1.

A 35 years old women come to clinic with

right nostril become narrow. Nose exam
showed abnormalities in the bulge of lateral
wall of cavum nasi. What is the name of
location described above?
a. Septum Nasi -medial
b. Concha Nasalis
c. Meatus Nasi

in the area between plica vocalis and

ventricularis. What is the structure name?
a. Ventriculus laryngeus
b. Vestibulum laryngeus
c. Cavum laryngeus
d. Rima glottidis
e. Cavum intra glottis

d. Ala Nasi
e. Choanae

2. A mother brought her child to the hospital

because of difficulty swallowing. The x-ray
showed a thickening of caudal part of the
cartilage Laryngis. What is the name of
structure that may have abnormalities?

4. thoracocentesis must do carefully as to

avoid neurovascular site at intercostal space.
what is the location of the neurovascular
site?
a. posterior margo superior costae
b. inferior margo inferior costae

a. Cartilago Thyroidea

c. between intercostal internum & externum

b. Cartilago Epiglottica

d. exactly at posterior of costae

c. Cartilago Arytaenoidea

e. in the middle of costae

d. Cartilago Cuneiform
e. Cartilago Cricoidea

3. A 10 years old boy was brought to the

Emergency Room because of difficulty in
breathing. After several examination the
doctor diagnose that there is corpus alienum

5.a man 37 years old come to clinic with

chief complaint runny nose and headache
since more than 1 year and the symptoms
come and go.doctor advised him to do head
and paranasalis sinus CT scan and the result
is pansinusitis.Histological epithelium
appearance of the organ involved with
disorder is

A.stratified squamos non keratinised

a.tb treatment sucessful

B.stratified squamos keratinised

b.child with malnutrition

C.cilliated pseudostratified cylindrical

epithelium

c.short term steroid use

d.child also have tb gland on neck

D.stratified cylindrical cilliated epithel

E.simple cylindrical cilliated epithel

e.child had measles vaccine 1 week before

tuberculine test

6.a woman 50 year old come to emergency

unit with complaint of difficult in breathing
since 1 month ago but become more serious
since last few days.CXR massive pleural
effusion of hemithirax dextra.epithel
histological appearance in related organ is

9. Seorang laki-laki berusia 25 tahun dibawa

ke unit gawat darurat RS oleh ayahnya.
Hasil pemeriksaan radiology menunjukkan
pneumothorax, struktur manakah yang
terkena tusukan sehingga mengakibatkan
pneumothorax pada kasus di atas?

A.simple cylindrical epithel

A. Pleura costalis

B.simple cuboid epithel

B. Cupula pleura

C.stratified cuboid epithel

C. Pleura mediastinalis

D.simple squamos epithel

D.Bronchus primer dextra

E.stratified squamos epithel

E. Bronchus lobaris superior dextra

7.

10.

8. a tuberculin test is done on a 5 years old

child. the result shows 12mm induration.the
child is given antituberculosis drug. after 2
month tuberculosis test shows 3mm
induration. the reason for the reduce
induration?

11.

12) new smear (+), radiology abnormality

(+)

which category treatment?

rifamsin

a. category 1
b. category 2

15.

c. category 3

16.

d.

17.
18.

13)man 40 yo cough more than 2 month,

diagnosis tb paru. increasing in SGOT dan
SGPT. kind of drug being used on
precuation ?
a.

INH

b.

etambutol

19. Pada seorang penderita PPOK terutama

pada stadium lanjut, sering didapatkan
bentuk rongga dada (barrel chest), perkusi
hipersonor dan bunyi napas ekspirasi yang
memanjang. keadaan tersebut disebabkan
oleh :

c.

pirazinamid

A alergi

d.

steptomisin

B hipertensi

e.

rifamsin

C Air trapping (udara terperangkap)

D spasma bronkus

14) women 38 yo, rs chronik batuk for

month.. a week ago coughing a blood, easy
to get tired, nafsu eating loss, sometimes got
fever but not high, LED-70, HB(-) foto
thoraks got kekaburan at apex
a.

pneumonia

b.

asma bronkial

c.

tuberkulosis

d.

jntung korener

A 32 years old woman present to Kalabahi

General Hospital with fever, breathlessness,
cough and left sided pain, weight loss and
night sweats and history of prior lung TB 2
years ago. Initial evaluation reveals to be
thin and chronically ill appearing. On
physical examination HR 112 beats/min, RR
24/min, temperature 38 'C, assimmetric lung
expansion. CXR show left lower lobe
consolidation and a moderate sized left
pleura effusion that layers on lateral

decubitus views. Laboratory result

hemoglobin 10.5 % and WBC 19700 mm3

20. What is the primary diagnostic

procedure is must perform in this case?
A chest CT scan
B chest USG
C bronchoscopy
D thoracoscopy

26.

A 5 month girl is bring to the hospital by her

mother due to difficulty in breathing since 2
days ago. This happen for the first time.
Runny nose and coughing since 5 days ago.
All family suffered from common cold. On
physical examinatio, body temperature was
38.5C, respiration 52 times, prolonged
expiration, diffuse wheezing was heardover
both lungs. Chest X-ray revealed a
hyperluscent lungs and flat diaphragm

E thoracocentesis and pleura analysis

27. the most likely diagnosis is
21. What is the diagnostic of this patient?
A a transudate pleura effusion
B giant abscess
C hydropneumothorax
D emphyema

A. pneumonia
B. Bronchiolitis
C. Bronchitis
D. Asthma
E. Rhinitis

E chylothorax
28. In a 5months old girl, tachypnea
according to WHO if respiratory rate is
22.
23.
24.
25.

A. >30x/minutes
B. >40x/minutes
C. >50x/minutes
D. >60x/minutes

E. >70x/minutes

E. COPD

29. Which among these respiratory disease

is closely related to asthma?

31. Treatment for this case

A. Broad spectrum antibiotic

A. pneumonia
B. B-2 Agonist Inhalation
B. Bronchiolitis
C. IV aminiphylline and corticosteroid
C. Laryngitis
D. Mucolytics
D. Pharyngitis
E. Antitussive
E. Epiglotitis

30. A girl 15 y.o. was admitted to the

hospital due to coughing and dyspnea. This
condition happende almost every month and
usually spontaneously resolve. No fever, the
girl look dyspneic prolonged expiration,
diffuse wheezing was heard over both lungs.
She was still able to communicate to doctor
with clear uninterrupted sentences. Family
history mother has atopic dermatitis, father
is a heavy smoker.

32. In pt. suffered asthma episodic

infrequent w/ moderate attack, the treatment
is?
A. B-2 Agonist inhalation
B. Steroid inhalation
C. Aminophylline injection
D. Steroid injection
E. Antibiotic injection

The most likely diagnosis

A. Asthma
B. Pneumonia
C. Bronchitis
D. Bronchiolitis

33.
34.
35.
36.

37. A synptom that may help to differentiate

adenoiditis from sinusitis is:
A.postnasal drips

40. An accepted and important function of

paranasal sinuses is:

B.rhinorrhea

A. Humidifying inspired air

C.snoring

B. Increasing surface inspired air

D.cough

C. secretion of mucus

E.fever

D. Regulation intranasal space

E. Lightening of the skull

38.Peritonsillar abscess(quinsy) is a
collection of pus in the peritonsillar space
which lies between the capsule of tonsil and:

41

A.superior constrictor muscle

B.inferior constrictor muscle

42. Increases incidence of paranasal sinus

infection is usually observed when

C.medius constrictor muscle

a. mucus viscosity increase
D.pterygoid muscle
b. mucus volume increase
E.palatoglossus muscle
c. mucus viscosity decrease
d. mucus volume decrease
39. The most common infecting organism
of acute tonsilitis is

e. mucus transport decrease

A. Haemolytic streptococcus

D. Staphylococcus aureus

43. yo man taken to UGD. coma and

difficulty of breathing. later revealed that he
was narcotic over dosage. blood pH 7.22;
CO2 26.3mMol/L (61 mmHg); HCO3 26.5.
acid base status?

E. Moraxella catharralis

a. uncompensated respiratory acidosis

B. Streptococcus pneumonia
C. Haemophylus influenza

b. uncompensated metabolic acidosis

c. uncompensated respiratory alkalosis

E. Both kidney and lung would respond

quickly together at the same time to
decrease the blood pH

d. uncompensated metabolic alkalosis

46. What type of acid base balance that can
compensate the condiion above?
44 The above acid imbalance condition was
most probably caused by:
A. narcotic overdosis increased [HCO3]
excretion
B. narcotic overdosis increased frequency
resulted in higher CO2 plasm
C. narcotic overdosis stimulated carbonate
anhydrase activity resulted lower pH
D. narcotic overdosis resulted in
hypoventilation increased CO2 plasm
E. narcotic overdosis increase [HCO3]absorption resulted in higher CO2 plasm

A.Acidosis Metabolic
B. Acidosis Respiratoric
C. Alkalosis Metabolic
D. Alkalosis Respiratoric
E. Cannot be compensate

47. Upon completion of the body

compensation mechanism, how much do
you expect the level of plasma bicarbonate
to be?
A. normal

45. Which one best describes above:

A. If was simple imbalances, chemical
buffer would compensate easily
B. Kidney takes several days to correct the
imbalance, required resp. support to
decrease PCO2

B. moderately low
C. approaching normal
D. slightly over normal
E. significantly over normal

C. Bicarbonate level slightly increases

immediately to corrects the imbalance
D. PCO2 increased significantly, it
demands more work of the lung to
increase breath activity

48.

49. A 62 years old factory worker has

worked in insulation industry for over 30
years, develop progress SOB. He finally
relents with the appearance of hemoptysis. A
chest x-ray is consistent with an alveolitis
from asbestos inhalation. Which of the
following is the major route for removal
particles from the alveoli?
a. Bulk flow
b. Diffusion
c. Phagocytosis

51. Voluminous sputum can be found in

patient with the undermention disease,
except
a. TB of early stage
b. Advance TB with cavities
c. Bronchiectasis with edema
d. Acute bronchitis, pneumonia
e. Pulmonary edema, abcess

d. Expectoration
e. Ciliary transport

50. Mr Joko, 62 years old came to the

hospital because of cough felt since one day
ago. The cough was accompanied by white
sputum. He had experienced asthma
bronchial since 15 years ago. From the
physical examination, ronchi +/+, no
wheezing. The expectory capacity in asthma
decrease mostly because of?

52.A group of third year medical student

accompanied a medical mission team to a
village in Malino. After arriving at the bus
station, they hiked to a remote mountain
village. At level of 18,000 ft, the barometric
pressure is 380mmHg, so the PO2air dry
inspired consist of what?
a. 160mmHg
b. 100mmHg
c. 80mmHg

a. Trauma in the respiratory tract

d. 70mmHg

b. Infection of the respiratory tract

e. 38mmHg

c. Spasm of the respiratory tract

d. Swelling of the respiratory tract
e. Hypersecretion of the respiratory tract

53. 61 year-old woman with chronic

pulmonary thromboembolism. Expiratory
CT scan shows air-trapping in left and right

lower lobes. Why air in the alveoli always at

the base of the lung?

b. Severe pneumonia
c. Pulmonary emphysema

A. More perfusion than ventilation at the

base
B. Interstitial pressure is lower in the base of
the lung

e. Wide spread of early TB

d. Bronchiectasis

C. V/Q is higher at the alveolar wall

D. More blood flow to the bottom of the
lung
E. Intrapleural pressure is more negative at
the base

56. Sputum crudum is to mention for:

a. Reddish serous sputum
b. Sputum covered by mucus
c. Sputum mixed with blood material

54.A patient has paroxysmal episodes of

unable to catch her breath. No abnormality
in pulmonary function screening.
Pulmonologist order methcholine challenge
test. Which one occurs as a result of
stimulating cholinergic receptor in bronchial
smooth muscle?
a. Lung compliance
b. Airway diameter
c. Anatomical dead space
d. Elastic work of breathing
e. Resistive work of breathing

55. The red spot was observed on sputum,

disease to be suspected :
a. Pulmonary empyema

d. Hard sputum and appeared rusty

e. Voluminous sputum in green colour

57. Dittrich plug is caseous and yellowish

mass which can be found in patient with
a. Along standing TB
b. TB early phase
c. Pulmonary edema
d. Bronchiectasis
e. Severe pneumonia

58. Removal of foreign material except:

a. cough reflex

b. mucociliary clearance

a. alveoli filled with macrophage

c. alveolar macrophage

b. alveoli filled with purulent exudation

d. surface tension and surfactant

c. alveoli filled with sanguinous

exudate+few neutrophils

e. alpha1-antitrypsin
d. alveoli filled with hyaline membrane
e. alveoli manifesting haemorrhage necrosis
59. pneumocystic cranii pneumoni, except:
a. its a fungal infection
b. commonest opportunistic infection in the
immunocompromised

62. patient ada batuk..chest xray: left sinus

and left diaphragm not cover by
intermediate density..diagnosis?

c. interstitial infiltrate of mononucleus cell

a.asthma

d. prognosis generally good

b.pleura effusi

e. alveolar airspace filled with foamy

eosinophilic materials

c.pulmonary TB
d.bronkitis
e.tumor

60. distinguishing features of tubercle

a. central caseous necrosa
63.honeycomb app. diagnosis?
b. nodule ada epitheloid cells
c. mass of lymphocyte surrounding large
pale cells

64.

d. presence of langhans giant cells

e. presence of acid-fast bacilli

61. microscopic appearance of lobar

pneumonia in red hepatization

65. 65. A 43-year-old woman came to the

doctor because feeling weak, plae and
sometimes accompanied by fever and cough,
especially at night sonce 2 months ago. On
chest X-ray showed patchy and cloudy in

the apex of right lung. What is the diagnosis

according to chest X-ray?

doctor asked for chest X-ray. What is the

radiological image can be found:

a. Inactive Righ Lung TB

a. Hyperluscvent avascular

b. Active Right Lung TB

b. Blunt of sinus costophrenicus

c. Bronchopenumoni

c. Hyperaeration of the lungs with low

position of the diapragm

d. Miliary TB
d. Infiltrates with calcification in the apex
e. Pneumonia
e. Homegenous covering at lower lung field

66. A 59-year-old man, heavy smoker came

to the doctor with frequent coughing,
especially at night. The patient were referred
to radiology for a chest X-ray. The result are
prominent and crowded of bronchovesicular
pattern. What is the diagnosis?
a. Chronic Bronchitis

68.A 35 years old man was taken to a

hospital with SOB and chest pain after
traffic accident 1 hour ago.On chest xray
found hiperlucent avascular in left
hemothorax fracture of costa V ,mediastinal
seemed pushed to the right .What is the
diagnosis:

b. Bronchiectasis

A.pneumothorax

c. Bronchopenumoni

B.pulmo emphysema

d. Pneumonia

C.traumatic wet lung

E. Miliar TB

D.pulmo embolism.
E.emphysema subcutan

67. A 30-year-old woman, came to the

doctor with complaint of cough since 1
month ago. Complaint accompanied by thick
phlegm and blood spots. On physical
examination found cracles in the right lung
field. The doctor diagnosis as pulmonary
tuberculosis. To confirm the diagnosis the

69. result chest radiography of patient

showed calcification and fibrosis in the right
upper lung. appropriate differential
diagnosis ?
A. active lung TB

B. bronkiektasis

C. Lobar pneumonia

C. left lung abscess

D. Transient tachypnea of newborn

D. inactive lung TB

E. Athelectasis

E. bronkitis kronik

70. A woman of 37 years came to the doctor

came with complaints of cough. Results of
chest radiographs showed a homogenous
covering in the upper right lung and trachea
shift to the right, and in the left upper lung
has y infiltrates with a cavity. What is the
diagnosis based on chest X-ray picture of
the patient?
a. Active pulmonary tuberculosis

72) A 35 years old man, chest X-ray shows

infiltrate in right lung, spread in middle and
lower lobe. Diagnose?
A. Lung TB
B. Bronchopneumonia
C. Athelectasis
D. Emphysema
E. Bronchitis

b. Bronchopneumonia
c. Lobar pneumonia
d. Atelectasis
e. Active pulmonary tuberculosis with
signs of atelectasis.

73) A 56 years old man, cough and dyspnea

since 2 weeks ago. Chest X-ray shows
consolidation in middle lobe of right lung
with 'air bronchogram sign'. Diagnose?
A. Bronchopneumonia
B. Pneumonia

71. A baby girl, shortness of breath and

cyanosis after birth prematurely. Chest Xray shows, corakan granular with 'air
bronchogram sign' that extends from medial
of both lungs with symmetrical distribution.
Diagnose?

C. Emphysema
D. Athelectasis
E. Lung TB

A. Meconium aspiration syndrome

B. Respiratory distress syndrome

74) A 50 years old man, dyspnea.

Complaints proceeded cough since 1 month

ago. History of asthma since 10 years ago.

Chest X-ray shows reduced
bronchovesicular pattern, ICS more wider,
flat ribs, low position of diaphragm, lie

wheezing. Breathing 30x/min. Treatment

given immediately?

s low and flattening of diaphragm.

Diagnose?A. Bronchitis

B. Kromolin

B. Athelectasis
C. Pneumothorax

A. Albuterol

C. Metaproterenol
D. Nedocromil
E. Terbutalin

D. Pulmonary emphysema
E. Bronchopneumonia

77. Asthma medication that has antiinflammatory effect?

a. albuterol

75. A man 35 years old came to the clinic

with complaint of dry cough since 1 week
ago that patient is often disrupted, especially
at night. On physical examination, did not
reveal any abnormalities. What is the
prompt treatment can be given

b. aminophyline
c. ephedine
d. glucocorticoid
e. salbutamol

a. Ammonium Chloride
b. Ambroxol
c. Bromhexine
d. Codeine
e. Glyceryl guaiacolate

78.Aman 36 years old come to hospital with

complain of cough..Doctor give
codein...what is the side effect?
hypotent
hemoptysis
stomatitis

76. A 40 years old woman, emergency room

with dyspnea. Physiscal examination-

bronchoconstriction
konstipasi

a. blood
79. Side effect of terbutaline

b.LCS

a. aritmia

c.faeces

b. angina pectoris

d.urine

c. insomnia

e.sputum

d. constipation
e. tachycardia

82. In sputum culture,the medium that

usually used for culturing bacteria will be
a.choc dextrose agar
b.SS agar

80. a man 36 years , come to the hospital

with cough, a little narrow, night sweats,
fever , and had been taking antibiotic . in
thorax photo, we found picture cloudy and
white patches at upper lung. routine blood
examination found increase LED.
in this case , the rapid method for diagnose
of this patient will be

c.ogawa media
d.nutrient agar
e.mueller-hinton agar

c.sputum culture

83. A woman 25 yo came to general

practition with swelling and fever, A week
ago she had a dentist pull out her tooth
which made a hole and inflammed. On
aspiration there was pus and contains
sulphur.what is the infection?

d.elisa

a.staphylococcus aureus

e.EIA

b.actinomycosis

a. microscope
b.blood culture

c.candidiasis
81. in this case , the important specimen
should be collected

d.streptococcus viridans
e.escherechia coli

86. cryptococcus characterized by

84. Most simple, easiest and quick
examination for the patient:

a. yeast with large capsule

b. yeast ad hyphae striae

a.PCR
b.Cell culture

c. velvet like appearance in saboraud

dextrose agar

c.ELISA

d. require cyclohexamide for growth

d.Acid fast staining

e. reddish mold grow on saboraud dextrose

agar

e.Gram negative

60 yo woman, complained a mild non

productive cough that has occured in the last
9 month. no chest pain. there is no history of
fever. her coughing occur at any time of the
day almost everyday. her appetite has not
changed over since. she was sent to have a
chest x ray and microscopic analysis and
culture of er bronchial lavage aspirate.

87.malnutrition always associated with

respiratory failure.one of the effects on
malnutrition in short term is:
A.decrease in mediated immunity
B.catabolism in respiratory muscle mass
C.altered immune response
D.decrease in surfactant production

85. which of the following disease is fungal

caused disease that often coincides with HIV
a. aspergillusmycosis
b. zygomycosis
c. cryptococcosis
d. histoplasmosis
e. coccidiomycosis

E.decrease in ability to repair

88. nutritional management for patient with

respiratory disease+hypercapnia is
a. energy needed calculated by severity of
disease
b. protein needed is in balance condition
c. carbohydrate need is higher than normal
need

d. fat needed is in the balance condition

e. monitor zinc is needed

number of patients who are expected to

recover so that the Puskesmas get the target
success rate?
a.100 people

89. macronutrient feeding should be on

consideration of

b.120 people
c.140 people

a. production of CO2 to O2
d.160 people
b. repairing of muscle mass
e.170 people
c. increasing the immune response
d. anabolism of respiratory muscle
93.
e. type of respiratory disease

90. immune enhancing diet should be given

to patient with respiratory failure, food that
can act as immune enhancing diet is
a. fish oil
b. soy oil

Seorang laki-laki berusia 45 tahun, perokok,

dirawat jalan di puskesmes dengan diagnosa
TBC sejak 1 bulan yang lalu. Penderita
tinggal bersama dengan keluarga, isteri 35
tahun yang sedang hamil, anak I laki-laki 17
tahun, anak II laki-laki 15 tahun, anak III
perempuan 12 tahun dan anak IV perempuan
8 tahun.

c. corn syrup
d. soy bean
e. mung bean

94. Tindakan pencegahan yang paling tepat

dilakukan pada pasien tersebut adalah :
a. Health promotion

91.
92. .In a region of Puskesmas XX there are
200 new pulmonary TB patients with smear
positive. Puskesmas treats those patients on
the DOTS strategy. What is the minimum

b. Specific protection
c. Early diagnosis and prompt treatment
d. Disability limitation

e. Rehabilitation

a.communicable disease
b.infectious disease and parasites

95.Tindakan yang paling tepat dilakukan

untuk bayi yang akan dilahirkan istri pasien
tersebut adalah :

c.respiratory system disease

a. Health promotion

e.disease virus infection

d.the disease is not contagious

b. Specific protection
c. Early diagnosis and prompt treatment
d. Disability limitation
e. Rehabilitation

96. research found 2,000,000 new TB

patients. what is the predicted new TB based
on the incidence rate of of Asia?

98. laki-laki 30 tahun masuk UGD akibat

kecelakaan lalu lintas. Pemeriksaan awal
didapatkan penderita tidak sadar, bibir biru
awal, dada tidak mengembang denyut nadi
kecil > 120x/menit. Terapi O2 yang cocok
pada pasien adalah :
a. kanula basal 2-4 L/menit
b. sungkup sederhana 10L/menit

a. 100
c. alat penafasan dan oxygen
b. 200
c. 1,000
d. 2,000
e. 10,000

97. .A 30 years old woman came to the

clinic with coughing up with bloody sputum.
The doctor diagnosed she got pulmonary TB
disease based on the ICD X,this disease
included in what classification?

d. Sungkup dengan reservoir rebreathing

12L/menit
e. Sungkup dengan reservoir nonrebreathing 12L/menit

99. man 60 y.o had dispneu. already got

oxygen with canule nasal 4 L/min. an hour
later, felt more dispneu, nervous n extremity
cold. what the best treatment?
a) increase flow rate canule nasal oxygen to
10 L/min

b) change canule nasal with simple mask

8 L/min
c) change canule nasal with reservoir
rebreathing 6 L/min
d) change canule nasal with reservoir
nonrebreathing 6 L/min

women 60yo, SOB, right side chest pain.

comfortable when lying right position.
doctor diagnose pleural disease. best
pulmonary pemfis to differentiate between
air and fluid in pleural cavity?

e) diazepam
a) pulse
b) inspection
100. women 60 y.o with dispneu. diagnose
with COPD. what the best method of oxygen
therapy?
a) nasal canule nose

c) palpation
d) percussion
e) auscultation

b) simple mask
c) mask with reservoir nonrebreathing
d) mask with reservoir rebreathing
e) venturi mask

man 37yo, cough for 3 week, whitish

sputum, mild fever, loss appetite, non
smoker, DM. pemfis: BP:120/80, pulse:
92x/min, respi rate: 20x/min, ronchi on apex
of left lung. diagnostic?
a) pneumonia
b) lung tumor
c) TBC

Drugs that give urine red in color

d) chronic bronchitis
a. Rifampisin
e) bronchiole asthma
b. Etambutol
c. Isoniasid
d. pirazinamid

woman 18yo, hemoptysis, diagnosispulmonary TBC. data collected before

choose therapy?

a) history TB contact, result sputum

d) history fever, result sputum

b) history bronchiole asthma, severity of TB

e) daily habits, severity of TB

c) previous anti-TB drug, result sputum