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TEAM BLOCK 8
CARDIOVASCULAR SYSTEM
FACULTY OF MEDICINE
UNIVERSITY OF MUHAMMADIYAH PURWOKERTO
PURWOKERTO
2018
BLOCK 8
CARDIOVASCULAR SYSTEM
CONTRIBUTORS
Curiculum Coordinator
dr. Anis Kusumawati, M.Sc
Block Coordinator
dr. Susiyadi, Sp. An
LIST OF CONTENT
Title
Contributors
List of content
Preface
CHAPTER I INTRODUCTION
A. Block Description
B. Departement Involve
PREFACE
CHAPTER I
INTRODUCTION
A. BLOCK DESCRIPTION
Name : Block of Cardiovascular
Code : 131401308
SKS : 5 SKS
Schedule : Semester 3th
Block Description :
Block of cardiovascular is the 8th block in two year of medical student.
This block will go on for six weeks where’s in the 3th and last week the
medical student will be evaluate.
This block will begin by understanding the anatomy, physiology,
histology and the pathophysiology of the cardiovascular system.
Thereafter the medical student will learn the abnormality involving the
organ, criteria diagnosis, and the therapy. Subsequently medical student
should be able to practice their knowledge and skill of cardiology at the
community health facility or the hospital.
B. DEPARTEMENT INVOLVE
1. Anatomy
2. Histology
3. Physiology
4. Pathology Clinic
5. Pathology Anatomy
6. Pharmacology
7. Internist
8. Pediatric
9. Radiology
10. Herbal Medicine
11. Heath Nutrient
12. Rehabilitation Medic
13. Islamic
CHAPTER II
LEARNING GUIDE
A. AREA OF COMPETENCE
1. Behave Professionaly
B. LEARNING OUTCOME
After completing six weeks of learning process in this block, medical
student should be able to :
C. STANDART COMPETENCE
22 Atrial flutter 3B
23 Atrial flutter pada Anak 2
24 Ekstra-sistol supraventrikular, ventrikular 3B
25 Ekstra-sistol supraventrikular, ventrikular 2
pada anak
26 Bundle Branch Block 2
27 Aritmia lainnya 2
28 Kardiomiopati 2
29 Kor pulmonale akut 3B
30 Kor pulmonale akut pada Anak 2
31 Kor pulmonale kronik 3A
32 Kor pulmonale kronik pada Anak 2
33 Penyakit Kawazaki 2
34 Spell hypoxic 3B
35 Sindrom koroner akut (angina pektoris tidak 3B
stabil, infark miokard akut)
Gangguan Aorta-Arteri
36 Hipertensi esensial 4A
37 Hipertensi esensial pada anak 3A
38 Hipertensi esensial dengan penyulit 3A
39 Hipertensi sekunder 3A
40 Rujuk balik hipertensi sekunder 4A
41 Hipertensi pulmoner 1
42 Hipertensi krisis (emergensi) 3B
43 Penyakit Raynaud 2
44 Trombosis / trombo emboli arteri 3B
45 Koarktasio aorta 2
46 Penyakit Buerger's/ Thromboangiitis 2
Obliterans
47 Subclavian steal syndrome 1
48 Aneurisma Aorta 1
49 Aneurisma diseksi 1
50 Aneurisma pembuluh darah perifer 2
51 Demam jantung reumatik 3A
52 Abses diabetik 3A
53 Gangren diabetik 3A
54 Iskemik tungkai akut 3B
55 Iskemik tungkai kronik 2
56 Peripheral artery disease 3A
57 Anomali vaskular 2
58. Malformasi vaskular 2
59. Trauma vaskular 3B
Vena dan pembuluh linfe
60. tromboflebitis 3A
61. Tromboflebitis pada anak 2
62. Limfangitis 3A
63. Limfangitis pada anak 2
No Keterampilan Tingkat
Keterampilan
ANAMNESIS
1 Melakukan anamnesis dengan bahasa yang 4A
mudah dipahami oleh pasien dan
keluarga/pengasuhnya terkait keluhan
utama sesuai daftar masalah
kardiovaskular.
2 Mendapatkan data tentang faktor risiko 4A
penyakit kardiovaskular yang ada pada
diri pasien
PEMERIKSAAN FISIK
3 Inspeksi dada 4A
4 Palpasi denyut apeks jantung 4A
5 Palpasi arteri karotis 4A
6 Perkusi ukuran jantung 4A
7 Auskultasi jantung 4A
8 Pengukuran tekanan darah 4A
9 Pengukuran tekanan vena jugularis (JVP) 4A
10 Palpasi denyut arteri ekstremitas 4A
11 Penilaian denyut kapiler 4A
12 Penilaian pengisian ulang kapiler (capillary 4A
refill)
13 Deteksi bruits 4A
Pemeriksaan Fisik Diagnostik
14 Tes (Brodie) Trendelenburg 4A
15 Tes Carvallo (Carvallo’s sign) 4A
16 Tes Perthes 3
17 Test Homan (Homan’s sign) 3
18 Uji postur untuk insufisiensi arteri 3
19 Tes hiperemia reaktif untuk insufisiensi arteri 3
20 Test ankle-brachial index (ABI) 3
21 Penilaian edema 4A
22 Penilaian perubahan warna kulit tungkai 4A
Pemeriksaan Diagnostik
23 Elektrokardiografi (EKG): pemasangan dan 4A
interprestasi hasil EKG sederhana
24 Exercise ECG Testing 2
25 Echocardiografi (M-mode, 2DE, Doppler, 2
transesofageal)
26 Phonocardiografi 2
27 USG Doppler 2
28 Exercise ECG Testing 2
29 CT Cardiac 1
30 Angiografi (arteriografi dan venografi) 1
31 Pemeriksaan Sidik Perfusi Jantung 1
32 Pulse Oximetry 4A
33 Ambulatoir Blood Pressure Monitoring 4A
34 Holter Monitor 2
35 Cardiac Magnetic Resonance Imaging 2
36 Kateterisasi Jantung, Elektrofisiologi 2
Resusitasi
37 Pemasangan bebat tekan 4A
38 Heparinisasi 4A
39 Sidik Perfusi Jantung 1
40 Defibrilasi (manual dan otomatik) 4A
41 Kardioversi 3
42 Kateterisasi Jantung 2
43 Operasi jantung 1
44 Kardioversi 3
45 Defibrilasi 4A
46 Valsava Test 4A
47 Massage Karotis 4A
48 Penggunaan Automated External 4A
Defibrillator (AED)
Biomarker Jantung
EKG
Penyakit Kardiovaskuler
E. LEARNING METHODE
1. Debriefing
Debriefing is done everyday according to schedule, to give
medical student a basic understanding or prior knowledge of the
concept related to the topic of their study.
2. Lecture
Learning in classroom where medical student hear expert teach
them in front of the class.
3. Expert Consultation
An activity whereas medical student will be doing consultation
with an expert about the problems they’re facing or the solution
that occur in their disscusion. The consultation will be carried out
by an agreement between the medical student and the expert of
place, date and time.
6. Skill Lab
Skill lab Skills laboratorium is aiming at practising the medical
student’s skills using a learning model for example, the
manequin, phantom and patient simulation. This activity is
perform from an early start and continously integrated throught
out the block. Clinical skills that are being learnt and practise in
the skills laboratory is one of the main competence in medical
7. Practical
Practical in laboratory related topic in cardiovascular system.
8. CD interactive
Performing a CD interactive is aiming to give the medical
student a better visualisasion of the health issue according to the
topic of the block. After watching the visualisasion then the
medical student will continue to discuss the issue between the
lecturers, so the medical student will get a comprehensive
understanding about the issue that are being dicussed.
9. Review Artikel
10. E- learning
F. LEARNING FACILITY
- Staff os lecturer
- Tutor with a ratio 1:10
- Laboratory
- Internet Access
- Library and e-Library
- Discussion room (PBL)
- Lecture room
- Laboratory skill and equipment
- LCD and Laptop
- White Board
- Wireless Microphone
- Secretariat Block room
- CD movie
EXPERT LECTURE
Patologi Anatomi PA
Defibrilation Anesthesiology
4 EKG Cardiology
Keislaman Islamic
Week Topic
2 sakitnya dadaku
4 saatnya beraksi
5 dadaku
PRACTICAL
Topic Departement
Anatomi klinis jantung Anatomy
Histologi jantung dan pembuluh darah Histology
Pembacaan EKG normal Physiology
Patologi Anatomi Jantung PA
β- Bloker Farmakology
Digitalis Farmakology
REVIEW ARTIKEL
SKILLS LAB
Topic Departement
Pemeriksaan Fisik Jantung (IPPA)
Pemasangan EKG & Interpretasi hasil EKG Skills
sederhana Laboratory
Rontgen jantung
Resusitasi Jantung Paru
Resusitasi Neonatus
G. SCHEDULE
SCHEDULE OF BLOCK CARDIOVASCULAR SYSTEM
Terlampir
student who did not passed the minimum score for certain
station, then they will get a zero score for that particular
station.
d) The total score for clinical skill is the total score of all
station divided by the number of station.
e) The team responsible for the clinical skill’s score is the
evaluation’s team and the clinical skill’s team.
d. Practical score
The percentage of the practical score is 25%.
e. Article Review score
The percentage of article review score is 5%
2. Passing Criteria
a. Attendance of all learning methode is not less than 80 %
b. Performance in tutorial PBL minimum70
c. Practical score minimum 70
d. Submit all the assignment before due date
3. Remedial
a. Remedial is given to the medical student who fulfill the criteria
to do a remedial examination. (attendance is no less than 80 %).
b. Remedial written exam is to be held with agreement
c. Grades obtained by remedial is the best grade with a maximum
of 68.
4. Score Component
The overall grade of the block is determined according to the
following reference :
Grade Scale Interpretation
CHAPTER III
QUALITY ASSURANCE OF BLOCK
A. BLOCK REGULATION
1. Quality Component
a. Medical student
b. Lecture / Tutor / Expert
c. Facility
d. Education regulation
e. Management
f. Lecture
g. Self directed learning
h. PBL
i. Laboratory skill
j. Practical
k. Evaluation
2. Quality Standart
a. Lecture
1) Actualisation of lecture is 100% from the total plan
2) Medical student who follow the lecture is 90%
3) The fulfilled of adequate learning facilities for the
activity, for example everyroom has its own LCD,
computer, soundsystem, OHP, AC, whiteboard and room
capacity is relevent to the number of medical student.
4) Consistent scheduling (unchanged 2 times)
5) The availability of module, CD, reference to use.
C. BLOCK MONITORING
1. The monitoring of the learning process is held periodicaly every
week by team of quality assurance.
2. The monitoring of learning process is held in the end of the block
by all staff involve including medical students, lecturer and staff
administration by filling in the form available.
3. Evaluation form and block monitoring form is included.
REGULATION
A. Regulation for Lecture and Expert Consultation
1. Medical student is compulsory to be present during the lecture.
The attendance allowed to be able to sit in a written exam is >
80%.
2. Medical student is compulsory to be present inside the lecture
room before the lecture begin.
3. Medical student is compulsory to fill in the absence form for
lecture.
4. Medical student is compulsory to follow the lecture with a good
behaviour, do not talk to others outside of the topic of the lecture
given, so not to interrupt the learning process.
5. Medical student by any reason is unable to be present during the
lecture is compulsory to inform (written) the accademic
coordinator or block coordinator.
6. Absence in the lecture activity must be accompanied with an
acceptable reason. For example :
i. Sick / gave birth ( with an evidence of the doctors letter)
ii. Get Married
iii. The dearh of main family member (father, mother, siblings)
iv. Undergo activity by the faculty/university proved by a dean
recomendation.
TUTORIAL CASE :
Scenario 1
My Chest Pain
When Physical examination the patient look pain. Week pulse, once a
while ektrasistole, weight 92 kgs, height 168 cms, awareness compos mentis,
blood pressure 100/70 mmHG. Pulse 100x/minute, content less pressure,
regular rhyme, respiratory rate 22x/minute, JVP not increase.
Scenario 2
Always Emotion
In the laboratory tests showed that the triglycerides 525 mg/dl with
numbers of HDL 30 mg/dl and LDL 314 mg/dl
Scenario 3
left side of heart shifted to laterally bottom and the right side of heart on SIC
V Linea right of parasternal. The result of auscultation showed that sound of
heart I on increase intensity, sound of heart II normal, the noisy of pansistolic
is spread laterally, rytme of gallop is positively, On lung examination showed
that on normal vesicular, wet ronkhi smooth basalt and on abdominal
examination found hepatomegaly and ascites.
Scenario 4
A nurse in hurry report that the patient on the bangsal, 56 years old, female,
has been hospitalized 2 days, suddenly loss her consciousness, cold sweat,
rapid of pulse increased, weak and oliguric. The patient look confusion and
agitation. Blood pressure 80/50 mm Hg, pulse 120 x/minutes, respiratory rate
28 x/minutes, temperature 360C. The patients had story of uncontrolled
hypertension for 5 years.
Scenario 5
MY CHEST
A 14-year-old man came to the UMP Hospital with his family, with
complaints of shortness of breath arising. Complaints of tightness in the chest
are affected by activities, for example when the patient is walking ± 20 meters,
and suddenly the patient feels tight. The patient said that this feeling of
tightness was not influenced by weather or emotions. Tightness is reduced
when the patient rests. Patients also complain of heart palpitations, no
complaints of chest pain.
The patient's mother said that patients often experience recurrent cold
cough. On physical examination, it was found that the general condition
seemed moderate, composmentis consciousness, pulse 98 x / minute,
breathing 28 x / minute, temperature 36.8 ºC.
On physical examination :
- BB 35 kg, TB: 145 cm.
- Neck found increase in JVP 5 + 4 cmH20,
- Pulmo is not found abnormalities.
- Heart: inspection looks corded, palpation of palpable palate at ICS V
midline cystic cords, percussion dullness, auscultation sounds irregular
BJ and I-II gallop (+).
- The inferior extremity has edema.