final-nbss-part-1 09.docx

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Academic Team 09 FINAL NBSS 2nd Year - 2009

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#Part 1

1. A 30 years old woman came to clinic with right auralfullness since 3 days. From HT, she has had cough and

rhinorrhea since 1 week. PE revealed no cerumen from

both ear.

2. Which one of the following is the most possibility ofhearing loss?

a. Right cochlear Hearing Lossb. Right mixed type Hearing Lossc. Right conductive Hearing Lossd. Right retrocochlear Hearing Losse. Right sensorineural Hearing Loss

3. -4. Where is the location of abnormalities?

a. Inner earb. Outer earc. Middle eard. Outer and innere. Middle and inner

5. Which one is the most likely right pure tone audiogramin this case :

a. AC and AB >20, a-b gap < 10 dBb. AC and AB > 20, a-b gap > 10 dBc. AC > 25 dB, BC 0-20 dB, a-b < 10dBd. AC > 25 dB, BC 0-20, a-b >10 dBe. AC 0-20, BC>25, a-b < 10 dB

6. A 8 month baby girl ada speech delay, ENT examnormal. Risk factor :

a. History of alergyb. Obatnyalupa (inisial CT)c. Gentamycind. Birth weight


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e. Provide ear plug at least 24 hour15.16. Right Pix Hallpike (+)

a. right cerebellumb. Left lateral semicircular canalc. right lateral semicircular canald. left posterior semicircular canale. right posterior semicircular canal

17. Ancillery test tuhapaajakomponennya??(maafsayalupanyatetsoal.. Cariajaancillery test..)

1 opsinyaada 3..(ada leukocyte, VLDL, cholesterol, blood

glucose etc..)

18. On history taking, she had tinnitus and fluctuatehearing. What is the appropriate treatment for her?

a. Low-fat dietb. Low-calories dietc. Give her diureticd. Give her antibiotice. Give her oral steroid

19. The symptom occurs when he get up with roll to left.Which oneis the first treatment?

a. Surgeryb. epley maneuverc. rolling maneuverd. semant maneuvere. liberatory maneuver

20. Tinnitus and hearing lossa. Bppvb. Vestibularc. Labyrintitisd. Menieree. perilymph fistula

21.22.23. The most common adverse effect of limiting this drug is

dyskinesia24. Sudden rotation while cooking. Jawabannyabetahistine25. -26. -27. Antipsychotic agent

28. 1 month baby is brought by her mother to theophthalmologist with chief complain of his eyeball.

Other complains are tearing and photophobia.

Ophthalmology exam revealed buphthalmia and cloudy

cornea. Diagnosis:

a. Congenital cataractb. Congenital glaucomac. Retinoblastomad. Rhabdomyosarcomae. Opthalmianeonatarum

29. Seorangwanitaseringmelihatibunyaduduk di sudut,menonton TV, danmerajutkaos kaki. Diarinduibunya

yang telahmeninggalsebulan yang

lalu.Termasukpenyakit?

30. Where is the position of the focal point beforecorrection ( S + 1.00)

a. in front of retinab. behind retinac. on the retinad.

2 point behind retina

e. 2 point in front of retina

31. Where is the position of the focal point after correctiona. in front of retinab. behind the retinac. on the retinad. 2 pts behind retinae. 2 pts in front of retina

32.


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33. Blurred vision, Visual acuity 6/18 both eyes, koreksidengan cyl. -150 x 90

o, visual acuity kembali normal.

Jenis kerusakan?

a. Pseudomiopiab. Simple astigmatism myopiac. complex astigmatism myopiad. presbyopiae. lupa

34. bayanganjatuh di manasebelummatadikoreksi :a. di depandanbelakang retinab. di depan retinac.

di belakang retina

d. di retinae. (satulagilupa)

35. 30 y.o, Blurred vision, visual acuity 6/36 both eyes, nextappropriate exam for visual acuity?

a. hirschberg testb. pinholec. version&ductiond. trial&errore. lupa

36. A 35 y.o woman present with blurred vision. Ophthalmicexam reveals visual acuity 6/60 on both eyes. With

pinhole examination, visual acuity becomes 6/9. What

does this result means?

a. Ambiyopiab. Malingeringc. refractive errord. media refractive opacitye. organic abnormality

37. Gradually blurred vision, shadow test +.answer : lens opacity

38. One of neurological factor in psychosis is increaseddopaminergic activity which cause increased dopamine

transmission specifically to mesocorticolimbic system.

Which of the following statement concerning is true

a. synthesized in cathecolaminergic vesicleb. metabolized by monoamine oxidase Bc. end product of dopamine metabolism is

homovanilic acid

d. dopamine receptor are ligand gated ion channele. D2 receptor has high affinity for antypsychotic

drugs

39. What is the most likely diagnosis?a. senile immature cataractb. cataract traumaticac. cataract complicated. cataract secondarye. steroid induced cataract

40.

41. A 25 year-old man chief complaint: red eye sinceyesterday. Also watery discharge and foreign body

sensation. His roommate also has similar complaint.

Normal Visual Acuity, conjunctiva injection, other exam

normal. What causative agent?

a. Virusb. Bacteriac. Parasited. Fungie. Allergy

42. Sakitmata yang ada stone2nya, itujawabannya ventral apavenkrelgt.ahaha

UNTUK 43-44

Seorangibu, mengalamipenurunanpenglihatan, riwayat DM

selama 10 tahun.Visual acuity 6/18di keduamatanya.

43. Pemeriksaanapalagiselanjutnya? Jb : Funduscopy


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44. Funduscopy show exudate and intraretinal hemorrhage.What patophysiology of this case?

a. Retinal detachmentb. Occlusion of central retinal arteryc. Occlusion of central retinal veind. Ischemic of optic nervee. Microangiopathy of retinal capillary

45. 60 th, CC : painful eyes, blurred left eyes, 1minggulaluoperasikatarak, VA : 1/300, injeksi,

hypopyon. Kenapa?

a. Cellulitisb. Keratitisc. Uveitisd. Endothalmitise. Lupa-

46. Seorangwanitaumur 35 tahun, matamerahsemenjak 2minggu yang lalu,matanyafotophobia, blurred vision, di

test visual aquitynya 20/60, adanya injection cornea

danfiltrasi di cornea.most cause disease ????

ans: viral konjunctivitis

47. Bayi 1 minggu, CC : yellowish discharge both eyes,edema palpebra, conjunctiva injection, mucopurulent

discharge, diplococcus gram (-) intracellular

a. S. Aureusb. Pseudomonas aeruginosac. N. Gonorrhoead. Acanthamoeba Sp.e. Chlamydia trachomatis

48. 25 th, awalnyasehat, jatuhdarikuda,langsungnggasadardandibawakerumahsakit,

tandaawalpeningkatan ICP adalah?

a. Diminished pupillary sizeb. Menurunnya GCSc. Menurunnya HRd. Menurunnya RRe. Meningkatnya blood pressure

49. You are performing cardiopulmonary resuscitation on apatient who has just suffered a cardiac arrest. Which of

the following provides the best indicate that

resuscitation is effective?

a. Electrocardiographb. Palpitation of the femoral pulsec. Color of the skin and mucous membraned. Site and reaction of the pupile. Response to stimuli

50. Akulupaceritalengkapnya, maaf.Tapikalugasalahsihanakmudakecelakaan, fracture fibula.

Lupalagilanjutannya, pertanyaannyaapa yang

harusdilakukanpertama kali :

a. Cek airway, breath, circulationb. Cek femoral arteryc. Cek breathing and pulsed. Lupae. Lupa, maafyaa

51. A 25 years old came to an otolaryngology withsymptoms of otoicap. The physician diagnosed

witmastoiditis. Then he asked X-ray photo to confirm

the diagnosis. What kind of a ray photo should the

physician order?

a. Schuller& Stevenb. Waters & Caldwellc. Towne &Submentovertexd. Ester &Rhesee. Anterioposterior& lateral skull

52. 55 year old female, left sided hemiparesis,consciousness menurun, chronic fibrillasi atrial.

Pemeriksaan yang pertama kali dilakukan?

a. CT Scan carotid artery dan intracranial arteryb. MRI dengan MRAc. X-raysd. USG neck

53. Gambar yang disuruhcarigambar neural tube di soalremedial NBSS54. (maafagaklupa) Anesthesia padawajahdimulaidari

midline, kira-kiradari nasal kananataske eye.,

merupakanterjadikerusakan?

a. lachrymal nerve of ophthalmic division oftrigeminal nerve

b. Frontal nerve of ophthalmic ..c. ophthalmic division of trigeminal of cranial cavity

55. A patient suffers a fracture of the base of the skullinvolving petrous temporal and occipital bones. On


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examination, it is found that he has nerve deafness and

cannot close his eye on the affected side and has lost

the sense of taste on the anterior 2/3 of the tongue on

the left side.Assuming the symptoms is due to the

injury, which of the following explanations is most

plausible?

a. pressure on nerve 7 and 8 in the internal auditorymeatus

b. pressure involving nerve 8 and 3c. pressure on nerve 8 in the internal auditory

meatus and on nerve 7 at the stylomastoid

foramen

d. pressure on nerve 8 and nerve 5 (mandibulardivision) because of a fracture running from

internal auditory meatus to foramen ovalee. pressure because of a hemorrhage deep to the pia

on the superior portions of the pons

56. Buatngecekkerusakan hypoglossal nerve, yangdokterlakukan?

a. Menelanb. bukamulutdanbilang ahc. julurinlidahd. Whistlee. Puff his / her face

57. Cranial Nerves berapa yang mengaturocculomotor?58. A 35 year old man presented with lesions in the left

frontal cortex adjacent to the face region of the motor

cortex. What is the most likely the result?

a. an inability to make facial movementsb. loss of sensation from the right side of the facec. impairment in the ability to recognize facesd. impairment of spatial abilitiese. impairment of language

59. A 65 years old presents with a 4 hour of diplopia,vertigo and ataxia. CT brain is normal. If it is assumes his

symptoms are due to cerebrovascular disease, which ofthe following vessels is the most likely to contain the

culprit lesion?

a. anterior cerebral arteryb. anterior choroidal arteryc. basilar arteryd. middle cerebral arterye. posterior cerebral artery

60.

61. A 45 years old female presented to the emergencycomplained of losing the visual field involving both

temporal visual fields (bitemporal field defect). What is

the most likely level of disturbance?

a. Left and right optic nerves prior to entering thechiasm

b. Chiasmc. Left and right parietal lobed. Left and right occipital lobee. Left and right temporal lobe

62. A patient presented with lost of visual field involving theupper left visual field in both eyes. Location of the

lesion?

a. Left optic nerveb. Chiasmc. Right parietal lobed. Right temporal lobee. Right occipital lobe

63.64. The right-handed 65 y.o suddenly feels weakness of her

right arm and hand and subsequently finds that she

cant move them voluntarily. During the examination

she has slow and hesitant speech. She can move her

legs normally, her vision is normal, her finger-to-nose

test is normal and there is no sign of disequilibrium.

Which of the following arteries is most likely to have

been affected?

a. Basilar arteryb.

Posterior cerebellar artery

c. Anterior choroidal arteryd. Middle cerebral arterye. Anterior cerebral artery

65.66.67. A 70 y.owoman have mild elevation of systolic blood

pressure come to ER with history progressive right side

weakness and speech disturbance. Her relative said that

she take tablet for blood pressure for 3 month. Her


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complaint transient episode numbness in her right arm.

What is diagnosis?

a. Subarachnoid hemorrhageb. Viral enchepalyc. Left side middle cerebral artery occlusiond. Right side cerebral embolisme. Left fronto parietal tumor

68.69. 66 years old falls and twist his right leg. Complain: pain

di upper lateral aspect of his shin. X-ray: spiral fracture

of fibula. Indikasi peripheral nerve injury?

a. Sensory impairment of dorsum of footb. Sensory impairment of great toec. Weakness of footd. Weakness of dorsiflexion inversione. Weakness of plantar flexion

70.71.72.73.74.

75. As the later stage of dark adaptation take place, whatcause the

major change occurring in visual sensivity?

a. cones becoming less sensitiveb. rods -||-c. cones becoming more sensitived. rods -||-

76. A hypothetical patient underwent removal of the leftprecentralgyrus. What will be expected in this patient?

a. Spinal shockb. Extensor rigidity in the right legc. Spasticity in the left legd. Flaccidity in both armse. Loss of sensation in the right leg

77. Hypothetical patient had accident that caused adestruction of the

left auditory cortex,what will be expected in this

patient?

a. Deafness in the right earb. Loss of abilty to discriminate different frequencyc. loss of the ability to discriminate sound intensitiesd. impairment n local using sounds bla.bla.bla

e. nonobvious effect78. A ct scan of an infant with an enlarged head showed

dilatation of

the lateral & 3rd ventricle. Which of the following is the

most likely diagnosis?

a. Hydranencephalyb. Macroencephalyc. Arnold-chiari malformationd. Obstructive hydrocephaluse. Communicating hydrocephalus

79.

80. A subject is rotated clockwise in a swivel chair for oneminute then suddenly stopped. What are the directionsof the fast phases of nystagmic eye movement just after

the beginning and end of rotation?

a. Both clockwiseb. Both anticlockwisec. Clockwise and anticlockwise respectivelyd. Anticlockwise and clockwise respectivelye. Cannot be identified

80. A bar of light at a particular orientation is the mosteffective stimulus in exciting which of the following?

a. Rods and conesb. Bipolar cellsc. Retinal ganglion cellsd. Lateral geniculate bodiese. Visual cortical cells

81. A hypothetical patient had an injury of selectivelysevered the dorsal columns at the mid-thoracic level.What would you expect to be found?

a. Prevent the production of voluntary movements ofthe legs

b. Initially abolish all reflexes in legsc. Give abnormalities of posture but no deficit in the

ability to move the toes

d. Abolish the sensation of pain in both legse. Impair the ability to stimuli on the soles of each

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82. A 45-years-old man is known of having damage to thespino-thalamic tract on one side of the body. What

would you expect to be found below the level of the

lesion?

a. Loss of pain sensation on the same side of bodyb. Loss of pain sensation on the opposite side of the

body

c. Loss of fine cutaneous sensation of the same sideof the body

d. Loss of fine cutaneous sensation on the oppositeside of the body

e. Loss of muscle sensations bilaterally83. Which of the following will occur in a girl who suddenly

stops spinning after several seconds of spinning to the

left?a. Her eyes will move slowly to the rightb. The hair cells in the right semicircular canal will

depolarize

c. The cupula in the right semicircular canal will moveaway from the utricle

d. The objects in the visual field will appear to bespinning to the right

e. She cannot control the movement of her feet84. A farm worker inhales a pesticide which blocks

acetylcholinesterase in the neuromuscular junction. He

presents with breathlessness. Which of the following

mechanisms is the most likely cause of his difficulty in

breathing?

a. Blockade of the acetylcholine receptors byacetylcholine Initially abolish all reflexes in legs

b. Rapid breakdown of acetylcholine in the synapsec. Lack of acetylcholine production in the synapsed. Decreased amount of acetylcholine in the smooth

muscle

e. Reduction in acetylcholine reuptake85. In a psychology practical class, when a steel rod washeld against an area of skin with a constant force,

students notice that the firing rate in the related

cutaneous sensory nerve decreased. What property of

the sensory system does this observation indicate?

a. Change in receptive fieldsb. Recruitment of the receptors of a different

modality

c. Increasing sensitivity to the stimulusd. Adaptation of receptorse. Adaptation of the central sensory mechanisms

86. If you were to perform a nerve graft that will allow forfastest conduction, which one of the following nerves

would you choose?

a. 2-3 micrometer diameter, unmyelinatedb. 15-20 micrometer diameter, myelinatedc. 20-25 micrometer diameter, unmyelinatedd. 2-3 micrometer diameter, myelinatede. 15-20 micrometer diameter, unmyelinated

87. A patient presented with the following speech: Wellthis is mother is away here working her work out

ohere to get her better, but when shes looking in the

other part. One their small tile into her time here. Shes

working another time Which ONE of the following

CORRECT?

a. This speech disorder is called Alexiab. She could understand everything she was toldc. This speech disorder is called global Aphasiad. This disorder is called Wernicks Aphasia (or fluent

aphasia)

e. This disorder result from a lesion of motor speecharea (Brocas area)

88. A patient with infarction in the left superior cerebellarpeduncle and the left superior cerebellar hemisphere,physical examination will show

a. Hyperreflexia on opposite side of bodyb. Resting tremor in the right handc. Reduced muscle tone on the left side of the bodyd. Clonus in the left lower limbe. Loss of pain and temperature sensation on the left

side of the body

89. Zainab had high frequency sound loss (deafness). WhichONE of the following is TRUE about Zainab?

a. The superior olivary nucleus is damaged in Zainabb. She cannot hear sounds of 500-1000 Hz frequencyc. The basilar membrane at the base of the cochlea is

affected

d. There is a lesson in the semicircular canalse. The tympanic membrane is perforated

90. A patient had embolism of the anterior spinal artery.Which ONE of the following features will be found on

examination of this patient?

a. Muscle weakness in both left limbs but the rightlimbs are normal


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b. Bilateral loss of pain and temperature sensationsbelow the site of the lesion

c. Normal reflexes In all four limbsd. Loss of tactile discrimination bilaterally below the

site of the lesion

e. Muscle wasting in all the four limbs

91. badansel yang menyebabkan pupil reflex adadimana?ans: ciliary ganglion

92. A 70 y.o. man had an ulcer at his right upper cheek,measured 2 cm, blablabla. Tumor nest resemble normalbasal layer (small columnar cell, palisading) nodular,

polymorph hyperchromatic nuclei. Jawaban : basal cell

carcinoma

93. Drug to produce mydriasis but not paralysis ofaccommodation:

a. cholinergic blocking agentb. alpha adrenergic blocking agentc. beta adrenergic blocking agentd. sympathomimetic agente. muscarinic agent

94. Sweating salivation lacrimation diarrheabradycardiakonstriksi pupil. Obatygmenyababkannya?

a. Atropineb. Succinylcholinec. Nicotined. Muscarinice. Scopolamine

95. Patients have the following sign and symptom :Parkinson-like tremor, dermatitis, and slight jaundice,

mild hypotension with tachycardia. What is the most

likely drug produced these syndromes?

a. Guanethidineb. Chlorpromazinec. Reserpined. a MOA inhibitore. Mephenesin

96. After installation of an eye drop a patient experiencemydriasis, loss of light reflex, cyclopegia, increased

intra-ocular pressure. What is the most likely

pharmacological profile of drug?

a. A direct acting cholinergic (eg. Pilocarpine)b. An indirect acting cholinergic (eg. Physostigmine)c. A local anaesthetic (eg. Cocaine)d. An antimuscarinic (eg. Homatropine)e. A sympathomimetic (eg. Epinephrine)

97. A 28 y.o. man is brought into casualty following anoverdose of cocaine. By what mechanism does the drug

exert its effect?

a. blockade of the noradrenaline reuptaketransporter

b. stimulation of presynaptic serotonin receptorsc. blockade of beta-2-adrenergic receptorsd. reduction in circulating adrenalinee. stimulation of the dopamine reuptake transporter

98.99. Agitated 26 y.o. man is brought into casualty by the

police. PE & psychiatric exam show that he has smokedcracked cocain 9 times in his last week. Which

neurotransmitter is most affected by this drug?

a. Acetylcholineb. Serotoninc. GABAd. Noradrenaline. glutamate

101.A 40 years old woman had depression. She was treatedwith tricyclic antidepressant, What is the function?

(lupapilihannya maap)

102.Dopamine receptor agonist such as bromocryphine areused to treat parkinsons disease because they

a. Inhibit metabolism of DOPA by decarboxylase inperipheral

b. Facilitate transport of L-DOPA across BBBc. Increase neuronal stores of dopamine in basal

ganglia

d. Mimic the action of dopamine at post synapticreceptors


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103.Which of the following drugs has the best evidencesupporting its effectiveness for long term prevention of

recurrences of mania and bipolar depression

a. Carbamazepineb. Lithiumc. Lorazepamd. Risperidonee. Valproate

104.Extra pyramidal side effect of antipsychotic drugs aremost likely due to the blockade of which one of the

following type of receptors

a. Adrenergicb. Cholinergicc. Dopaminergicd. GABAe. Serotonergic

105.The most appropriate drug for therapy of anxiety,alcohol withdrawal and status epilepticus is

a. Chlorpromazineb. Diazepamc. Paraldehyded. Phenobarbitale. Meprobamate

106.Penyakit Alzheimer mengalamigangguanpadaneurotransmitter apa? Jawab : Acetylcholine

107.A 65 years old male patient with mild to moderatesevere Alzheimer disease living with his sons family has

delusion and hallucinations. An appropriate drug to

control his delusion and hallucination:

a. Haloperidolb. Pthioridazinec. Lithiumd. Clozapinee. Diazepam

108.A 49 years old man with chronic alcoholism is admittedwith acute alcoholic delirium. He is prescribed high dosechlordiaxepoxide as part of his detoxification treatment.

What neurotransmitter is primarily involved by this

drug?

a. 5-hydroxy-trypthamineb. Acetylcholinec. Encephalind. GABAe. Glutamate

109.-

110.14 y.o girl epileptic (tonic-clonic) and has been treatedwith carbamazepine. Has poor compliant with her

medication and has been rushed to A/E with status

epilepticus. Most appropriate immediate control of the

convulsion ?

a. Diazepam i.v. injectionb. Phenytoin i.v. infusionc. Thiopentone sodium i.v. bolus injectiond. Tubocurarinei.v. injection

111.112.113.114.115.A young child presented with meningitis. A gram (-)

cocobacili isolated from csf on chocholate agar andrequire both x and v growth factor. Which one the

etiology?

a. Haemophilus Influenzab. H. ducreyic. N. meningitisd. H.parainfluenzaee. H. parahemolitikus

116.117.Neonatus 3 thn conjunctiva edema pdmatadari 2 hari

yang lalupadahari 3 edema menjadiparahdan purulent.

Etiologi :

a. gram +b. abundant intracelldipococci in neutrophilc. extracell lymphocyted. intracellular elementary bodiese. gram

118.A 42 year old male, had visited the ophthalmologistwith the chief complaint of watery discharge from both

eyes, which become puffy and red. What is the most

likely microorganism cause of infection in this patient?

a. bacteriab. virusc. arthropodsd. fungie. protozoa


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119.A previously healthy 7 years old girl presented with atwo-day history of fever, headache, rash, and

photophobia. Blood cuture as negative and CSF analysis

revealed high lymphocyte number, elevated protein and

normal glucose levels. The most ikely etiological

pathogen is :

a. Cryptococcus neoformansb. neisseriameningitidesc. streptococcus pneumoniad. coxsackie viruse. rotavirus

120.121.122.You are assessing a child 2 year age. Behavior:

a. ride tricycleb. draws a circlec. walk upstairs, alternating feetd. uses 3 words sentencee. know full name

123.124.125.126.127.6 months old infant, indirect hyperbilirubinemia, he is

babbling, what the best advise to mother?

a. Perform tymphanogramb. Perform brainstemc. Plan for cochlear implantd. Plan for hearing aide. Reassure the mother

128.A 7 year old boy has a seizure. Each attack lasts 10-20second in duration. EEG shows bursts of 3 cycles per

second spike waves. His attacks can be precipitated by

hyperventilation. Attack of the boy are characteristic of:

a. Myoclonic seizureb. temporal lobe epilepsyc. petit mal seizured. grand mal seizuree. infantile spasm

129.130.Anak 14 bulangangguan language development,

yglainnya normal, dianangisdannunjukbuatdapetin yang

diamau, anaksebayanyaudahbisa 2 kata, pernyataan

yang benar:

a. refer to speech rehabb. investigasi hearing

c. language dev normald. cerebral palsye. lupa

131.A 6 y.o is brought to your office with a complaint ofstomachache. He has been out of school for the last 2

weeks. His illness is worst in the morning. Tehe most

likely cause is:

a. Hepatitisb. peptic ulcerc. lactose intoleranced. school phobiae. subacuteappendicitis

132.A man brings his 49 y.o wife to the emergencydepartment. She is dazed. Confused, disorientated,

agitated and pacing restlessly. She was well until thismorning when she heard about her only son being

admitted to an intensive care unit in a critical state

following a road traffic accident. What is the most

appropriate treatment to help her cope over the next

48 hours?

a. Amitriptysineb. Diazepamc. Fluoxetined. Haloperidole. Lithium

133.A 53 y.o man consult you complaining anxiety. He is offsick and fearful of returning to work. He is conflict with

his manager. you wonder if he is suffering from clinical

depression. Which of the following symptom support

this diagnosis?

a. avoiding being seenb. feeling guiltyc. irritabilityd. lost intereste. lost libido

134.A 24 y.o. man presents to you with longstanding lowmood & problems at work. He tells you that he hasbeen spending excessive time on the internet at work

and has been disciplined for this. He is frustrated with

himself, also sad and guilty. He is a perfectionist with

work tasks and tends to avoid them by going on the

internet and eating chocolate. What is the most likely

underlying problem to evaluate in further HT?

a. Depressionb. generalized anxiety disorderc. obsession disorder


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d. personality disordere. schizophrenia

135.35 y.o male, drug dependent, unconcious on side walk,brought by ambulance. Exam: pinpoint pupil&multiple

needle mark on forearm, intervensi?

a. naloxon ivb. diazepam ivc. folic acid dan thiamine ivd. haloperidol ime. observasidan monitoring

136.A 5 y.o boy becomes terrified whenever his parentsleave the house. He also avoids going to school in order

to remain with his mother. Which one is the following is

the most likely the diagnosis

a. social sensitivity disorderb. generalized anxiety disorderc. avoidant disorderd. somatoform disordere. separation anxiety disorder

137.A 40 y.o. lady presents with multiple somatic symptomsin various parts of her body of 15 years duration.

Repeated medical investigations have not revealed any

organic basis for her symptoms. During the interview,

you notice that she is very critical of doctors and she

accuses them of failing to diagnose her il lness. Which

one of the following is the most likely diagnosis?

a. hypochondrial disorderb. somatization disorderc. atypical disorderd. conversion reactione. dissociative disorder

138.A 5 y.o boy becomes terrified whenever his parentsleave the house. He also avoids going to school in order

to remain with his mother. Which one is the following is

the most likely the diagnosis

answer : separation phobia139.Patient with sign-symptom: vomit, headache, right

sided ataxia, nystagmus, decrease reflex of cornea.

What illness shes suffering?

a. cerebral hemisphere infarctionb. sagital sinus thrombusc. intracerebral hemorrhaged. rupture of posterior communicating arterye. thalamus hemmorhage

140.A young man complain unsteadiness of gait with suddenchanges of posture. This is most likely due to

a. difficulty with visionb. posterior column diseasec. cerebellar ataxiad. involvement of vestibular connectione. peripheral neuropathy

141.A 45 years old farmer with corneal ulcer of the right eyecomes to the hospital. To determine the etiology of the

ulcer corneal scraping is performed. Doctor gives the

patient natamycin. Mikroorganisme yangditemukan di

corneal scraping:

a. Gram (+) rodb. Gram (-) coccusc. Hyphaed. Tropoziode. Cyst

142.A 75 y.o man comes to you complaining pain in the face(sharp and very severe). It is triggered ny speaking or

chewing. What is the most likely diagnosis?

a. cluster headacheb. temporal arteritisc. trigeminal neuralgiad. brain tumor

143.Weak, 63 y.o,, hemiparesis resolves in 24 hours. Sinusrhythm, carotid Doppler 80% stenosis. Appropriate

management?

144.A 63 years old man complains of burning numbness onhis feet and weakness of his leg. Examination shows

reduction of tendon reflex and superficial sensation in

the leg. The muscles are weak and tender. Diagnosis:

a. Polymyositisb. sympathetic reflex dystrophuc. amyotrophic lateral sclerosisd. peripheral neuropathye. multiple sclerosis

145.A 72 years old man is brought by his family forevaluation of an episode of acute confusion that

occurred 3 weeks ago. His family notes that the patient

has had increasing problem with his memory for the last

year and that his activities of daily living have declined

to the point that they are considering placement in a

long term care facility. The patien has hypertension that


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12 | P a g e

is poorly controlled by propanolol. They finding most

likely to suggest a diagnosis of multiinfarct dementia

rather than dementia of the alzeimer type is

a. no familiyhistyory of dementiab. score 14 mmsec. asymmetry of deep tendon reflexd. cerebral atrophy on cte. increased protein in csf

146.147.Wanita tiba2 pingsan, apa yang

harusditanyakanuntukkepentingan diagnosis?

a. Sudahmakanataubelumb. Ada gejalaapasebelumpingsanc. Sedangmensatautidakd. Konsumsiobatapae. Ada family history

148.149.150.An otherwise healthy 15 yo boy is brought to the gp by

his mother. The mother says she has noticed over the

past 2 weeks that the boy has had black spells, and that

without provocation he becomes uncommunicative,

does not respond to questions and grimaces with

repetitive movement of his mouth. They report that he

complains of strange smells. He has not collapsed to the

floor or been incontinent. His mother say that he has

had 1 febrile convulsion as a child and that he has been

knocked out less than a minute several times while

playing football. He was not brought to the doctor

because he was unconscious for a very short time and

seemed fine when he regained conscious each time.

The most likely ethiology is...

a. febrile illness of any kindb. epilepsy of unknown/genetic origin.c. result of head injury meningitisd. brain tumor

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