COMPREHENSIVE punya twinning

COMPREHENSIVE PART 1


1.common test use for pregnanacy
a.urine
b.blood
c.feces
d.spatum
e.CSF

2.most suitable statement for IVF
Answer: fertilization occur in tetube

3.a 38 years old women is alredy 5 years married. She go to aster clinic in hasan sadikin hospital to take part in assisted reproductive technology (ART) programmed
What is the best way to prepare her?
a.to give her information about her medical condition
b.to tell her about pregnanacy, on going and take home baby rate
c.to tell her about therapeutican diasnostic procedure she has to endure
d.to tell her all information she needed to change her apearence
e.not to give her copius hope

4.when the doctor in charge tell her that there is possibility to failure it is mean that he is trying to tell her
a.the limitation of medical capability (CURE)
b.he is beneficience
c.he is trying to prevent non maleficience
d.to prepare herself from emotional disapurintment
e.he is respecting her right aoyonomy

5.the patient is 38 years old women. Ths the success rate for the ART is low. So what is the best way to treat her?
a.cure first, care later
b.care first, cure later
c.cure and care simultaneously
d.cure and care simultaneously equally
e.cure and care ,care is the major

6.which is the bioethical issue in ART ?
a.informent consent
b.IVF
c.embryo transfer
d.at the end of the programmed
e.at every stage of ART

7.child in cianjur and banten are suffered from malnutrition. The children in cianjur have plump appearance with swollen abdomen cause dby accumulation in the cavity abdomen. The distention of the fluid in the abdominal cavity can press direct to what part of the abdominal wall?
a.parietal peritoneum
b.visceral peritoneum
c.transversal peritoneum
d.camper’s face
e.scarpa’s face

8.what is the mostly cause of plump appearace in cianjur children?
a.low carbohydrate level
b.low fat level
c.low protein level
d.low albumin level
e.low mineral level

9.cianjur children experience hypoalbinemia. What method used to separate albmin from protein blood?
a.cromatography
b.polymerase chain reaction
c.electrophoresis
d,flow cytometry
e.impedance

10.the substance can be measdured based on principal tah t concentration of substance is directly proportional of the amount of light absorbanced or inversely proportional to the logarithm of transmited light. The principal is
a.elecromagnetic law
b.enderson haselbarch law
c.beer lambert law
d.icaplan law
e.thermodinamic law

11. protein build up from amino acid in example albumin. What bond between one of amino acid to answer amino acid?
Answer: peptide bind

12.one function of protein is control chemical reaction. The protein is called
a.antibody
b.enzyme
c.hormone
d.trnasport protein
e.structure protein

13.if ana essential amino acis to make protein is unavailable, what must the cell do?
a.substitute the similar amino acid
b.break down the dietary protein to obtain it
c.syntesize amino acid from fat
d.detrmine another protein
e.syntesize the maino acid from gucose and nitrogen

14.which of the following is the important of protein reference
a.calculate % energy malnutrition
b. calculate assess protein-energy malnutrition
c.determine protein quality
d.estimate weight of protein in food
e.quantity energy in food

15.if children digest protein in stomach, HCl?
Answer: denatures protein and activate pepsin

16.pathophysiology of edema
Answer: increase hydrostatic preasure

17.high glicemic index means
a.high fat contain
b.high protein contain
c.easy absorb
d.high fiber contain
e.more solid form

18.banten children from marasmus. What is the possible cause?
a.mega dose intake of amino acid supplement
b.axcessive fluid intake cause edema
c.imbalance trace mineral intake
d,inadequate protein and energy intake
e.too much clogging thchildern are verye liver

19.in prolonged starvation, which of the following will be used to replace gucose for brain?
a.glycerol
b.amino acid
c.fatty acid
d.triglyceride
e.keton bodies

20.about clark’s formula

21.childern are very emicated and prone to invection. They are given drugs (medication) as a treatment . appropriate drug dosage for the children
a.small dosage,more frequent,longer duration
b.high dosage,more frequent,short duration
c.small dosage,less frequent,longer duration
d.high dosage,less frequent,shorter duration
e.small dosage, more frequent,shorter duration

22.apart from famine, malnutrition can also be caused by parasite. Parasite that most possible for children caused by intestinal nematode
a.trichinella spiral
b.acylostoma duodenale
c.glyceris vermicularis
d.ascaris lubricoides
e.trichuris trichiura

23.accurate method for parasite (nematode) that can cause malnutrition
a.sucking the intestine blood
b.ingestion of lyses tissue and blood
c.feeding on intestinal content
d.ingestion of nourishment from body to fluid
e.penetration of blood vesscels and digestion of blood

24.who discover vitamin B1?
a.L. Pasteur
b.R. Koch
c.P. ehnlich
d.C. Eijkman
e.L.Otter

27.how many is the prevalence of famine in west jawa?
a.90
b.100
c.110
d.120
e.130

28.what is the enviorment factor?
a.bad sanitation
b.bad habit
c.poor people
d.crowded family

(29-40)Senior researcher was admitted to the hospital because of epigastric pain and vomit.

29.he vomit a large number of gastric contents. What cranial nerve form afferent limbs of vomit reflex?
a.CN V
bCN VII
c.CN IX
d.CN X
e.CN XI

30.statment most appropriate of development of stomach
a.orogin is mesoderm
b.forms by dilatation of fore gut
c.initial shape is oval
d.ventral part grows faster than dorsal part
e.rotate 45 degree

31.galactose is epimer of glucose. How many chiral carbon atom in its epimer?
a.1
b.2
c.3
d.4
e.5

32.most appropriate mechanism of antacid
a.it is incorporated to specific target
b.interact with enzyme
c.depens on non-spesific chemical reaction
d.bound to protei in stomach wall

33.ulcer and many other complains. Which factor decrease absorbtion of drug?
a.vomit
b.smoking
c.diarrhea
d.drug ineraction
e.upper left abdominal pain

34.patient regularly consume multivitamin and mineral. What is pharmaceutical characteristic of vitamin?
a.ethical drug
b.sold based on prescription
c.red dot
d.potential drug
e.without caution level

37.mineral best for antioxidant
a.copper
b.manganese
c.molybdenum
d.selenium
e.potassium


38.which mineral enhance insulin activity
a.iodine
b.magnesium
c.ferrum
d.zinc
e.chromium


39.most potential in inalignancy
a.coffe
b.drug
c.gastric ulcer
d.smoking
e.stress

40.diarrhea increase osmolarity in intestinal lumen
a.water shift to intestinal lumen
b.amino acid > absorb
c.glucose > absorb
d.lipid > absorb
e.intestinal cell swollen

41 sth 2 do with strongyloides stercoralis

42.case: CHOP
Cause of epigastric pain is
a.smoke
b.coffe
c. alcohol
d.stress
e.H.pylory

45.appropriate anatomical position
a.upper limb by the sid with dorsal facing aneriorly
b.lower limbs together with feet directed anteriorly
c.head direct lateral
d.eye direct laterally
e.toes direct laterally

46.which of the following reflect that measurement of height and weight
a.fat fold measurement
b.waist to hp ratio
c.bioelectrical impedance
d.BMI
e.mid arm circumference

53.what is the best parameter to calculate the glucose level
a.blood glucose
b.urine glucose
c.glycated Hb
d.methemoglobin
e.carboxyHb

54.blood glucose = 126(90-110).term for this condition?
Answer: hypoglycemia

57.one of the test perform for Mr. Obelix for calculation blood glucose concentration. What will produce if the method is oxidase peroxidase?
a.gluconic acid
b.amino phenazone
c.phenol
d.oxygen
e.glucose

58.what new method to detect diabetes mellitus?
a.c-peptide
b.gucose tolerance test
c.2pp blood glucose
d.random blood glucose
e.fasting blood glucose

59.Mr. Obelix having high calories food and pastries. What pharmacokinetics process influence by this food?
a.elimination
b.absorption
c.metabolism
d.distribution
e.excretion

60.Mr. Obelix using obese drug. Which appropriate drug dosage for him?
a.adjustment dose
b.adjustment dose , less frequent
c.therapeutic dose
d.low dose
e.high dose

61.which drug will decrase the body weight?
a.anticholesterol
b.antidabetic
c.anorexant
d.anticoagulant
e.antacid

62.differentiate between glucose and galactose etructure on position
a. chiral arbon
b.a carbon atmo
c.hydroxyl group
d.ketone group
e.aldehyde group

63.stage oocyte

65.what core structure of maino acid?
a.maine group,acid group and side chain in C after amino group
b.amine group,acid group and side chain in C after acid group
c.amine group,acid group and side chain in C
d.zwitter ion
e.amine and acid group

66.which important to support membrane and can move readily flip flop from one leaflet to adjacent one?
a.phospholipid
b.glycolipid
c.cholesterol
d.faty acid
e.trigyceride

67.determinant important in developing obesity among adult except?
a.high socioeconomic status
b.lack of exercise
c.low fat diet
d.low vegetable intake
e.low fruit fiber

68.programme conduct to cope this problem?
a.family planning
b.MCH
c.health promotion
d.regular intaegrated post
e.treatment facilities

71.main function of blood cells in thalassemia?
a.transport oxygen
b.produce antibody
c.stop excessive bleeding
d.prevent invection

72.thalassemia affect blood cells. Term of this production
a.erythropoeitis
b.hematopoeitis
c.lymphopoeitis
d.thrombopoeitis
e.grnaulopoeitis

73.examinaton that doctor needs to find out what type of tata’s anemia?
a.erythrocyte sedimentation rate
b.red ceel distribution rate
c.mean platelet volume
d.red cell indices
e.mean corpuscular volume

74.MCV = 58 fc, MCV =22 pg. MCHC = 27 g/dl
What type of tata’s anemia?
a.normrochome normocytic
b.hypochrome normochtic
c.hypochrome microcytic
d.normochrome macrocytic
e.hypochrome macrocytic

81.trnsmission of parasites can occur through blood transfusion
a.wucheria brancofti
b.toxoplasma gondii
c.brugia malayi
d.schistosoma japonicum
e.plasmodium falciparum

82.stool examination used saline wet mount, we can fount egg worn oval shaped with thin shelled egg and have 8 cell stage, clear space between cell and developing embrio. How its can cause anemia?
a.the nutrients
b.suck blood
c.suck blood and nutrient
d.absorb cobalamine
e.suck blood and absorb coblamane

85.suitable for chromosome analysis?
a.chromosome length divide into A,B,C,D,E,F,G
b. chromosome position is not important for classification
c.denver classification for standard classification
d.chromosome X equal to B group
e.normal chromosome number is 47

86.from genetic screening both parent are correct for beta-thalassemia with type IVS 5. Tata has mutation in beta globin chain with hohmzygote form of IVS 1 not 5. From which organelle we get material for DNA analysis
a.plasma membrane
b.nucleus
c.mitichondria
d.endoplasmic reticulum
e.golgi body

87.how many percentage genetic factor influence health?
a.25%
b.5%
c.35%
d.40%
e.1%

88.to prevent genetic desease, we can conduct
a.mass treatment
b.surveillance
c.personal lab exame
d.enforcment couple before married to examine health


population 120.000
pregnant mother 150
stillbirth 100
livebirth 1000
maternal death 4
fetal death between 28 week pregnancy & 1 week after delivery
neonatal death 10
infant death 40

89.post natal moratlity rate (per 1000)
a.25
b.30
c.40
d.50
e.55

90.
Maternal moratlity rate (per 1000)
a.200
b.300
c.400
d.500
e.600

91.innervation of sweat gland?
Answer: vagus

92.other NSAID which have at least anti-infalmatory but antipyretic?
Answer: paracetamol

93.which of the following is the effect of the drug that kill plasmodia?
a.fungicide
b.germenticide
c.helminiticide
d.schizonticide
e.insecticide

94.anemia in malaria ais due to destruction of the membrane plasma of RBC, which of the following lipid is structural component of cell membrane?
a.phospolipid
b.steroid
c.sphingolipid
d.sphingomyelin
e.waxes

95.body response to microbal infection by producing antibody.i.e.IgG, what is the group to this protein antibody?
a.peptidoglcan
b.glucosamine
c.glucosaminoglycan
d.chondroitin
e.glycoprotein

96.which of the following microorganism is the cause of malaria
Answer: protozoa (plasmodium)

97.most of the lifa cycle of the causing agent in this disease (not sure, maybe malaria)
a.man is definitve host
b.all mosquito is the definitive host
c.culex is intermediate host
d.female anopheles is definitive host

98.in the life cycle of malaria’s causing agent, we can found some stage . what is the infective stage of this agent?
a.gemetosyte
b.schizont
c.tropozoite
d.sporozoite
e.merozoite

99.maria have fever, sweat and chills and 3 days abrupt of infection. What is the type of the transmission?
a.transvarial
b.cyclico development
c.propagative
d.cyclico propagative
e.hereditor

100.according to maria’s symptom, she is diagnosed as malignant tertian malaria. Which of the following is correct about causing agent?
a.causing agent always infect to young red cell
b.red cell infected only by 1 species causing agent
c.causing agent always infected the older red cell
d.transmission only by the insect bite
e.causing agent infect the young and older red cell

101.which is correct related to the ojective of eradication and control of arthropod vector
a.anhilate all dangerous insect
b.increase vector population
c.minimize contact between vector and man
d.eradicate the vector borne disease
e.eradicate all vectors

102.the life cycle of the following parasite pass through blood sirkulation. Which parasite, that mthod of microscopic diagnocsis can be made with thin blood smear with giemsa stain?
a.ancylostoma duodenale
b.wuchereria brancofti
c.srongiloides stercoralis
d.plasmodium sp
e.trichinela spiralis

103.in the inflammatory response, there are several process include
1.rolling phase
2.neutrophil with combining actin-intracellular attachmentprotein transmembrane integrin bind to selectin in endothelial cell
3.the complex of chemokin-chemokin receptor leads to the expression of endoCAM
4.chemokine is secreted by macrophage bind the chemokine receptor on the endothelial surface
5.lamellipodium is formed in diapedes
a.1,2,3,4,5
b.2,3,4,1,5
c.3,4,1,2,5
d.4,3,2,1,5
e.3,2,1,4,5

104.about reticular fiber.

105.malaria in Indonesia is hard to eradicate. What is other desease that is in similar condition?
a.bactery dysentery
b.bronchitis
c.cholera
d.amoeboic dysentery
e.acute hepatitis

106.further physical examination on malaria revealed liver and spleen slightly enlarge. Which explanation suitable to liver development?
a.outgrowth-midgut
b.no related to development of digestive track
c.formed initially as liver bud
d.origin – mesoderm layer
e.outgrow – dorsal part of duodenum

107.the animal somatic cell is proliferation my cell mitosis. In what phase in the chromatin condense into chromatin condense into chromosome?
a.prophase
b.anaphase
c.metaphase
d.telophase
e.interphase

108.explain the meiotic division…..
a.meiosis consist of 1 round step
b.meiosis is somatic cell division
c.mitosis consist of 2 round step
d.crossing over occurs during meiosis division
e.the result is 2 haploid daughter cells

111.scale for blood preasure is…..
a.nominal
b.ordinal
c.interval
d.ratio
e.numeric

112.the characteristic of patient ie.income per month
a.nominal scale
b.ordinal scale
c.interval scale
d.ratio scale
e.category scale

113.to know the effect to the outcome (recovered/not recovered) dependent variable is…..
a.drug
b.patient’s diagnose
c.blod preasure
d.temprature
e.recovered/not recovered

117.chromosome gain material, called?
a.transversion
b.deletion
c.insertion
d.inversion
e.duplication

118.steps appropriate – development of ovum /oocyte?
a.primordial germ cells produced in ovary
b.primordial germ cells differentate into oogonia
c.oogonia will become primary follicle
d.graafian follicle become follicle
e.primary follicle become primary follicle

121.explain which appropriate for development of sperm?
a.maturation of sperm begins at puberty
b.spermatogenesis begins with formation of spermatids
c.2 types of spermatogonia – small and large
d.spermatogonia undergo mitosis to form 1 spermatocyte
e.sperm is diploid

124.what is appropriate statement for fertilization?
a.oocyte is ovulated tu uterine
b.occur in ampulary region
c.more than one sperm enter the oocyte
d.sperm penetrate zone pellucid
e.fusion of oocyte and sperm forming zone

128.cytoskeleton that can help in sperm motility??
Answer: microtubule

131.which metabolic change in cellular aging??
a.increase mitochondria oxidatoion
b.increase protein synthesis
c.increase cell receptor
d.decrease telomerase
e.oxidative peroxidative of erganells

135.epidural hematoma is due to rupture of middle menigeal artery which is branch from what artery?
a.maxilla
b.facial
c.lingual
d.pharyngica ascendant
e.bacillar

136.fracture of 1/3 distal of right clavicle elevates medial fragment of fracture due to contain to condition of……..muscle
a.sternocleidomastoid
b.trapezius
c.scalena