Final respi 2009 9 - Januari 2012

1. For questions number 1 to 2, refer to scenario below:

A 17 year old man was biught to the emergency department due to sports injury. He was guarding the
goalpost when suddenly the ball was kicked right in his face’s direction and he couldn’t avoid it. His
nose was bleeding profusely, and bent. After the doctor performed maneuver to his nose, the shape
returned to normal.
Which of the following structure most likely cause the difference in his nose shape?
a. The septal cartilage
b. The alar cartilages
c. The cribiform plate
d. The vomer bone
e. The nasal bone

2. Which of the following artery most likely cause the bleeding?

a. Ophthalmic artery
b. Internal carotid artery
c. Anterior ethmoidal artery
d. Sphenoethmoidal artery
e. Facial artery

3. What structure anterior tampon filled to stop bleeding?

a. Middle meatus
b. Common meatus
c. Inferior meatus
d. Posterior choanae
e. Sphenoethmoid recess

4. Wanita 45 th datang dengan keluhan sneezing dan runny nose sejak pagi. Struktur manakah yang
bertanggungjawab untuk sensory innervasi pada pasien ini?
a. Olfactory nerve
b. Anterior dan posterior ethmoidal nerve
c. Vestibulocochlear nerve
d. Infratochlear nerve
e. Sphenoethmoidal nerve

5. 37 old brought to ER because of rapid and breathing difficulty. His family brought him to the hospital
after he fell from 5m pole in independent day. X-ray : collapsed right lung
From the following which sentence is the most appropriate ?
a. Right lung has 3 lobes and 10 segment
b. Right lung only have oblique fissure
c. Right lung have cardiac notch
d. Right lung only have horizontal fissure
e. Right lung only have 2 lobes and 10 segment

6. A middle aged man found in the road form traffic accident. His right clavicle was fractured. Which
part of the lung should be concerned?
a. Lower lobe of left lung
b. Upper lobe of left lung
c. Upper lobe of right lung
d. Middle lobe of right lung
e. Lower lobe of the right lung

7. On cadaver dissection, you found intersection muscle in the anterior part of thorax. The muscle
attached from lower end of one ribs to upper part of ribs below it. Muscle apakah itu?
a. Innermost intercostals muscle
b. Internal intercostals muscle
c. Anterior intercostals muscle
d. External intercostals muscle (inspirasi)
e. Serratus posterior

8. A 49 yo man complained of having constant hiccups for 2 day. He tried everything to stop them, but it
wouldn’t stop. What a innervations of the responsible structure for the case above?
a. Vagus nerve
 b. Left and right recurrent laryngeal nerve
c. Intercostals nerve
d. Splanchnic nerve
e. Phrenic nerve

9. Bagian roof dari nasopharynx?

a. Body of sphenoid
b. Base of frontal
c. Mastoid part of temporal
d. Vomer
e. Perpendicular plate of ethmoid

10. A 42 years old woman came to emergency because of chocking after swallowing a big ball of rice. She
was eating fried fish when she felt a prickly sensation in her throat. Where would fish bone most
likely stuck?
a. The pharyngoepiglotic fold
b. The interarytenoid notch
c. The retropharyngeal space
d. The laryngeal inlet
e. The piriform recess
Ans : E. the piriform recess

11. Regarding the skeleton of larynx, WOTF statement is most suitable?

A. Thyroid cartillage lies superior to cricoid cartilage. Thyroid cartilage has laryngeal prominence at
lateral right below its greater horn.
B. Cricoid cartilage connected with epiglotis cartilage through thyrohyoid membrane
C. Epiglotic cartilage forms the laryngeal inlet, lies superoposteriorly from thyroid cartilage
D. Paired arytenoid cartilago lies lateral and inferior to the thyroid cartilage
E. Hyoid bone lies superior to all the laryngeal cartilage right at upper part of cricoid cartilage

12. Structure below form laryngeal inlet:

A. Cricoid cartilage
B. Triticeal cartilage
C. Thyroid cartilage
D. Corniculate cartilage
E. Hyoid bone

13. A 26 y.o man came to the clinic with chief complaint hoarse voice. This man is a vocalist of a rock
band that had performance in two consecutive days. In what mechanism which sound likely
produced?
A. a wide-opened rima glottidis passed through when expiration
B. Apposition of vocal cord when expiration
C. Apposition of vocal cord when inspiration
D. Extension of vestibular folds during expiration
E. The widening of laryngeal vestibule during inspiration

14. . A 25 yo woman complaining of losing her voice after she had surgery that removed her thyroid
gland. What stucture is must likely affected in the surgery and cause the above symptom
A. Recurent laryngeal nerve
B. Vagus nerve
C. Inferior vagal ganglion
D. Superior laryngeal nerve
E. Glossopharyngeal nerve

15. Wotf sentence regarding the windpip (trachea)?

A. Extends from the base of pharyx into the posterior mediastinum
B. Has ring cartilage to keep its lumen open.
C. Innervated by the branch of CN xi
D. Started at level C6 to Tg IV disk
E. Lies posterior to esophagus
16. 7 years old come to the outpatient clinic due to earache and decrease hearing since 2 days before. His
parents says he had prior to earcharce, greenish nasal discharge for 2 weeks and was unable to
relieve symptoms by over the counter medicines. First change ...
A. long limb of incus
B. body of stapes
C. ...of stapes
D. lenticular process of incus
E. handle of malleus

17. 30 y.o female had complaints of uncomfortable feeling in the ear and decrease hearing after her plane
landed.
What structure is responsible to relieve the complaint above?
A. The tensor veli palatini muscle that pulls the opening of pharyngotympanic tube in middle ear
B. The levator veli palatini muscle that pulls the opening of pharyngotympanic tube in middle ear
C. The tensor veli palatini muscle that pulls the opening of pharyngotympanic tube in nasopharynx
D. The levator veli palatini muscle that pulls the opening of pharyngotympanic tube in nasopharynx
E. The tensor tympanic muscle that pulls the opening of pharyngotympanic tube in middle ear
18. 24 years old medical student diagnosed having sinusitis and ask his physician why he experienced a
nasal drainage during the night but not the day. What's your explaination?
A. Disruption drainage due to mastication
B. Location ostia within nasal passage
C. Diurnal mucus production increases at night
D. Location ostia within eustachian tube
E. Sinus most likely affected is maxillary sinus

19. 22 yo woman, possibly sinusitis. Terdapat purulent discharge di middle nasal meatus. Sinus likely to
be affected?
A. posterior sphenoid sinus
B. lacrimal duct
C. frontal duct
D. sphenoid sinus
E. posterior ethmoid sinus

20. 42 y.o woman had accident trauma to orbital structure (extraocular muscle)maybe push inferior into
sinus:
A. Frontal
B. Maxilla
C. Sphenoid
D. Ethmoid
E. Sphenoethmoid

21. 18 y.o boy having sinusitis. Translucent (+). Sinus mana yang bisa diperiksa dengan teknik
transillumination?
A. Maxillary & ethmoidal
B. Anterior ethmoidal & frontal
C. Frontal & sphenoidal
D. Maxillary & frontal
E. Sphenoidal & maxillary

22. Post-tonsillectomy. Lost of taste sensation at posterior one-third of tongue. Inervasinya?

A. CN IX
B. Pterygopalatine nerve
C. Great-palatine nerve
D. CN V
E. CN X

23. During a procedure to remove a palatine tonsil, the operating field was suddenly filled with bright
red blood.
Which artery was inadvertently damaged?
A. Tonsillar branch of facial artery
B. Ascending pharyngeal artery
C. Ascending palatine artery
D. Descending palatine artery
 E. Superior laryngeal artery

24. Cowo, menghirup kacang. Dilakukan bronchoscopy, objek ada di?

A. Left lower lobar bronchus
B. Left main bronchus
C. Left superior segmental bronchus
D. Right lober lobar bronchus
E. Right superior segmental bronchus

25. 55 y.o man smoker has an acute onset of shortness of breath and severe chest pain with breathing.
Physical exam shows COPD with barrel chest, decreased breathing sound, hyperresonance on
percussion at left lung. What is the most likely diagnosis?
A. AMI
B. Angina pectoris
C. Pneumothorax
D. Empysema
E. Pleural effusion

26. Pkoknya tadi ada pasien ibu-ibu 65 tahun, di lobectomy terus hoarseness, yang kena nerve apa.
Pilihannya lupa =p
27. Thoracosentesis, you decide to insert the aspiration needle over the top of the rib into n intercostal
space inferior to the lower border of the lung in the midaxillary line at the end of normal expiration.
What of the following is the higest level at which procedure might safely done?
A. 4th ICS
B. 5th ICS
C. 6th ICS
D. 7thICS
E. 8thICS

28. Orang 26 tahuun melakukan exercise stress test. Apa yang terjadi di skeletal musclenya?
A. Decrease capillary hidrostatic pressure
B. Decrease metabolite concentration
C. Increase arteriolar diameter
D. Increase oxygen concentration
E. Vascular resistance

29. Nausea, Vomit gastroentritis. 3 hari kemudian light-blindness ketika duduk atau berdiri. Hasil BGA
nya ? metabolik alkalosis

30.
In the diagram shown, point X indicates the acid base status of healthy person. Which of the following
is the most likely cause of the condition indicated by point Y?
a. Adaptation to high altitude
b. Chronic obstructive pulmonary disease (COPD)
c. Diarrhea
d. Ingestion of strong acid
e. Severe prolonged vomiting

31. The unlabeled solid curve in the graph shown represents the loading behavior of normal human
hemoglobin at a pH of 7.35 as a function of oxygen concentration.
 Which of the following labeled curves best represents the most likely change after addition of
carbon dioxide? B

32. Laki-laki 60 tahun, datang dengan keluhan shortness of breath. Riwayat hipertensi selama 25 tahun,
diobati dengan diuretic.
RR 19x/menit, HCO3 turun. Abnormalitas yang terjadi:
A. Respiratory alkalosis
B. Respiratory acidosis
C. Metabolic acidosis
D. Metabolic alkalosis
E. No abnormalities

33. After release O2 to tissue, Hb will transport …

A. CO2 + proton into lung
B. O2 into lung
C. CO2 + proton into tissue
D. O2 into tissue
E. O2 + proton into lung

34. Kurva disosiasi

oksihemoglobin, kalo increase 2,3 biphosphoglycerate kurvanya bergeser ke mana?
 a. Displacement of the oxyhemoglobin dissociation curve to the left
b. No change in oxyhemoglobin dissociation curve
c. Displacement of the oxyhemoglobin dissociation curve to the right
d. Dissociation curve is not valid for 2,3 biphospoglycerate
e. Increase affinity for oxygen

35. 75 yo man ada peningkatan SOB selama 2 minggu terakhir, ada 25 tahun sejarah hipertensi terkontrol
dengan diuretic, 2 months ago serum urea nitrogen and creatinin were within references ranges. PR 98,
RR 19, BP 180/100. Lung dull percussion at base and crackles 1/3 way up bilaterally. JVP increase, S3
gallop, no murmur, and +3 pitting edema lower limb. Lab : Na 126, K 5,4, Cl 108, HCO3 16, urea
nitrogen 75, creatinin 3, Hb 12. Correct statement main fisiological buffer in case above?
A. Hb
B. Creatinin
C. Urea bitrogen
D. Bicarbonate
E. Chloride

36. Large quantities of carboxyhemoglobin hinder oxygen delivery substance related?

A. CO2
B. CO
C. HCO3-
D. HCN
E. Cl-

37. Buffering agent di asam basa tubuh adalah extracellular bicarbonate. Kalo kekurangan zat itu apa yang
terjadi?
A. Metabolic acidosis
B. Respiratory alkalosis
C. Metabolic alkalosis
D. Respiratory acidosis

38. The abnormality of blood pH is dangerous because mostly they will change the function of which
biomolecules
A. Lipid
B. Protein
C. Amino acid
D. Nucleic acid
E. Carbohydrate

39. Can severe asthma attack change blood pH ?

a. No, because asthma attack would not influence the function as a pH regulator organ
b. No, because the decrease of O2 blood level will decrease the oxidation processes so less CO2 are
produced
c. No, because in asthma the alveoli are still intact so gas exchanges are not disturbed
d. Yes, because the decrease of O2 blood level will lead to anaerobic metabolism causing higher level
of blood lactic acid
e. Yes, because less CO2 could be excreted by the lung causing higher level of blood carbonic acid

40. Long time hyperventilation akibat panic attack menyebabkan perubahan pH apa?
A. Respiratory acidosis
B. Respiratory alkalosis
C. Metabolic acidosis
D. Metabolic alkalosis
E. Tidak berubah

41. The ability of lung to act as pH regulator organ is because it can:

a. Produce CO2
b. Excrete CO2
c. Absorp O2
d. Produce H-
e. Excrete H-
 42. 2 y.o boy didiagnosis pneumonia. Kultur: + Streptococcus pneumoniae. Alergi terhadap Penicillin
dan Cephalosporin. Antibiotik yang tepat?
a. Azithromycin; the most effective antibiotic against streptococci that can penetrate into most tissue
b. Amoxicillin + clavulanate; it is a broad spectrum antibiotic that can prevents activity of bacterial
betalactamase
c. Clarithromycin; it is effective against gram positive organism and has different immunologic
characteristic with beta-lactam antibiotic
d. Streptomycin; it is effective against both gram + dan gram – can be given by parenteral
e. Metronidazole; it is effective against both gram + and –

43. 45 y.o rhinosinusitis, alergi penicillin, renal insufficiency. Agennya resisten gentamycin tapi
susceptible terhadap penicillin dan macrolide. Resepnya eritromycin dan pseudoephedrine untuk 3
hari

44. kalau dokter ngasih erythromycin, info apa yang dikasih ke pasien?
A. Drug should be taken with food
B. Kemungkinan progresi renal dysfunction
C. Kemungkinan alergi karena riwayat alergi penisilin
D. Kemungkinan liver toxicity
E. Resiko toksisitas karena renal insufficiency

45. If the doctor gave him (penicillin allergic patient) clarythomycin, which issued should be considered
when the doctor prescribe it?
A. The ototoxic of clarythomycin
B. Toxicity potency related to his renal failure
C. Possibility of allergic reaction related to history of penicillin allergic
D. Potency of treatment failure related to sensitivity test result
E. Other drug used that may enhanced secretion by renal
Soal untuk 46 dan 47
a 10 year old boy; 25 kg came with runny nose with whitish discharge, cough, and nasal blockage since 3 days
before. The doctor gave him pseudoephedrine, gliserilgualakolatin combination with dextramethorphan
46. What is the most appropriate reason that the combinationof dextromethorphan as cough reflex
suppression is not rationale?
a. Gliserilgualakolat reduce the viscosity of mucus
b. Gliserilgualakolat increase the transportability of mucus
c. Gliserilgualakolat stimulate surfactant secretion
d. Gliserilgualakolat increase the tenacity of secretions by increasing adhesivity
e. Gliserilgualakolat increase airway mucus secretion by hidrating

47. Role of pseudoephedrine in rhinitis?

A. Menurunkan volume mucus lewat reseptor alfa-1
B. Mengubah permeabilitas vaskuler lewat histamine
C. Menurunkan produksi mucus lewat parasimpatetik
D. Intervensi produksi mucus lewat reseptor alfa-2
E. Lewat simpatetik membuat bronkokonstriksi

48. Seorang ibu yang baru melahirkan bayinya. Ibunya diobati OAT tapi menghentukan pengobatan karena
hamil. Appropriate planning for mother?
A. Lanjutkan pengobatan, stop menyusui
B. Lanjutkan menyusui dan beri pengobatan baru (kategori 2)
C. Stop menyusui dan beri pengobatan baru
D. Lanjutkan menyusui dan beri 5HRE
 E. Stop menyusui, beri 5HRE

49. Woman, 25 yo, diagnosed lung TB few months before her pregnancy. She had 1 month of continuation
phase therapy using R & H before she stopped her treatment by herself, because afraid it may harm her
fetus. 1 week before she delivered a helath baby, BP, T, RR and HR increased. Lymphadenopathy of
deep cervical, ronchi on apex chest. What most appropriate planning for mother?
A. Start new regiment: 2HRZES/ HRZE/ 5 (HRE)3
B. Continue her last regiment until full 6 months
C. Give rest continual phase, then change it with category II regiment
D. Start new regiment: 2 HRZES/ HRZE/ 5(HRE)3
E. Start with 5 (HRE)3

50. Ibu hamil, dulunya suspect TB, berhenti pengobatannya karena takut mengganggu kondisi bayi. Jika
pasien mengalami renal insufficiency dan tidak mengubah dosis regimen, symptom apa yang bisa
terjadi?
A. Isoniazid jadi nephropathy
B. Streptomycin jadi hyperuricemia
C. Rifampin jadi hepatotoxic
D. Ethambutol jadi retrobulbar neuritis
E. Akumulasi pyrazinamide jadi peripheral neuropathy

51. 53 yo extra pulmo TB, taking kategori II regimen anti TB with B6, normal liver, but starting visual
disturbance. WOTF of the appropiate statement related to his visual disturbances?
A. Pyrazinamide and consult to opthalmologist
B. Pyrazinamide with suplement B6
C. Check AST/ALT
D. Reduce streptomycin dose
E. Stop ethambutol

52. Which is the most correct prescription for this patient?

53. What is the role of vitamin B6 in this patient?

A. Prevent the gouty attack
B. Prevent the peripheral neuropathy
C. Prevent the drug induces neuropathy
D. Reduce abdominal upset because of INH dan R
E. Protect eyes from toxicity

54. 45 yo admnistrated ART, recently diagnosed TB.

A. 2HRZE/4HR, STOP ART
B. 2HRZE/4H3R3, STOP ART
C. 2HRZES/HRZE/4H3R3, CONTINUE ART
D. 2HRZE/4HR, CONTINUE ART
E. 2HRZE/4H3R3, CONTINUE ART

For questions number 55 to 58, refer to scenario and options below:

A 64 year old man came to the clinic complained prolong cough, night sweat, body weakness, loss of apetite
and mild fever since three month ago. After taking history, physical examination and preliminary investigation,
he was diagnosed with pulmonary and cervical lymph node TB. He also had history of after default therapy of
tuberculosis. He got fivedrug regiment consisting INH, rifampisin, pyrazinamide, acid ethambutol, and
streptomycin.

a. INH
b. Rifampisin
c. Pyrazinamide
d. Ethambutol
e. Streptomycin

55. inhaled Obat TB yang pemakaiannya dibarengi dengan pemberian pyrodoxine? A. Isoniazide
56. Obat TB apa yang menghambat sintesis yang mengikat subunit RNA polimerase? B. Rimfampisin
57. The drug inhibit he meabolic of phenitoin? A. Isoniazide
58. OAT with poor bioavailability? E. Streptomycin

Untuk no 59-63 :
A 10 year old girl with history childhood asthma complained cough, dyspnea, and wheezing. Her sympyoms
became severe that her parent brought her to the emergency room. Physical examination revealed
diaphoresis, dyspnea, tachycardia, and tachypnea. Her respiratory rate was 40x/min, pulse rate was 112 beat
per minute, and blood pressure was 130/60 mmHg.

a. Inhaled albuterol
b. Inhaled cromolyn
c. Oral or IV metilprednisone
d. Inhaled ipratomium
e. IV propanolol

59. What is the most effectively drug to reverse bronchoconstriction? A. Inhaled albuterol (SABA)
60. The drug most likely to provide sustained resolution of patient’s syndrome? C. Oral/IV
metilprednisone
61. Yang kontraindikasi buat pasien diatas? E. IV propanolol
62. Yang menyebabkan side effect muscle tremor, tachycardia dan cough? A. albuterol

63. Factor that should be consider to calculate the actual energy need for COPD patient ...
a.Stress level add to total energy required
b. BEE
c. Normal physical activity
d. Lupa
e.Balance protein requirement

64. Decreased food intake is common in each person with COPD but actually energy needs may be
increase or decreased. It is crucial to remember that energy balance.
A. Normal stress level add to total energy need
B. BEE
C. Normal physical activity
D. Give more simple carbohydrates composition
E. Balance Ratio Protein

65. The situation appears related to pulmonary complications such as the degree of airflow obstruction,
thus increasing the energy needs resulting from the increased work of breathing, gas difussing capacity,
CO2 retention, respiratory inflammation and biochemical mediators such as hormones and cytokines affect
energy expenditure.
The incorrect condition about metabolic disorders in pulmonary disease is:
a. Hypercatabolic
b. Hyperglycemia
c. Increase lipolysis & ketogenesis
d. Depletion of vitamin & mineral
e. Decreasing of free radicals

66. Lifestyle chnge with healthy food intake decrease risk factor exerbation COPD
These healtjy food supplement or antioxidant can improve health and decrease risk factor exacerbation
of COPD:
a. Vitamin A and ferum
b. Potassium and Biotin
c. Calcium and Vitamin E
d. Natrium and Riboflavin
e. Vitamin C and magnesium

67. Protein requirement in patient with COPD depend on degree of hypercatablic. Sufficient protein is
necessary lung and muscle strength as well as to promote immune function is …
a.<0.8 g/kg BW
b. 0.8-1.2 g/kg BW
c. 1.3-1.5 g/kg BW
d. 1.5-2 g/kg BW
e.>2 g/kg BW

68. These are dilated cavities in the frontal, maxillary, ethmoid and sphenoid bones around the nose and
eyes. Mucus produced here drains into the nasal fossa through small openings protected by the conchae.
Which of the following epithelial tissue is most likely lined the mucous layer of these dilated cavities?
a. Stratified squamous non keratinized
b. Stratified squamous keratinized
c. Pseudostratified columnar
d. Stratified columnar
e. Stratified cuboidal

69. Upper part dari pharynx adalah broad single cavity overlying the soft palate it is continuously
anteriorly with nasal fossae and inferiorly with oral part pharynx. The wall supported by bone and
skeletal muscle. Epithelial tisuue?
a. Stratified squamous non keratinized
b. Strat squamous keratinized
c. Respiratory epithelium
d. Strat columnar epithelium
e. Strat cuboidal

70. This cavity in temporal bone and has connection with auditory meatus. It is closed by thympanic
membrane and communicate with nasopharyng through Eustachian tube. Epithelial tissue? (pilihan
jawaban sama dengan no 69) simple cuuboid
a. Stratified squamous non keratinized
b. Strat squamous keratinized
c. Respiratory epithelium
d. Strat columnar epithelium
e. Strat cuboidal

71. This serous membrane has 2 layers, 1 covering the lung and the other covering internal wall of the
thoracic cavity. The narrow cavity lies between the 2 layers of serous membrane contain only a firm of
lubricating fluid. Wotf epithelial tissue is most likely lined the inner layer of these sac?
a. simple squamous
b. simple cuboidal
c. simple columnar
d. pseudostratified columnar
e. stratified columnar
72. These small air sacs form the primary structural and functional unit of the respiratory system, because
their wall permit exchange of CO2 for O2 between the air in their lumina and blood in adjacent capillaries.
Which of the following epithelial tissue is the most likely lined the inner layer of these sacs?
a. Simple squamous
b. Simple cuboidal
c. Simple columnar
d. Pseudostratified columnar
e. Transitional

73. Polio paralysis intercostals muscle. Wotf is the appropriate value?

a. Increase IRV
b. increase ERV
c. Total lung capacity not affected
d. decrease IRV
e. vital capacity las affected
74. A 45 year present with fever and cough. She has had no past medical problems and was well until
about 3 days ago. Physical examination is remarkable for a temperature of 39 oC and the presence of diffuse
rales on chest examination. Except for an elevated white count with a left-shifted differentia, her blood has
resting hypoxemia and requires hospital admission.
Which of the following is the most appropriate cough mechanism in this patient?
a. 2,5 liter air expired
b. Increase abdominal pressure
c. Increase the pressure of the alveoli
d. Afferent nerve impulse through the Vagus nerve
e. Automatic sequence triggered by fever

75. 22 m.o boy chief complaint: shortness of breath, inspection: chest show retraction of the chest wall.
Wotf event during expiration?
a. lung expands
b. diaphragm stop contraction
c. initiates by neural impulse
d. intrapleural pressure more subatmosphere
e. increaseof transpulmanary pressure

76. Mr.P, an 18 years old motorcyclist involved in a road traffic accident. He complained of pain over his
right upper chest, and breathlessness, which increased progressively. Doctor in charge at E.R has diagnoses
that patient has pneumothorax.
Which of the following statement is a correct about pleural pressure?
a. It always eventually equalizes itself with the atmpspheric pressure
b. It is negative relative to the alveolar pressure
c. It is a measure of the elastic forces in the lungs
d. It is also called the recoil pressure
e. It is the difference between the alveolar and intrapleural pressure

77. 70 y.o man, cc: shortness of breath & yellowish sputum history DM +, PE: RR 30, T 38 celcius, Bp
130/80, ronchi +/-, wheezing -/-, blood glucose 276 mg/dl, chest x-ray: infiltrate +, no history of
hospitalization. wotf describes most accurately about pecculiarities found in case above?
a. alveolar macrophage effectively combated of infection process
b. the smooth muscle on the wall constrict many smaller airways
c. the obstruction will cause air entrapment in the alveoli
d. bronchial obstruction will decrease airway resistance
e. the pathological process increases the lung difusing capacity

78. Once you were on duty in emergency room a 5 years old girl patient was taken by her parents with
chief complaint stridor since 2 days ago. Her parents also complained about sore throat, fever, difficulty on
swallowing and breathing. There was no cough and she was unable to control her own saliva and began to
drool
Result from the physical examination are:
The child sat upright in a bent-forward position. The jaw was open and drooling was frequently present.
She presented a hot potato voice, suprasternal retraction and inspiratory stridor.
Radiologic findings:
Form soft tissue radiograph : “thumb sign” appreance. Chest X-ray : within normal limit.
Related to the case above, which of the following describes most accurately about functions of the
respiratory passageways?
a. All the passageways have cartilage to keep them form collapsing
b. All of the passageways are surrounded by smooth muscles
c. In obstructive disease all of the passageways are constricted
d. The greatest amount of resistance to airflow occurs in alveoli
e. In disease conditions, the smaller bronchioles determine resistance

79. O2 saturation correlates with PO2 and O2 delivery to tissue. Factor influencing?
intinya ini yang kurva antara saturasi dan PO2. Curve is shift to the right if:
a. pH turun
b. 2,3 BPG naik
c. temperatur naik
d. CO2 naik
80. The lung function test in this patient revealed a decrease in MEV. Wotf will be the most probably
found in his lung function test?
a. FEV1 normal
b. FVC nomal
c. FEV1/FVC increase
d. FEV1 increase
e. FEV1 decrease

81. A 39 years old male underwent tracheostomy after sever head injury. For this, air thorugh the tube does
not anymore pass through the nose, so that it is not favorable in term of normal respiration. Because of
that, which of the following describes most accurately about very impotant functions of the nose.
a. Its warming effect is endowed by filtration process in the nose
b. It serves as air conditioning function of upper respiratory tract
c. Its filtration process involves turbulent precipitation by the hairs
d. The entrapped particles will be transported to the trachea
e. The nose can still filtrate the particles smaller than 1 micrometer

82. WOTF can cause increase gas exchange ?

a. Polycythemia vera
b. Physical exercise
c. hypertention
d. Emphysema
e. Increase surface area of respiratory membrane

83. Which is TRUE about respiratory regulation :

a. Dorsal respiratory center causes expiration
b. Ventral respiratory center causes inspiration (ventral = ekspirasi)
c. Dorsal respiratory center causes inspiration
d. Increase pCO2 detected by peripheral chemoreceptor
e. Increase pO2 detected by central chemoreceptor

84. What is the most powerful stimulus for breathing in healthy person ?
a. Increase O2
b. Increase CO2
c. Increase pH
d. Decrease pH

85. Hasil BGA dari seorang pasien pneumothorax usia 25 tahun :

HCO3 = 32,1(tinggi)
BE +2,8
SaO2 = 96,4%
pO2 = 97,4
pCO2 = 71,4 (tinggi)
ventilation process disturbed. WOTF breathing work is mostly possibly involved ?
a. Compliance work is increased
b. Tissue resistance work is increased
c. Airway resistance work is increased
d. Tissue resistance work is decreased
e. Airway resistance work is decreased

86. A 22 month old boy brought to the emergency room with chief complaint shortness of breath,
inspection of the chest showed retraction of the chest wall.
Which of the following muscles pulls the rib cage downward during expiration?
a. External intercostals
b. Abdominal recti
c. Sternocleidomastoideus
d. Anterior serrate
e. Sacleni

87. 70 y.o man, cc: shortness of breath & yellowish sputum history DM +, PE: RR 30, T 38 celcius, Bp
130/80, ronchi +/-, wheezing -/-, blood glucose 276 mg/dl, chest x-ray: infiltrate +, no history of
hospitalization. wotf describes most accurately about pecculiarities found in case above?
a. Alveoli are filtered with due to increased hydrostatic pressure
 b. Total surface area of respiratory membrane decreased
c. Ventilation and perfusion increased
d. CO2 pada darah turun
e. Physiologic dead space decreased

88. What disease caused by absent or insufficient surfactant in baby?

a. Respiratory distress syndrome
b. Elastin membrane disease
c. Pneumothorax
d. Congenital lung cysts
e. Lung hypoplasia

89. A male newborn infant was choking and coughing suddenly after his first feeding. These was an
excessice amount of mucus secretion and saliva in the infant’s mouth and the infant experienced
considerable difficulty in breathing. The pediatrician was unable to pass a catheter through the
esophagus into the stomach. Which of the following is the embryological basis that causes that this
anomaly?
a. Failure of recanalization of the larynx
b. Incomplete of recanalization of the larynx
c. Narrowing and obstruction the trachea
d. Abnormal partitioning of the trachea and esophagus by the tracheoesophageal septum
e. Larynx and upper trachea fail to separate completely from the esophagus during the first trimester

90. The sphlancnic mesoderm in respiration system will develop which component ?
a. Bone
b. Epithelial tissue
c. Striated smooth muscle
d. Gland
e. Connective tissue

91. A newborn infant was choking and coughing after 1st breastfeeding. There was excessive mucus
secretion and saliva in infant mouth and infant considerably difficult to breath. Pediatricians is unable
to pass catheter through the esophagus. Yg terjadi?
a. Laryngeal atresia
b. Laryngotracheoesophageal atresia
c. Atresia esophagus & trachea esophageal fistula
d. Laryngeal web
e. Tracheal atresia

92. Bayi,RDS.ttg surfactan?

a.Meningkatkan surface tension
b. Mulai diproduksi minggu ke-18
c. Diproduksi alveolar cells tipe 1
d. Minggu 24-26 sufficient amount
e.Sufficient amount: saccular stage

93. Which of the following statements is TRUE about secondary pulmonary tuberculosis lesion?
a. It is Gohn comnplex, consists of parenchymal subpleural lesion and enlarge caseous lymph nodes
b. Cavitary fibrous tuberculosis
c. Milliary tuberculosis
d. Tuberculosis bronchopneumonia
e. Pulmonary tuberculosis represent reactivation of an old (subclinical infection)

94. Newborn, chief complaint choking & coughing suddenly after breastfeeding, mucus secretion dan
saliva banyak ditemukan di mulut, dan dia susah nafas. Catheter gak bisa dimasukkin lewat esophagus
menuju lambung. Penyebab anomalinya apa?
a.Failure of recanalization of larynx
b. Incomplete recanalization of larynx
c. Narrowing n obstruction in trachea
d. Abnormal partition of trachea n esophagus by tracheoesophageal septum
e.Larynx n upper trachea failed to saperate completely from esophagus during first semester
 95. Coughing & chocking. Dokter tidak bisa memasukkan Nasogastric tube ke gastric. Kelainan
embriologi ini sering disertai oleh kelainan berupa :
a.Achondroplasia
b. Amelia
c. Anencephali
d. Cranial defect
e.Renal failure

96. Which of the following is the most likely rehabilitation of medicine for COPD patients in acute
stage?
a.Recondition
b. Upper arm exercise
c. Chest expantion exercise
d. Control breathing
e. Postural drainage

97. Approximately one week after major surgey, a patient experience some right-sided chest pain and
cough up blood. What is the mmost likely diagnosis?
a. Pulmonary embolism.
b. Atelectasis.
c. Adult respiratory disteress syndrome.
d. Right subdiaphragmatic abcess.
e.Pneumonia

98. Pengendara motor kecelakaan, RR 18x/min, BP sistolik 80 mmhg, vein neck distention, xray
menunjukkan tdk ada aliran udara ke right pulmo. Management?
a.Full primary survey
b. Right intercostal chesttube
c. Right needle thoracocentesis
d. Sedation with mida..(lupa nama obatnya)
e.Urgent craniotomy

99. 25 yo cewek accident, gcs 8, bp 90/60, rr 30, upper airway clear, jvp not distended, trache deviate to
right, breath sound absent over left chest, percussion at left chest dull. right chest normal. Diagnosis:
massive hemothorax
100. 12 y.o girl. Moderate persistent asthma, appropriate drugs
a.Terbutalline syrup
b. Inhaled glucocorticoid
c. Inhaled beta-2 agonist
d. Citrilline oral
e.Oral Theophylline

101. Girl 9 yo asthma since 6 year old. Last year her asthma exacerbate once a week, night symptoms less
than once aa week. Between exacerbation she has normal lung function. Medication:
a.Rapid acting inhaled b2 agonist
b. low dose inhaled corticosteroid
c. medium dose inhaled
d. high dose inhaled
e.medium dose inhaled + oral glucocorticoid

102. Barking cough, stridor, awakened at night, fever :

a.viral laryngitis
b. spasmodic croup
c. epiglotitis
d. viral tb

103. A 5 YO male child presented to the ER department with a history of breathlessness since 5 hours. This
symptoms associated with cold and cough which has been occuring for a week and particularly present
at night and morning times. He had been treated by GP with antibiotics and cold and cold remedies
without any improvement. During the last one year the symptoms appeared recurrently. On PE she
appeared alert, dyspneic, afebrile, chest intercostal and subcostal retraction was noted. Prolong
expiration was found. No expiratory wheeze nor crackles were heard. No abnormality was found on
other examination. Which of the following diagnosis is most likely to this patient?
 a.Moderate acute asthma attack
b. mild acute asthma attack
c. Persistent asthma
d. Frequent episodic asthma
e.Acute asthma attack

104. Brutono, 3 tahun, sudah mengidap asma sejak umur 8 bulan, tahun lalu asma ny kambuh 2x sebulan,
Night symptoms lbh dr 1 kali seminggu, menggangu tidur dan aktifitas.
obat controller apa yg diberikan?
a.LABA
b. Low dose ICS
c. Low to medium ICS + LABA
d. High dose ICS + LABA
e.High dose ICS + LABA + phenyltaline

105. The initial approach is considered to any children of all ages without symptoms illness who are known
to have had a recent TB infection?
a.INH 5mg/kg once daily until 3 months
b. 5mg 6months
c. 10mg 3months
d. 10mg 6months
e.15mg 3 months

106. Soal ttg deep neck infection, di mana kena submandibular, submental, sublingual. Diagnosisnya?
ANS : Ludwig angina
107. What's the initial step in mananging this condition?
a.Tracheostomy
b. Broad spectrum antibiotic
c. Incision and drainage
d. Surgery
e.Palliative

108. 30 yo woman, yellowish nasal secretion from both nostril since 5 month. Nasal blockage, secretion
comes down to oropharyngeal area. Rhinoscopy : secretion comes from ostium maxillary sinus,
mucosal edema, post nasal drip. Diagnostic tools to know every aspect of disease?
a.Posterior rhinoscopy and CT scan
b. Transillumination and sinus paranasal radiology projection
c. CT scan and transillumination
d. Nasal endoscopy and CT scan
e.Water's and Coldwell position radiologic
109. –
110. Pria 70 thn melakukan pemeriksaan spirometri. Hasilnya : FEV1/FVC =52%,
FEV1 = 35% predicted value. Diagnosisnya?
a.Copd stage 0
b. Copd stage I
c. Copd stage II
d. Copd stage III
e.Copd stage IV
111. Seorang pria, setelah kecelakaan, mengalami nyeri, worsening breathing, deviasi trachea, penurunan
vesicular breath sound. Diagnosis?
ANS : Tension pneumothorax

112. SABRINA MUNGGARANI

113. Result of air trapping in asthma :
a.airway obstruction during inhalation
b. increased lung compliance caused by inflammation
c. collapse bronchioles during exhalation
d. shunt ventilation upper lung field
e.increased mismatch ventilation

114. Pasien BTA (+) udah di treatment 1 bulan, pilihan regiment apa?
 115. 18 y.o man complaints : cough with sputum for 5 weeks, low grade fever, night sweats. FAB (+), lesion
at upper lung. Past history : 2 years ago undergo TB treatment for 6 month, feel better and cured.
Category for treatment?
a.new case
b. relapse
c. after default
d. treatment failure
e.transfer in
116. ARVIANA PUTRI
117. Wanita 27 tahun tiba-tiba pleuritic pain in left chest, sulit bernapas
a.mycoplasma pneumonia
b. spontaneous pneumothorax
c. pulmonary embolism
d. acute pericarditis
e.pleurodynia
118. A 66 year old man complains of breathlessness for 3 weeks. On examination, he has an area of
dullness to percussion at the left base with markedly decrease tactile fremitus. Breath sound on the l
eft area are distant at the base, but there is an area of bronchial breathing in the mid posterior chest.
What are these physical signs most compatible with?
a.pericardial effusion
b. consolidation of the left lower lobe
c. consolidation of the left lingual
d. left sided pleural effusion
e.atelectasis of the lower lobe
119. SILMINA KUSMAEHADI
120. 65 y.o man come with cough, SOB, whitish sputum for 5 years. 15 years smoking. X-ray:
hyperinflation, deflate diaphragm, no infiltrate. FEV1/FVC : 45% FEV1: 60%. Sign will not found?
a.Crackles
b. prolong expiration
c. wheezing
d. –
e.pursed lip breathing
121. Laki laki 65 tahun datang dengan acute chest pain, diaphoresis dan near syncope, T: 37, 6 C.
distended JVP, pulmonic second sound dan edema ekstremitas. Penyebab hipoksia ? Impaired arterial
diffusion of O2….. shunting …..
122. Tanda-tanda gejala mirip Pneuonia, Namun tidak ada infiltrasi dan no opacity pada X-ray.
Penyakit apa ?
123. Acis
124. 20 tahun wanita dengan keluhan SOB, palpitasi, ketakutan merasa akan mati tanpa ada sensasi lain.
Terjadi 3-4x/minggu. Diagnosisnya ?
A. MI
B. COPD
C. Asthma
D. Panic attack
E. Agrophobia

125. A 40 year old woman presents with complaints of being able to leave her house since one month ago,
she constantly worries that she will not able to get help if she has attack. In fact, she has had numerous
unprovoked episodes of intense fer, associated with shortness of breath, chest pain, diaphoresis and
dizziness that lasted 5 minutes. Which of the following is the mosy likely diagnosis?
A. generalized anxiety disorder
B. social phobia
c. Specific phobia
d. Panic disorder with agoraphobia
e. panic disoreder without agoraphobia

For questions number 126 to 128, refer to scenario below:

A 27 year old woman came to our clinic with 10 days history of nasal discharge. The discharge is yellow-
greenish, thick, blood tinged also accompanied by decreased of the smelling sensation, nasal blockage, fever,
and headache. Three days ago she felt pain and fullness on the left ear with mild hearing lost.

126. she suffered the disease because, she had the predisposing factor is:
a. Allergy
 b. virus infection
c. congenital defect
d. cold waaether
e. immunonompremise

127. in this case there is decreased of smelling sensitive cause of ?

A. infacted olfactory
B. bleedy nose
C. increase intranasal pressure
D. increase nasal discharge
E. increase intrasinus pressure
128. At this case sinus x ray we found :
a. Mass image
b. darkness
c. clear
d. cloudiness
e. no abnormality

For questions number 129 to 131, refer to scenario below:

A 15 month old boy brought by his mother with a chief complaint of respiratory distress since the last 6 hours.
Four days ago he had a common cold. His mother also complains of an audible hoarseness, inspiratory stridor,
and barking cough.

129. The etiologi of the disease is:

a. bacterial infection
b. viral infection
c. fungi infection
d. parasite infection
e, pseudoviral infection

130. The inspection of the chest we found?

A. Suprasternal retraction
B. decreased of the respiratory rate
C. Stridor
D. Barel chest
E. Bulging

131. In this case, the microorganism attacks:

A. Laryngeal vestibule
B. Laryngeal muscle
C. Laryngeal nerve
D. Blood vessels
E. Laryngeal cartilage

For questions number 132 to 133, refer to scenario below:

A 30 y.o. Man came to outpatient clinic RSHS, he came with complaint: chronic nasal congestion.
Rhinoscopy shows: gelatinous grayish white tissue with smooth and shiny surface, fill in the right and
left nasal cavity. The biopsy was performed and the microscopic appearance showed the picture below

132. What is the most appropiateTerminology for the nasal mass in this patient?
A. Chronic Rhinitis
B. Nasal polyp
C. Inverted papilloma
 D. Angiofibrosis
E. Nasal carcinoma

133. According to pathogenesis, which inflammatory cell are seen microscopically on above picture(nasal)?
A. Limfosit
B. Plasma cell
C. Neutrofil
D. Basofil
E. Eosinofil

For questions number 134 to 135, refer to scenario below:

A 23 year old male came to the hospital because of epitaxis since 2 days ago, he also complained nasal
blocked since 1 month ago. Rhinoscopy and nasopharyngoscopy revelaed a reddish ulcerative mass in the
choane and nasopharynx posterior. Biopsy of the nasal and nasopharynx was performed, macroscopic and
microscopic appearance of the mass was shown as picture below:

134. what is the most appropriate terminology describing the disease in the nasal and nasopharynx of above
patient?
A. Polyp
B. Angiofibroma
C. Papiloma
D. Carcinoma
E. Chronic inflammation

135. Cause pathogenesis?

A. Pollen
B. House mites
C. Ebv
D. HPV
E. HIV

For questions number 136-137, refer to scenario below:

A 45 y.o male come to out patient clinic because of dyspnea, fever, and productive cough since 7 days ago.
He said thar sputum was yellow green sometimes with blood streak. PE showed fever, takipnea, tachycardia
and crackles in his left chest. Macroscopic and microscopic appearance of his lung were shown as picture
below:

136. what is the disease that occur in above patient?

A. pneumonia
 b. pulmonary tb
c. emphysema
d. lung Ca
e. COPD

137. What structure are pointed by the white arrows in above case?
a. extravasated erythrocytes
b. alveoli destruction
c. datia langhans cells
d. caseous necrosis
e. tumor cells

138. Mrs. S is a 24 year old college student. She has a history of Crohns disease and is complaining of a four
daya history of bloody-watery diarrhea. A blood gas is obtained to assess her acid/base balance.

What is your interpretation?

a. partially compensated metabolic acidosis due to excessive bicarbonate loss from her diarrhea
b. uncompensated metabolic acidosis due to excessive bicarbonate loss from her diarrhea
c. uncompensated respiratory acidosis due to bicarbonate retention from her diarrhea
d. partially uncompensated respiratory acidosis due to bicarbonate retention from her diarrhea
e. uncompensated metabolic acidosis due to bicarbonate retention from her diarrhea

139. Mrs. L is a thin, elderly looking 61 y.o COPD patient she has an arterial blood gas done as part of her
routine care in pulmonary clinic. The results are as follows:

What is your interpretation for BGA in this patient ?

a. Fully compensated respiratory acidosis with hypoxemia
b. Fully compensated metabolic acidosis without hypoxemia
c. Fully compensated metabolic acidosis with hypoxemia
d. Partially compensated respiratory acidosis with hypoxemia
e. Partially compensated metabolic acidosis with hypoxemia

140. Ms. St is a17 y.o with intractable vomiting and dehydration. She has some electrolyte abnormalities, so
a BGA is obtained to assess her acid/base balance

What is your interpretation and treatment ?

a. Uncompensated respiratory alkalosis. Treatment consist of fluids, anti emetic and management of her
electrolyte disorder
b. Partially compensated metabolic alkalosis. Treatment consist of anti emetics and management of her
electrolyte disorder
c. Partially uncompensated respiratory alkalosis. Treatment consist of bicarbonate, anti emetics and
electrolyte disorders
d. Uncompensated metabolic alkalosis. Treatment consist of bicarbonate and anti emetics

141. Mr. F is a 60 y.o with pneumonia He is admitted with dypnea, fever, and chills. His blood gas is below:
What is your interpretation and what are treatment goals for Mr. F ?
a. Uncompensated metabolic acidosis with hypoxemia, improve both ventilation and oxygenation
b. Partially metabolicacidosis with hypoxemia, improve oxygenation only
c. Uncompensated respiratory acidosis without hypoxemia, improve ventilation only
d. Partially compensated respiratory acidosis with hypoxemia, improve both ventilation and oxygenation
e. Uncompensated respiratory acidosis with hypoxemia, improve both ventilation and oxygenation

142. mrs J is a patient with chronic COPD being admitted for surgery, her admission labworkreveals in
arterial blood gas with the following values:

What is your interpretation ?

a. Fully compensated respiratory acidosis
b. Fully compensated respiratory alkalosis
c. Fully compensated metabolic acidosis
d. Partially compensated metabolic alkalosis
e. Partially compensated respiratory acidosis

143. Yang required most agressive ventilation:

A. 33 tahun woman, breathing 18 breaths/mnt, pulse 76, wheezing and shortness of breath
B. 7 tahun cewek breathing 16 breaths/mnt, pulse 76, sleepy
C. 6 bulan, breathing 16 breaths/mnt, pulse 76, lethargic
D. 65 tahun COPD, breathing 18 breaths/mnt, pulse 76, wheezing, has just ran out oxygen tank

144. A 5-year-old child is brought into the emergency department with drooling, strident cough, and
lethargy. Epiglotitis is suspected. The priority intervention for this child is:
A. Take vital signs
B. Secure child's airway
C. Take arterial blood for BGA
D. Obtain throat culture

145. Anak rumahnya kebakaran, dalam 24 jam gejala apa yang mesti kita waspadai:
A. Infection
B. -aduh lupa-
C. PTSD
D. Pneumothorax

146. Yang paling tepat dikasih PPV (positive pressure ventilation)?

A. 18 years old, shortness of breath, rash on chest
B. 66 years old, shortness of breath, swollen ankle
C. 80 years old, diminished lung sound, smoker >20 years, RR= 24 bpm
D. 6 years old, wheezing bilateral, constantly cries

147. Anak 2 tahun kekurangan oksigen karena S. pneumoniae dan membutuhkan endotracheal tube.
Indikasi manajemen ini berhasil?
A. bilateral breath sound terdengar
B. SaO2 80%
C. ujung endotracheal tube mencapai mainstem bronkus kiri
D. ujung edotracheal tube mencapai mainstem bronkus kanan

148. Prolonged nausea, vomitting, diare. BGA?

A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
 D. Respiratory alkalosis

149. Standard precautions include following:

A. covers body fluid containing visible blood
B. specified for patient known specific pathogen
C. prevent transmission droplet nuclei
D. hand washing as personal hygiene
E. hand-to-hand contact prevention

150. As standard precautions do not cover patients infected with H5N1 influenza virus. It should be
completed by
A. droplet precautions
B. hand hygiene campaign
C. personal protective equipment
D. antimicrobial soap
E. environmental control

151. Anoxic condition which is important in forensic medicine is : (151)

A. Anemic hypoxic
B. Metabolite hystotoxic hypoxia
C. Stagnant hypoxia
D. Hypoxic hypoxia
E. Extra hystotoxic hypoxia

152. Riani Wulandari

153. Thomas Adhi Nugroho Chaidir
154. Endi Pramudya Laksana

155. 20 y.o male complaint persistent nasal discharge, discharge was yellowish and thick. Past history nasal
itchy and nasal obstruction when cold weather. Water film shows cloudy at maxillary sinus. What is the
most likely diagnosis?
A. Tumor of right maxillary sinus
B. Right hematosinus
C. Chronic sinusitis
D. Acute sinusitis
E. Mucocele

156. On posteroanterior chest film, there is a cavity in the apical part of upper lobe, the wall of cavity is
thick and surrounded by patchy consolidation. (156)
A. Lung abscess
B. Pulmonary cyst
C. Mycectoma in cavity
D. Cavitating tumor
E. The cavity at pulmo TB

157. The segmental homogenous lung opacification with air bronchogram is (157)
A. Atelectasis
B. Pleural effusion
C. Pneumonia
D. Schwarte
E. Bronchopneumonia

158. Cerita untuk 157 dan 158. Dyspneu, cough, high fever. Anteroposterior X-ray homogenous lung
opacification with air bronchogram in lateral segment. Pertanyaan: this disease begin as localized
infection of: (158)
A. Terminal air space
B. Terminal bronchioles
C. Respiratory bronchioles
D. Acinus
E. Interstitial

159. A girl, usia 2 tahun menderita dyspneu, fever, dan cough sejak 7 hari lalu. Di X-ray ada homogenous
lung opacities dengan air bronchogram di lateral middle lung. Lateral lung itu di sebelah mana? (159)
 A. Upper left lobe
B. Upper right lobe
C. Middle of right lung
D. Lower lobe of left lung
E. Lower lobe of right lung

160. What is the basic standard radiograph for any patient presenting with cough >3 weeks? (160)
A. Posteroanterior chest film
B. Oblique chest film
C. Left lateral decubitus
D. Apical lordotic
E. Anteroposterior chest

161. Azhar – lupa nyatet

162. factor that can interfere BGA in heavy smoker
A. false high pco2 because high pco2 value
B. false low ph level bcoz of low ph level
C. false low o2 bcoz of low o2 value
D. false high o2 saturation
E. false high base excess

163. a 2 months old girl suffered from cough for more than 2 weeks. The patient mother become concerned
with the child turned blue after series of coughing spells that ended with vomiting. She bought her to
pediatrician. The patient had not yet any vaccination . the doctor diagnosis pertussis. What is
characteristic property of etiology of this disease?
A. grow on Mac concay agar
B. gram – bacteria
C. obligate anaerob bacteria
D. non fastidious bacteria
E. specimen culture is sputum

164. Yuni
165. the principal reservoir for antigenic shift variant to be:
A. people in isolated communities such as jungle
B. animal : pigs, horses fowl
C. soil : tropics
D. sewage
E. humid environment

166. 54 yo fever, chill and productive cough of minimal sputum. He stay at local hotel, several more person
same complain possible cause
A. S. pneumonia
B. Cryptococcus
C. RSV
D. legionella pneumonia
E. P. Jirovecii

167. wanita 61 tagun yang merupakan seorang tuna wisma ditemukan tergeletak dijalanan pada saat hujan.
Suhunya 40 C. productive cough. Malnutrisi. Dokter menduga ia TBC. Maka dilakukan pemeriksaan
sputum. Prosedur yang sebenarnya adalah…
A. KOH methylene blue staining
B. gram staining
C. ZN staining
D. nessier staining
E. scafhefer fultok… staining

168. lab menggunakan mac conkey dihasilkan mucoid gram -, lactose fermentation, indol -, apa itu?
A. mycoplasma pneumonia
B. klebsoella pneumonia
C. streptococcus pneumonia
D. legionella pneumophilla
E. Chlamydia pneumonia
169. ada pasien fever, diketahui etiologinya gram +, alfa hemolytic, sensitive optochin?
B. S. pneumonia