MDE GUS 2011

Minggu, 19 Juni 2011

3. Calcium metabolism is also regulated by kidney because of vit D3 has to be catalyzed by WOTF kidney enzyme?

A. vit D3 phosphorylase

B. vit D3 transferase

C. vit D3 hydroxylase

D. vit D3 kinase

E. vit D3 synthetase

A 50 y.o. woma with 5 year history of uncontrolled hypertension à theray with thiazide diuretic and β-blocker à evaluated because of proteinuria during routine yearly medical visit.

PE : height 167 cm, weight 91 kg, BP 170/100 mmHg, trace pedal edema

Lab : serum creatinine 1.7 mg/dL, BUN 27 mg/dL, creatinine clearance 97 mL/min

Urinalysis : pH 5, protein +3, specific gravity 1.018, no glucose, occasional coarse granules

4. According to the condition of the patient, WOTF pathway is true for her condition?

A. glycolysis

B. glycogenolysis

C. gluconeogenesis

D. glycogenesis

E. lipogenesis

9. Gross appearance of malignant nephrosclerosis?

A. broad U shaped cortical scars overlying dilated calyces in renal poles

B. depressed cortical areas overlying necrotic papillae of varying stages

C. multiple small petechial hemorrhages on the surface

D. multiple small white areas on the surface

E. wedge shaped pale cortical scars

12. A 7 y.o. male come to the hospital with gross hematuria in the morning & disappear in the afternoon. HE had history of throat infection 2 weeks earlier. According to the clinical statements above, what is the most possible cause of the boys’ hematuria?

A. increase globulin in urine

B. Hb in urine

C. leucocyte in urine

D. abnormal number of RBC in urine

E. increase protein in urine

16. Na+ reaborption in the tubule cells membrane is a/an … process.

A. simple diffusion

B. facilitated diffusion

C. active transport

D. endocytosis

E. paracellular transport

18. The forst morning urine is the specimen of choice for routine analysis because?

A. it has a high volume

B. it is produced while the body in resting state

C. more concentrated resulting in better detection of abnormalities

D. more dilute preventing flase (-) reaction

E. more concentrated preventing false (-)

19. Best preservation in urine sediments?

A. boric acid + hydrochloric acid

B. formalin + boric acid

C. formalin + freezing

D. chloroform + refrigeration

E. chloroform + freezing

21. Lubang yang terdapat pada endotel glomerulus adalah?

A. filtration membrane

B. fenestrae

C. filtration slit

D. glomerulus


22. Paisen uncontrolled hypertension, diberi new diuretic target to Na+ reasorption site from basolateral surface of renal epithelial cells. Proses yang dipengaruhi oleh obat tersebut?

A. Na-glucose

B. Na-K

C. Na-H

D. solven drug

E. facilitated diffusion

23. A patient have persistent diarrhea for the last 7 days. WOTF will increased?

A. filtration load of HCO3-

B. NH3 synthesis by proximal tubule

C. H+ secretion by diatal nephron

D. anion gap

E. production of new HCO3- by distal nephron

27. DM à glukosa di urin sebagai konsekuensi proses apa di PCT?

A. saturasi Na/glucose tranporter

B. inhibisi Na/K ATPase

C. saturasi NA/H cotransport

D. stimulasi glucose secretion

E. stimulasi glycogen breakdown

29. A 25 y.o. man has generalized edema prominent in the periorbital regions early in the morning & hypertension. The microscopic feature of kidney shows diffuse thickening of glomerular capillary wall & mesangial proliferation. The following statement is correct for capillary portion of the renal corpuscle?

A. Bowman’s capsule

B. fenestrae

C. podocytes

D. glomerulus

E. renal column

31. Cell that has long primary process and great number of secondary foot process?
A. macula densa

B. mesangial cell

C. podocyte

D. juxtaglomerular


32. This portion is collection of cortical kidney’s tissue found between the medullary pyramids. WOTF structure is most likely?

A. corpuscle

B. medullary ray

C. renal columns of Bertin

D. interlobular cortex

E. renal sinus

33. WOTF contain mesangial cell?

A. renal corpuscle


C. thick ascending limb



34. Structure most commonly found in conical pyramid region?



C. loop of henle

D. renal corpuscle

E. afferent arteriole

40. Iv infusion of 1L of WOTF will be the largest to increase ECF?

A. distilled water

B. hypotonic NaCl

C. isotonic NaCl

D. hypertonic NaCl

E. hypertonic ureum

42. Decreased BP caused by captopril is result from?

A. decreasing of angiotensin I level

B. decreasing of angiotensin II level

C. decreasing of bradykinin

D. blocking angiotensin II receptor

E. decreasing plasma renin level

43. Non pharmacological treatment of hypertension?

Jawaban : reduce body weight

44. The target organ damaged in hypertensive patient is?

A. prostate hypertrophy

B. leukosituria

C. atherosclerosis plaque

D. vein narrowing

E. liver enlargement

47. GFR increased à PCT reabsorption of salt and water increased by glomerotubular balance, include :

A. increase peritubular capillary hydrostatic pressure

B. decrease peritubular sodium concentration

C. increase peritubular oncotic pressure

D. increase proximal tuble flow

E. increase peritubular capillary flow

50. Apa proses yang terjadi pada penicillin di PCT?

Jawaban : sekresi

52. The origin of collecting duct in the kidney?

Jawaban : ureter bud

53. WOTF is correct for development of bladder?

A. developed from hind gut

B. originated from endoderm

C. shaped from mesoderm

D. shaped from urogenital sinus

E. originates from allantois

54. ARPKD. What is the embryological basis of this congenital anomaly?

A. dysmorphology during development of renal system

B. failure of ureteric bud derivates to join the tubule

C. division of the mesonephric diverticulum

D. failure of mesenchymal cells to migrate

E. the poles of the kidney are fixed

55. Anak menderita polycystic di ginjal. Nama penyakit?

JAwaban : ARPKD

57. Penyebab double ureter?

A. splitting of metanephric bud

B. development of ureteric bud

C. splitting of ureteric bud

D. non-dysfunctional of ureteric bud and metanephros blastema

E. splitting of mesonephric bud

59. A 40 y.o. woman with essential hypertension complaining headache, flushing after taking her medicine. Besides, recently she got bad experience in sense of taste. What is the most possible antihypertensive agent she takes?

A. ACE-inhibitors

B. α-blocker

C. β-blocker

D. diuretics

E. vasodilator

61. AN increase of WBC in urine is called?

A. pyelonephritis

B. custitis

C. urethrtis

D. glomerulonephritis

E. pyuria

62. A 6 y.o. had a throat infection three weeks ago. Presently, he has hematuria, oliguria, mild hypertension. On microscopic feature of kidney : proliferation of endothelial and mesangial cells and also shows neutrophil an mnocyte infiltration. WOTF diagnosis is the most possible for the patient?

A. acute post streptococcal glomerulonephritis

B. crescentic glomerulonephritis

C. Goodpasture’s syndrome

D. idiopathic rapidly progressive glomeruloneprhitis

E. Heyman nephritis

63. Lab results from a 5 y.o. boy with swelling of his whole body : urine color light yellow, appearance : cloudy, pH 6, nitrite (-), urobilinogen (+), blood (-); serum : urea 20 mg/dl, creatinine 0.8 mg/dl. OWTF conditions is the most possible color of the urine?

A. the nephron excretion of blood borne

B. the glomerulus excretion of blood borne

C. the glomerulus excretion of albumin

D. the nephron excretion of albumin

E. the glomerulus excretion of ureum

64. The formation of crystal in the urine sample depend on pH of urine. Low acidity urine sample (low pH) can form several crystals such as?
A. uric crystals, sodium urates

B. triple phosphate, calcium phosphate

C. calcium carbonate, ammonium biurate

D. cystine, cholesterol, leucine, thyrocine

E. bilirubin, sulfonamides

65. WOTF is most likely to cause a false positive dry reagent strip test for protein?

A. urine of high specific graity

B. highly buffered alkali urine

C. bence-jones proteinuria

D. salicylates in urine

E. acidic in urine

66. A 40 y.o. male has abdominal discomfort. A mass found on palpation of upper right abdominal. The microscopic featue of kidney shows cysts rising from the tubules throughout the nephron. WOTF diagnosis is the most possible for this patient?

A. autosomal dominant PKD

B. cystic disease of renal medulla

C. acquired cystic disease

D. simple cyst disease

E. autosomal recessive PKD

67. A 30 y.o. man has general edma promeinent in preorbital regions early in the morning and hypertension. The microscopic feature of kidneys shows diffuse thickening of glomerular capillary wall and mesangial proliferation. WOTF is the most possible diagnosis for this patient?

A. minimal change disease

B. focal segmental glomerulosclerosis

C. membranoproliferative glomerulonephritis

D. IgA nephropathy

E. chronic glomerulonephritis

68. A 30 y.o. man medical lab technician recovering from hepatitis B develops hematuria, proteinuria, and red cell cast and oval fat bodies identified by microscopic exam of urine. WOTF statements describes the changes of the kidney in this patient?

A. no deposits of antibodies

B. IgG linier fluorescence along the glomerular basement membrane

C. granular deposits of antibodies in the GBM

D. diffuse GBM thickening by subepithelial immune deposits

E. nodular hyaline glomerulosclerosis

For question no 69-71

A 60 y.o. man works in asbes factory. On the microscopic feature of bladder biopsy shows papillary from and highest anaplastic.

69. WOTF diagnosis is the most possible for this patient?

A. transitional cell papilloma

B. TCC grade I

C. TCC grade II

D. TCC grade III

E. squamous cell carcinoma

70. Approximately 90% epithelial bladder malignancy is?

A. carcinoma in situ

B. adenocarcinoma

C. transitional

D. squamous

E. undifferentiated

71. What is the diagnostic tool for early staging of bladder cancer?


B. USG + biopsy

C. sectio alta + biopsy

D. cytoscopy + IVP

E. cytoscopy + transurethral resection

72. A 50 y.o. male with painless hematuria undergoes bladder biopsy. ON the microscopic features shows atypical epithelial surface. What is the most possible diagnosis?

A. transitional cell carcinoma


C. squamous cell carcinoma

D. adenocarcinoma

E. mixed carcinoma

73. A 25 y.o. man has general edma promeinent in preorbital regions early in the morning and hypertension. The microscopic feature of kidneys shows diffuse thickening of glomerular capillary wall and mesangial proliferation. WOTF is the most possible diagnosis for this patient?

A. focal segmental glomerulosclerosis

B. membranoproliferative glomerulonephritis

C. membranous glomerulopathy

D. minimal change disease

E. IgA nephropathy

74. A 4 y.o. boy has an abdominal mass, hematuria, and flank pain. Microscopic feature of kidney shows nest of primitive blastema sheet intertwine with mesenchymal abortive glomeruli. What is the most possible diagnosis?

A. cystic renal dysplasia

B. Wilm’s tumor

C. neuroblastoma

D. teratoma

E. hamartoma

For number 75-76

A 60 y.o. man has early and terminal dysuria. A nodule in anterior location is found on DRE. Prostate cut section shows gritty and firm. Micriscopic feature shows numerous small acini lying ‘back to back’.

75. The most reliable method of diagnosing prostatic carcinoma?

A. prostate acid phospatase


C. prostate ultrasound

D. transrectal biopsy


76. Indication of prostate biopsy is?

A. PSA level between 4-10 ng/dl

B. PSA level below $ ng/dl

C. nodule on DRE of prostate

D. PSA density below 0.15

E. prostate weight > 60 gr

87. A 9 y.o boy à difficult to urinate. There was constricting preputial ring and non-retractable foreskin. WOTF condition most likely occurred accompanying disease above?

A. balanoposthitis

B. urethritis

C. cystitis

D. pyeloneprhitis

E. nephritis

88. Most common urinary retention in older men?

A. carcinoma prostate


C. chronic prostatitis

D. urethral stricture

E. prostatic abscess

89. A 5 y.o. female, best method for urine collection?

A. urine bag collector

B. midstream urine

C. urine catheter

D. suprapubic puncture

E. fresh urine

A 7 y.o., dark cola colored urine, voiding 2x/24h. Facial puffiness, no swelling at hands or feet. Headache, blurry vision.

PE : compos mentis, edema anasarca, BP 180/120, PR 100x/min, T 36.9oC

Lab : Hb 10.6 gr/dL, serum ureum 45 mg/dL, serum creatinine 1.3 mg/dL, WBC 9600/mm3

Urinalysis : dark cola colored, protein +2, many erythrocyte, leucocyte 8-10 HPF

92. WOTF is the criteria to make the diagnosis?

A. hypoalbuminemia

B. hypocholesterolemia

C. hematuria

D. hypertension

E. renal insufficiency

95. What is the most common complication of this disease?

A. infection

B. heart failure

C. encephalopathy hypertension

D. lung edema

E. chronic renal failure

97. WOTF drug is first line for this patient?

A. diuretics

B. antibiotics

C. steroid

D. lovamisol

E. ACE inhibitor

100. Wanita, 18 y.o., arthralgia 6 bulan dengan intermittent fever. BP 165/110, WBC 3200/µL, Hb 10.8, PLT 74000/µL, proteinuria 3.8 gr/day, pleural effusion. Diagnosis?

A. chronic pyeloneprhitis

B. amyloidosis

C. lupus nephritis

D. Alport’s syndrome

E. membranous glomerulonephritis

111. A man has spinal cord injury 3 months ago. He has problem with micturition. The level of the lesion is T12. What urodynamic problem that he has?

A. urine retention

B. urine incontinence

C. overflow incontinence

D. hyperactive of bladder

E. incompetence of urethral sphincter

118. A 57 y.o. male have chief complain of difficulty voiding and have BPH. WOTF prostatic lobe is it likely are possible?

A. middle lobe

B. anterior lobe

C. posterior lobe

D. lateral lobe

E. superior lobe

121. A 40 y.o. male come with complain… X-ray : artery closed with this muscle

A. psoas muscle

B. serratus uscle

C. obturator muscle

D. external oblique muscle


129. You have a patient who has renal failure. While he is currently on dialysis, he is hoping to receive a new transplanted kidney. He asks you if they are going to remove one of his bad kidneys & put the new transplanted kidney back in the same place. Wou tell him WOTF?

A. right kidney à removed, more inferior, and easier to remove

B. left kidney à removed, easier to move descending colon

C. keep both kidneys, new one à left posterior waal,inferior to left kidney

D. new à in iliac fossa in greater pelvis, attach to iliac vessels, connect to bladder

E. left kidney à removed, more inferior and easier

132. Both autonomic and vascular system need to function properly successful male sexual function. WOTF statement concerning erction, emission, and ejaculation in the males is correct?

A. contraction of internal urethral sphincter is under control of parasympathetic nervous system

B. parasympathetic nerves stimulate closure of helical artery

C. sympathetic neuron stimulate helicine artery to dulate and increase blood flow to corpora cavernosum

D. parasympathetic innervations stimulate emission of seminal fluid

E. contraction of bulbospongiosus muscle impede drainage of blood from corpus spongiosum

136. A 65 y.o. woman came with metabolic acidosis. There is history of DM & hypertension. She refused to take medicine and change her lifestyle.What is the mechanism of kidney ot prevent serious condition?

A. reabsorb H+

B. excrete HCO3-

C. neutralize excess acid

D. neutralize excess base


140. Pasien DM + hypertension. WOTF caused the leakage of a protein?

A. increase capillary hydrostatic pressure

B. decrease capillary hydrostatic pressure

C. inhibition of protein kinase C

D. glycating of end product

E. decrease colloid osmotic pressure

141. What is the component of bipyramid crystal?

A. calcium oxalate

B. cystine

C. calcium phosphate

D. uric acid

E. struvite

142. WOTF material that inhibit crystal formation?

A. mangan

B. citrate

C. bicarbonate

D. potassium

E. sodium

143. Enlargement of prostate. Enzyme that catalyze the enlargement?

Jawaban : 5α-reductase

148. NH3?

A. impermeable to epithel

B. titrable acid

C. synthesized in DCT

D. menurunkan HCO3-

E. meningkat di respiratory acidosis

149. A patient with hypertension is given a K+ sparing diuretic. The amount of potassium excreted by the kidney will decrease if WOTF occur?

A. distal tubular flow increase

B. circulating aldosterone increase

C. dietary intake of potassium increase

D. natrium reabsorption by the distal nephron increase

E. the excretion of organic ion decreases

153. A patient with CHF is given loop diuretic : furosemide, K sparing diuretics, and spironolactone. WOTF comparisons between distal nephron and PCT?

A. DCT is more permeable to H+ than PCT

B. DCT is less responsive to aldosterone than PCT

C. DCT has more negative intraluminal potential than PCT

D. DCT secretes less K+ than PCT

E. DCT secretes more H+ than PCT

154. An elderly woman present with spiking fever, shaking chills, nausea, CVA (+) tenderness. Urine cultures are (+), she is hospitalized for pyelonephritis.

158. Malnutrition in CKD karena?

A. hypercatabolism of protein, carbohydrate, lipid


C. abnormalities in lipid metabolism


E. uremic syndrome caused by hypercatabolism of protein, carbohydrate, lipid

160. What kind of food should be limited in a patient with kidney stone?

A. soft drink, vit C, high protein, high calcium

B. soft drink, high cholesterol, high vit C, high selenium

C. soft drink, low cholesterol, low protein, low calcium

D. soft drink, junk food, high natrium, high kalium

E. soft drinks, high natrium, high cholesterol, high lipid, high natrium, high kalium

161. When you are at ER at HAsan Sadikin hospital, A 25 y.o. was admitted to the hospal with the complains of small producing urine. This complains occurred prior to massive diarrhoeas and vomiting. It all started five days before admitted to the hospital. What is the main goal of nutrition recommendation with acute kidney injury?

A. to minimize the protein catabolism cause dby the underlying disease

B. to prevent anorexia

C. to minimize uremic syndrome

D. to prevent progressivity of renal failure

E. to prevent vomit and diarrhea

162. A 34 y.o came to STI clinic with chief complain of dysuria and yellowish urethral discharge since 3 days ago. The rest of the culture revealed that the bacterium is N. gonorrhoeae. The virulence factor that play a role in adherence of the bacteria on the mucosa is?
A. lipopolysaccharide

B. capsule

C. flagella

D. peptidoglycan

E. pili

163. A 30 y.o. male patient was seen by emergency service and reported a 2 week history of penile ukcer. He noted that this ulcer did not hurt. WOTF conclusions/actions is most valid?

A. draw bloof dor a herpes antibody test

B. perform a dark feld exam of the lesion

C. prescribe acyclovir for primary genital herpes

D. even if treated, the lesion will remain for months

E. failure to treat the patient will have no untoward effect, as this is a self limiting infection

164. N. gonorrhoeae is a fastidious bacterium that should be isolated from sites often contaminated with normal flora. The best medium for isolation is?

A. sheep blood agar

B. Loeffler medium

C. Thayer-Martin agar

D. Loewenstein-Jensen medium

E. Mac Conkey agar

165. A 42 y.o. man who has a penile ulcer appears in STI clinic. The base of ulcer is soft and [ainful with suppuration. Microscopic gram stain shows gram (-) rods with school of fish arrangement. The bacteria is?

A. Neisseria gonorrhoeae

B. Haemophilus ducreyi

C. Mycoplasma hominis

D. Ureaplasma urelyticum

E. Treponema pallidum

166. A 24 y.o. sexually active woman develops vaginal discharge, left lower quadrant pain, and fever. On pelvic exam there is tenderness in the left adnexa. Gram staining from cervical discharge reveals low number of leukocyte cells, no gram (-) diplococci. No bacteria grow on selective media for N. gonorrhoeae. The most possible cause of the symptom is?

A. Haemophilus ducreyi

B. Treponema pallidum

C. Gardnerella vaginalis

D. Chlamydia trachomatis

E. Pseudomonas aeruginosa

167. A 33 y.o. woman referred to STI clinic because of vaginal discharge. She has history of sxual contact with several male partner. Microbiological exam reveals that the cause of this symptom is Mycoplasma homini. How is the characteristic of this bacterium?

A. growth in an anatomic site where anaerobic organism thirive

B. the absence of bactria cell wall

C. cannot culture on the artificial media.

D. the absence of cilia on the surface of the host cell

E. gram (-) rods morphology

168. A 60 yo. Man has experienced some frequent, urging, and painful urination. DRE revelaed enlargement of the prostate and he has a history of several catheterization. Culture of the urine on Mac Conkey agar reveals non-lactose fermenter colonies without evidence of swarming and gram stain shows gram (-) rods. WOTF organisms us to be the cause of those symptom?

A. Pseudomonas aeruginosa

B. Proteus mirabilis

C. Escherichia coli

D. Haemophilus ducreyi

E. Chlamydia trachomatis

169. A 30 y.o. female appear with symptoms of dysuria, frequency, and urgency since 2 days ago. She has also been suffering from fever and cills. Urine culture is performed which grow 105 CFU/ml of E.coli. How is the characteristic of this bacterium?

A. non-lactose fermenter

B. cannot grow on Mac Conkey agar

C. gram (-) diplococcic

D. gram (-) rods, lactose fermenter

E. obligate intracellular

170. An adolescent female came to the clinic because of a new and unusual vaginal discharge. She has recently become sexually active and had two new partners during previous minth. A purulent discharge was seen from endocervical canal. WOTF statements about this case is most correct?

A. the endocervical specimen should be analyzed for HAemophilus ducreyi

B. wet mount preparation of endocervical specimen showed clue cells

C. gram staining of endocervical specimen would show Chlamydia trachomatis

D. the possibilities infection caused by Chlamydia trachomatis or N. gonorrhoeae

E. dark field microscopy of endocervical specimen showed spiral bacteria

171. A 25 y.o. young female goes to health center after 2 days increasing pain during urination. Her urine is cloudy and shows microscopic evidence of erythrocyte and pyuria. Urine culture grows colonies of gram (+) cocci, catalase (+), coagulase (-). Her relevant past medical history is significant ofr no previous urinary tract infection. Which organism is ost likely responsible for this infection?

A. Enterococcus faecalis

B. Streptococcus pyogenes

C. Staphylococcus saprophyticus

D. NEisseria gonorrhoeae

E. Escherichia coli

172. A 37 y.o. woman with a history of UTI comes to the ER with burning on urination along with frequency and urgency. She says her urine smells like ammonia. The cause of her UTI is likely to be?

A. Enterobacter aerogenes

B. Proteus mirabilis

C. Citrobacter freundii

D. Escherichia coli

E. Serratia marsescens

173. A 65 y.o. male hospitalized for 7 days as indication of diabetic nephropathy and catheter inserted because of problem I urination. Within this period developed UTI. The most common opportunist pathogen bacteria that cause the infection is?

A. Proteus vulgaris

B. Serratia marsescens

C. Staphylococcus aureus

D. Enterococcus faecalis

E. Escherichia coli

174. A 6 y.o. boy came to the hospital with gross hematuria as the chief complain. There was eyelids swelling in the morning and disappeared in the afternoon. He has history of throat infection two weeks earlier. The causative agent that cause the diasease is?

A. Streptococcus pneumonia

B. Staphylococcus aureus

C. Streptococcus agalactiae

D. Streptococcus pyogenes

E. Staphylococcus epidermidis

175. Pseudomonas aeruginosa is an opportunist pathogen as one of the cause of UTI. WOTF statements about P. aeruginosa is correct?

A. typically susceptible to penicillin G

B. readily grown in anaerobic condition

C. able to penetrate intact normal human tissue

D. gram (-) rods, lactise fermenter

E. have fimbriae which promote attachment to epithelial cells

176. A 50 y.o. man develops UTI. Gram (-) rods from urne ulture grow on Mac Conkey agar produce large sticky, lactose fermenter colonies, does not have flagella. This bacteria is second only to E. coli as a urinary tract pathogen. What bacterium those cause infection of this patient?

A. Enterobacter aerogenes

B, Klebsiella penumoniae

C. Pseudomonas aeruginosa

D. Proteus mirabilis

E. Serratia marsescens

177. The pus of STD that has fishy odor is caused by?

A. N. gonorrhoeae

B. Treponema pallidum

C. Gardnerella vaginalis

D. Trichomonas vaginalis

E. Candida albicans

178. Diagnostic test for Treponema pallidum?

A. gram stain

B. culture in Loefler agar

C. ZN stain


E. culture in LJ agar

179. To differentiate Staphylococcus epidermidis and S. saprophyticus we can use test?

A. bacitracin disc

B. DNAse test

C. novobiocin disc

D. catalase test

E. coagulase test

180. Differentiate colonies of S. aureus with colonies of E. coli in blood agar?

A. color of colonies

B. lactose fermentate

C. size of colonies

D. color of halo around colonies

E. non hemolytic

181. A 40 y.o. male is consulted to the nuclear medicine for kidney function exam due to chronic kidney failure. What is the most appropriate examination of this patient?

A. effective renal plasma flow

B. glomerular filtration rate

C. renal scintigraphy

D. renal arterial flow rate

E. conventional renography

182. A 40 y.o. male is consulted to the nuclear medicine for kidney function exam due to nephropathy diabeticum. What is the most appropriate examination for this condition?

A. effective renal plasma flow

B. glomerular filtration rate

C. renal scintigraphy

D. renal arterial flow rate

E. conventional renography

183. A 45 y.o. ale come with possibility of renovascular hypertension based on the history of uncontrolled hypertension. USG Doppler examination shows impairment at left kidney renal blood flow. Patient then consulted to nuclear medicine for captopril renography. What is the most possible result?

A. renovascular hypertension, if captopril renogram show decreased left kidney function, while in the captopril renogram is normal.

B. renovascular hypertension, if conventional renogram show decreased left kidney function, while in the conventional renogram is normal.

C. renovascular hypertension not exist, if both captopril and conventional renogram are not normal

D. renovascular hypertension not exist, if captopril renogram show improvement in left kidney function, while conventional renogram shows abnormality.

E. renovascular hypertension, if both show improvement of left kidney

184.A 25 y.o. male came with scrotal pain. From PE found inflammation sign at the right scrotum. You consulted this patient to the nuclear medicine. What is the most appropriate exam?

A. scrotal scintigraphy for differentiate testis torsion with orchitis epidydymitis

B. scrotal cintigraphy for identifying UTI source

C. bladder scintigraphy to differentiate UTI with vesicolithiasis

D. ureteral scintigraphy to determine urethritis as etiology of scrotal inflammation

E. penis scintigraphy to determine any priapismus or hypospadia as etiology of UTI

185. A 65 y.o. male with scrotal malignancy. His PSA serum is increasing significantly compared with last month result. X-ray pelvis show abnormality at pelvic bones. PAsien then consulted to nuclear medicine. What is the most appropriate exam

A. conventional renogram, to evaluate the blood flow to renal

B. GFR to determine each kidney function

C. kidney scintigraphy to fin sign of acute pyelonephritis

D. malignancy prostate scintigraphy localization to find any sequel and recurrency

E. bone scintigraphy to find any metastase to the bone

186. A 60 y.o. came to the outpatient clinic for follow up. He noted as hypertensive and type 2 DM for the last 2 years. On PE found : BP 160/90, no other abnormality on PE and lab exam. The doctor prescribed oral antidiabetic and ACE inhibitor. What is theadvantage og this antihypertensive agent for the patient?

A. it decreases blood glucose level

B. it delays diabetic nephropathy

C. it prevents RAAS stimulation

D. it decreases peripheral resistance

E. it prevents vascular remodeling

187. WOTF is the prototype of ACE inhibitor?

A. valsartan

B. atenolol

C. captopril

D. hydralazin

E. diltiazem

188. A 62 y.o. man came to the doctor for routine follow up. BP was 160/90, HR 76 bpm. Random blood glucose level was 140mg/dl. He is given nifedipine. What is the most possible side effect of the drug?

A. decrease blood glucose level

B. orthostatic hypotension

C. cardiac depressant

D. hyperkalemia

E. palpitation

189. What is nifedipine?

A. beta blocker

B. alpha 1 selective blocker

C. vasodilator

D. calcium channel blocker

E. diuretic

191. A 65 y.o. woman. BP 200/120 à given direct vasodilator à BP increase. Mechanism of drug?

A. decreased peripheral resistance

B. inhibit RAAS

C. decreased CO

D. increased venous return

E. chronotropic negative

Woman, dysuria, no flank pain, no tenderness, pemeriksaan lain within normal limit but many WBC. Other examination needed for diagnostic tool is urine microscopic exam of?

A. protein

B. casts

C. bacteria



Hypertension, proteinuria, height 167, weight 91, BP 170/100, edema, creatinine clearance turun, BUN turun. Urinalysis : pH 5, prot +3, no glucose, occasional course granular cast. Diagnosis?

A. nephropathy

B. neuropathy

C. retinopathy

D. nephrolithiasis

E. nephrovesicolithiasis

Struktur yang mebagi perineum jadi anal triangle dan genitourinary triangle?

0 komentar: