Tambahan Midterm PHOP 2009

14. Seorang manajer pada tingkat bawah, ketrampilan yang lebih dibutuhkan adalah :
A. ketrampilan teknis lebih besar dibandingkan ketrampilan konsep
B. ketrampilan teknis dan ketrampilan konsep sama besarnya
C. ketrampilan teknis lebih kecil dibandingkan ketrampilan konsep
D. ketrampilan teknis lebih dibutuhkan dibandingkan ketrampilan berkomunikasi
E. ketrampilan teknis kurang dibutuhkan dibandingkan ketrampilan berkomunikasi

15. Salah satu tokoh dalam perkembangan manajemen yang mengemukakan tentang fungsi-fungsi manajemen adalah :
A. Frederick W. Taylor
B. Henry L. Gantt
C. Gilberth & Gilberth
D. Henry Fayol
E. Elton Mayo

16. Salah satu tokoh manajemen yang mengemukakan tentang human relationship theory adalah :
A. Frederick W. Taylor
B. Henry L. Gantt
C. Gilberth & Gilberth
D. Henry Fayol
E. Elton Mayo

17. Manajemen sebagai suatu ilmu dapat diartikan sebagai :
A. Melakukan dengan tangan
B. Ilmu dan seni mengelola sumber daya dengan efektif dan efisien untuk mencapai tujuan organisasi yang telah ditetapkan
C. Ilmu dan seni mengelola anggota organisasi agar mau secara bersama-sama mencapai tujuan organisasi
D. Ilmu dan seni menggunakan tangan orang lain untuk mencapai tujuan yang telah ditetapkan oleh pimpinan organisasi
E. Ilmu dan seni mengelola berbagai keinginan anggota organisasi agar menjadi satu kesatuan yang merupakan tujuan organisasi

18. Yang dimaksud dengan kepemimpinan adalah :
A. Kemampuan seseorang untuk mengelola suatu organisasi
B. Kemampuan untuk mempengaruhi sekelompok orang untuk mengarahkannya mencapai tujuan organisasi
C. Kemampuan seseorang untuk berkreasi dan berinovasi dalam rangka mencapai tujuan organisasi yang telah ditetapkan
D. Kemampuan seseorang untuk menjadi inspirator bagi organisasi yang dipimpinnya
E. Kemampuan seseorang untuk mencapai tujuan organisasi dengan memanfaatkan orang lain

19. Salah satu cara untuk mengembangkan kemampuan kepemimpinan adalah denga cara :
A. Partisipatif
B. Birokratif
C. Autokratif
D. Continuum of leadership
E. Reflecting

Final CRP 2009

65-year-old man experiences shortness of birth for the last 3 days. He got fever and cough with yellowish sputum for 7 days. It got worse because he had no money to buy medicine. He is a farmer, so he works even on rainy days. He is also a heavy smoker with chronic cough. He has been hospitalized 5 times due to his lung problems. Currently he is diagnosed with pneumonia.

1. Precipitating factor ?
A. Unduly hard work
B. Old age and sex
C. Previous illness
D. Respiratory infection
E. Inadequate medical care

Ada yg nulis optionnya sbb :
A. Old age
B. Previous illness
C. Unduly hard work
D. Respiratory infection
E. Sex

2. The predisposing factor is …
A. Smoking
B. Old age
C. Low income
D. Exposure to rain
E. Sex

3. What is reinforcing factor ?
A. Unduly hard work
B. Age
C. Sex
D. Previous illness
E. Low income

4. When he was entering the hospital, what was the stage of the disease process ?
A. Subclinic
B. Clinic
C. Pathological changes
D. Disable
E. Susceptible

5. The agent from this case ?
A. old age
B. bacteria
C. Cigarette
D. Hard work
Ans. B

6. The host is …
Ans. The patient

7. Enabling factor ?
A. Respiratory function
B. Old age
C. Unduly hard work
D. Inadequate treatment
E. Previous illness

8. The external mechanism is …
A. Humoral immunity
B. Cough
C. Cellular immunity
D. Shortness of breath
E. Hard work

9. The internal mechanism is …
A. chronic cough
B. cough
C. yellow sputum
D. fever
Ans. D

10. 3 faktor yang berkaitan dengan epidemiologic triangle pada kasus di atas …
A. patient, cough, bacteria
B. inadequate medical care, patient, bacteria
C. immunological factor, cough, bacteria
D. patient, bacteria, environment
E. age, environment, cough

11. The environmental factor is …
A. Vector
B. Cough
C. Bacteria
D. Medical care
E. Climate

12. Arti incubation period dalam kasus di atas …

13. Data : 98, 107, 114, 123, 128, 128, 130, 134, 136, 160
Mean systolic blood pressure …
A. 114
B. 118.5
C. 123
D. 125.8
E. 129

14. Median of systolic blood pressure is …

15. Standard deviation of systolic blood pressure is …

16. Mode of systolic blood pressure is …
A. 98
B. 114
C. 128
D. 136
E. 160

17. Comparing a set of data presented both in simple frequency and in class-interval frequency distribution, which of the following statement is true ? (soal sama seperti di modul lab CRP yg pertama)

18. The only measure of central tendency that can be found for nominal data is the …
A. Mean
B. Modus
C. Median
D. Range interval
E. Quartile

19. The measure of central tendency that is most affected by a few large or small numbers is …
A. mean
B. median
C. mode
D. range
E. quartile

20. When a distribution is bell-shaped, approximately what percentage of data values will fall within one standard
deviation of the mean ?
A. 32 %
B. 50 %
C. 68 %
D. 95 %
E. 99 %

21. When a distribution is bell-shaped, approximately, what percentage of data value will fall within two standard
deviation of the mean ?
A. 32 %
B. 50 %
C. 68 %
D. 95 %
E. 99 %

22. The measure of central tendency that is more robust for extreme values is …
A. mean
B. median
C. mode
D. range
E. quartile

For question no. 23 – 24, refer to the information below :
The outcome of 9 patients are : 2, 0, 2, 2, 0, 1, 2
(0 = Live; 1 = Dead; 2 = Still hospitalized)

23. The mean outcome is …
A. 0
B. 1,0
C. 1,3
D. 2
E. cannot be calculated

24. The mode of outcome is …
A. 0
B. 1
C. 2
D. Dead
E. Still hospitalized

For question no. 25 – 27, refer to information below :
The following frequency distribution for number of errors 55 students made in test :

Interval Frequency
0 – 2 14
3 – 5 13
6 – 8 11
9 – 11 8
12 – 14 9
Total 55

25. The mean error is :
A. 1,2
B. 1,5
C. 6,2
D. 6,5
E. 12

26. The median of error is (without decimal) :
A. 3
B. 5
C. 6
D. 10
E. 13

27. The percentage of students with errors more than 8 is :
A. 8 %
B. 9 %
C. 17 %
D. 30,9 %
E. 74,5 %

28. The p-value is :
A. the probability that the null hypothesis is true
B. the probability that the alternative hypothesis is true
C. the probability of obtaining a test statistic at least as extreme as the one that was actually observed,
assuming that the null hypothesis is true.
D. the probability of obtaining the observed or more extreme results if the alternative hypothesis is true
E. always less than 0.05

To answer question no. 29 – 42, use the table on standard normal distribution.
Area under the curve :
From Z = 0 to 1 = 0,3413
From Z = 0 to 2 = 0,4772
From Z = 0 to 3 = 0,4987
From Z = 0 to 1,5 = 0,4332
From Z = 0 to 1,645 = 0,450
From Z = 0 to 1,28 = 0,400

29. P (Z > 0) = …
A. 0
B. 0,3413
C. 0,5
D. 0,475
E. 1,0

30. P (Z < 3,0) = …
A. 0
B. 0,4772
C. 0,5
D. 0,4987
E. 0,9987

31. P (-1,5 < Z < 2,0) = …
A. 0,4332
B. 0,4772
C. 0,5
D. 0,9104
E. 0,9772

32. P (-2 < Z < -1) = …

33. P (1.5 < Z < 3) = …

34. P (Z > -2) = …

35. P (Z > 2) = …

36. μ pengukuran systolic blood pressure = 110 mmHg. σ = 10 mmHg. Berapa nilai area under curve untuk blood pressure > 130 mmHg?
Ans. = P (Z > 2) = 0.5 – 0.4772 = 0.0228

37. Tentukan area under the curve untuk systolic blood pressure di atas 140 mmHg

38. Tentukan area under the curve untuk systolic blood pressure di atas 150 mmHg

39. Tentukan area under the curve untuk systolic blood pressure di antara 90 dan 120 mmHg

40. What is the area under the curve below 90 mmHg or above 140 mmHg …
A. 0.0241
B. 0.0278
C. 0.4782
D. 0.4987
E. 0.9758

41. Systolic blood pressure: mean = 110, standard deviation = 10 mmHg
What value of systolic blood pressure will divide the normal distribution into lower 95% and upper 5%?
A. 110
B. 120
C. 126.50
D. 140.50
E. 150.50

42. What is the value of systolic blood pressure that divides the area under the curve into the lower 10% and upper
90% ?
A. 97.2
B. 110
C. 120
D. 130
E. 140

Routine Test Total
(+) (-)
Gold Standard HIV (+) 92 10 102
(-) 2 196 198
Total 94 206 300

43. P (Routine + / HIV +) = …

44. P (routine - / HIV - ) = …
A. 198/300
B. 196/198
C. 196/206
D. 196/300
E. 206/300

45. P (HIV + / Routine + ) = …

46. P (HIV - / Routine - ) = …

47. Prevalensi HIV = 92/300

50. x bar = 20, s = 5
CI 95 %
Range …
A. 15 – 25
B. 10,2 – 29,8
C. 7,1 – 32,9
D. 5 – 35
E. 5 – 15

51. The standard deviation of a set of observation …
A. Equal with coefficient of variation
B. Has the same unit of measurement as the raw data
C. Range
D. Central distribution
E. Location

52. Mean systole 110 mmHg. Variance 25 mmHg2. Coefficient of variation …
A. 25/110
B. 5/110
C. 5/√110
D. 110/25
E. 110/5
Ans. B. CV = SD/mean x 100%

Final PHOP 2009

1. Yang merupakan UPGK
A. Upaya untuk meningkatkan status gizi masyarakat yang dilaksanakan oleh puskesmas
B. Upaya untuk meningkatkan status gizi masyarakat dengan melakukan koordinasi lintas sektoral
C. Upaya untuk meningkatkan status gizi masyarakat untuk mencapai kadarzi
D. Upaya untuk meningkatkan status gizi masyarakat di tingkat institusi
E. Upaya untuk meningkatkan status gizi masyarakat oleh posyandu

2. Yang termasuk Sistem Kewaspadaan Pangan & Gizi
A. Pemantauan tinggi badan anak baru masuk sekolah
B. Pemantauan jajanan sekolah
C. Pemantauan tinggi badan anak SMP kelas 1
D. Pemantauan pencapaian hasil kerja penimbangan di posyandu
E. Pemantauan pemberian makanan tambahan di posyandu

3. Upaya perbaikan gizi pada institusi dilakukan pada
A. Semua balita yang berkunjung ke posyandu
B. Semua peserta haji yang berada di embarkasi haji
C. Semua balita yang berkunjung ke puskesmas
D. Semua balita yang berkunjung ke posyandu dan puskesmas
E. Semua balita dalam wilayah kerja puskesmas

4. Pencatatan dan pelaporan program gizi masyarakat yang dilakukan di puskesmas adalah…
A. Jumlah pemberian tablet besi pada mereka yang menderita anemia
B. Jumlah pemberian imunisasi TT pada ibu hamil
C. Jumlah balita yang memiliki KMS balita
D. Jumlah ibu hamil dalam wilayah kerja puskesmas
E. Jumlah balita yang tidak hadir dalam penimbangan di puskesmas

5. Indikator keberhasilan pembinaan kesehatan wilayah dan peningkatan peran serta masyarakat pada program gizi
A. Penurunan angka KEP
B. Peningkatan partisipasi kader kesehatan, guru, UKS, LSM
C. menurunnya defisiensi dan gangguan gizi
D.
E.

6. Kegiatan penimbangan balita di posyandu. Huruf S pada SKDN adalah
A. Seluruh balita yang terapat di wilayah kerja puskesmas
B. Seluruh balita yang punya KMS
C. Seluruh balita yang ditimbang pada bulan tersebut
D. Seluruh balita yang berat naik di bulan tersebut
E. Seluruh balita yang dating pada penimbangan tersebut

7. Huruf D pada SKDN mencerminkan
A. Jumlah balita yang punya KMS
B. Jumlah balita yang ada pada saat penimbangan
C. Jumlah balita yang ditimbang pada bulan tersebut
D. Jumlah balita yang berat naik di bulan tersebut
E. Jumlah balita yang ada di wilayah kerja puskesmas

8.

9. Pelayanan kesehatan primer akan berhasil dengan baik bila di pihak puskesmas
A. Melaksanakan program pokok dan pengembangan di tingkat puskesmas sebaik mungkin
B. Lintas sektoral dalam melaksanakan pembangunan kesehatan
C. Perbaikan kesejahteraan masyarakat di wilayah kerjanya
D. Perbaikan pendidikan masyarakat di wilayah kerjanya
E. Perbaikan penghasilan masyarakat di wilayah kerjanya

10. Faktor yang mempengaruhi status kesehatan di setiap negara
A. pelayanan kesehatan, social, ekonomi, politik
B. pelayanan kesehatan, social, ekonomi
C. pelayanan kesehatan, social, politik
D. pelayanan kesehatan, ekonomi, politik
E. pelayanan kesehatan, ekonomi

11.

12.

13. Konsep puskesmas berdasarkan Kepkes Menkes RI no. 128/Menkes SK II/2004 adalah
A. Merupakan unit organisasi yang menyelenggarakan pelayanan kesehatan di tingkat kecamatan / kelurahan
B. Unit pelaksana yang bertanggung jawab terhadap pembangunan kesehatan di wilayah kerjanya
C. Merupakan unit penyelenggara pelayanan kesehatan kedua setelah puskesmas pembantu
D. Merupakan unit pelaksana teknis dinas kesehatan kabupaten / kota yang menyelenggarakan pelayanan kesehatan
E. Merupakan unit pelaksana teknis dinas kesehatan kabupaten / kota yang menyelenggarakan pembangunan kesehatan

14.

15. Fungsi puskesmas
A. Pemberdayaan masyarakat
B.
C.
D. melibatkan tokoh masyarakat
E.

16. Basic 6 puskesmas

17. Untuk mencapai keberhasilan program dilakukan manajemen yang memerlukan…
Jawab : koordinasi

18. Sistem rujukan kesehatan masyarakat dalam sistem kesehatan
A. Rujukan kasus
B. Rujukan logistic dan peralatan
C. Rujukan keterampilan dan pengetahuan
D. Rujukan bahan pemeriksaan
E. Rujukan pasien

19. Fungsi puskesmas sebagai pelayanan kesehatan strata 1
A. Memberdayakan masyarakat di wilayahnya
B. Melibatkan masyarakat untuk hidup sehat
C. Implementasi program kesehatan
D. Sebagai public goods & private goods
E. Pelaporan dan outcome

20. Definisi dari wabah

21. Penyakit menular potensi mewabah
A. Anthrax
B. HIV/AIDS
C. TB
D. Malaria
E. ISPA

22. Yang termasuk penyakit menular yang memiliki sifat endemis tinggi adalah
A. DBD
B. Malaria
C. TBC
D. HIV/AIDS
E. Diare

23. Tempat perindukan Aedes aegypti
A. Tempat yang pencahayaannya kurang
B. Semak-semak
C. Tempat penampungan berisi air bersih
D. Baju dalam lemari
E. Tempat penampungan berisi air

24. Apabila petugas puskesmas menemukan suatu kasus demam berdarah di wilayahnya, mak ayang harus dilakukan
A. Fogging massal
B. Abatisasi massal
C.
D.
E. melakukan pelaporan ke dinkes kabupaten / kota dalam waktu 24 jam

25. Salah satu masalah yang dihadapi pelaksanaan program TB di Indonesia adalah
A. Sebagian besar pasien TB adalah wanita
B. Sebagian besar pasien TB adalah anak-anak
C. Sebagian besar pasien TB adalah kelompok usia produktif
D. Sulitnya menegakkan diagnosis TB di puskesmas
E. Banyak kasus resistensi terhadap OAT

26. Berdasarkan hasil SKRT tahun 195, TBC di Indonesia merupakan…
A. 1st pada infeksi
B. 3rd di dunia
C. 3rd penyebab kematian
D. 3rd penyebab kematian pada infeksi
E. 1st penyebab kematian

27. Tingkat penularan penyakit TB ditentukan oleh
A. Adanya BTA di sputum
B. Pengumpulan SPS
C.
D. Jumlah orang yang diperiksa sputumnya
E. Jumlah kuman

28. Bila ARTI pada penyakit TB paru sebesar 3%, maka untuk setiap 1 juta penduduk berapakan jumlah penduduk yang memilki risiko terinfeksi TB paru?
A. 30
B. 300
C. 3000
D. 30000
E. 300000

29. Bila ARTI pada penyakit TB paru sebesar 3%, maka untuk setiap 1 juta penduduk berapakan jumlah penduduk yang menjadi sakit TB paru?
A. 30
B. 300
C. 3000
D. 30000
E. 300000

30. Target penanggulangan TBC tahun 2010
A. Semua sembuh
B. Semua BTA+ dapat pengobatan
C. 50% BTA+ sembuh
D.
E.

31. Fungsi SPS pada suspect TB
A. Keberhasilan pengobatan
B. Menjaring pasien TB paru
C.
D.
E.

32. Kriteria pesien default pada penanganan TB
A. Pasien yang pernah minum OAT < 4 minggu
B. Pasien BTA+ yang menjalani pengobatan penuh tapi pada pemeriksaan sputum (+)
C. Pasien BTA+ yang menjalani pengobatan penuh selama 5 bulan tapi pada pemeriksaan sputum (+)
D. Pasien BTA+ yang dirujuk ke tempat lain
E. Pasien BTA+ yang menjalani pengobatan 2 bulan tapi menghentikan pengobatannya

33. Tahap intensif pada pengobatan TB untuk mencegah
A. Kekambuhan
B. Resistensi
C.
D.
E.

34. K4 pada pemeriksaan antenatal adalah

35. Salah satu pelayanan yang diterima oleh ibu hamil pada saat pemeriksaan antenatal yang memenuhi kriteria K4
A. Mendapatkan tablet besi
B. Mendapatkan tablet besi 90 tablet
C. Mendapatkan imunisasi TT untuk kedua kali
D. Mendapatkan pemeriksaan lingkar lengan atas
E. Mendapatkan tablet besi 30 tablet

36. Apa yang dimaksud dengan maternal mortality ratio?
Jawab : number of maternal death per 100.000 live birth

37. Maternal mortality rate mencerminkan…

38. Salah satu penyebab ibu hamil tidak mendapatkan pelayanan kesehatan sesuai dengan kebutuhannya jika dilihat dari sudut pandang pelayanan kesehatan adalah
A. Tidak adanya biaya
B. Akses ke unit pelayanan kesehatan
C. Geografis
D. Tidak berjalannya sistem rujukan
E. Ketersediaan alat pelaytanan obstetric emergency

39. Penyebab utama kematian ibu hamil …
A. Jumlah anak terlalu banyak
B. Terlambat dirujuk
C. Jarak terlalu dekat
D. Pendarahan
E.

40. Basic factor pada kematian ibu hamil
A. Status kesehatan ibu hamil
B. Sistem pelayanan kesehatan
C. Bidan…
D. Pendidikan ibu hamil
E. Keluarga dan masyarakat di sekitar ibu hamil

41. Kegiatan penunjang puskesmas
A. Balai pengobatan
B. Upaya kesehatan sekolah
C. Promosi kesehatan
D. Primary Health Nursing center (PHNC)
E. Pencatatan dan pelaporan

42. Melalui pendekatan sistem tahap proses pada system informasi kesehatan adalah
A. Data
B. Pencatatan data
C. Pengolahan data
D. Analisa data
E. Menginformasikan hasil analisa

43. Melalui pendekatan sistem, tahapan input pada sistem informasi kesehatan adalah
A. Data
B. Pencatatan data
C. Pengolahan data
D. Analisis data
E. Menginformasikan hasil
44. Melalui pendekatan sistem, tahapan output pada sistem informasi kesehatan adalah
A. Data
B. Pencatatan data
C. Pengolahan data
D. Analisis data
E. Menginformasikan hasil

45. Dalam sistem informasi, top referral manager harus mengetahui
A. Seluruh informasi
B. Seluruh informasi yang berkaitan dengan kebijakan
C. Seluruh informasi yang berkaitan dengan operasional
D. Seluruh informasi yang berkaitan dengan operasional dan kebijakan
E. Sebagian informasi yang berkaitan dengan operasional dan kebijakan

46. Berdasarkan pendekatan sistem, proses koding terdapat dalam tingkatan…
A. Pengumpulan data
B. Transmisi data
C. Pengolahan data
D. Analisis data
E. Menginformasikan data

47.

48. Informasi berpengaruh terhadap tahap mana dalam siklus manajemen berikut
A. Perencanaan
B. Pengorganisasian
C. Pelaksanaan
D. Evaluasi
E. Semua tahap dalam siklus menajemen

49. Manakah yang termasuk emerging infectious disease?
A. Osteoarthritis
B. Typhoid
C. Osteomyelitis
D. Conjunctivitis
E. Lymphadenitis

50. Misi pengendalian penyakit menular adalah meningkatkan kualitas hidup penduduk di wilayahnya. Coba sebutkan dengan cara apa saja :
A. Pengobatan penderita
B. Penyuluhan kesehatan
C. Melakukan imunisasi
D. Pengendalian vektor
E. Meningkatkan perlindungan spesifik

51. Faktor apa yang memepengaruhi munculnya penyakit baru atau munculnya lagi penyakit yang sudah pernah ada?
A.
B.
C.
D. Perubahan iklim
E. Ozon depletion

52. Karakteristik penyakit tidak menular
A. Reversibel
B. Tidak dapat diobati
C. Mudah didiagnosis
D. Umumnya tidak tercatat pada unit terdepan
E. Lintas program

53. Manakah penyakit menular yang paling potensial mewabah?
A. Disentri
B. TB
C. Malaria
D. Kusta
E. Anthrax

54. Penyakit tidak menular yang paling banyak ditemui …
A. Cervical cancer
B. DM
C. Lung cancer
D. Chronic Vascular Disease
E. Cirrhosis hepatic

55. Penyakit endemic tinggi yang menular
A. Lepra
B. Filariasis
C. Pneumonia
D. Malaria
E.

56. Penyakit potensi tinggi untuk mewabah
A. TB
B. DBD
C. Syphilis
D. Lepra
E. Anthrax

57. Program control malaria secara dini dengan harapan dunia bebas malria, tapi malria timbul kembali. Kenapa hal ini terjadi; coba sebutkan :
A. Menurunnya resistensi vektor
B. Perubahan iklim
C. Pendudk yang stabil
D. Obat malaria kurang banyak
E. Makan obat tidak teratur

58. Roll Back Malaria merupakan gerakan sosial yang bertujuan untuk mengurangi malaria sampai 2010. Coba sebutkan apa saja tindakannya?
A. Collaboration lintas program
B. Health education
C. Penggunaan pestisida
D. Penyemprotan
E. Advocacy

Untuk soal no. 59 – 67
A. Kontrol terhadap lingkungan
B. Kontrol terhadap vektor
C. Kontrol terhadap host
D. Kontrol terhadap infection agent
E. Kontrol terhadap manusia terinfeksi
F. Kontrol terhadap binatang
59. Housing sanitation
60. Restriction or reduction
61. Cooling
62. Chemical control
63. Intravenous drug use
64. Hospital nososcomial infection
65. Barriers
66. Irrigation
67. Organo phospate

Untuk soal no. 68 – 76
A. Distal socioeconomic cause
B. Proximal cause
C. Physiological & pathophysiologic cause
D. Outcome
E. Sequelae
68. Alcohol intake
69. Glucose metabolism
70. CHD
71. Occupation
72. Kelumpuhan
73. Inactivity
74. Cholesterol level
75. Education
76. Stroke

Untuk soal no. 77 – 83
A. Decentralization to district level
B. Advocacy to the highest level
C. Health care financing reform
D. Gender issues
E. Forging partnership

77. Health is social goal, BOTH government & non-government can contribute to the health and well being population
78. GDI was lower than HDI
79. To motivate them to mobilize additional resource
80. Orienting them to strategies that can be used to address the problem
81. Social health insurance is being implemented in some countries
82. A relevant and realistic health programs to address the need of the population can be planned and implemented
83. To sensitize the policy makers to the new & emerging health program

MDE DMS 2007

72. d
73. a
75. a
76. mungkin D
77. b
78. e
79. e
84. b
85. d
86,87. Aneh soalnya..
89. b
90. a
91. e
94. a
96. e
97. a
98. c
99. e
100. d
101. d
102. c
103. c
108. b,c
109. d
111. b
112. b
113. c
114. a
115. b
116. c
117. a
120. c
121. b
124. d
126. Chlamydia : Mc Coy, Haemophilus : nutrient agar (Chocolate agar), Corynebacterium : Loeffler media, blood agar
127. b
128. d
130. d
132. b
133. b
134. b
135. c
136. e
137. d
138. d
139. c
140. e
141. a
143. e
144. Group of quadratus femoris muscle: A. rectus femoris, vastus lateralis, vastus medialis, vastus intermedius
** biceps femoris, semitendinosus, semimembranosus, sartoriuS: harmstring muscle
** thenar(dibawah ibu jari) ,hipothenar (bawah kelingking)
** subscapularis, supraspinatus, infraspinatus, teres minor: rotator cuff
** biceps branchii, brachialis, coracobrachialis: anterior compartment of arm
145. Lokasi cephalic vein: B. along lateral side of forearm
**basilic vein: medial aspect of forearm
146. Insert jarum di cubital region→ feel radiating down venous surface of forearm and hand include thumb, index, middle finger, nerve yg rusak: B. median nerve (mempersarafi anterior aspect forearm sampai hand yg bagian ibu jari-telunjuk-jari tengah dan lateral aspect jari manis)
147. Fraktur neck of humerus, persarafan otot apa yg bermasalah: B. deltoid
149.Otot untuk elevasi jaw: C. medial pterygoid muscle (++ temporal, masseter)
Alasan: liat moore hal986 (movement of TMJ) : depresi jaw: lateral pterygoid, suprahyoid, infrahyoid muscle
150. lapisan yg akan mereplace outer layer: horny layer
Alas an: maksud oter layer disini ialah periderm layer: jadi diganti oleh st. corneum/horny layer saat periderm slough off
151. A. neural crest cell
Alas an: yg ditanya kan connective tissue di head..jadi dari neural crest cell (lait langman hal 146)
152: D. MYOD-5 (liat gambar 103 langman hal 145)
153.B. MYF-5 (liat gambar 103 langman hal 145)
155. yg nyebabin kontraksi otot saat lari: B. folding of myosin (penjelasan baca tortora hlm 299-300)
156. pengganti sumber energy kalo ATP abis: E, creatinine phosphate
157. E
158 interferon alpha 2b dipake sebagai anticancer drug, bisa untuk treatment?E. hairy cell leukemia (alasan sama kayak di buku soal)
159. diagnosis untuk trichinellosis: B.muscle biopsy (lap parasit)
160. symptom trichinellosis:D. peubahan ECG (lab parasit)
161. efek toxic ibuprofen: D. gastric ulcer (alasan: sama kayak dibuku soal), efek ibuprogen lebih ke GI tract
164. anastesi paling sering: gak tau..procaine, bubivocaine, tetracin: local anastesi
166 . simpatetik nerve blockage is one of local anasthethic, best location to apply this? Gak tau,,mungkin nerve cell ending
167. local anastesis mengganggu pergerakan molekul: A. Na (lippincot hal 137)
168. chemotrapi trophoblastic disease: ??
169, 171, 172, 173 gak tau
174. exfoliative dermatitis: anemia
174.. E
178 A. rod
179. A
181. E
182B
183D
185C
186C
187. C
188.A
189.C
190.D
191B.
192.E
193.E
195C/E
196 B
197?
198 D
199. A
200. B

MDE DMS 2006

For question 44-47
A 35-year-old man complained thick scaling at elbow & knee area accompanied by mild otching and reddish.

44. Which of the following is likely the diagnosis?
A. Psoriasis
B. Erythroderma
C. Sun burn
D. Lichen planus
E. Dermatitis
Jawaban : A.
Pembahasan :
Psoriasis adalah kelainan kulit akibat hiperproliferasi keratosit pada epidermis, dengan ciri lesi erythrosquamous (kemerahan & pengelupasan sisik).

45. Which of the following test is appropriate to diagnose this disease?
A. Auspitz test
B. Prick test
C. Skin test
D. KOH test
E. Woods test
Jawaban : A.
Pembahasan :
Auspitz’s sign  gambaran titik perdarahan halus bila sisik diangkat dari plak psoriasis, disebabkan oleh penipisan epiddermis di atas dermal-papilae.

46. Which of the following microscopic findings is characteristic for the lesion?
A. Hyperkeratosis
B. Acanthosis
C. Dysphasia
D. Abscess Monroe
E. Hyperplasia
Jawaban : (?)  B/D.
Pembahasan :
Menurut pembahasan 1001 soal  B. acanthosis
Pendapat lain  D. abscess Monroe = kumpulan sel PMN secara fokal pada bagian parakeratosis stratum corneum, ciri khas pada psoriasis.

47. Which of the following layer of the skin is most likely to be affected?
A. Stratum corneum
B. Stratum lucidum
C. Stratum granulosum
D. Stratum spinosum
E. Stratum basale
Jawaban : (?)  A/D.
Pembahasan :
Menurut pembahasan 1001 soal  D. stratum spinosum (hiperplasia difus stratum spinosum = acanthosis)
Pendapat lain  A. stratum corneum (abscess Munroe terdapat pada stratum corneum)

48. Shake lotion refer to a vehicle mixture made from?
A. Powder and solution
B. Powder and tincture
C. Ointment and solution
D. Powder and ointment
E. Powder and ointment and solution
Jawaban : A.
Pembahasan :
Lecture Dermoterapi:
Lotion = solution + powder
Cream = solution + ointment
Paste = powder + ointment
Cold paste = solution + powder + ointment

51. Which one is correct regarding arrector pili muscle?
A. They are composed of bundles of myoepithelial
B. They help to push sebum onto skin surface
C. They have no effect on hair position on humans
D. They attach directly to the external root sheath by desmosomes
E. They contain capillary networks that nourish growing hairs
Jawaban : (?)  B/D
Pembahasan :
A. salah, harusnya smooth muscle
B. mungkin membantu mendorong sebum ke permukaan kulit?
C. salah, harusnya punya efek pada posisi rambut
D. mungkin menempel pada external root sheath, walaupun harusnya dermal root sheath
E. salah, karena tidak ada kapiler

52. Which is the function of the skin?
A. Produce vit.C
B. Produce vit.B
C. Produce melatonin
D. Secretion of hormones
E. Vit.D metabolism
Jawaban : E.
Pembahasan : sinar UV matahari mengaktifkan precursor vit.D pada kulit

53. Burn injury 1% (grade II) at left arm due to flame. Deepest layer affected?
A. Stratum corneum
B. Stratum lucidum
C. Stratum granulosum
D. Stratum basale
E. Stratum papillary
Jawaban : E.
Pembahasan :
2nd degree burn :
A. Superficial Partial Thickness  sampai upper dermis / papillary layer (+ blister, pain, moist)
B. Deep Partial Thickness  sampai lower dermis / reticular layer (+ mottled, less sensation, hypertrophic scar result)

56. D. Retinoblastoma
57. A. it occur primarily in children
Retinoblastoma is rare congenital tumor of young children
Sumber 56 dan 57: pathophisiology,Mosby
59. C. cell are polymorph
Retinoblastoma may contain both undifferentiated and differentiated elemet
Sumber: robin cotran 1442
58. C. seidel test
Seidel test is the test to indicate leakage of aquoes humour
60. B. decomposition
Decomposition is the late change in cadaver. It is start 24 hours after death
61.C. It is persist until the decomposition process start
Livor mortis will be disappear with appearance of decomposition
Sumber 60 dan 61: slide Thanatology
62. E. several vesicle must be active
Myosin dan actin sarcomerefilamentmyofibrilmuscle fiberfascicleskeletal muscle
Agar skeletal muscle bisa manghasilkan movement maka beberapa fascicle harus aktif
Sumber: tortora, 295
63. C. shape of bony component of each joint
Bentuk-bentuk tulang yang bergabung dalam membentuk sebuah sendi akan mempengaruhi jenis peregerakan dari sendi tersebut
65. D. burn grade II- III 36%
Grade of burn injury
1. 1.only epidermis without blister
2. 2.with blister: A. upper layer of dermis(papillary) berwarna pink. B. deeper layer of dermis(reticular)
3. involve all layer of dermis
4. not only the skin but also involve subcutaneous and struktur under the skin like tendon,ligament,and others
Rule of nine
1. Face and head: 9 %
2. Each upper limb: 9%
3. Each lower limb: 18%
4. Trunk : anterior 18%,posterior 18%
5. Perineum :1 %
Sumber: case review 2006 and 2007
66. A. lactate ringer
Lactat ringer is the most extensively used for rescusitation fluid to maintain intravascular volume initially after burn injury
Colloid is the protein replacement therapy. It is not administered before 24 hours after burn injry
Sumber: case review 2006,treatment of burn injury
67.B. 7200 cc in the 1st 24 hours
Parkland formula= 4 ml lactate ringers x TBSA % of burn injury x weigh in KG in the 1st 24 hours
68. B. grade IIa
Lihat penjelasan no 65
69. B. silver sulfaniazid ointment
It is the broad spectrum antibiotic fot treating burns
70. A. chest X-ray
73. B. le fort II: pyramidal fracture of maxilla
Fracture of face bone
1. Le fort I : horizontal maxillary fracture
2. Le fort II : pyramidal fracture of maxilla
3. Le fort III: transverse facial fracture
Sumber: case review 2007, facial bone fracture
74. Hemangioma:
1. Strawberry hemangioma: start appear on 3-5 week after birth,superficial lesion,elevated skin
2. Covernosus hemangioma: primarily in head and neck area,bluish red color,less distinctive border,deep lesion,spongy mass
75. D. covernosus hemangioma
Sumber 74 dan 75: andrew’s 684
76. A. observation for spontaneous regression
Sumber: andrew’s 686
77. D. serratus anterior
The function of the serratus anterior muscle: protract scapula,hold it against thoracic wall. It is innervated by long thoracic wall.
Paralysis of this muscle cause wing sacapula
Sumber : moore anatomy,752-753
78.A.tuberculous spondylitis of T12 vertebrae with neurologic deficit
79.B. spine
Tuberculous Spondylitis
80.A. Compresion of spinal cord by bony fragment
83.B. Hematogenic
84. E. DEXA
Apley’s,116
85. A. thin bone cortex,thin trabeculae,diminished number
85. B. lung
86. A.concervative
87. A. green stick fracture
Sumber: Apley’s 540
90. C
91. C
92. A
Sumber: andrew’s 803
94. B
95. C
96. B
97.E
98. B
Sumber: moore 28
99. B
100. B
102. B
105. E
106. D
107. E
Sumber: tortora 312
111. nevus
112. C
114. A
115. C
117. C
118. D
119. C
120. A
121. A
Sumber: case review 2006,clinical Finding(CF) of seborrhoid dermatitis
122. E
Sumber: case review 2006, CF of psoriasis
123. D
126.C
127. B
128. A
131. D
134. C
135. B
137. B
138. A
141. D
For question 192-195 :
A 25-year-old woman, good health, underwent extraction of impacted 3rd molar teeth. In the evening, she developed fever. 2 days later swelling of bilateral submandible. Her tongue was elevated, dyspnea, paroxysm with evidence of respiratory paralysis.

192. Which of the following spaces involved in this case?
A. Sublingual, submandibular, submucus
B. Sublingual, submental, subperitoneal
C. Sublingual, submandibular, submental
D. Submandibular, parapharyngeal, submental
E. Submandibular, buccalis, sublingual
Jawaban : C.
Pembahasan :
Kemungkinan pasien ini mengalami Ludwig’s angina, maka space yang terkena adalah : sublingual, submandibular, submental.

193. Which one is the diagnosis?
A. Osteodynitis
B. Cellulitis
C. Submandibular abscess
D. Ludwig’s angina
E. Lymphadenitis
Jawaban : D.
Pembahasan : -jelas-

194. Which of the following is the most likely to be cause of mortalitiy for above disease?
A. Asphyxia and dehydration
B. Sepsis and dehydration
C. Sepsis and asphyxia
D. Dehydration and dysphagia
E. Asphyxia and dysphagia
Jawaban : C.
Pembahasan :
Komplikasi paling sering adalah asphyxia / sulit bernafas karena pembengkakan mouth floor. Komplikasi lain adalah sepsis.
195. This patient may have risk to suffer from acute necrotizing Ulcerative Gingivitis. Which of the following factors related to this complication?
A. Poor oral hygiene, local trauma, smoking
B. Local trauma, drug, systemic disease
C. Smoking, drug
D. Drug, poor oral hygiene
E. Poor oral hygiene, smoking
Jawaban : E.
Pembahasan :
Acute necrotizing ulcerative gingivitis (ANUG) adalah infeksi progresif disertai rasa nyeri, bengkak, ulcer, & sloughing-off jaringan mati dari mulut / tenggorokan akibat infeksi gusi. Penyebabnya terutama infeksi, poor oral hygiene, stress, merokok.

196. A 25-year-old woman is 5 months pregnant had swelling at her gum at frontal region of the upper jaw since 3 months ago. The swelling was as big as a green pea. This is a reactive lesion if ginggivae composed of stratified squamous epithelium lining granulation tissue and chronic inflammatory infiltrate. What is the diagnosis?
A. Mucocele
B. Oral trush
C. Epulis granulomatosa
D. Apthous ulcer
E. Leukoplakia
Jawaban : C.
Pembahasan :
Mucocele  pembengkakan pada lower lip / buccal / tongue / mouth floor, akibat obstruksi / ruptur dari salivary gland
Oral trush  akibat candida, oral cavity keputihan
Epulis granulomatosa  tumor gusi, berupa tonjolan paling sering pada rahang atas, mudah berdarah namun tidak sakit, subtipe gravidarum
Apthous ulcer  ulcer pada oral mucosa, berupa lesi halo berwarna putih-kuning, sangat sakit
Leukoplakia  plak putih pada oral cavity, akibat merokok / alkohol


197. Fracture of the bony callus in fracture repair is followed by :
A. Hematoma formation in the middle of callus
B. Fibrocartilaginous callus formation after bone remodeling
C. Bone remodelling to convert woven bone to compact bone
D. Formation of granulation tissue to compact bone
E. Protein release from the callus
Jawaban : C.
Pembahasan :
Tahapan bone fracture repair :
Hematoma formation  Fibrocartilaginous callus formation  Bony callus formation  Bone remodelling

198. Which of the following is NOT true about hyphema?
A. Blood accumulation at anterior chamber
B. It can cause glaucoma
C. It is treated with antibiotic
D. Patient should be in bed rest
E. Topical steroid is necessary
Jawaban : C.
Pembahasan :
Hyphema = perdarahan pada anterior chamber, biasanya akibat trauma tumpul pada mata. Bisa mengakibatkan naiknya tekanan intra-okular (glaucoma). Treatment meliputi bed rest, pain reliever, tetes mata steroid untuk mencegah inflamasi, proteksi mata (coverings).

MDE DMS 2005

1. Which cells involved in in the resorption and modeling of bone tissue?
a. Osteoblast
b. Osteocytes
c. Multinucleated giant cells
d. Monocytes
e. Fibrocytes
Bone is a specialized connective tissue composed of intercellular calcified material, the bone matrix, and three cell types:
- osteocytes (osteon, bone, + kytos, cell), which are found in cavities (lacunae) within the matrix;
- osteoblasts (osteon + blastos, germ), which synthesize the organic components of the matrix;
- osteoclasts (osteon + klastos, broken), which are multinucleated giant cells involved in the resorption and remodeling of bone tissue.
Histology, Junqueira 11th, ch.8 bone

2. Which cells synthesizes the organic component of bone matrix?
a. Osteoblast
b. Osteocytes
c. Osteoclast
d. Monocytes
e. Fibrocytes

3. Which cells increased activity results in removal of bone matrix and fibrotic degeneration of fibrosa cystics?
a. Osteoblast
b. Osteocytes
c. Osteoclast
d. Monocytes
e. Fibrocytes
Osteitis fibrosa cystica, in which osteoclast activity results in removal of bone matrix and fibrous degeneration
Histology, Junqueira 11th, ch.8 bone

4. Which cells play prominent role in bone growth and repair?
a. Osteoprogenitor cells in periosteum
b. Osteoblast cells in periosteum
c. Osteoclast cells in periosteum
d. Osteocyte cells in periosteum
e. Fibrocyte cells in periosteum
The inner, more cellular layer of the periosteum is composed of fibroblastlike cells called osteoprogenitor cells, with the potential to divide by mitosis and differentiate into osteoblasts. Osteoprogenitor cells play a prominent role in bone growth and repair
Histology, Junqueira 11th, ch.8 bone

5. The organic matter in bone matrix are?
a. Type I collagen and ground substances
b. Type II collagen and ground substances
c. Type III collagen and ground substances
d. Type IV collagen and ground substances
e. Type V collagen and ground substances
The organic matter in bone matrix is type I collagen and ground substance, which contains proteoglycan aggregates and several specific structural glycoproteins
Histology, Junqueira 11th, ch.8 bone

6. Which one of the following layers in mainly for regeneration of epidermis?
a. Stratum corneum
b. Stratum lucidum
c. Stratum granulosum
d. Stratum spinosum
e. Stratum basale
Stratum Basale (Stratum Germinativum) containing stem cells, is characterized by intense mitotic activity and is responsible, in conjunction with the initial portion of the next layer, for constant renewal of epidermal cells
Stratum spinosum are filled with bundles of keratin filaments, which play an important role in maintaining cohesion among cells and resisting the effects of abrasion
Malpighian layer consists of both the stratum basale and the stratum spinosum, which contains epidermal stem cells
Stratum Granulosum acts as a barrier to penetration by foreign materials and provides a very important sealing effect in the skin
Stratum Lucidum, more apparent in thick skin, is a translucent, thin layer of extremely flattened eosinophilic epidermal cells
Stratum corneum is filled with a birefringent filamentous scleroprotein, keratin, on sole of feet
Histology, Junqueira 11th, ch.18 skin

7. Which one of the following statements is mainly for the fracture repair?
a. Osteoprogenitor cell in outer circumferential lamella
b. Osteoprogenitor cell in inner circumferential lamella
c. Osteoprogenitor cell in interstitial lamella
d. Osteoprogenitor cell in haversian system
e. Osteoprogenitor cell in endosteum
The inner, more cellular layer of the periosteum is composed of fibroblastlike cells called osteoprogenitor cells. The endosteum lines all internal cavities within the bone and is composed of a single layer of flattened osteoprogenitor cells and a very small amount of connective tissue
Periosteum and the endosteum around the fracture respond with intense proliferation producing a tissue that surrounds the fracture and penetrates between the extremities of the fractured bone
Histology, Junqueira 11th, ch.8 bone

8. Which of the following is the almost unique characteristic of biochemistry content of collagen fibers?
a. Glucosamine
b. Galactosamine
c. Glycine
d. Hidroxy proline
e. Apatite crystals
Hydroxyapatite crystals of bone appear as plates that lie alongside the collagen fibrils but are surrounded by ground substance
Histology, Junqueira 11th, ch.8 bone

9. Histology of bone matrix usually refers to the...
a. Organic material minus the collagen fiber
b. Organic material remaining after decalcification
c. Material composing the whole bone
d. Contents of hydration shell crystaline portion of the bone
e. ...
Inorganic matter represents about 50% of the dry weight of bone matrix. The organic matter in bone matrix is type I collagen and ground substance
Histology, Junqueira 11th, ch.8 bone

10. Histology longitudinal growth of long bone is accomplish by...
a. Preosteoblast on periosteum
b. Part of epiphysis
c. Part of metaphysis
d. Osteoblast and osteoclast and the other cells on the epiphyseal plate
e. ...chondrium
Endochondral ossification of a long bone consists of the following sequence of events. This process begins at the central portion of the cartilage model (diaphysis), where blood vessels penetrate through the bone collar previously perforated by osteoclasts, bringing osteoprogenitor cells to this region. Next, osteoblasts adhere to the calcified cartilage matrix and produce continuous layers of primary bone that surround the cartilaginous matrix remnants. In this way the primary ossification center is produced. Then, secondary ossification centers appear at the swellings in the extremities of the cartilage model (epiphyses)
In the secondary ossification centers, cartilage remains in two regions: the articular cartilage, which persists throughout adult life and does not contribute to bone growth in length, and the epiphyseal cartilage, also called the epiphyseal plate, which connects the two epiphyses to the diaphysis. The epiphyseal cartilage is responsible for the growth in length of the bone, and it disappears in adults, which is why bone growth ceases in adulthood
Histology, Junqueira 11th, ch.8 bone

11. In physiologic motor fiber is stimulated, the impluse arriving at the nerve ending
a. Release cholinesterase which by quota reaction cause muscle contraction
b. Creates action potential at motor end plate by formation of postiggmine-like...force
c. Release of electrical impulse to muscle fibers cause contraction
d. Activates release acetilcholyne in turn stimulates motor end plate to form propagated action potential
e. All above are true

13. Histology of bone on haversian canals have been described as containing:
a. A capillary vessel and extracellular fluid
b. A capillary and venule vessels
c. An arteriole, a venule, and a lymphatic
d. An arteriole and a venule vessels
e. An arteiole, a venule, a lymphatic, a nerve fiber, and extracellular fluid
Haversian system showing lamellae, a central blood capillary (there are also small nerves), and many osteocytes with their processes
The whole complex of concentric lamellae of bone surrounding a canal containing blood vessels, nerves, and loose connective tissue is called a haversian system, or osteon
Di gambar tortora ada lymphatic vessel
Histology, Junqueira 11th, ch.8 bone

15. Scoliosis is a condition...
a. Mainly but not always toward the CONVEXITY
b. Always toward the concavity of the curve
c. Mainly, but not always to the CONCAVITY
d. On either direction depending upon muscle imbalance rather than the direction of the curve
e. Indometachine
Scoliosis (crooked or curved back) is characterized by an abnormal lateral curvature that is accompanied by rotation of the vertebrae. The spinous processes turn toward the cavity of the abnormal curvature, and when the individual bends over, the ribs rotate posteriorly (protrude) on the side of the increased convexity.
Anatomy, Moore 5th, ch.4 back

17. Classifying a peripheral nerve injury according to SEDDON, a complete severance is defined:
a. Axonotmesis
b. Neurotmesis
c. Neuropraxia
d. Complete
e. Transverse
Axonotmesis → gangguan axon → wallerian degeneration, konduksi atau transmisi syaraf terganggu, tapi continuity syaraf dan endoneural tube nya masih ada → masih bisa regenerasi
Neurotmesis → paling parah → konduksi syaraf terganggu dan wallerian degeneration → continuity sarafnya sudah tidak ada → endoneural tube hancur → hasil regenerasinya: banyak akson baru yang tdk bisa mencapai segmen distal syaraf → fungsinya tdk akan pernah kembali normal
Neuropraxia → reversible physiological nerve conduction block → spontaneous recovery
Sekarang klasifikasi nerve injury:
- grade 1 → neuropraxia
- grade 2 → axonotmesis
- grade 3 → axonotmesis
- grade 4 → axonotmesis
- grade 5 → neurotmesis
Appley 8th, p231 tabel 11.1

18. You are the first to see the patient in ER following traffic accident. The pateint is obviously onjured with closed fracture of left extremities. The most important first sign of Volkman’s ischemia is...
a. Cold and cyanosis of the fingers
b. Pallor of fingers
c. Obliterations of the radial pulse (pulseness)
d. Paralysis of the flexor and extensor muscle in forearm
e. Pain
Nerve is capable of regeneration but muscle, once infarcted, can never recovered and is replaced by inelastic fibrous tissue (Volkmann’s ischaemic contracture).
Volkman ischemia is final sequale of acute compartment syndrome
Volkmann’s contracture is fibrosis and shortening of muscle due to inadequate blood supply. It is a complication that arise if the blood supply is interrupted by pressure on the blood vessel from a fracture fragment, or from raised pressure due to compartment syndrome, or by pressure fromconstricting bandages and plaster cast
Classic feature of ischaemia are the five Ps: pain (earliest), paraesthesia, pallor, paralysis, pulselessness
Appley 8th, p563-564

19. A greenstick fracture of the midshaft of the radius and ulna in 4 years old child is observed to have 10o of angulations. The best treatment wolud be (under general anasthetic):
a. Without reposition, cast the arm
b. Straighten the extremity to less than 5o and apply cast
c. Anatomical induction, reduce the deformity to 0o and apply cast
d. No plate’s pain is required and simple splinting will surfice
e. Open reduction and internal fixation (ORIF)
Tidak perlu dilakukan tindakan operasi karena bisa menyebabkan komplikasi yang lebih besar, tetapi tulang harus tetap direposisi ke tempat semula (reduce)

20. 5 years old boys has an acute hematogenous ostemyelitis in the distal right femur for 10 days duration. The treatment of choice would be
a. Surgical draining covered by antibiotics
b. Blood culture and sensitivity test and give antibiotic selected from the sensitive group
c. Blood culture, sensitivity test and suregery covered by selected antibiotics
d. Surgical drainage and culture of surgery followed by an antibiotic of proven sensitivity
e. Broad spectrum antibiotic, surgical and culture of surgery followed by an antibiotic of proven sensitivity
Tidak perlu surgical, tetapi dicari bakteri penyebabnya, kemudian diberikan antibiotik yang bekerja spesifik untuk bakteri tersebut

23. Radiation therapy is the LEAST value in
a. Osteosarcoma
b. Ewing’s sarcoma
c. Angiosarcoma
d. Reticulosarcoma
e. Chondrosarcoma
Osteosarcoma → wide resection of tumor and chemoterapy
Ewing’s sarcoma → radotherapy has dramatic effect
Reticulosarcoma → chemotherapy and radial section, radiotherapy is reserved for less accessible lesion
Chondrosarcoma → amputasi, doesn’t respond to either radiotherapy or chemotherapy
Appley 8th, p184-191

26. Bone pain may be presenting complaint in
a. Malignant secondary bone tumor
b. Leukimia
c. MM (multiple myeloma)
d. Osteomalacia
e. All of above

27. Serum alkaline phosphatase level is significantly raised in disease of:
a. Scurfy
b. Arthrogyplasia
c. Sterile osteoporosis
d. Secondary bone tumors
e. Parther disease of hip (avascular...)
Alkaline phosphatase increased in tumor of bone
Henry 25th, p256

28. The deep branch of the ulnar nerve in the hand:
a. Supplies all the lumbrical muscle
b. Profundus muscle
c. The skin of the little finger
d. Adduction pollicis
e. When paralysed produced clawing of all the fingers in that hand
Ulnar nerve
- origin: Larger terminal branch of medial cord, receiving fibers from C8, T1 and often C7
- course: Descends medial arm; passes posterior to medial epicondyle of humerus; then descends ulnar aspect of forearm to hand
- structure innervated: Flexor carpi ulnaris and ulnar half of flexor digitorum profundus (forearm); most intrinsic muscles of hand; skin of hand medial to axial line of digit 4, 5
Anatomy, Moore 5th, ch6 upper limb, tabel 6.5

29. The patient get a lesion of median nerve at the level of the elbow caused by supra...humerus
a. Result in loss of flexion of the thumb
b. Result in loss of flexion of index finger
c. Due to closed fracture is managed by conservative treatment
d. Under general anasthetic, reposition and immobilization
e. All of the above correct
Median nerve innervated muscles of anterior forearm compartment (except for flexor carpi ulnaris and ulnar half of flexor digito-rum profundus), five intrinsic muscles in thenar half of palm and palmar skin
Median Nerve Injury
When the median nerve is severed in the elbow region, flexion of the proximal interphalangeal joints of the 1st and 3rd fingers is lost and flexion of the 4th and 5th fingers is weakened. Flexion of the distal interphalangeal joints of the 2nd and 3rd fingers is also lost. Flexion of the distal interphalangeal joints of the 4th and 5th fingers is not affected because the medial part of the FDP, which produces these movements, is supplied by the ulnar nerve. The ability to flex the metacarpophalangeal joints of the 2nd and 3rd fingers is affected because the digital branches of the median nerve supply the 1st and 2nd lumbricals. Thus, when the person attempts to make a fist, the 2nd and 3rd fingers remain partially extended. Thenar muscle function (function of the muscles at the base of the thumb) is also lost, as in carpal tunnel syndrome
Closed fracture biasanya ditreatment dengan closed reduction (reposition atau immobilization), perlu dilakukan tindakan anasthesia
Anatomy, Moore 5th, ch6 upper limb

30. Acute poliomyelitis in Bogor area is a viral infection that primary affects (damage) what...the nervous system
a. Posterior column of spinal cord
b. White matter of the spinal cord
c. Cerebral motor cortex
d. Frontal lobe
e. Anterior horn cells at the spinal cord
Poliomyelitis: an infectious virus disease affecting CNS. Poliovirus invades the CNS and replicate in motor neuron of the spinal cord (spinal poliomyelitis) or brain stem (bulbar poliomyelitis)
Acute case show mononuclear cell perivascular cuff and neurophagia of the anterior horn motor neuron of the spinal cord
Pathology, Robin Cotran 7th, p364, p1374

31. A 12 years old girl has a 26 idiophatic thoracic scoliosis with the apex at the T9. She is past menarche and is Risser stage I. The management consist of:
a. Use milwakuee brace
b. Conservation and radiographic evaluation in 3-4 months
c. Electrical stimulation
d. Postural exercise
e. Thoracolumbosacral orthosis
Hold reduction dengan mengunakan bracing Milwaukee

32. Secondary bone tumor:
a. Are chiefly found in vertebrae, skull and upper ends of humerus and femur
b. From prostate are usually osteoblastic
c. Cause hypercalcemia
d. From breats cancer are usually osteolytic
e. All of the above correct
Secondary bone tumor (metastatic bone disease):
- skeleton adalah daerah yang paling sering termetastasis oleh kanker dari daerah lain
- sumber kanker yang paling banyak adalah payudara, berikutnya prostat, kidney, lung, thyroid, bladder, dan GI tract
- tempat yang paling terkena kanker sekunder: vertebra, pelvis, proximal half femur dan humerus
- biasanya bersifat osteolitik dan sering terjadi fraktur patologis, kecuali kanker prostat yang bersifat osteoblastik
- CF: pain, fraktur, gejala hiperkalsemi (anorexia, nausea, thirst, polyuria, abdominal pain, weakness, depresi)
Appley 8th, p193-194

33. A plaster of Paris cast:
a. Is usually applied on a padding of cotton
b. The next day patient must be controlled for compartment syndrome
c. If tight be split completely right down to the cotton wool
d. Can be wedge to correct angular deformity in management of closed fracture shaft of tibia
e. All of the above are correct
Plaster of paris cast can be wedge if further correction of angulation is necessary
Appley 8th, p551
A preparation of gypsum (calcium sulphate) that sets hard when water is added. It is used to make plaster cast, untuk memfiksasi bagian tubuh (dorland)

For number 114-118 see clinical scenario below :
An adult male comes to your ER 2 hours after burn injury due to flame. He gets burn in … of his face and neck, the whole right arm, chest, abdomen, groin. After a thorough physical examination, doctor gives him oxygen and infusion.

114. Burn extent examination in this patient is :
A. Burn grade I-II 35%
B. Burn grade II 39%
C. Burn grade II-III 27%
D. Burn grade II-III 36%
E. Burn grade III 29%
Jawaban : (?)
Pembahasan :
Face & neck (%), whole right arm (9%), chest & abdomen (18%), groin (1%). Total 32.5%.

115. According to Baxter-Parkland formula of the fluid resuscitation should be given is :
A. 7800 cc in the first 16 hours
B. 7200 cc in the first 24 hours
C. 3500 cc in the first 8 hours
D. 3600 cc in the first 26 hours
E. 5400 cc in the first 24 hours
Jawaban : (?)
Pembahasan :
Baxter Parkland formula  4cc per weight (kg) per %TBSA in first 24 hours.
Divided to 6 periods (each 4 hours)
Period 1,2  each 25%
Period 3,4,5,6  each 12.5%

116. In his right arm, you could see burn wound that is erythematous, bullae (+), pin prick test (+). It is classified into wound :
A. Grade I
B. Grade II A
C. Grade III B
D. Grade III
E. Grade IV
Jawaban : B.
Pembahasan :
1st degree burn  sampai epidermis (+ erythema, pain, peeling)
2nd degree burn :
 Superficial Partial Thickness  sampai upper dermis / papillary layer (+ blister, pain, moist)
 Deep Partial Thickness  sampai lower dermis / reticular layer (+ mottled, less sensation, hypertrophic scar result)
3rd degree burn  sampai subcutaneous tissue, bahkan sampai bone / muscle (+ painless, white/cherry-red/black, dry, leathery, skin graft is needed)


121. The … for nerve impulses into the muscle occurs at the …
A. Muscle level
B. Fiber level
C. Myofibril level
D. Sarcomer level
E. Fascia level
Jawaban : (?)  B.
Pembahasan :
Proses penghantaran impuls saraf dari sel saraf (neuron) ke sel otot melibatkan peran T-tubule, sarcoplasmic reticulum, myofibril yang ketiganya itu terdapat pada level muscle fiber (= sel otot).

122. In shortening (contraction) of the functional unit of the muscle :
A. The myosin “walks” along the actin filaments
B. The actin “walks” along the myosin filaments
C. The actin and myosin filaments move toward each other
D. The actin and myosin filaments shorten individually
E. The actin filament is shorten
Jawaban : A.
Pembahasan : Tortora hlm 299-300 “The Sliding Filament Mechanism”

123. To produce movement of a limb …
A. One sarcomer acts independently
B. Several sarcomeres, myofibrils, and fibers must be active
C. Only one fiber need to be active
D. Only one myofibril need to be active
E. Several fascicles must be active
Jawaban : E.
Pembahasan :
Untuk pergerakan limb dibutuhkan kontraksi skeletal muscle, yang terdiri dari beberapa fascicles yang terbungkus epimysium.

124. The determinant factor in the action of 2 joint muscles is :
A. The proximity of the muscle belly to each of the joints
B. The length of the movement arm at each joints
C. The shape of bony components of each joints
D. The direction of muscle fibers relative to the joint
E. The strength of the muscles to the joints
Jawaban : (?)
Pembahasan : (?)

125. The shaft of the bone is properly called the …
A. Epiphysis
B. Periosteum
C. Diaphysis
D. Compact bone
E. Metaphysis
Jawaban : C.
Pembahasan : bagian tengah dari bone disebut diaphysis

126. Fracture of the bony callus in fracture repair is followed by :
A. Hematoma formation
B. Fibrocartilaginous callus formation
C. Bone remodelling to convert compact bone
D. Formation of granulation tissue
E. Protein release from the callus
Jawaban : C.
Pembahasan :
Tahapan bone farcture repair :
Hematoma formation  Fibrocartilaginous callus formation  Bony callus formation  Bone remodelling

127. Fracture in which the bone ends are incompletely separated is …
A. Greenstick
B. Compound
C. Simple
D. Comminuted
E. Compression
Jawaban : A.
Pembahasan :
Greenstick fracture  fraktur parsial di mana salah satu sisinya patah, sedangkan sisi lainnya masih tersambung namun menjadi bengkok.

128. Remodelling of the bone is a function of these cells :
A. Chondroblast – osteocyte
B. Osteoblast – osteoclast
C. Chondroblast – osteocyte
D. Osteoblast – osteocyte
E. Osteoblast – osteocyte
Jawaban : B.
Pembahasan :
Osteoblast  bone deposition
Osteoclast  bone absorption

130) jaw : D ;reference : moore,developing human,8th ed;pg 377
131)
132) C ; reference : moore,developing human,8th ed;pg 440
133)C
134)B ; reference : moore,developing human,8th ed;pg 339
137)
137)B ; reference : moore,developing human,8th ed ; pg 352-353
138)
138)C ; explaination:the lens develops from the lens vesicle,a derivative of the surface ectoderm (moore,developing human,8th ed ; pg 427)
139)B
139)B ; explaination:congenital dislocation of hip : 1)heritage-multifactorial pattern of inheritance ; 2)acetabulum and head of femur (moore,developing human,8th ed ; pg 377)
140)A ; reference : junqueira,basic histology,11th ed
143)A or B ; explaination: radial groove-it is a depression for the radial nerve and deep brachial vessels;fracture of the humerus at mid shaft can injure the radial nerve and deep brachial vessels b`coz they are in contact with bone at this location (medical gross anatomy,university of Mich Medical School)
you can also referred to moore,clinically oriented anatomy pg 793,for more detail,then compare both answers
144)B ; explaination : when it is necessary to ligate the femoral artery,anastomasis of branches of the femoral artery with other arteries that cross the hip joint,may supply blood to lower limb.however,the cruciate anastomosis,consisting of a 4-way common meeting of the medial & lateral circumflex femoral arteries with the inferior gluteal artery superiorly & the 1st perforating artery inferiorly posterior to the femur,occurs less commonly than its frequent description in textbooks & depiction in atlases implies (moore,clinically oriented anat,5th ed ; pg 604)
145)C ; reference : moore,developing human,8th ed ; pg 449
146)B ; cell of the inner ep. Differentiate into ameloblast (moore,developing human,7th ed ; pg 469)
147)A ; the arrector pili muscles are bundles of smooth muscle cells.their contraction results in the erection of the hair shaft to a more upright position (junqueira,basic histology,11th ed ; chapter 18)
148)D ; secrete RAR & RXRboth are members of steroid thyroid hormones superfamily (Fitzpatrick,5th ed ; pg 128-129)
149)A ; can check it in past year compilation
150)E ; after correctly diagnosing a cutaneous disease,the dermatologist must consider a myriad option in formulating an effective treatment plan : selection of an appropriate agent,consideration of the areas of the body affected,the state of the disease skin,concentration of the drug…(Fitzpatrick 6th ed,chapter 242.principle of topical therapy)
151)B ; slide DERMATOTHERAPY
152)E ; slide DERMATOTHERAPY
153)A ; wet dressing is recommended for use on severely affected or chronically involved areas of dermatitis refractory to therapy.wet dressing has potential to promote drying & fissuring of skin (topical therapy – atopic dermatitis chapter 122)
156)C ; Fitzpatrick 6th ed ;pg 807
158)E ; Fitzpatrick chapter 44
159)C ; hyphema –hemorrhage within the anterior chamber of the eye ;treatment-rest in bed with the head of the bed elevated as much as u can tolerat;steroid dropto fight inflammation & pain (emedicine)
165)A ; treatment of congenital cataract requires surgery,typically at a very early age (younger than 4 months) –moore,developing human,8th ed ; pg 429
166)D ; excessive tearing (epiphora) is occasionally due to canalicular stenosis.in infantile dacryocystitis (inflammation of lacrimal sac),the site of stenosis is usually at the valve of Hasner
167)B ; many cases of infection may still be ‘culture negative’ (Vaughan ophthalmology)
168)B ; hyperacute purulent conjunctivitis caused by M.gonorrhea is transmitted through sex contact.copious green pus is produced and the lid are often extremely edematous.preauricular lymphadenopathy is common.immediate intervention is critical to prevent perforation of corneal ulcers caused by bacterial exotoxins.gram stain and culture of the conjunctiva should be performed.copious irrigation with saline solution is required yo dilute the toxins.systemic antibiotics are required.3rd-generation cephalosporins may be givan intramuscularly/intravenously.adjunctive topical treatment with ciprofloxacin,gentamicin or bacitracin may be helpful. (cecil,textbook of medicine,22nd ed ; pg 2411-2412)
statement of ans E would be correct if the word ‘not’ is deleted,but,if not,the answer would be B and E
169)D ; treatment for corneal ulcer : xboleh dibebat,karena akan menaikkan suhu sehingga akan berfungsi sbg incubator ; diberi antibiotika sesuai dgn kuasa (ilmu penyakit mata UI)
170)C ; can referred to past year questions’ book
171)B ; the fenamates are derivatives of N-phenylanthranilic acid.they include mefenamic,meclofenamic,and flufenamic acid (Pharmacological basis and therapeutics ,goodman & gilman)
172)A ; prolongation bleeding time is common side effect no t specific ; sede effect of mefenamic is hemolytic anemia
173)B ; 1)choice of drug for children :aspirin,naproxen,tolmetin and acetaminophen.aspirin is associated with Reye’s syndrome in children. 2)pregnant women : NSAIDs generally is not recommended.low doses of aspirin propably the safest. 3)piroxicam for treatment dysmenorrheal,acute musculoskeletal disorder,potop pain,and acute gout. 4)acetaminophen for patient in whom aspirin is contraindicated
174)A ; probenecid-uricosuric drugs employed to decrease the body pool of urate in patients with tophaceous gout/in those with increasingly frequent gouty attacks (Katzung 9th ed ; pg 596-598)
175)D ; external application-methyl salicylate ( ‘oil of wintergreen’)is used externally as a cutaneous counterirritant in liniments. (lippincott’s,pharmacology,3rd ed ; pg 500)
176)D ; etodolac is slightly more COX-2-selective than most other NSAIDs (katzung) ; celecoxibcox-2-inhibitor(Lippincott,3rd ed,495)
177)D ; intoxication is not rare.the other statement are correct
178)D ; refer book of past year question
179)E ; piroxicam is a nonselective COX inhibitor but at high concentration also inhibits polymorphomuclear leukocyte migaration,decreases oxygen radical production,and inhibits lymphocyte f(x).its long half-life permits once daily dosing.piroxicam can be used for the usual rheumatic indications (katzung,9th ed ;pg 596-598)
180)B ; mycobacteria are notorious for their ability to develop resistance.combinations of two /more drugs are required to overcome these obstacles and to prevent emergence of resistance during the course of therapy (katzung)
181)D ; mini lecture radiodiagnostic,slide no.58
182)D ; mini lecture radiodiagnostic,slide no.51
185)A ; CT scan is sensitive in demonstrating mucosal thickening and revealing trapped secretions within the sinus cavities.(otorhinolaryngology).b`coz of mucosal thickening,the antrum become thinning
186)B ; skeletal tuberculosis-weght bearing joint (spine-40% cases,hips-13%,knees-10%) are most commonly affected (Harrison,internal medicine,17th ed ; pg 1012)
187)C ; lab man
188)C ; any cancer can spread to bone,but,in adults,>75% of skeletal metastases originate from cancers of prostate,breast,kidney and lung (robbins & cotran,7th ed ; pg 1303)
189)
190)
191)D ; mitochondrial DNA reference from maternal lineage available (minilecture Forensic Identification,slide no.35)
192)B

MDE DMS 2004

1. Jawaban:C
Alasan : ameloblast berasal dari inner enamel epithelium / ectoderm (moore embryology hlm 449)
2. Jawaban : B
Alasan : sama dgn buku
3. Jawaban : C
Alasan : agak ga yakin, tapi yang pasti fungsi arrector pili untuk bikin rambut berdiri (goosebump effect)
4. Jawaban : E
Alasan : sama dengan buku
5. Jawaban : C / E
Alasan : Moore hlm 75
6. Jawaban : E
Alasan : sama dengan buku
7. Jawaban : C / D
Alasan : sama dengan buku
8. Jawaban : B
Alasan : sama dengan buku
9. Jawaban : B
Alasan : sama dengan buku
10. Jawaban : A
Alasan : sama dengan buku
11. Jawaban : Resemble normal basal cell of epidermis, arise from epidermis or follicular epithelium. Two patterns : multifocal growths and nodular lesions (Robbins hlllm 1243)
12. Jawaban : C
Alasan : jaringan lipid ga punya nuclei
13. Jawaban : C
Alasan : sama dengan buku
14. Jawaban : A
Alasan : sama dengan buku
15. Jawaban : B
Alasan : sama dengan buku
16. Jawaban : E
Alasan : sama dengan buku
17. Jawaban : B
18. Jawaban : A
Alasan : sama dengan buku
19. Jawaban : B
Alasan : Moore anatomy hlm 603
20. Jawaban : C
Alasan : lab muscle contraction
21. Jawaban : D
Alasan : interactive pgysiology bagian skeletal tissue
22. Jawaban : B
Alasan : sama dengan buku
23. Jawaban : A
24. Jawaban : C
Alasan : sama dengan buku
25. Jawaban : A
Alasan : sama dengan buku
26. Jawaban : D
Alasan : fascicle  fibers yang dikelilingi CT
27. Jawaban : D
28. Jawaban : A
Alasan : sama dengan buku
29. Jawaban : A
Alasan : sama dengan buku
30. Jawaban : B
Alasan : osteoblast  pembentukan, osteoclast  perombakan
31. Jawaban : A
Alasan : sama dengan buku
32. Jawaban : semua benar
33. Jawaban : D
Alasan : sama dengan buku
34. Jawaban : D
Alasan : sama dengan buku
35. Jawaban : D
Alasan : sama dengan buku
36. Jawaban : D
Alasan : sama dengan buku
37. Jawaban : D
Alasan : sama dengan buku
38. Jawaban : B
Alasan : ciri khas TB
39. Jawaban : E
Alasan : sama dengan buku
40. Jawaban : A
41. Jawaban : D
Alasan : sama dengan buku
42. Jawaban : B
Alasan : sama dengan buku
43. Jawaban : B
Alasan : tumor marker ada klo ada tumor
44. Jawaban : A
Alasan : sama dengan buku
45. Jawaban : E
Alasan : case review 07
46. Jawaban :
Alasan : B, D benar
47. Jawaban : C
Alasan : ada peningkatan ESR
48. Jawaban : A
Alasan : slide dermotherapy
49. Jawaban : D
Alasan : slide dermotherapy
50. Jawaban : A
Alasan : itchy skin lesions; lesions become dark, thick, and leathery with round scaly plaque underneath. The lesions may have well-defined rectangular borders, or present in oval, irregular, or angular shapes; exaggerated skin lines in the lesions; usual locales -- nape of the neck, forearms, area on inside of elbows, wrists, inner thighs, behind the knees, and lower legs
51. Jawaban : A
Alasan : perlu sirkulasi udara yg baik
52. Jawaban : B
Alasan : sama dengan buku
53. Jawaban : B
54. Jawaban : D
Alasan : untuk melihat soft tissue
56 e.GCS. untuk mengetahui seseorang jatuh kea rah shocked atau improvement setelah dilakukan resusitasi adalah:
1. CNS : improvement dari GCS
2. Renal : increase urine output
3. Skin: warm and capillary refill
4. Pulmonary : improved rate and depth
5. Vital sign : return to normal
57.C. (dari hasil eliminasi.. sumber: Chapman orthopaedic surgery 3rd ed)
(A) justru high velocity berakibat great tissue damage yang terkena atau yang dileawati oleh peluru
(B). penjelasan sama dengan option A jika yg kena langsung ke nerve
(D). membutuhkan 2 stage debridement, yaitu initiall debridement (directly), kedua, 48-72 jam setelah initial debridement
(E).apabila tidak diremove, maka bisa berakibat adanya abrasi mekanik di daerah sendi. Meski hal itu tidak terjadi, maka resiko adanya infeksi tidak pernah hilang.
58. C.. sudah jelas apabila ada riwayat open fracture  di suture dan terjadi gejala2 komplikasi septic kurang dari 24 jam, maka bakteri yang berperan adalah anaerob (dalam hal ini Clostridium welchii). Maka dilihat dari option, yang paling mungkin dari waktu dan gejala yg timbul adalah gangrene. (appley: complication of fracture)
59. volkman’s ischemic = contracture dari muscle fiber karena direplace oleh jaringan fibrosis. Maka penampakan klinisnya adalah weakness of flexor muscle. (Appley: complication of fracture)
60. A. (jalan ceritanya mirip di case kita)
61. ???? (sori pisan ga nemu reffrencenya). 2 joint muscle itu otot yang origo-insersionya melewati 2 sendi, contohnya bicep brachii.. tapi jawaban kayanya mengarah ke C, karena prinsip pergerakan tulang-sendi, tergantung di mana origo-insersionya sehingga menentukan jenis aksi dari otot tersebut. (mohon dikoreksi juga)
72. D. Appley hal 193: in patient over 50 years, bone metastases seen more frequently than all primary malignant bone tumors together. The commonest source is carcinoma of the breast.
74. E . gambarannya berupa loss of trabecular pada X-ray tanpa adanya swelling dari soft tissue sekitar.

75.B. (hasil eliminasi)
(A). post menopause condition dianggap sebagai physiologic condition
(C). diagnosis pastinya adalah dengan X-Ray
(D). manage seharusnya dengan supplement, early exercise, dan Hormone replacement therapy (jika ada keterlibatan dengan hormone = pada post menopausal osteoporosis)
76. B. appley hal 81, gambar 5.5 clinical feature.
77. B. Appley hal 684
80. B. Case review 2006 management dari snake bite
81. C Systemic sign dari snake bite:
- hypotension and shock
- neurotoksisitas: muntah2, kontraksi frontal, penglihatan kabur,nyeri kepala, paresthesis peroral, otonom hyperexcitation, penurunan kesadaran. Maka jika dihubungkan dengan option, maka jawabannya C
82. ?? soal kurang lengkap
84. D. yang menjadi provide durability barrier adalah collagen. Basal cell provide mitosis process for renewing epidermal cells
85. E. Fitzpatrick ed 6, tidak ada penjelasan mengenai pressure barrier, yang ada adalah mechanical barrier dari mechanical blunt trauma
86. ?
87. b. pertama adalah BCC, kedua squamous cell carcinoma. (lab act PA)
88.?
91. ?
92. impairment: any loss/ abnormality of psychological, physiological or anatomical structure or function
Disability : activity limitation that creates a difficulty in the performance, accomplishment, or completion of an activity in the manner or within the range that considered normal in human being.
Diliat dari definisi: A
93. D
94. B.
95. B
97. handicap : setiap cacat berupa fisik/mental, congential/acquired yang membatasi/mencegah seseorang berpartisipasi dalam kehidupan normal/ kemampuan bekerja.
Maka dari sini, menggambarkan posisi seseorang dalam kehidupan social, jawabannya A
99. B. uda jelas ya..
100 dan 101. Kurang yakin, karena ga ada sumber buku yang menjelaskan efek dari chronic edema pasca fraktur.tapi, dari analisa, akibat dari edema adalah adanya peningkatan tekanan di dalam fascia sehingga reduce blood perfusion ke otot, akibatnya proses kontraksi jadi lemah. Dengan demikian, muscle weakness + penurunan blood perfusion berakibat muscle wating.. jadi sepertinya D
103. E. joint contracture bisa berasal dari fibrosis di otot, jaringan penunjang otot, atau jaringan penunjang joint sehingga berakibat resistensi terhadap regangan pasif. Dengan demikian lebih mengarah ke jawaban E.
105.?
106. C. case review 2006 tentang Ludwigg’s angina
107. soal kurang lengkap..
108. ga tau jawabannya yang mana, tapi saya dapet faktor2nya:
- poor hygiene
- systemic disease
- trauma
- DM
109. B. dari Labman PA tentang ameloblastoma
110. E.
111. E. gambaran lesinya sesuai dengan penyebaran radix
113. B. karena ada impaired pain sensation dari umbilical ke bawah (T10)
114. B. dibuktikan adanya sensory loss di C5-T1 dan absent tendon2 reflex yang berasal dari sumber yang sama (motoric B.plexus)
116. C. (catatatn kuliah), anthropologist memiliki kemampuan mengidentifikasi bone dan skeletal remains sehingga menyediakan informasi mengenai sex, race, age, dan waktu kematian
117.D, jika istrinya A: IA IA atau IA IO dan suaminya: seperti istrinya atau IB IB atau IB IO
118. B ada di buku mini lecture
120. C. ada di buku mini lecture
122. E. Visum et repertum, melakukan pemeriksaan fisik yang berkenaan dengan kekerasan fisik, kejahatan susila,jenazah, dan psikiatrik. Dasar hukumnya adalah KUHAP pasal 186 dan 187c
123. ga ada jawabannya.
(A). jikaterjadi advance lesion berupa ulceration bisa terjadi extensive local tissue destruction
(B) lebih sering di male
(C) dan (D) Sensitve radiotherapy dengan prognosis yang baik, tp memiliki resiko kerusakan cosmetic dalam waktu 15 tahun ke depan (khususnya pada non elderly people)
126??
127. B. Hasil dari kultur corneal scrapping merevealed positif terbanyak = pseudomonas aureginosa  gram negative
129. C. di Bunga rampai parasitology, CLM ini masuk ke dalam larva nematode.
132. Geographical epidemiology of CLM ?
D. Most common occur in USA
Demographic Distribution of CLM
Endemic in deprived communities. Tropical and subtropical areas, especially southeastern United States, Caribbean, Africa, Central/South America, Southeast Asia. (Fitzpatrick)
133. Gnathostoma spinigerum ?
A. Cause cutaneous larva migrans only
Visceral larva migrans characterized by persistent hypereosinophilia, hepatomegaly, and frequently pneumonitis (Loeffler's syndrome). Caused by Toxocara canis, T. cati, A. lumbricoides.(Fitzpatrick)
134. People at risk of CLM ?
D. Plumber
Activities and occupations that pose risk include contact with sand/soil contaminated with animal feces: playing in sandbox, walking barefoot or sitting on beach, working in crawl spaces under houses, gardeners and plumbers, farmers, electricians, carpenters, pest exterminators. (Fitzpatrick)
135. Not pathology of CLM ?
E. Larvae burrow in the subcutaneous
Third-stage larvae penetrate human skin and migrate up to several centimeters a day, usually between stratum germinativum and stratum corneum. Parasite induces localized eosinophilic inflammatory reaction. Most larvae are unable to develop further or invade deeper tissues and die after days or months. (Fitzpatrick)
136. Larva found in biopsy ?
D. Taken just upper of the clinically evident tract
Part of the parasite can be seen on biopsy specimens from the advancing point of the lesion(s). (Fitzpatrick)
137. Larva’s complete life cycle ?
?
139. Not true about clinical manifestasion of CLM ?
E. Creating tunnel within subcutaneous
See no. 135.
141. Diagnostic of CLM ?
E. All true (based on clinical evidence, based on tract, larvae rarely found, larvae beyond the serpiginous tract)
142. Best prevention for CLM contamination ?
B. Avoid exposed skin with soil
Prevention of CLM
Avoid direct skin contact with fecally contaminated soil. (Fitzpatrick)
143. Reducing soil contamination by larvae causing CLM ?
C. Periodic deworming by cats and dogs
Infestation Helminth(s) Comments
Cutaneous larva migrans Primarily Ancylostoma braziliense and A. caninum Larvae of dog/cat hookworms

144. Ineffective treatment of CLM ?
?
Topical Agents
Thiabendazole, ivermectin, albendazole are effective topically. (Fitzpatrick)
147. Strongyloides stercoralis life cycle ?
B. Skin penetration-lungs-adult in intestine-egg-rhabditiform+filariform-autoinfection, direct infection, and indirect in external environment. (Pediatric Nelson)
148. Children who are more likely to get CLM ?
C. Contact with contaminated soil
149. Pleomorphic adenoma ?
?
150. Not included to the feature of osteosarcoma ?
?
152. Retina is originated from ?
D. Optic vesicles
As the lens vesicles are developing, the optic vesicles invaginate to form double-walled optic cups. The retina develops from the walls of the optic cup, an outgrowth of the forebrain. (Embryology Moore)
153. A 5 month old baby boy has 4 fingers in one of his hands; 2 of the fingers are fused. During the development of foot and hand, fingers are formed when cell death in the apical ectoderm ridge separates into 5 parts. Baby’s abnormality is called ?
D. Syndactyly
Cutaneous syndactyly results from failure of the webs to degenerate between two or more digits. (Embryology Moore)
154. Development of the ear begin with ?
C. Meatal plug
156. During development of face, secondary palate is formed by outgrowth from ?
C. Maxillary prominence
The secondary palate begins to develop early in the sixth week from 2 mesenchymal projections that extend from the internal aspects of the maxillary prominences. (Embryology Moore)
157. During development of tibial endochondral bone. Which cells begin to form the cartilaginous model ?
A. Chondroblast
158. During development of vertebrae, cells of the sclerotome surrounds the spinal cord and notochord, the notochord regress to form ?
C. Nucleus pulposus
Between the vertebrae, the notochord expands to form the gelatinous center of the invertebral disc – the nucleus pulposus. (Embryology Moore)
159. Physical abnormalities is asymmetry of back and chest. Radiographic examination, successive vertebrae found asymmetry and one vertebrae is missing.
A. Scoliosis
Scoliosis; a hemivertebrae results from failure of one of the chondrification centers to appear & subsequent failure of half of the vertebrae to form. (Embryology Moore)
160. In osteomyelitic, the radiographical features of sequestrum ?
?
162. Main features of osteomyelitis in long bones is ?
A. Usually derives from metaphysis
Apley page 29
163. What is the possible diagnosis of lesion of epiphyseal with soap bubble appearance ?
D. Giant cell tumor
Apley page 181
164. The most possible diagnosis for infiltration of osteolytic… in play X-ray photo of skull ?
?
165. In metastase of malignancy to columnar vertebralis. The predilection area would be ?
?
166. Radiological features of Colle’s fracture ?
A. Fracture at distal radius with post angulation and radial dislocation
Apley page 616
169. Specific radiologic signs of maxillary sinusitis ?
?
171. Radiological appearance of osteoporosis ?
A. Thin bone cortex, thin trabeculae, diminished in number
172. Radiologic appearance of chronic abscess which is surrounded by marked sclerosis is known as ?
B. Brodie’s abscess
Apley page 32
175. Sunray or sunburst appearance of periosteal reaction is found in ?
C. Osteogenic sarcoma (or osteosarcoma)
Apley page 185
177. The primary quasi malignant bone tumor is ?
C. Osteosarcoma
Apley page 185
178. Radiological features of spondylitis TB ?
B. Paravertebral abscess
Apley page 44
180. If we saw that the patient had oral cancer T2 N2 it means that ?
?
181. Which part of the cell cycle that the tumor is most radioresistant ?
A. G0
185. Most frequent cranial nerve damage that happens in patients of nasopharynx carcinoma ?
D. VI
The most common deficits are ophthalmoplegia (CN VI), ptosis (CN III), and pain and anesthesia of the supraorbital and superior maxillary regions (CN V1 followed by CN V2). (Pubmed)
186. In nasopharynx carcinoma, intracranial infiltration/extension most frequently through ?
D. Foramen lacerum
Cavernous sinus invasion occurs because the tumor tracks through the foramen lacerum, which often leads to multiple CN deficits. (Pubmed)
187. To differentiate medullary thyroid carcinoma and other thyroid carcinoma, we use ?
A. Calcitonin
Calcitonin is the principal biochemical marker in MTC; it is used for detection, staging, postoperative management, and prognosis. (emedicine)
189. A 56 years old man came to ENT clinic, has hoarseness for 6 months with dyspnea. On physical examination it’s found that one of his vocal cord have tumor with immobility. Neck node size… , no other enlargement. What ‘T’ does the patient have ?
?
192. A lady is diagnosed to have tumor. Ther’s a swelling … you detected a lymph node enlargement at mid jugular. No other lymph node enlargement on other area is detected. What is the location of the lymph node enlargement at the neck ? which level ?
?
193. During development of hand and foot, the mesenchyme between prospective digits in the hand and foot plates will break down. If mesenchyme fails to break down, result in abnormality called ?
C. Syndactyly
Abnormal fusion is usually restricted to the fingers or toes (syndactyly). Normally mesenchyme between prospective digits in the handplates and footplates breaks down. (Langman’s Embryology page 191)
197. Etiological agent for opthalmia neonatorum ?
C. Neisseria gonorrhoeae
Opthalmia neonatorum due to N. gonorrhoeae usually appears from 1-4 days after birth. (Nelson Pediatrics)
198. In wound healing, increase collagen synthesis and proliferation of blood vessels occur in …
A. Fibroplasias phase
B. Remodeling phase
C. Inflammatory phase
D. Coagulation phase
E. Bag phase
Jawaban : (?)  A/B.
Pembahasan :
Collagen synthesis  fibroplasia phase
Proliferation of blood vessels / angiogenesis  remodelling phase

199. A burn patient …
A. No hospitalization required
B. Fluid resuscitation
C. Urinary catheter
D. Skin grafting
Jawaban : B.
Pembahasan :
Treatment utama untuk burn patient secara general  fluid resuscitation