Bagaimana menjadi pasien yang pintar?

Kebanyakan pasien tidak pandai berkomunikasi dengan dokter mereka. Hal ini selain disebabkan karena pola pikir “doctor knows best” yang membuat pasien percaya saja apa yang dikatakan dokter, juga karena para pasien sering hanya diberikan sedikit informasi yang relevan mengenai penyakitnya. Ingat, seperti halnya detektif, dokter juga bertugas mencari fakta. Pada saat yang bersamaan, mereka juga memberikan kita banyak detail-detail yang tidak relevan dan topik pembicaraan yang tidak ‘nyambung’.

Menjadi pasien yang cerdas bisa mengembalikan kesehatan Anda, mencegah pengeluaran yang sia-sia untuk tindakan medis, bahkan menyelamatkan jiwa Anda. Untuk menjadi pasien yang cerdas, Anda bisa merujuk pada tips-tips berikut ini.

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Nilai Referensi Pemeriksaan Kimia Darah


TEST NORMAL VALUE* CLINICAL SIGNIFICANCE
Blood urea nitrogen (BUN) 7-18 mg/dL Increased in renal disease and dehydration; decreased in liver damage and malnutrition
Carbon dioxide (CO2) (includes bicarbonate) 23-30 mmol/L Useful to evaluate acid-base balance by measuring total carbon dioxide in the blood: Elevated in vomiting and pulmonary disease; decreased in diabetic acidosis, acute renal failure, and hyperventilation
Chloride (Cl) 98-106 mEq/L Increased in dehydration, hyperventilation, and congestive heart failure; decreased in vomiting,diarrhea, and fever
Creatinine 0.6-1.2 mg/dL Produced at a constant rate and excreted by the kidney; increased in kidney disease
Glucose Fasting: 70-110 mg/dL Random: 85-125 mg/dL Increased in diabetes and severe illness; decreased in insulin overdose or hypoglycemia
Potassium (K) 3.5-5 mEq/L Increased in renal failure, extensive cell damage, and acidosis; decreased in vomiting, diarrhea, and excess administration of diuretics or IV fluids
Sodium (Na) 101-111 mEq/L or 135-148 mEq/L (depending on test) Increased in dehydration and diabetes insipidus; decreased in overload of IV fluids, burns,diarrhea, or vomiting
Alanine aminotransferase (ALT) 10-40 U/L Used to diagnose and monitor treatment of liver disease and to monitor the effects of drugs on the liver; increased in myocardial infarction
Albumin 3.8-5.0 g/dL Albumin holds water in blood; decreased in liver disease and kidney disease
Albumin-globulin ratio (A/G ratio) Greater than 1 Low A/G ratio signifies a tendency for edema because globulin is less effective than albumin at holding water in the blood
Alkaline phosphatase (ALP) 20-70 U/L (varies by method) Enzyme of bone metabolism; increased in liver disease and metastatic bone disease
Amylase 21-160 U/L Used to diagnose and monitor treatment of acute pancreatitis and to detect inflammation of the salivary glands
Aspartate aminotransferase (AST) 0-41 U/L (varies) Enzyme present in tissues with high metabolic activity; increased in myocardial infarction and liver disease
Bilirubin, total 0.2-1.0 mg/dL Breakdown product of hemoglobin from red blood cells; increased when excessive red blood cells are being destroyed or in liver disease
Calcium (Ca) 8.8-10.0 mg/dL Increased in excess parathyroid hormone production and in cancer; decreased in alkalosis, elevated phosphate in renal failure, and excess IV fluids
Cholesterol 120-220 mg/dL desirable range Screening test used to evaluate risk of heart disease; levels of 200 mg/dL or above indicate increased risk of heart disease and warrant further investigation
Creatine phosphokinase (CPK or CK) Men: 38-174 U/L Women: 96-140 U/L Elevated enzyme level indicates myocardial infarction or damage to skeletal muscle. When elevated,specific fractions (isoenzymes) are tested for
Gamma-glutamyl transferase (GGT) Men: 6-26 U/L Women: 4-18 U/L Used to diagnose liver disease and to test for chronic alcoholism
Globulins 2.3-3.5 g/dL Proteins active in immunity; help albumin keep water in blood
Iron, serum (Fe) Men: 75-175 g/dL Women:65-165 /dL Decreased in iron deficiency and anemia; increased in hemolytic conditions
High-density lipoproteins (HDLs) Men: 30-70 mg/dL Women:30-85 mg/dL Used to evaluate the risk of heart disease
Lactic dehydrogenase(LDH or LD) 95-200 U/L (Normal ranges vary greatly) Enzyme released in many kinds of tissue damage, including myocardial infarction, pulmonary infarction, and liver disease
Lipase 4-24 U/L (varies with test) Enzyme used to diagnose pancreatitis
Low-density lipoproteins (LDLs) 80-140 mg/dL Used to evaluate the risk of heart disease
Magnesium (Mg) 1.3-2.1 mEq/L Vital in neuromuscular function; decreased levels may occur in malnutrition, alcoholism, pancreatitis, diarrhea
Phosphorus ((Page*)) (inorganic) 2.7-4.5 mg/dL Evaluated in response to calcium; main store is in bone: elevated in kidney disease; decreased in excess parathyroid hormone
Protein, total 6-8 g/dL Increased in dehydration, multiple myeloma;decreased in kidney disease, liver disease, poor nutrition, severe burns, excessive bleeding
Serum glutamic oxalacetic transaminase (SGOT) > See Aspartate aminotransferase (AST)
Serum glutamic pyruvic transaminase (SGPT) > See Alanine aminotransferase (ALT)
Thyroxin (T4) 5-12.5 g/dL (varies) Screening test of thyroid function; increased in hyperthyroidism; decreased in myxedema and hypothyroidism
Thyroid-stimulatinghormone (TSH) 0.5-6 mlU/L Produced by pituitary to promote thyroid gland function; elevated when thyroid gland is not functioning
Triiodothyronine (T3) 120-195 mg/dL Elevated in specific types of hyperthyroidism
Triglycerides Men: 40-160 mg/dL Women: 35-135 mg/dL An indication of ability to metabolize fats; increased triglycerides and cholesterol indicate high risk of atherosclerosis
Uric acid Men: 3.5-7.2 mg/dL Women:2.6-6.0 mg/dL Produced by breakdown of ingested purines in food and nucleic acids; elevated in kidney disease, gout, and leukemia

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Uji Kompetensi… Siapa yang mau ikut hayo ?

Ujian Kompetensi Tahun 2008 ini akan di adakan pada tanggal:

  • 16 Agustus 2008
  • 15 November 2008

Sistem KBK tidak menjalani Uji Kompetensi, tetapi menjalani Internship
sebagai gantinya.
Perpanjangan SIP perlu CPD (250 SKP)

Tujuannya adalah :
Memberikan informasi berkenaan kompetensi pengetahuan, keterampilan, dan sikap dari para lulusan dokter umum secara komprehensif kepada pemegang kewewenangan dalam pemberian sertifikat kompetensi Continue reading

The Scary Anaphylactic Story…


Dear para rekan-rekan dokter dan juga para koass (“kok aku selalu salah… ?) berikut ada “sekelumit” makalah tentang shock anafilaksis yang sering menghantui para dokter. Makalah ini saya kumpulkan dari beberapa kepustakaan, untuk kepentingan penulisan di format blog ini saya tidak mencantumkan narasumber dari berbagai kepustakaan yang saya buat, tapi bila ada yang ingin tahu, silakan email saya ntar insya Allah saya balas dgn kepustakaannya. Saya juga Continue reading