102. Anion gap = (K++Na+) – (Cl-+HCO3-)
103. Osmolality =
104. Kation dominan di extracellular fluid : Sodium (Na+)
Kation dominan di intracellular fluid : Kalium (K+)
106. Osmolality refers to the number of moles of solute in a kg of water (solvent)
Osmolality of serum or plasma can be measured directly with an osmometer or estimated as the sum of the concentration of all the solutes in the plasma. Because an osmometer does not distinguish between effective and ineffective osmols, effective osmolality can only be estimated. As it happens, urea is the only ineffective osmol that has substantial concentration in the plasma, 5 mOsm/L. In the normal plasma, therefore, total osmolality is nearly equal to effective osmolality. Plasma osmolality is estimated as follows:
Serum osmolality = {Serum Na+ (mEq/L) × 2}+{Glucose (mg/dL)/18}+ {Urea (mg/dL)/2.8}
107. Post-analitycal error: Kesalahan yang terjadi setelah pemeriksaan/analisis dilakukan
108. Yang membuat osmotic gap:
Nonelectrolyte solutes that accumulate abnormally in the serum, e.g., ethanol, ethylene glycol, methanol, and mannitol, will cause the measured osmolality to exceed the calculated osmolality, producing an osmolal gap. Accumulation of neutral and cationic amino acids also causes a serum osmolal gap.
109.
110. Jawab: Teratoma
This is a tumor composed of multiple tissues foreign to the site of growth.
It is a true neoplasm and must be distinguished from developmental anomalies in which tissues may be displaced.
Teratomas arise in the gonads or in the midline of the body.
111. Henderson-Hasselbalch equotion:
pH = 6.1 + log HCO3- X 0.03
PCO2
112. Vomiting → [H+] banyak yang keluar → Tubuh menjadi basa → Metabolic alkalosis (B)
113. For BGA blood artery sample:
In adult usually from femoral artery, and in baby we make an arteriolization in their heel (D)
114. Lipoma: Common benign tumor composed of well-differentiated fat cell (C)
115. ?
116. Rhabdomyosarcoma: Rare malignant tumor, usually of childhood, originating in, or showing the charateristic of striated muscle. (A)
117. (C) Undifferentiated.
118. (B) Growth slowly, small, not infiltrative
| CHARACTERISTIC | BENINGN | MALIGNANT |
| Differentiation/ Anaplasia | Well differentiated; Structure may be typical of tissue of origin | Some lack of differentiation with anaplasia; Structure is often atypical |
| Rate of Growth | Usually progressive and slow; May come to a standstill or regress; Mitotic figure are rare and normal | Erratic and may be slow to rapid; Mitotic figures may be numerous and abnormal |
| Local Invasion | Usually cohesive and expansile well-demarcated masses that do non invade or infiltrate surrounding normal tissues | Locally invasive, infiltrating the surrounding normal tissues; Sometimes may be seemingly cohesive and expansile |
| Metastasis | absent | Frequently present; The larger and more undifferentiated the primary, the more likely are metastases |
120. Anaplasia: lack of differentiation
characteristic:
Cell and nucleus plemorphic in size and shape
Tumor cell more bigger or smaller than normal cell
Nucleus content more DNA and hyperchromatic
Ratio nucleus : cytoplasm more bigger near 1 : 1 ( normal 1 : 4 to 1 : 6 )
Nucleolus prominent
More mitotic on poor differentiated tumor
Making giant cell : big nucleus with 2 – 3 nucleolus
Necrotic or ischemic area because growth spur need more vascular supply but vascular in stroma not enough
Well differentiated tumor cell, difficult to differentiate with normal cell
(C) Nucleolus prominent
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