PANDUAN SKILLS LAB PEMERIKSAAN FISIK KUSTA FAKULTAS KEDOKTERAN UNIMUS

Summary

This transcript outlines a medical training session on the examination and diagnosis of leprosy. Dr. Gita, a trainer at the Faculty of Medicine, University of Muhammadiyah Semarang, guides students through a hands-on examination process. The session includes instructions on assessing patients for skin abnormalities, sensory function tests, and nerve thickening. It emphasizes the importance of identifying cardinal signs of leprosy—skin lesions, nerve thickening, and the presence of acid-fast bacilli. The video also touches on leprosy classification and the use of laboratory tests for accurate diagnosis and treatment.

Takeaways

• 😀 Leprosy diagnosis involves a detailed examination of skin lesions, peripheral nerves, and sensory functions.
• 😀 The primary examination tools for leprosy include test tubes, safety pins, flashlight, magnifying glass, gauze, and gloves.
• 😀 Clinical examination of the face, ears, nose, and extremities is crucial to identify abnormalities such as lesions, nerve thickening, or muscle weakness.
• 😀 Sensory testing is done on healthy and affected skin areas, assessing the patient's ability to feel sensations such as temperature, smooth touch, and pain.
• 😀 Leprosy skin lesions typically present as dry, scaly, hypopigmented macules with clear boundaries and can appear in different configurations such as annular or circular.
• 😀 Thickening of peripheral nerves is assessed through palpation, particularly along the ulnar, radial, and auricularis magnus nerves.
• 😀 Abnormalities in nerve functions, such as numbness or pain, are significant indicators of leprosy.
• 😀 Leprosy classification includes bacillary and multibacillary forms, determined by clinical, bacteriological, and immunological findings.
• 😀 WHO's diagnostic criteria for leprosy include skin lesions, thickened nerves, and the presence of acid-fast bacilli in tissue scrapings.
• 😀 Supporting laboratory tests, such as histopathological and serological BTA examinations, can help confirm the diagnosis and guide treatment options.
• 😀 Patients diagnosed with leprosy should start medication immediately and adhere to regular treatment to prevent further complications.

Q & A

What is the purpose of this session as introduced by Dr. Gita?

Dr. Gita introduces the session as a discussion on the examination and diagnosis of leprosy, aiming for students to be able to conduct physical examinations and correctly diagnose leprosy.

What tools are required for the examination as mentioned in the script?

The tools required for the examination include a test tube filled with water at temperatures of 20°C and 40°C, a safety pin, a flashlight, a magnifying glass, gauze, and gloves.

What is assessed in the general condition examination for leprosy?

In the general condition examination, Dr. Gita checks for any infection on the face, including abnormalities such as lagophthalmus, and assesses the patient's ears, nose, and extremities for any signs of leprosy-related damage.

What is the significance of checking for skin abnormalities like hypopigmented macules?

The presence of hypopigmented macules with clear boundaries is indicative of skin abnormalities associated with leprosy. These macules are often dry, scaly, and can present in specific patterns, which help in diagnosing leprosy.

How does Dr. Gita test the patient's sensory function during the examination?

Dr. Gita tests the patient's sensory function by asking the patient to close their eyes and then applying smooth or sharp sensations using a safety pin or toothpick. The patient’s ability to feel these sensations is crucial in diagnosing leprosy.

What does the lack of sensation on certain skin areas indicate during the examination?

The lack of sensation on certain skin areas, particularly in areas with lesions, suggests nerve involvement, a common sign of leprosy, where nerve damage impairs sensory perception.

What role do the nerve thickening and pain assessments play in diagnosing leprosy?

Assessing nerve thickening and pain is essential in diagnosing leprosy, as thickened nerves and painful areas are common symptoms due to neuritis or inflammation, which is associated with the disease.

What is the significance of the 'bacterial index' in the diagnosis of leprosy?

The bacterial index, which ranges from 0 to 6, indicates the presence of acid-fast bacilli (AFB) in tissue samples. A higher bacterial index helps determine the severity and type of leprosy, particularly in the classification of leprosy as bacillary or multibacillary.

What are the three cardinal signs of leprosy as mentioned in the script?

The three cardinal signs of leprosy are: skin disorders or typical leprosy lesions, thickening of peripheral nerves with impaired nerve function, and the presence of acid-fast bacilli (AFB) in tissue samples.

How does the WHO classify leprosy, and what are the key differences between its categories?

The WHO classifies leprosy into two categories: bacillary and multibacillary. These categories are based on clinical, bacteriological, histopathological, and immunological features, with multibacillary leprosy having a higher number of bacteria and more widespread nerve involvement.