Dr. Ahmad Rasyid, SpPD-KP, FINASIM

31 Pages·2016·1.85 MB·Indonesian

Dr. Ahmad Rasyid, SpPD-KP, FINASIM
Pekerjaan : Kepala Divisi Pulmonologi
Bag.IPD FK UNSRI /RSMH
Palembang
Jabatan : Ketua PERPARI Cab Sumsel
2006- sekarang
Bandung Integrated Respiratory Care IV |16–18 September 2016
DIAGNOSTIC APPROACH
OF COPD IN
THE ABSENCE OF SPIROMETRY
Ahmad Rasyid , dr, SpPD, K-P, FINASIM
Sub. Bagian Pulmonologi FK UNSRI/RSMH
Palembang
ATLAS ID 364896 / April 2017
Global Strategy for Diagnosis, Management and Prevention of COPD
Definisi PPOK 2014
PPOK, penyakit umum yang dapat dicegah
dan diobati, ditandai oleh keterbatasan aliran
udara yang menetap yang biasanya progresif
dan berkaitan dengan respons peradangan
yang meningkat di jalan napas dan paru-paru
terhadap partikel atau gas-gas berbahaya.
Eksaserbasi dan komorbiditas berperan
dalam derajat keparahan seorang pasien
secara keseluruhan
© 2016 Global Initiative for Chronic Obstructive Lung Disease
Differential Diagnosis:
COPD and Asthma
COPD ASTHMA
•
Onset early in life (often
• Onset in mid-life
childhood)
•
Symptoms slowly
•
Symptoms vary from day to day
progressive
•
Symptoms at night/early morning
•
Long smoking history
•
Allergy, rhinitis, and/or eczema
•
Dyspnea during exercise
also present
•
Largely irreversible airflow
•
Family history of asthma
limitation
•
Largely reversible airflow
limitation
Global Strategy for Diagnosis, Management and Prevention of COPD
Mekanisme yang Mendasari Pembatasan
Aliran Udara pada PPOK
Penyakit pada saluran napas
kecil
Kerusakan Parenkim
 Inflamasi pada saluran napas
• Kehilangan ikatan alveolar
 Fibrosis pada saluran napas,
• Penurunan elastisitas recoil
luminal plugs
 Peningkatan hambatan udara
Pembatasan Aliran Udara
© 2016 Global Initiative for Chronic Obstructive Lung Disease
Global Strategy for Diagnosis, Management and Prevention of COPD
Faktor Risiko untuk PPOK
Genes
Infections
Socio-economic
status
Aging Populations
© 2016 Global Initiative for Chronic Obstructive Lung Disease
Global Strategy for Diagnosis, Management and Prevention of COPD
Diagnosis PPOK
PAPARAN DARI FAKTOR
GEJALA
RISIKO
sesak napas
tembakau
batuk kronis
pekerjaan
sputum
Polusi indoor/outdoor
è
SPIROMETRY: Dibutuhkan untuk
menegakkan diagnosis
© 2014 Global Initiative for Chronic Obstructive Lung Disease
Diagnosis of COPD
 Assessment of symtoms and signs
 Measurement of airflow limitation
 Assessment of severity
 Differential diagnosis
Symtomps
 Chronic cough
 Chronic sputum production
 Dyspnea; progressive & persistent
 History of exposure to risk factor
 Additional symptoms in severe disease:
– Weight loss
– Anorexia
– Hemoptysis
– Cough syncope
DIAGNOSIS
1. Anamnesis
2. Pemeriksaan fisik
3. Sarana bantu : - foto toraks / CT scan
- uji faal paru
- laboratorium dan EKG
1. Anamnesis : - Batuk berdahak, khronik, berulang
- Sesak, progresif dan persisten
- Riwayat terpapar dg faktor2 Resiko
→ Perokok, polusi udara