lead to unconsciousness,

convulsions, and even death.

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3.) Chronic more difficult to detect because it is not

immediately felt and causes no specific symptoms and

signs.

However, chronic toxicity in the long term can cause

health problems. example irritation of eyes and skin,

cancer, birth defects, and neurological disorders, liver,

kidney and respiratory.

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3. What is first aid for the person who poisoned by

pesticide?

1. Dont be panic, in order to be able to think to do the most

appropriate action and fast.

2. If the victim's skin is exposed to pesticides, washing clothes

and immediately open up to clean with water and soap.

3. If the eyes of victims exposed to the pesticide, wash withplenty of water for 15 minutes, use water-washing shower

first so that pesticides are carried by the water faster

4. If pesticides are ingested and the victim is still conscious,

make victim vomit by giving a solution of warm water thathas been mixed with as much salt 1 tablespoon full. If

pesticides ingested, to note that never give artificial

respiration by word of mouth.

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5. If ingested, pesticides and fungicides from the copper

compound, not stimulated stimulation vomiting, bowel or

to rinse stomach.

6. If that person stop breathing, immediately make artificial

respiration. Make sure the mouth is clear of saliva, mucus,

or foods that clog persons breathing.

7. Do not give milk or greasy food poisoning victims in

organoklorin, since the granting of the milk or food will

add oily organoklorin absorption by the digestive organs

8. If the victim is not aware of, so the breathing is not

interrupted. Clear the mouth of saliva, mucus, or food. If

the victim wears dentures, remove dentures. Then put

the victims at the position of tengkurap, with his head

facing to the side and resting on his arms are bent.

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9. If the patient had a seizure, then try nothing makes

victims of injuries. Put a pillow under the head of the

victim, and then loosen clothing around the neck. Chock

the mouth so that the victim does not bite his tongue and

lips.

10. After that bring immediate sufferers to the nearest

hospital or clinic. Show packaging of pesticides to poison

him to have medical treatment can be determined quickly

that is most appropriate.

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4. Why are acute toxins occurred on Farhan?

In these case we know that Farhan was spaying the plant

with insecticide. When farhan did it, he didn't wear mask in

his mouth and noses, so many gases entry to farhan's nose

when he was breathing. Insecticide gases has 3 materials,

such as organophosphates, organoklorat, and carbonate.

Organophosphates is a more dangerous than other.

Organophosphat can make loss of consciousness, in our body

it inhibit acetyl choline esterase, causes make a long time to

break down acetylcholine in the body tissues. If acetylcholine

is not broken down, it will make a tissues actively secret

nerve impulses.

Than makes atp in the body decreases, decrease of atp make

the body lacks the energy to transfer oxygen to the brain. So

that is the reason why farhan becomes poisoned and make

loss of consciousness

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5.Why there is shortness of breath and pain in the gut?

a. Shortness of Breathe

Normal : 14-20 times / minutes

As a respon of changes in oxygen and carbondioxide

levels in tissue.

b. Heartburn

Pain arising from tissue damage.

nyeri akan menjalar ke berbagai tempat. salah satunya

adalah regio epigastrium yaitu tempat nyeri ulu hatiterjadi.

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6. What causes left ventricular hypertrophy and

infarction?

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Left ventricular hypertrophy is an adaptation of cells, left

ventricular hypertrophy of the left ventricle occurs because

cells experience stress pathological

Hypertrophy is an increase in cell size results in an increase inthe size of the organ. In the scenario of left ventricular

hypertrophy is an adaptation of hypercholesterolemia.

Infarctionoccurs due to lack of blood flow to the network so

that no nutrients and oxygen to keep running the functionalcells in the process of metabolism, infarction occurs here

because due to hypercholesterolemia, cholesterol can lead to

muscle specially in the heart muscle can not be adequate

nutrition so that will happen ischemic cell will be an end tohypoxia and infarction. Hypoxic cells is a major cause cells into

the injury, cell injury will adapt if the stimulus can be removed

in the presence of adequate blood flow, but if not then it will

be irreversible cell injury and the death of muscle infarction.

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7. What are the causes and consequenses of

hypercholesterolemia?

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Causes of hypercholesterolemia

1. Amount of lipid intakes

2. Hypertension > liver works more actively to metabolizelipid > liver produce more cholesterol and triglyseride >

hypercholesterolemia

3. LDL>HDL

4. Metabolic disease, ex: diabetes5. Certain disease, ex: obesity

6. Habituation, ex: smoking, drinking

7. Genetic

8. Genre

Consequenses of hypercholesterolemia

1. Atherosklerosis > hypertension

2. Coroner heart disease 3. Miocard infark

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8. What is the relationship of hypertension and rarely

control the disease suffered by the patient?

Hypertension resulted in further improve cardiacperformance resulting in left ventricular hypertrophy.

hypercholesterolemia patients also have resulted in the

emergence of plaque (atherosclerosis) which will disturb

the arterial blood flow or reduced venous drainage.arteriosclerosis with increased oxygen demand due to

hypertrophy resulting in ischemic myocardial infarction

occurs. history of the disease has been suffered by the

patient, if not controlled properly will certainly exacerbatethe patient's medical condition.

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9. Why doctors recommend regular control and

lifestyle changes ?

Although people with hypertension have to take medicine

for the rest of his life, but the quality of life is still guarded

by setting diet and a healthy lifestyle while to prevent us

from the risk of hypertension, and since early is to live

healthy, among others, reduce consumption of salt, dont

smoke, sports physical at least 30 minutes a day, and eat

more vegetables and fruits.