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Soal Blok 14

1. Berikut ini yang menghasilkan sitokin : a. limfosit b. granulosit c. d. semua diatas benar 2. Pernicious anemia adalah gangguan autoimun karena. 3. The possibilities causes anemia megaloblastic : c. Deficiency of folic acid & cyanocobalamin 4. During the treatment, the patients should be informed about the side effects of oral iron preparation which may happen during the treatment. Adverse effect of oral iron preparation include . a. abdominal cramps b. constipation, darken of feces c. headache, insomnia d. gastric ulcer 5. Parenteral Fe therapy should be reserved for patient with Fe deficiency who are unable to tolerate or absorb oral Fe, or for patients with extensive chronic blood loss who can not be maintained with oral Fe alone. On harmful adverse reaction that may occur at the administration of parenteral Fe preparation, especially with iron dextran is . a. venophlebitis b. anaphylactic reactions c. headache d. feeling pain at the side of 6. Kriteria diagnosis untuk severe aplastic anemia : b. jumlah sel sumsum tulang <25%, neutrofil absolut <0,5.109 dan trombosit < 20.000 7. Older HIV (+) patient predominantly suffers from one of the following sub types of Hodgkin Lymphoma: a. HL, nodular sclerosis b. HL, lymphocyte deplet c. HL, lymphocyte rich d. HL, mixed cellularity 8. Precursor dari heme : a. glycine & succinate b. glycine & sucsinil CoA c. Valine & sucsinil CoA d. Lysine & sucsinil CoA 9. The pathogenic agent in Filariasis are :

a. the microfilariae b. the adult worms of W.B c. both of the adult W.O d. the adult worms of loa loa 10. Megakariosit pada kehamilan bulan a. 2 b. 3 c. 4 d. 5 11. Platelet disorders characteristically : a. echymosis b. bleeding from mucosal surface c. some disorder recurrent (hemarthrosis) d. hematoma 12. Kadar Hb minimal bayi baru lahir : a. 17 b. 16 c. 12 d. 13 13. Kadar Hb maksimal bayi baru lahir : a. 17 b. 16 c. 12 d. 21 14. Follicular lymphoma has one of the following features : a. hallmark translokasi chromosom 14 into 18 b. more on male than female c. centroblast mayor cell d. aggressive disease 15. The reason of failure to respond to treatment with oral iron preparation include : a. chronic disease b. malabsorbtion c. severe blood loss/ poor compliance to the medication 16. Which of the following option should be chosen to coagulation disorder : a. PRC b. frozen fresh plasma c. whole blood d. trombosit 17. Pada evaluasi sediaan sumsum tulang yang diperhatikan :

a. cellularity b. M:E ratio c. semua seri eritrosit, leukosit, dll d. semua di atas 18. Pada usia kehamilan 4 bulan sel darah dibentuk terutama di organ : a. sumsum tulang b. hepar c. kel. Limfe d. lien 19. Metrotrexate menyebabkan anemia : . 20. Reaksi yang paling sering ketika transfusi : 21. Pembentukan sel-sel darah primitif pada janin berlangsung sampai usia kehamilan bln a. 1 b. 2 c. 3 d. 4 22. Nodular schlerosis type HL has 1 charactere below : a. fibrosis abundant with pleomorfik cells as small limfosit, eosinofil, neutrofil, and plasma cell b. the less common c. associated with EBV d. prognosis is worst 23. Vector B.Bruncroffi: a. culex b.aedes c. anopheles, culex, aedes d. mansonia 24. Criteria mayor multipel mieloma : a. bone marrow plasma sel 10- 30% b. little bone lesion c. IgM < 50 , IgA < 100, IgG < 600 mg/dl d. bone marrow plasma sel > 30% 25. A patient came to doctors clinic complained of having enlarged lymph node in the cervical Region. You will get one of the following bellow : a. Follicular hyperplasia b. Lymphoid follicles prominent with debris containing macrophages c. Sinus hystocytes d. Marginal zone B cell hyperplasia

26. Wanita 15 tahun mengeluh lemah dan sakit kepala (Riwayat Vegan), MCV 102, MCH 38, MCHC 40, BP 110/80 mmHg. Tipe anemia : 27. Yang bukan termasuk MPD: a. Essensial trombositosis b. Myelofibrosis c. LGK d. MDS 28. Approximately 65% total body Fe in human circulate in the blood as Hb. The remainder is present in the liver, spleen, bone marrow, mioglobin, & cytochrome & various enzyme. Storage Fe that is available for fresh Hb synthesis is present in the : a. liver, spleen, & bone marrow b. myoglobin, cytochrome c. enzyme, bone marrow d. bone marrow, liver 29. Pemberian anti hemofilia factor poada pnderita hemofilia berat idealnya: a. setiap terjadi luka b. bila hemarthrosis c. bila ekstraksi gigi susu d. setiap hari seumur hidup 30. Eritrosit pada janin paling besar ditemukan : a. primitive erythrocyte b. erythroblast basophil c. erythroblast acidophil d. eritrosit bentuk dewasa 31. Burkit lymphoma is atypical lymphoma occurs in children on young adults with characteristic : 32. A 60 years old male patient suffered from lymphadenopathy, with night sweats & weight loss, pathological findings revealed heterogenous cellular infiltrate includes lymphocytes, plasma cells, eosinophills admixed with neoplastic cells which have effaced the nodal structure. What is your diagnosis ? a. HL, lymphocyte predominance type b. HL, nodular sclerosis type c. HL, mixed cellularity type d. HL, lymphocyte depleted type 33. Hb Portland pada janin mengandung rantai globin : a. Zeta dan epsilon c. Alfa dan epsilon b. Zeta dan gamma d. Alfa dan gamma 34. Hidrocele pada filariasis is associated with obstructive of the lymph nodes of :

a. superficial inguinal lymph nodes b. deep lymph nodes c. preaortic & retroperitoneal lumbal lymph nodes d. axila lymph nodes 35. Wanita 25 thn, menorragi, poor diet, & deficiency Fe anemia, ferrous sulfat given : a. several days b. several week c. several month d. several year 36. Transfusi RBC, disadvantage: a. no anticoagulan b. decrease alergic reaction c. infection d. reduce autoimun 37. Interferon gamma dapat diproduksi oleh : a. sel leukosit b. sel limfosit c. sel yang diinfeksi virus d. semua benar 38. Lead poisoning inhibit enzime in the formation : a. ALA sintesa b. propoporphirinogen c. ALA reductase d. Ferochelatase 39. Sirkumsisi pada penderita hemofilia butuh dirawat selama hari 40. Pada evaluasi sediaan hapus gambaran darah tepi dilihat : a. eritrosit b. leukosit c. trombosit dan lain lain d. semua yang disebut diatas 41. Tropical pulmonary eusinofilia: a. tidak ada mikrofilariae di darah tepi b. banyak mikrofilariae di darah tepi c. chest X-Ray similar to loeffloer syndrome d. no respons to D.E.C 42. The infective stage of the larva microfilaria is a. 1st stage larva b. 2nd stage larva

c. 3rd stage larva d. 4th stage larva 43. Sel darah yang terakhir dibentuk oleh janin didalam kandungan adalah a. eritrosit b. granulosit c. limfosit d. monosit 44. A female should have to concerned with eritroblastosis fetalis: a. Ob. AB + c. B + d. O + 45. The most clinical presenting sign of CLL are: a. symetrical enlargement of superficial lymph nodes b. anemia c. hepatomegali dan splenomegali d. trombocytopenia 46. When microfilariae shows nocturnal periodicity the blood for the detection of microfilariae should be collected at : a. during day time b. between 10 p.m to 2 a.m c. all day and night d. only at 12 p.m 47. Subakut (etiologi) DIC : a. Obstetri komplikasi b. Malignancy c. Sepsis d. Acute hemolisis 48. Pembentukan sel-sel darah pada kel.limfe pada janin mulai terjadi pada usia kehamilan bulan. a. 2 b. 3 c. 4 d. 9 49. Vektor dari B.Malayi : a. culex b. aedes c. anopheles d. mansoni & anopheles

50. Primary (hereditary) thrombophilia : a. prolonged immobilisasi of the patient b. estrogen therapy c. myeloproliferatif disorders d. deficiency of protein S and C 51. In treating anemia : a. oral Fe if often poorly absorbed by iron deficient anemic patient b. anemia should always be treated in the first instance by blood tranfsfusion c. EPO is deficient in chronic renal disease d. Folat deficiency may occur because of GI bleeding 52. The doctors should be continuosly given the whole blood to these circumstances, except : a. renal disease b. post partum hemmorage c. decreased cardial reserve d. oedema anasarca 53. If new born was blood type of which followed his blood contain : a. anti B antibodi b. anti A antibodi c. anti Rh antibodi d. eritrosit which express neither A nor B antigen 54. The lymphadenetis of filariasis : a. pitting edema b. non pitting c. pitting & non pitting d. temporary edema 55. Hodgkin lymphomas have one of following characteristic : a. are unusual tumor of T cell origin b. spread in a unpredictable fashion c. pop corn cell is also L-H cell & R-S cell must be present in a background of non specific inflammatory cell d.the spread first involves marrow, then spleen & finally the nodes. 56. Alpha globin cluster : a. chromosom 11 b. ,, 22 c. ,, 16 d. ,, 10 57. Kekurangan asam folat karna peningkatan kebutuhan. Terjadi pada : a. pregnancy

b. peptic ulcer c. DM d. hipotensi 58. Untuk menghindari penyakit menular pada transfusi darah harus memenuhi kriteria : a. 5 tahun setelah hepatitis b. 5 bulan setelah sifilis c. 5 minggu serangan malaria d. 5 hari setelah transfusi sebelumnya 59. Satu unit Friopresipitan mengandung f.vili sebanyak % a. 50 b. 60 c. 70 d. 80 60. Hb gower 2 pada janin, terdiri dari rantai globin : a. alpha & delta b. alpha & gamma c. alpha & delta d. alpha & epsilon 61. Yang meningkat pada anemia deficiency Fe : (transferin) 62. Penurunan respon pada bone marrow : gangguan endokrin

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