Soalan Tutorial (1) 1. Apakah yang dimaksudkan dengan ujian penyaringan?

Screening test is a strategy used in a population to detect a disease in individuals without signs or symptoms of that disease. Unlike most medicine, in screening, tests are performed on those without any clinical indication of disease. (Ujian penyaringan merupakan suatu strategi yang digunakan dalam suatu populasi untuk mengesan penyakit dalam kalangan individu yang tidak menunjukkan se arang signal atau symptom penyakit terse ut. Ujian penyaringan dilakukan ke atas mereka yang tidak menunjukkan se arang indikasi klinikal sesuatu penyakit tertentu.!

2. "eri e erapa contoh ujian penyaringan.

A skin test called the PPD test is widely used to screen for exposure to tuberculosis. Health care providers may screen for depression using questionnaires such as the Beck Depression nventory. Alpha!fetoprotein screening is used in pregnant women to help detect certain fetal abnormalities. "ancer screening is testing to diagnose risk factors for cancer and early!stage pre!symptomatic cancer# such as using the Pap smear to detect potentially precancerous lesions and prevent cervical cancer# or mammography to detect breast cancer.Bitewing radiographs are routinely taken at dental examinations and used to screen for interproximal dental caries.$ost public school systems in the %nited &tates screen students periodically for hearing and vision deficiencies and dental problems. &creening for spinal and posture issues such as scoliosis is sometimes carried out# but is controversial as scoliosis 'unlike vision or dental issues( is found in only a very small segment of the general population and because students must remove their shirts for screening. $any states no longer mandate scoliosis screenings# or allow them to be waived with parental notification.

(Ujian ##$,ujian kulit% digunakan untuk mengesan pendedahan terhadap tu erculosis. Unian penyaringan Alfa%fetoprotein & digunakan dalam kalangan wanita mengandung untuk mengesan kea normalan fetal. Ujian penyaringan kanser & digunakan untuk mendiagnos risiko menghidap kanser dan kanser pre%simptomatik pada tahap awal. Se agai contoh, #ap smear digunakan untuk mencegah kanser servikal manakala mammography digunakan untuk mengesan kanser payudara.!

'. "agaimanakah ujian makmal oleh digunakan mengdiagnos sesuatu penyakit dan mem e(akan di antara penyakit?
)aboratory tests check a sample of your blood# urine or body tissues. A technician or your doctor analy*es the test samples to see if your results fall within the normal range. +he tests use a range because what is normal differs from person to person. )aboratory tests are often part of a routine checkup to look for changes in your health. +hey also help doctors diagnose medical conditions# plan or evaluate treatments# and monitor diseases. '%,ian makmal digunakan untuk megu,i sampel darah# urin dan tisu tubuh. Doktor boleh mengunakan sampel u,ian tersebut untuk menentukan samada keputusan u,ian makmal seseorang individu berada pada paras normal. &uatu ,ulat digunakan untuk mengkategorikan individu!individu yang berada dalam paras normal tersebut. Bagi membe*akan di antara penyakit# analit!analit yang diperoleh daripada sampel darah atau urin digunakan untuk menun,ukkan indikasi sesuatu penyakit tersebut. &ebagai contoh# kehadiran analit glukos dalam sampel darah digunakan untuk mengu,i samada pesakit tersebut menghidap Diabetes $ellitus# manakala kehadiran analit hormone h"- dalam sampel urin digunakan untuk menentukan samada seseorang wanita tersebut mengandung.(

SOALAN TUTORIAL (2) .yatakan u,ian penyaringan dan diagnosis yang dapat dilakukan dan hasil yang akan diperolehi terhadap individu yang berpenyakit/

a( Diabetes $elitus 0enis Penyakit gangguan dalam metabolisme karbohidrat# lipid dan protein akibat daripada gangguan sekresi hormone insulin. Diagnosis/'i( paras glukosa darah1233mg4dl 5hiperglisemia 'ii( glikosuria! di dalam urin dapat dikesan glukos 'iii( penentuan bahan keton! peningkatan bahan keton dalam plasma dan urin dikesan pada D$ . 'iv( 6ral glucose tolerance test.

b( $iokardium infarksi
nitial screening for "AD commonly involves stressing the heart under controlled conditions. +hese stress tests are able to detect the presence of flow!limiting blockages in the coronary arteries# generally in the range of at least a 738 reduction in the diameter of at least one of the three ma,or coronary arteries. +here are two basic types of stress tests9 those that involve exercising the patient to stress the heart 'exercise cardiac stress tests(# and those that involve chemically stimulating the heart directly to mimic the stress of exercise 'physiologic stress testing(. Physiologic stress testing can be used for patients who are unable to exercise.

Diagnosis/ 'i( "linical history of ischaemic type chest pain lasting for more than 23 minutes 'ii( "hanges in serial :"- tracings 'iii( ;ise and fall of serum cardiac biomarkers such as creatine kinase!$B fraction and troponin

c(

)epatitis )epatitis%associated antigen can e detected within * hours y using an electrophoretic techni+ue and cellulose acetate mem ranes saturated with anti ody. ,he speed of the techni+ue now allows testing of lood intended fortransfusion on the day of collection, and the sensitivity of the method compares favora ly with standard immunodiffusion. $iagnosis- (i! .iver /unction ,ests ,hese tests show how well the liver is functioning ut will not accurately assess the many and varied functions for which liver is responsi le. ,ests do check the level of liver en(ymes, transaminases and cholestatic en(ymes, iliru in and liver protein levels. )igh levels of transaminases in the lood do not always reveal how adly the liver is inflamed or damaged. 0levated levels can also occur in genetic liver disease, liver tumors and heart failure. ,he normal ranges of AS, and A., transaminases are around 1 to 21 3U4. and 1 to 25 3U4. respectively.

(ii!.iver #roteins and hepatitis Al umin, prothrom in, and immunoglo ulins are checked and a normal levels are indicative of severe liver disorder. #rothrom in times, ecause the liver produces many of the clotting factors re+uired to stop leeding needs to e determined. (iii!.iver "iopsy for hepatitis 6ne of the main and most accurate diagnostic procedures that can determine what is wrong with the liver and how adly it has een damaged. As most liver diseases affect the entire organ uniformly, the small sample o tained y iopsy, generally performed under a local anesthetic, will show any a normalities.
d(

,irotoksikosis $ise a kan sekresi hormone tiroid oleh kelenjar sekresi yang erle ihan. $iagnosis- (i! peningkatan kepekatan ,2 dan ,' dalam plasma. $idapati ,' 7,2. (ii! peningkatan tiroglo ulin dalam plasma.

e(

Urolitiasis

,he process of forming stones in the kidney, ladder, and4or urethra (urinary tract!. ,he diagnosis of kidney stones is suspected y the typical pattern of symptoms when other possi le causes of the a dominal or flank pain are e8cluded. 3maging tests are usually done to confirm the diagnosis. A helical 9, scan without contrast material is the most common test to detect stones or o struction within the urinary tract. /ormerly, anintravenous pyelogram (3:#; an <%ray of the a domen along with the administration of contrast dye into the loodstream! was the test most commonly used to detect urinary tract stones, ut this test has a greater risk of complications, takes longer, and involves higher radiation e8posure than the non% contrasted helical 9, scan. )elical 9, scans have een shown to e a significantly more effective diagnostic tool than the 3:# in the diagnosis of kidney or urinary tract stones.

f(

=olelitiasis 9holelithiasis is the formation or presence of gallstones ( iliary gallstones! in the gall ladder. >ost clinical diseases affecting the e8trahepatic iliary system are connected with the presence of gallstones. Some factors can increase the pro a ility of gallstone disease, such as- female se8, o esity, old age, ?orth American 3ndian ethnicity, western diet and a positive family history. ,he clinical conse+uences of the formation of gallstones in the gall ladder are varied. ,he diagnosis, in the presence of typical symptomatology, is confirmed y an a dominal ultrasound scan, with the discovery of various si(es of stones in the gall ladder. ,here are several therapeutic options for this pathology, medical or surgical. ?o data e8ists justifying an indication to remove the gall ladder in patients with asymptomatic lithiasis, therefore surgical operation to remove the gall ladder is indicated for persons who have had at least one episode of iliary colic.

SOALAN TUTORIAL (3) ,erangkan kesalahan yang sering erlaku dalam menjalankan ujian makmal diagnostic. 1. =esalahan pemilihan jenis ujian makmal. %kekurangan kefahaman terhadap teknik analisis, hu ungan ujian makmal dengan kea normalan pada pesakit, serta had kemampuan sesuatu ujian. *. =esalahan megumpul data dari segi waktu, lokasi dan penyimpanan.

-@aktu- (tk fr notes! -.okasi-penyimpanan. '. =esalahan perlaksanaan ujian makmal 2.=esalahan interpretasi hasil ujian makmal

Aelaskan dengan satu contoh apa yang dimaksudkan dengan 1.Ujian 6ne%6ff