1. Mr.

Wawan, a 25 years old cleaning service came to doctor’s private practice with a
chief complain of frequents sneezing since two days ago. This symptom appear
especially in the morning and while he was working, it also appears more than four
time in a weeks, and Mr. Wawan also thought that this symptoms were disturbing his
daily activity.
a. What is the anatomy, fisiology, histology in nose?
b. What is the meaning Mr. Wawan a 25 years old cleaning service came to doctor’s
private practice with a chief complain of frequents sneezing since two days ago?
c. What is relation between age, gender with complain?
d. What is etiology of sneezing?
e. What is possible disease with sneezing?
f. How is mechanism of sneezing?
g. What is the meaning this symptoms appear especially in the morning and while he
was working?
h. What is the meaning it also appears more than four time in a weeks?
i. What is the meaning Mr. Wawan also thought that this symptoms were disturbing
his daily activity?

2. Mr Wawan also complains of runny nose, itchiness on the nose and the eyes, and also
some nasal congestion.
a. What is the meaning Mr Wawan also complains of runny nose, itchiness on the
nose and the eyes, and also some nasal congestion?
b. What is etiology of runny nose, itchiness on the nose and the eyes, and also some
nasal congestion?
c. What is mechanism of runny nose, itchiness on the nose and the eyes, and also
some nasal congestion?

3. This symptom have been felt by Mr. Wawan since 2 years ago, he never went to the
doctor but he often bought some flu drugs on some small shop. Mr. Wawan’s granpa
used to had an asthma.
a. What is the meaning this symptom have been felt by Mr. Wawan since 2 years ago?
b. What is the meaning he never went to the doctor but he often bought some flu
drugs on some small shop?
c. What is possible flu drugs on some small shop?
 d. What is the meaning Mr. Wawan’s granpa used to had an asthma?
4. Physical examination: General Appearance : looks, mildly sick, compos mentis
Vital sign: BP: 110/70mmHg, Pulse: 90x/m reguler, RR: 22x/m, T: 37,0oC
ENT Examination:
- Ear : tymphanic membrane intact, light reflection +/+
- Nose : narrow Cavum nasi, whitish secret (+/+), konka livide hypertrophy conca
(+/+), mass (-)
- Throat : symetric arcus faring, uvula on the midle, tonsil T1-T1 Normal, posterior
faring normal
a. What is interpretation of general apperance?
b. What is mechanism abnormal of general apperance?
c. What is interpretation of ENT examination ?
d. What is mechanism abnormal of ENT examination?
e. How to do ENT examination?
5. Laboratory Examination: Hb 14,0 g/dl, Ht 42 g/dl, leucosyte 3500, thrombosyte
200.000, erithrosyte 4,6 x 1012, diff count 0/7/45/0/45/3
a. What is interpretation of laboratory examination ?
b. What is mechanism abnormal of laboratory examination?
6. How to diagnose?
7. What are the differential diagnostic in this case?
8. What are the supporting examination to diagnose in this case?
9. What is the working diagnostic in this case?
10. a. What is definition of rhinitis allergy?
b. What is epidemiology of rhinitis allergy?
c. What is classification of rhinitis allergy?
d. What is etiology of rhinitis allergy?
e. What is pathofisiology of rhinitis allergy?
f. What is trigger factor of rhinitis allergy?
g. What are the symptom of rhinitis allergy?
11. What are the governance in this case?
12. What is the complication of this case?
13. How is the prognostic in this case?
14. What is the general practitioner’s competence in this case?
15. What is islamic view in this case?