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RINCIAN KEWENANGAN KLINIS YANG DIMINTA Unit Kerja : RS. ADVENT BANDUNG Nama : dr. Tracey C. C. W. Rompas Spesialisasi : Dokter Umum



CARDIOVASCULAR Veins Cardiac disorders: 1.1. Thrombophlebitis Angina pectoris 2. Unstable angina 2. Septic shock 3. Myocardial infarction 4.vessels Heart Failure Lymph Cardiorespiratory arrest 1.5. Lymphangitis Supraventricular tachycardia 2.6. Lymphadenitis 7. Atrial flutter primary and secondary 3. Lymphedema, 8. Ventricular extrasystole RESPIRATORY Aorta-arteries disorder 1. Uncomplicated pulmonary TBC 2.1. TBC Essential with HIV hypertention 3.2. Acute Secondary Bronchitis hypertension 4. Bronchiolitis Jejunum, ileum, colon 5. 1. Bronchial Enteritis asthma 6. Status 2. Irritableasmaticus bowel syndrome 7. emphysema 3. Lung Necrotizing enterocolitis 8. 4. Atelectasis Diverticulosis/ diverticulitis 9. 5. Bronchiectasis Colitis 10. 6. COPD Rectal, anal prolapsed 11. 7. SARS Proctitis 12. 8. Pneumonia Hemorrhoids 13. Pleurisy TBC Pediatrics 14. Pneumothorax 1. Aspiration Gastroesophageal reflux 15. Pneumonia 2. Gastroenteritis GASTROINTESTINAL 3. Gastroenteritis dengan dehidrasi Mouth 4. Worms 1. 5. Candidiasis Dehydration 2. ulcers 6. Mouth Malabsorbtion 3. Glossitis 7. Food intolerance Esophagus 8. Peritonitis tuberculosis 1. lesion of esophagus 9. Corrosive Umbilical hernia 10. Hepatitis 2. Reflux esophagitis 11. Cirrhosis of the liver Acute 12.abdomen Food allergy 1. Ileus NEFROLOGY 2. Salphingitis 3. Acute appendicitis 4. Appendicular abscess



3A 3A 3A 3B 3B 3B 3B 3A 3B 3A 3B 3A 3A 4 4 4 43A 3A 4 4 3B 3A 3A 3A 3B 3A 3A 3A 3A 3A 3B 3A 3B 3A 3A 3B 4 3A 4 3B 4 3B4 3A4 3A3A 4 3A3B 3A3A 3A 4 3B 3A3A 3A 3B



Stomach and duodenum 1. Acute glomerulonephritis 1. Gastritis 2. Chronic glomerulonephritis 2. Gastric/ duodenal ulcer 3. Renal colic 3. Gastrointestinal bleeding 4. Urinary stone diseases or urinary calculi without colic 4. 5. Gastroenteritis Urinary tract infection 6. Liver Uncomplicated pyelonephritis 7. 1. Prostatitis Fatty liver



3A 4 3A 3B 3A 3B 3A 44 4 3A4



Male2.genitalia Hepatitis A 3. Uncomplicated hepatitis B 4. Amoeboic liver abscess



3A4 4 4



5. Acute cholecystitis



3A



3 A



1. Hypospadia 2. Epispadia 3. Undescended testes/ cryptorchidism 4. Retractile of testes 5. Torsion of testes 6. Paraphimosis 7. Ruptur uretra 8. Ruptur VU 9. Ruptur ginjal 10. Striktura uretra 11. Priapismus 12. Penyakit peironi 13. Ekstrophia vesicae



3A 3A 3A 3A 4 4 4 4 4 4 4 4



14. Infertility



3A



Vulva 1. Vulvitis 2. Cyst of bartholin, abscess of bartholin’s gland



4 4



3. Abscess of hair follicle or sebaceous gland



4



4. Condiloma acuminate



4



Vagina, cervix, uterus, adnexae 1. Vaginitis 2. Bacterial vaginosis 3. Foreign body 4. Cervicitis 5. Salphingitis 6. Ovarian cyst HEMATOLOGY 1. Iron deficiency anemia 2. Macrocytic anemia 3. Hemolytic anemia 4. Anemia associated with chronic disease IMMUNOLOGY 1. Uncomplicated SLE 2. Vasculitis Lupus 3. Polymyalgia rheumatic 4. Rheumatoid arthritis 5. Anaphylactic reaction 6. Rheumatic fever 7. Atopy 8. Immunodeficiency HIV GENETICS/NEWBORN/CHROMOSOMAL DISORDER 1. Hypotermia 2. Bacteraemia and septicaemia 3. Respiratoty stress syndrome 4. Bronchopulmonary dysplasia 5. Aspiration pneumonia 6. Pneumothorax 7. Apnea attacks 8. Jaundice of the newborn 9. Severe neonatal jaundice 10. Hypoglycemia 11. Child of diabetic mother 12. Neonatal convulsion 13. Cerebral hemorrhage 14. Conjunctivitis



4 4 4 4 4 3A 4 3A 3A 3A 4 4 3A 3A 3B 3B 3A 4 4 3B 3B 3A 3A 3A 3A 4 3A 3A 3A 3B 3B 4



15. Infection of umbilicus 16. SIDS ENDOCRINE, METABOLIC DISORDER and NUTRITION 1. IDDM 2. NIDDM 3. Complication of DM (acute&chronic) 4. Hypoglycemia 5. Hyperthyroidism 6. Adrenal cortex failure 7. Marasmus 8. Kwashiorkor 9. Vitamin deficiencies 10. Hyperlipoproteinemia 11. Gout 12. Obesity CENTRAL AND PERIPHERAL NEURAL SYSTEM Loss of consciousness 1. Metabolic encephalopathy 2. Comatous 3. Brain death Headache 1. Tension headache 2. Migraine 3. Cranial arteritis 4. Trigeminal neuralgia 5. Cluster headache Cardiovascular disease 1. TIA 2. Cerebral infarction 3. Intracerebral hematoma 4. Subarachnoid hemorrhage 5. Hypertensive encephalopathy Cranial nerve and brainstem lesions 1. Bells palsy 2. Brain stem lesions Disorder of vestibular system 1. Meniere’s disease 2. BPPV 3. Vertigo central Movement disorder 1. Parkinson’s disease 2. Secndary parkinsonism,



4 3B 3A 4 3A 3B 3A 3B 4 4 4 4 3A 4



3B 3B 3B 4 3A 3B 3A 4 3B 3B 3B 3B 3B 4 3B 3A 3A 3A 3A 3A



Epilepsy and other seizures 1. Generalized epilepsy 2. Absance seizure



3A 3A



3. Status epilepticus



3B



Diseases of spine and spinal cord 1. Complete spinal transaction 2. Neurogenic bladder 3. Myelopathy 4. Medulla compression acute



3B 3B 3A 3B



5. Radicular syndrome/ HNP



3A



6. Spondilitis TB



3B



Neuromuscular diseases and neuropathy 1. Carpat tunnel syndrome 2. Tarsal tunnel syndrome 3. Neuropathy 4. Peroneal palsy



3A 3A 4 4



5. Guillain Bare syndrome



3B



6. Myasthenia gravis



3B



Infectious disease 1. Meningitis 2. Encephalitis 3. Malaria cerebral 4. Tetanus 5. Cerebral toxoplasmosis



3B 3B 3B 3B 3A



6. HIV-AIDS Congenital , pediatric neurologic disorders 1. Hydrocephalus 2. Meningitis 3. Encephalitis 4. Cerebral abscess 5. Epilepsi 6. Petit mal epilepsy 7. Febrile convulsion 8. Poliomyelitis 9. Cerebral palsy 10. Kernicterus Neurobehaviour disorders, trauma, tumor CNS, gangguan visual 1. Amnesia pasca trauma 2. Afasia 3. Mild Cognitive impairment 4. Epidural hematom 5. Subdural hematom 6. SAH 7. Trauma medulla spinalis 8. Tumor CNS primer 9. Tumor CNS sekunder 10. Buta mendadak 11. Diplopia EAR, NOSE AND THROAT Ears, hearing and equiblirium 1. Inflammation of auricle 2. Herpes zoster oticus 3. Pre-auricular fistula 4. Foreign body in ear 5. Wax (serumen) 6. Otitis externa 7. Acute otitis media 8. Otitis media serous (glue ear) 9. Chronic otitis media 10. Perforated tympanic membrane 11. Bullous myringitis 12. Otosclerosis 13. Tympanosclerosis 14. Presbyacusis



3B 3B 3B 3B 3B 3A 3A 4 3B 3B 3B 3B 3B 3B 3B 3B 3B 3B 3B 3B 3B 3B



3A 3A 3A 3A 3A 4 3A 3A 3A 3A 3A 3A 3A 3A



15. Mastoiditis 16. Benign postural vertigo 17. Motion sickness



3A 4 4



18. Meniere’s disease 19. Acute acoustic trauma 20. Ear, other trauma



4 3A 4



21. Congenital deafness



4



22. Facial palsy or paralysis



4



Noses and sinuses 1. Epitaxis 2. Furuncle of nose 3. Acute rhinitis (common cold) 4. Vasomotor rhinitis 5. Allergic rhinitis 6. Chronic rhinitis 7. Chronic sinusitis



4 4 4 4 4 3A 3A



8. Foreign body in nose



4



Larynx and pharynx 1. Pharyngitis



4



2. Tonsilitis



4



Neck 1. Medial and lateral brachial cyst and fistula 2. Cystic hygroma 3. Torticollis Thyroid gland and parathyroid glands 1. Cyst 2. Goitre 3. Hyperthyroidism 4. Hyperparathyroidism



3A 3A 3A 3A 3A 3A 3A



5. Hypoparathyroidism



3A



EYE Conjunctiva 1. Conjunctiva, foreign body 2. Conjunctivitis, allergy 3. Conjunctivitis, viral 4. Conjunctivitis, bacterial 5. Pterygium



3B 4 4 4 3A



6. Subconjunctival haemorrhage Eyelids 1. Blepharitis 2. Hordeolum 3. Chalazion 4. Eyelid laceration 5. Eyelid retraction Anterior chamber, iris and ciliary body, glaucoma, lens 1. Hyphaema 2. Hypopyon 3. Iridocyclitis, iritis 4. Glaucoma congenital 5. Simple glaucoma 6. Acute glaucoma 7. Secondary glaucoma 8. Cataract Lens dislocation



3B 3A 3A 3A 4 4 3A 3A 3A 3A 3A 3A 3A 3A 3B



9. Refraction and accommodation 1. Hypermetropia 2. Myopia 3. Astigmatism 4. Presbyopia 5. Anisometropia Vision and visual fields 1. Amblyopia 2. Diplopia 3. Suppresion 4. Night-blindness 5. Scotoma 6. Hemianopia 7. Loss of vision and blindness



3A 3A 3A 3A 3A 3A 3A 3A 3A 3A 3A 3A



Optic disc and optic nerve 1. Papiledema



3A



2. Optic atrophy



3A



SKIN Eczematous dermatitis 1. Contact dermatitis irritant 2. Contact dermatitis allergic 3. Atopic dermatitis (kecuali recalcitrant) 4. Nummular dermatitis 5. Lichen simplex chronicus 6. Napkin eczema



4 3A 4 4 3A 4



Erythrosquamous lesions 1. Psoriasis vulgaris 2. Palmoplantar pustulosis 3. Seborrhoic dermatitis



3A 4 4



4. Pityriasis rosea



4



Disorders of skin eccrine and sebaceous glands 1. Acne vulgaris 2. Rosacea 3. Hidradenitis supurativa 4. Perioral dermatitis 5. Miliaria Viral skin infections 1. Verruca vulgaris 2. Condyloma accuminata 3. Molluscum contagiosum 4. Herpes zoster Bacterial infections 1. Impetigo 2. Ulcerative impetigo (ecthyma) 3. Superficial folliculitis



4 3A 4 4 4 4 3A 4 4 4 4 4



4. Furuncle, carbuncle 5. Erythrasma



4 4



6. Erysipelas



4



Superficial fungal infection 1. Tinea capitis 2. Tinea barbae



4 4



3. 4. 5. 6. 7. 8. 9.



Tinea faciale Tinea corporis Tinea manus Tinea unguinum Tinea cruris Tinea pedis Tinea versicolor



10. Mucocutaneus candidiasis Insect bites and infestations 1. Pediculosis capitis 2. Pediculosis pubis 3. Scabies 4. Insect bites reactions Allergic skin, autoimmune diseases 1. Urticaria 2. Angioudema 3. Lupus erythematosus



4 4 4 4 4 4 4 4 4 4 4 4 4 3B 3A



Disorders of hairs 1. Alopesia areata 2. Androgenic alopecia 3. Trichotillomania



3A 3A 3A



4. Telogen effluvium



3A



Disorders of keratinizations 1. Ichtyosis vulgaris Other noninfectious inflammatory skin disorders 1. Lichen planus 2. Granuloma annulare Drug reactions 1. Exanthematous drug eruption 2. Fixed drug eruption Pigmentary disorders 1. Vitiligo 2. Melasma 3. Post inflammatory hyperpigmentation 4. Post inflammatory hypopigmentation INFECTIOUS ABD TROPICAL DISEASES Localized infections and abscess Infections of the hands 1. Paronichia 2. Suppurative tenosynovitis 3. Human bite Infections of the head and neck 4. Suppurative parotitis 5. Suppurative cervical adenitis 6. Peritonsilar abscess 7. Ludwig’s angina 8. Bezold abscess Gram positive and negative cocci 1. Superficial infections 2. Osteomyelitis 3. Staphylococcal pneumonia 4. Rheumatic fever



3A 3A 3A 4 4 3A 3A 3A 3A



4 4 4 4 4 3A 3A 3A 4 3A 4 3A



5. Nasopharyngitis



4



Gonococcal infections 1. Gonnorhea



4



Gram negative bacilli 1. Urinary Tract Infecton 2. Typhoid fever 3. Dysentry bacilli 4. Cholera 5. Pertussis 6. Canchroid Toxin producing bacteria 1. Diphteria (THT)



4 4 4 4 4 3A 3B



2. Tetanus (pediatric)



3B



Mycobacterial diseases 1. Tuberculosis cutis 2. Leprosy



4 4



3. Lepra reaction



3A



Spirochetal diseases 1. Syphilis 2. Yaws



4 4



3. Leptospirosis



3A



Viral infections 1. Influenza 2. Avian influenza 3. Viral gastroenteritis 4. Poliomyelitis 5. Rabies 6. Morbili 7. Varicella 8. Herpes zoster 9. Herpes simplex 10. Mumps 11. CMV infections 12. DHF



4 3B 4 3B 3B 4 4 4 4 4 3A 3A



13. HIV-AIDS



Protozoal infections 1. Amebiasis 2. Malaria 3. Leishmaniasis and tripanosomiasis 4. Toxoplasmosis 5. Giardiasis 6. Trichomoniasis Worm infestasions 1. Hookworm diseases 2. Strongyloidiasis 3. Ascariasis 4. Filariasis 5. Schistosomiasis 6. Cutaneus larva migrant 7. Taeniasis



3A



4 4 3A 3A 3A 3A 4 4 4 4 4 4 4



NEOPLASMA 1. Leukoplakia 2. Benign Prostate Hyperplasia 3. Condyloma accuminata 4. Epithelial cyst 5. Mycosis fungoides 6. Mastocytosis 7. Langerhans cell histiocytosis 8. Ganglion cyst 9. Liposarcoma PSYCHIATRY and MENTAL HEALTH 1. Mental deficiency 2. Autistic disorder 3. Transient tic disorders 4. Intoxication 5. Withdrawl syndrome 6. Delirium 7. Dementia 8. Amnestic syndrome 9. Other organic disorders 10. Misuse of psychoactive drugs 11. Skizophrenia 12. Other psychosis 13. Bipolar disorder, manic episode 14. Bipolar disorder, deppresive episode 15. Anxiety disorder 16. Somatic disorder 17. Dissociative disorder 18. Sexual dysfunctions 19. Insomnia 20. Hypersomnia 21. Side effects of psychoactive drug therapy



4. 5. 6. 7. 8. 9.



3A 3A 3A 3A 3A 3A 3A 4 3A 3A 3A 3A 3A 3A 3A 3A 3A 3A 3A 3B 3B 3B 3A 3A 3A 3A 3A 4 3A 3A



22. Neuropsychiatric and psychosomatic disorders



3A



MUSCULOSCELETAL SYSTEM 1. Arthritis 2. Osteoporosis



4 3A



3. Physical overload



3A



Osteomyelitis, acute Arthritis Fractures of femur Fractures, capsule, tendon and ligament lesions of knee Achilles tendonitis Rupture of Achilles tendon



10. Instability of ankle TRAUMATOLOGY Birth trauma 1. Caput succedaneum Trauma 1. Drowning 2. Head injury 3. Burning 4. Poisoning 5. Suffocation 6. Bleeding 7. Hypovolemic shock 8. Dislocation of jaw



3B 4 3A 3B 3A 3B 3A



3B 3B 3B 3B 3B 3B 3B 3B 3B



9. Dislocation of knee 10. Dislocation of patella 11. Prapatellar bursitis 12. Fractures of tibia 13. Rib fractures / contusion 14. Injury caused by rib fractures 15. Sternal fractures 16. Fractures of toes 17. Crush injury to the heel (in children) 18. Fractures of fibula 19. Whiplash 20. Fractures, capsule, tendon and ligament lesion of ankle 21. Pneumothorax 22. Hemothorax Injury specific to internal organs (liver, kidney, lung, etc) 3B Injury of peripheral nerves Neck, shoulder and upper extremities 1. 2. 3. 4. 5. 6.



Fractures of shoulder Dislocation of shoulder Ligamentous lesions of shoulder Instability of shoulder Fracture of clavicle Frozen soulder 7. Fracture of humerus, radius, ulna, elbow, wrist, fingers, thumb 8. Lateral epicondylitis (tennis elbow) 9. Dislocation of distal radius, wrist



10. Progressive inflammation of finger following injury 11. Olecranon bursitis 12. Carpal tunnel syndrome 13. Injury of finger tendon 14. Nail loss 15. Subungual hematoma 16. Traumatic vessel injury Accident and emergency neurology 1. Head injuries 2. Diffuse brain damage 3. Cerebral contusions and concussion 4. Brain death 5. EDH 6. SDH 7. Basilar fracture scalp 8. Acute traumatic spinal transaction 9. Injury of plexus and peripheral nerves REPRODUCTION SYSTEM Infections during pregnancy/delivery 1. Syphilis 2. AIDS



Pregnancy disorder 1. Incompleted spontaneous abortion 2. Completed spontaneous abortion 3. Hyperemesis gravidarum



3B 3B 3B 3B 3B 3B 3B 3B 3B 3B 3B



3 B



3B 3B 3B



3B 3B 3B 3A 3A 3B 3A 3B



3 A 3A 3A 3A 4 4 3B 3B 3B 3B 3B 3B 3B 3B 3B 3B



3A 3A



3B 4 3B



4. Dysmaturity 5. Polyhydramnion 6. Iron deficiency anemia Delivery 1. Premature contractions 2. Premature delivery 3. Postmature infant 4. Prolonged delivery 5. Primary mild contractions 6. Secondary mild contractions 7. Hypoxia of fetus 8. Rupture of perineum 9. Retained placenta



3A 3A 4 3A 3A 3A 3A 4 4 3B 4 3A



Postpartum 1. Retained placental tissue



3B



2. Postpartum haemorrhage



3B



Puerpurium 1. Mastitis 2. Cracked nipple 3. Inverted nipple 4. Endometritis 5. Inflamation of pelvis 6. Incontinence of urine 7. Incontinence of faeces 8. Post-natal psychoses 9. Post-natal depression 10. Subinvolution of uterus



Keterangan: Tingkat Kemampuan 1:



3A 4 4 4 3A 4 4 3A 3A 4



Mengenali dan menjelaskan. Mengenali dan menjelaskan gambaran klinik penyakit, dan mengetahui cara yang paling tepat untuk mendapatkan informasi lebih lanjut mengenai penyakit tersebut, selanjutnya menentukan



rujukan yang paling tepat bagi pasien. Lulusan dokter juga mampu menindaklanjuti sesudah kembali dari rujukan. Tingkat Kemampuan 2:



Mendiagnosa dan merujuk. Mampu membuat diagnosis klinik terhadap penyakit tersebut dan menentukan rujukan yang paling tepat bagi penanganan pasien selanjutnya. Lulusan dokter juga mampu menindaklanjuti sesudah kembali dari rujukan. Tingkat Kemampuan 3: Mendiagnosis, melakukan penatalaksanaan awal, dan merujuk Tingkat Kemampuan 3A: (Bukan gawat darurat) Mampu membuat diagnosis klinik dan memberikan terapi pendahuluan pada keadaan yang bukan gawat darurat, mampu menentukan rujukan yang paling tepat bagi untuk penanganan pasien selanjutnya, dan mampu menindaklanjuti sesudah kembali dari rujukan. Tingkat kemampuan 3B: (Gawat Darurat) Mampu membuat diagnosa klinis dan memberikan terapi pendahuluan pada keadaan gawat darurat demi menyelamatkan nyawa atau mencegah keparahan dan atau kecacatan pada pasien, mampu menentukan rujukan yang paling tepat untuk penanganan pasien selanjutnya, dan mampu menindak-lanjuti sesudah kembali dari rujukan. Tingkat Kemampuan 4: Mendiagnosa, melakukan penatalaksanaan secara mandiri dan tuntas. Mampu ,membuat diagnosa klinis dan melakukan penatalaksanaan penyakit tersebut secara mandiri dan tuntas. 4 A: Kompetensi yang didapat saat lulus dokter. 4 B: Profisiensi (kemahiran) yang dicapai setelah selesai internship dan/atau Pendidikan Berkelanjutan (PKB).



CATATAN: Pemberian angka 1 sampai 4 adalah berjenjang. Misalnya: apabila diberikan angka 3 (a,b) maka secara otomatis dapat dilakukan angka 1 dan 2. Ditetapkan di: Bandung Pada tanggal : Direktur,



DR. Dr. Roy David Sarumpaet, Sp.THT-KL.MMRS. NIK. 01131530