Minggu, 19 Juni 2011

3. 2 years old boy, 10 kg, visit emergency departement. History : 4 day high fever,spontaneous ptechiae, without vomiting. Lab Platelet 88.000/ml Ht 36%; further examination platelet 66.000/ml Ht 48%. Management?
A. Orally since there is no vomit
B. 750 cc/24h parenteral and adjust when needed
C. 1000cc/24h parenteral and adjust when needed
D. 1250cc/24h parenteral and adjust when needed
E. 1500cc/24h parenteral and adjust when needed

4. Diagnosis of typhoid fever is confirmed by culturing salmonella strain. WOTF is correct statement?
A. (+) blood culture in 40-60% patient during 2nd week of illness
B. most stool culture (+) during 1st week of illness
C. most urine culture (+) during 1st week of illness
D. bone marrow culture is less sensitive
E. bone marrow culture is the most sensitive since it less influenced by prior antimicrobial therapy

9. A girl with lobar pneumonia with high fever for 3 days. remission of fever < 1 C
A. Continuous
B. Saddle-back
C. Intermittent
D. Remittent
E. Relapsing

14. soalnya lupa, pokoknya mendiskripsikan penyakit DBD, pertanyaan : causative agent nya?
e.single stranded RNA positive --> ini kayaknya jawabannya

19. 9 months old infant, bodyweight 7 kg, receive corticosteroid, sudah dapat vaksinasi BCG waktu umur 1 bulan. dikasih imunisasi apa sekarang ?
A. Measles, DTP
B. Measles, DTaP
C. Measles, hepatitis
E. DTP, hepatitis B

22. Lesi kulit dipunggung, hypopigmentation. Diagnosis?
Ans : tinea versicolor

25. pasien usia 38 tahun kena leprosy. nerve di elbow medial terhadap epycondile mengalami perbesaran. apa yang terjadi? a. drop wrist
b. claw thumb
c. claw hand
d. drop hand
e. claw finger

29. 31 year old woman comes with her daughter. complant : discrete papular itchy lesion with pinpoint blue color on its top, located at neck and axilla. diagnosis ?
A. Pediculosis capitis
B. Pediculosis corporis
C. Pediculosis pubis
D. Scabies
E. Insect bite

For questions 38 and 39
4 months old baby boy comes with skin patch at neck, ibunya juga memiliki skin lesion yang sama di breast. PE : numular eritropapulosquamous patches with active borders, clear area at middle. di rumah pelihara kucing

38. Gambaran mikroskopis skin scrapingnya seperti apa ?
A. Epithel, long septate-branched hyphae, round spores
B. Epithel, long septate-branched hyphae, arthrospores
C. Epithel, short hyphae, round sometimes oval spores
D. Epithel, budding cells, round spores, germ tubes
E. Epithel, short hyphae, arthrospores, germ tubes

39. tipe funginya ?
A. zoophilic
B. Geophilic
C. Anthropophilic
D. Hydrophilic
E. Keratinophilic

42. Trichrome stain indicated the presence of intestinal pathogenic protozoa.
WOTF statement is correct for lifecycle of all intestinan pathogenic protozoa
A. Infective stage occured in soil
B. Encystation in lower ileum
C. The most frequent primary sites are caecum and rectosigmoid
E. Cysts and trophozoites may be found in liquid feces

Options for 47-50
A. Entamoeba dispar
B. Entamoeba coli
C. Giardia lamblia
D. Trichomonas hominis
E. Entamoeba histolytica

47. amoeboid trophozoite with cytoplasmic pseudopodia and fine granular cytoplasm
48. eccentric karyosome
49. ellipsoidal cyst

For question number 51 until 53, refer to this option:
A. Negative
B. Primary Infection
C. Secondary Infection
D. Invalid
E. Primary and secondary infection

51. C-Line and M-Line are pink color
52. C-Line, M-Line, and G-Line are pink color
53. C-Line, M-Line, and G-Line are white color

58. A 14 y.o. girl typhoid fever. Salmonella antigen harus meningkat berapa kali dari acute sera ke convalescence sera?
A. 1/2x
B. 1x
C. 2x
D. 3x
E. 4x

61. The doctor in charge gives her chloramphenicol. WOTF is the adverse effect of the drug?
A. Aplastic anemia
B. Hypotension
C. Weakness
D. Malaise
E. Dizziness

71. Which statement is TRUE about cerebrospinal fluid?
A. Lumbar puncture may be drawn at L3-L4 intervertebrae level
B. CSF is formed at choroid plexus within the ventricle
C. Choroid plexus only occur along the inferior horn of the lateral ventricle
D. CSF flows through the ventricle and enter arachnoid space
E. CSF drains into the venous system when the venous pressure greater than CSF pressure

72. jenis epitel yang melapisi sisi dalam dari lapisan meningen terluar adalah..
(pokoknya optionnya ada yang simple squamous, simple cuboidal, simple columnar, truz gw lupa apa lagi:)))

88. Pasien datang ke RS dengan demam tiba2 mencapai 39 derajat C, sakit kepala dan jaundice 3 hari yang lalu. Memiliki riwayat pekerjaan bekerja di gudang yang banyak tikus.
Penyebab organisme?
A. Acromonas hydrophila
B. Mycobacterium marinum
C. Streptococcus pyogenes
D. Leptospira interrogans
E. Vibrio Vuilnifiens

89. Which of the following is the characteristic of this microorganism? (Leptospira)A. Rods with microgranular form
B. Spirochetes gram negative
C. Rods gram positive
D. Cocci gram positive
E. Spirochetes with hooked ends

A. P. falciparum
B. P. vivax
C. P ovale
D. P. malariae
95. Schuffner stipple on routine blood examination

102. Pemeriksaan mikroskopis pada pasien malaria menunjukkan adanya sel darah merah dengan ukuran normal, "no stippling", "multiple ring-form", dan pada beberapa sel darah merah terdapat trofozoit yang berkembang yang berbentuk "band". Etiologi apa yang paling mungkin?
A. Plasmodium malariae
B. Plasmodium vivax
C. Plasmodium falciparum
D. Mixed infection (Plasmodium malariae & Plasmodium vivax)
E. Mixed infection (Plasmodium falciparum & Plasmodium malariae)

108. Classification of patient with sepsis
A. Hospitalized in ICU and undergo mechanic ventilation
B. Fever with core temperature more than 38.8'C
C. Hypothermia with core temperature less than 36'C and tachypnea
D. Increase circulating imflamatory mediators
E. Combination of infection with Systemic Inflamatory Response Syndrome

109. Correct statement about plasmodium ?
A. agent does not develop or multiply inside vector
B. agent multiply inside vector
C. agent grow and multiply inside vector
D. agent develop but not multiply inside vector
E. agent grow inside vector

115. Drug nteraction chlorapenicol and phenytoin?
A. half life phenytoin increase
B. serum concentration phenytoin increase
C. half life phenytoin decrease
D. chlorampenicol doesn’t inhibit hepatic microsomal enzyme
E. serum concentration of both increase

118. WOTF characteristic of Dapson?
A. it inhibits protein synthesis
B. resistance can emerge if very high doses are given
C. the combination of dapsone, rifampin and clofazimine is not iniatially recomended
D. Dapsone is well tolerated
E. Dapsone can not be given to renal failure patient

122. Indikasi pemberian clofazimin?

125. Side effect permethrin
A. unpleasant odor
B. staining
C. pruritus
D. itching
E. nonirritating

129. MOA acyclovir?
Maaf jawabnnya lupa T___________T

130. Pharmakokinetic spesification of acyclovir:
a. biovailability is affected by food
b. it is cleared by glomerular filtration
c. it is not cleared by tubular secretion
d. it is not cleared by hemolysis
e. it is cleared by peritoneal hemolysis

136. Manakah diantara obat di bawah ini yg menghambat sistesis ergosterol?
a. Allylamine
b. Polyene
c. triazole
d. Inidazole

142. A 40 year old woman came to the doctor due to high grade intermittent fever for a week. Typically it was started by chills, followed by high fever and sweating. She also had headachen myalgia, nausea, and vomiting. The patient has just come back from the P.falciparum endemic area.
Which of the most appropriate combination antimalaria should be added to amodiaquine?
A. Quinine
B. Mefloquine
C. Artesunate
D. Doxicycline
E. Chloroquine

148. Scaling patch di punggung
A. seborrheic dermatitis
B. pityriasis versicolor
C. pityriasis rosea
D. psoriasis
E. lepra

157. Clue that suggests anaerobic infection:
A. + in facultative anaerobic culture
B. Special cotton swab
C. Foul-smelling discharge
D. Infect mucosal area
E. Grow on McConkey agar

For question 161-162
A 60 year old female complains about red patches, papules, and blisters on a red base at the right side of her face, neck, and upper chest since 3 days ago. She also feels discomfort, pain, numbness, and varies from superficial itching, tingling, and burning sensation in the involved area.
161. What is the source of her infection?
A. Aerosolized droplets of the causative agent
B. Contaminated food or water
C. Sexual activity
D. Puncture with contaminated needle
E. Endogenous reactivation of an earlier infection

163. Diagnosis : diphtheria. Stain?
A. gram stain
B. Ziehl-Neelsen
C. Neisser
D. Burr-gins
E. negative staining…
164. Viruses can be isolated in the embryonated egg into appropriate region. Which part of the embrionated egg for incubation of herpes virus?a. Amniotic cavity
b. Allantoic cavity
c. yolk sac
d. intraembryonal
e. chorioallantoic membrane

168. A 26 year old obese female presents to the clinic with scaly erythematous patches on the grain. Skin scrapping in taken from the lesion, for microscopic examination.
How is morphologic pattern of the etiologic agent of that case when you observe using KOH solution?
A. Spaghetti & meatballs appearance
B. Long branches septate hyphae & arthrospore
C. Pseudohyphae
D. Long branches non septate hyphae
E. Yeast cells with budding

171. 27 years old athletic male. White patch of skin mainly on axilla, back, trunk. No itching. Multiple hypopigmented macules covered by fine scales. Woods lamp : positive yellow fluorescence. Diagnosis : tinea versicolor.
WOTF fungus cause disease?
A. Microsporum canis
B. Malassezia furfur
C. Trichophyton beigelii
D. Epidermophyton werneckii
E. Epidermophyton floccosum

178. A 27 y.o. businessman experienced high fever, serius retroorbital headache, severe joint and back pain for 5 days. Rash appear on his palm and sole that lasted for 2 days. At the same time, his 5 y.o. son experienced mild flu like symptom, collapse after 2-5 days. There were petechiae on his forhead, ecchymosis elsewhere. What is the structure of the virus that aused this disease?
A. double stranded RNA
B. double stranded DNA
C. positive sense single stranded RNA
D. negative sense single stranded RNA
E. single stranded RNA

A. Biologic control
B. Environmental control
C. Vector control
D. Vector survey
195. Alteration in breeding site of vectr

Itraconazole adalah?
A. phenylallamines
B. triazole
C. imidazole
D. allyamines
E. beta-3-glucose synthase inhibitor

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