Vous êtes sur la page 1sur 19


A 35 years old woman came to the hospital with pain on her both metacarpophalangeal
joints. Which movement will be affected?
A. Flexi, extensi
B. Abduction, adduction
C. Flexi, extensi, abduction
D. Flexi, extensi, adduction
E. Flexi, extensi, abduction, adduction

2. Before taking further treatment, the doctor gives the patient non narcotic analgesic to
reduce the inflammation and pain. It is also know that the patient is 6 months old pregnant.
What is the NSAID given to the patient?
A. Acetaminophen
B. Aspirin
C. Ibuprofen
D. Metyrapone
E. Mefenamic acid

3. A 58 years old man came to the clinic, his muscles become easily fatigued and weak. The
physical examination shows decreased muscle strength. The physician diagnoses him with
myasthenia gravis. What is the neurotransmitter involved in neuromuscular junction?
A. Epinephrine
B. Norepinephrine
C. Acetylcholine
D. Dopamine
E. Serotonin

4. Perempuan 60 tahun, 80kg, 165cm, mengeluh lututnya sakit Kalo dibuat jalan Dan kaku
pada pagi Hari kurang Dari 10 menit. Sel Apa yg Affected?
A. Chondrocytes
B. Osteocytes
C. Leukocytes
D. Macrophages
E. Synovicytes(sp?)

5. 58 year old man came to the clinic with easily fatigued and weak muscle. Physical
examination shows decreased muscle strength. What is the neurotransmitter involved in
the neurojunction?
Answer is C

6. A 25 year old man came to the clinic with a tibia fracture that started last month. Physical
examination and radiology shows normal phase of bone remodelling. What cell is most
involved in this process?
A. Osteoclast
B. Osteon
C. Osteocyte
D. Osteoblast
E. Osteoid

7. Woman 60 years old came with left femoral fracture, mineral density kurang dari -2,5.
Microscopic show bone cortex dan trabelcule less complex, apa penyebab fracture:
A. Senile osteoporosis
B. Immabilization osteoporosis
C. Vit. D deficiency
D. Multiple myeloma
E. Hyperthyroid

8. 75 year old menopausal women went to evaluate bone mass density. She has low bone
mass density in the lumbar spine, femoral neck and …hip. She has no problem with
absorption in gastrointestinal tract. Which drug is most appropriate?
A. Alendronate
B. Calcium
C. Glucosamine
D. Raloxifene
E. Vitamin D

9. a 20 yo man complains sharp and almost constant pain in the region of the right knee.
this pain has been present for 2month and is associated with swelling of the knee. on
admission to hospital a radiograph report as follow: "bulky, sclerotic lesion at the end of
femur. the lesion extends to surrounding extra-osseous tissue with 'sunray' of radioopacity"
what is most likely the disorder of the bone? a. hiperparathyrpid
b. metastatic cancer
c. oosteomalacia
d. osteosarcoma
d. paget's disease

10. 36 years old man , backache for the past 6 month, which has becoming more severe
during last few weeks. he head history of pulmonary tuberculosis. On examination, his lower
lumbar spine was tender and the right hip was flexed and externally rotated. There was a
fluctuant painless lump (swelling) in his right groin. There was also fullness in the right iliac
fossa. What is the most probable diagnosis?
A. Femoral hernia
B. Inducted (oblique) inguinal hernia
C. Undescended (ectopic) testis
D. Psoas abscess
E. Appendicular mass

11. anak kecil fraktur, di nangis sambil pegangin tangannya. ada swelling, tenderness, pulse.
tapi pada x-ray ditemukan seperti ini : *gambar x-ray*
fracture yang no deficit sensoris ?
a. carpal bone
b. radiocarpal joint
c. radial diafisis
d. radius epifisial plate
e. radius metafisis

12. 80 y.o woman who lives independently at hone presents with low back pain in the
setting of a fall. She slipped on a wet floor in the kitchen. Blood tests revealed hb 10.5,
normal wbc count, but an elevated esr. X rays of the lumbosacral spine reveal a
compression fracture of L4 and multiple lytic lesions of her thoracic spine are seen on x ray.
What is the most likely diagnosis?
A. Ankylosing spondylitis
B. Fibromyalgia
C. Metastatic carcinoma
D. Multiple myeloma
E. Osteoarthritis

13. Perempuan 45 thn unilateral limb edema habis kemo breast cancer long bed rest. D
dimer elevated. Most likely diagnosis.
A. Peripheral artery disease
B. Buerger disease
C. Acute limb ischemic
D. Critical limb ischemic
E. Deep vein thrombosis

14. Total cholesterol: 220, TG: 150, HDL: 70, hitunglah LDL 120

15. A 60-year-old woman is diagnosed with primary hypertension for 15 years. She typically
drinks two glasses of whiskey with dinner. Her height is 160 cm and weight is 65 kg. what
examination would you suggest to this patient to know any complication of her illness?
A. Measurement of complete blood count
B. Measurement of serum homocysteine levels
C. Measurement of kidney function
D. Measurement of lipid profile
E. Measurement of liver function

16. 56 years old man with Congestive Heart Failure presents to Emergency Department
because of rusty-red color sputum. Which of the following vessels are most likely
responsible for the sputum in this patient?
A. Pulmonary vein
B. Pulmonary capillaries
C. Pulmonary trunk
D. Pulmonary artery
E. Pulmonary lymphatics

17. 1 month year old baby, murmur in auscultation, cyanosis when cry, chest xray :
decreased vascularization to lung. What is possible diagnosis?
A. Teralogy of fallot
B. ASD secundum

18.. Seorang pria berumur 30 tahun datang ke klinik dengan keluhan palpitasi dan dizziness.
Pemeriksaan fisik normal. Apa yang selanjutnya harus dilakukan?
a. EKG
b. X-Ray
c. CT Scan
d. (Singkatan, kalo nggak salah ARBP atau apa gitu, maaf aku lupa :[ )
e. MRI

19 . A 29 yo woman came to the clinic with history of shortness of breath. On physical

examination, her blood pressure is 90/60mmHg and her HR 92bpm. You notice mid diastolic
murmur, radiating to the left axilla, opening snap with increase jugular venous pressure.
There is a slight oedem in extremities. ECG showed left atrium hypertrophy. What is likely
the etiology of this woman's heart valve problem? MITRAL STENOSIS
A. Congenital heart disease
B. Degenerative heart disease
C. Rheumatoid heart disease
D. Ischemic heart disease
E. Hypertensive heart disease

20. 54 thn, chief complain orthopnea. Dia ada post MI 2 thn yg lalu. Bp 100/60, ada
ascites,pitting edema di lower extremitas. Ada extended jvp, ada rales di kedua paru.
Penyebab increased left ventricular end diastolic pressure apa
A. Increase jvp
B. Bp 100/60
C. Ascites
D. Rales

21. Pria 60 thn, hipertensi, dm, riwayat ckd. 1 minggu belakangan dia minum jus buah terus
Ada ekg
Jawab: hiperkalemia

23. Newborn baby boy, brought to ER with bluish lips and nails. RR 80bpm, SatO2 75%.
Doctor gave oxygen but the baby died 1 day after. What possible pathogenesis...
B. Coarctation of aorta
Jawabannya A
24. A 61 year old man come to emergency department with chest pain since 10 days ago. If
this man suffered from myocard infarction. What enzyme concentrated still high in the
A. Lactic dehidrogenase
B. Troponin T

25. a 50 y.o lady has decreased exercise tolerance and palpitation for 1 year. She presented
to A and E department with fever and cough with a temperature of 39,2C and blood
streaked sputum for 4 days. Physical examination revealed sphinter haemorrhages under
the fingernails, an irregular small volume pulse, a displaced apex beat in the 6th intercostal
space anterior axillary line, and a volume overload-left ventricular impulse. What is the most
likely diagnosis?
A. Pulmonary tuberculosis
B. Bronchiectasis
C. Acutre myocarditis
D. Pulmonary embolism
E. Infective endocarditis

26. 23 yo man was punched in chest. Become breathless n difficult to breath. Neck vein
severely congested n peripheral pulse cannot be felt. Diagnosis?
A. Rupture of lung
B. Paradoxical respiration
C. Hemo pneumothorax
D. Cardiac tamponade
E. Tension pneumothorax

27. A 4 months old forl is brought to the ER due to difficulty of breathing and irritability, 2
day prior consultation she developed sneezing, clear rhinorrhea, with intermittent fever.
Fradually she developed dyspnea and paroxysmal wheez cough. Her mother had minor
respiratory symptoms 5 days earlier no family history with asthma. On physical exam
respiratory rate was 65x/minutes, accompained with nasal flaring, suprasternal and
intercostal retactions, auscultation revealed fine crackles, wheeze witg prolongation of
expiratory phase of breathing. The white blood cell and diff count were normal what is the
most propable diagnosis of this patient?
A. Bronchial Asthma
B. Broncho Pneumonia
C. Acute Epiglotis
D. Croup
E. Acute Bronchiolitis

28. 13 years old girl, sob since 6 years old. Worse in the morninh. Her brother has rhinitis.
Feel better with sabutamol. Physiology : ASMA
a. Ventilasi
b. Difusi
c. Perfusi
d. Ventilasi/Perfusi
e. Diffusi/perfusi

29. 67 tahun batuk 4 bulan, yellowish sputum pada saat pagi hari lalu berkurang pada sore
hari. Poorly treated recureent respiratory infect when young. Chest x-ray? BRONKIEKTASIS
A. Ring nodule
B. Increased vascular marking
C. Gohn
D. Honeycomb
E. Blunked costophrenicus

31. An industrial worker has been diagnoses with pulmonary tuberculosis. He has been
working in an industry with dust as an occupational hazard for the past 5 years. Which is the
most likely associated dust causing pulmonary disease?
A. Asbestosis
B. Anthracosis
C. Bagassosis
D. Silicosis

32.A man was stabbed on the left of lower neck and abdomen. He began breathing
difficulties. Xray shows elevated left hemidiaphragm.
Why is his left hemidiaphragm elevated?
A. Collapse of the left lung
B. Injury to phrenic nerve
C. Lupa
D. Large left sided hematothorax
D. Injury to vagus nerve

33. 16 y.o boy has sudden onset of left localised pleritic chest pain. There is no history of
trauma or recent infections. He is a non smoker, non drinker and enjoyed a good past
health. Physical examination is done, he is alert and is in respiratory distress. Vital sign is
stable. There is reduced entry in left chest, resonant percussion note, breath sound is
vesicular, trachea is not deviated. No heart problem and no murmur is heard.
A. Atelektasis
B. Asthma attack
C. Pulmonary edema
D. Pulmonary embolism
E. Spontaneous pneumothorax

34. A 60 years old man has had cough and sputum for 15 years. Now, he complaint the
sputum has blood tinge, particularly when he wake up in the morning. His chest x-ray shows
"tram-lines" apperance at the basal of both lungs. What this info suggest?
A. Carcinoma of the lung
B. Bronchiectasis
C. Interstitial lung disease
D. Heart Failure
35. 60 yo man, merokok 90 pack per year. For the past 5 years, he has had productive cough
of copious mucoid of sputum for a month. He had a history of pneumonia due to strep
pneumonia and e.coli. His last episode of pneumonia, complicated by sepsis and brain
abscess and he died. His autopsy of bronchi microscopy. What the clinical cause related to
the finding?
A. Scc
B. Chronic bronkial
C. Bronkial asthma
D. Lupa
E. Bronkietasis

36. 36yo woman deep rapid respiratory. Ph 6.96. PO2:85 PCO2:25. Hco3 5.
A asidosi respi
B asidosi metabolik
C alkalosis respi
D alkalosis metabo
E mixed
Jawaban B

37. Cowo antibody HIV (+). Fever, keluhan nafas. Ditemukan budding yeast, giemsa stain
(+). Microorganism penyebabnya?
A. Histoplasma capsulatum
B. Cryptococcus neoformans
C. Pneumocystis jirovecii
D. Mycobacterium

38. 7 tahun anak2 baruk kronik 3 minggu. Pf dia turun bb dan ibunya melihat 2 cacing
oanjang 10 cm keluar dari anusnya. Penyebab batuknya ?
A. Asma
B. Loeffler syndrome
C. Sore throat
D. Disentry syndrome
E. Occult filariasis

39. A TB patient with an intermittent joint disease, what TB drug must not be given to him?
A. Rifampicin
B. Isoniazide
C. Pyrazinamide

40. 57 years old man frank pain since 2 days. Cough, fatigue. What is the best position to
manage the hemoptysis?
A. Non trendelemberg
B. Trendelemberg
C. Upright
D. Supine
E. Prone
41. Seorang pemuda kecelakaan motor, luka di c3 - c5, trus sesek nafas, nerve apa yang
kena ? PHRENIC

42. 7 hari di rs karena patah tulang. Kena pneumonia. Alasan?

A. Pneudomonas aeruginosa
B. Streptoccocus pneumoniae
C. Mxyocella pneumoniae
D. Legionella
E. Mycobacteroium tubercullosis

43.) 30 y.o. male has bloody cough in the last 24 hours. There was history of Tb treatment
for 2 months but had no improvement. RR: 22x/min HR: 105x/min. Crackles found. Culture
of sputum shows septae hyphae. CT scan of chest shows fibrosis and hyperlucent area.
What is the most possible cause of the hemoptysis?
A. Lung mycosis D. Bronchiectasis
B. Bacterial Pneumonia E. COPD
C. Pulmonary Embolism

44. A 35 yo female came to the clinic with cough, nasal congestion, muscle aches, and fever.
The next day her temperature is 38.5 celcius. Her cough is productive with rusty sputum.
She feels right chest pain that is worsened by deep breathing. She is directly sent to
hospital. The next day her temperature is 40 celcius, heart rate 115 beats per minute,
respiratory rate 30 times per minute, blood pressure 130/80mmHg. From physical
examination, there is dull on percussion at the right upper side, increase tactile fremitus,
rhonchi and bronchial sound at auscultation. What is the most likely causative organism?
A. Klebsiella pneumonia
B. Streptococcus pneumonia
C. H. Influenza
D. Moraxella catarrhalis

46. Woman with substernal burning pain come to doctor. Endoscopy-Biopsy showed
hyperemic lower esophagus. Biopsy was also taken. What are the possible pathological
A. Squamous metaplasia
B. Columnar metaplasia
C. Chronic esophagitis
D. Ulcerative esophagus
E. Adenocarcinoma

47. 25 y.o woman datang dengan keluhan diare selama seminggu. Diare watery, bloody,
mucoid. Pada analisis mikroskopik terdapat protozoa dengan pseudopodia. Apa
A. Minuta stage of Entamoeba histolytica
B. Vegetative stage of Entamoeba histolytica
C. Cyst stage of Entamoeba histolytica
D. Vegetative stage of Entamoeba coli
E. Cyst stage of Entamoeba coli

49. 35 yo women traveled to aceh one wee pasca tsunami,she developed diarrhea causing
hypovolemic shock and metabolic acidosis. With watery diarrhea and , no fever no
abdominal pain,what organism involved?
b.shigella dysentri
C.salmonella typhii
d.vibrio chollerae

50. 45 y/o woman discomfort & abdominal pain RUQ. USG -> multiple diffuse nodule in
liver. Biopsy -> tumor cell have prominent nucleoli, coarser chromatin, mallory's hyaline.
Typical for?
A. Hepatocelullar adenoma
B. Hepatocelullar carcinoma
C. Cavernous hemangioma
D. Cholangio sarcoma
E. Hamartoma

51. Female 43 thn dtng dgn keluhan ikterik dan pruritus, makan padang 5 hr yg lalu pada
siang, malamnya lngsng colic di right region, skrg udh ga colic lg sejak 2 hr yg lalu. Skrng apa
g meningkat...
A. Unconjugated bilirubin
B. Albumin
C. Globulin
D. Cholecystokinin
E. Conjugated bilirubin

52. 30 thn cowo dari south kalimantan dtg dgn keluhan diare and abdominal pain. Stool :
large, ellipsoidal operculetes parasite eeg with thin transparant shell 140 x 85. Which parasit
can be cause?
A. Schistosoma japanicum
B. Fasciolopsis bulski
C. Thrichinella spiralis
D. Echinococcus granulosus
E. Clonorchis sinensis

53. A 70 years old man presents with 4 days history of colicky lower abdominal pain. He has
been vomiting for the past 2 days and last opened his bowels 3 days ago. He has been
unable to pass gas for the past 24 h. He had history of change in bowel habit, and his stools
are in small caliber. Moderate weight loss past year, no other past medical history.
Exam :
afebrile, PR 100x/min, BP 100/50 mmHg. Abdomen is distended and tympanic. The bowel
sounds are 'tinkling'. What is the most possible diagnosis for this patient?/
A. Diffuse peritonitis
B. Peptic ulcer
C. Appendisitis perforation
D. Large bowel obstruction
E. Intraabdominal bleeding

54. 55 year old male, no medical history since childhood. He wants to test for lower
colorectal cancer. No family history of colorectal cancer.
a. 3 fecal occult blood test
b. Abdominal ultrasound
c. Abdominal CT
d. Lupa
e. Lupa

55. Pasien wanita 60thn mempunyai keluhan utama black tarry stool and coffe ground
hematemesis.pasien terdapat sclera icteric.usg menunjukan nodule di right lobe liver.
Tes lab apa yabg digunakan untuk memastikan diagnosis: CA HEPAR, PORTAL HTN
A.alfa feto protein
E.ca 125

56. A hospital cleaning service worker accidentally got injured by a used syringe. What
laboratory test is the most appropriate for him?
A. HbsAg
B. Anti-Hbs
C. IgM Anti-HAV
E. Anti-HBe atau HBeAg (lupa)

57. Meri, a 3-year-old girl, came to the Puskesmas with ulcer on her left leg. Through the
history taking it was revealed that Meri had not been well fed in this past year since her
father lost his job. From her physical examination it was found that her BMI (body mass
index) was below -2 SD (standard deviation) for girls of her age. She was fully alert but
looked pale with a face appearance like a thin old person. Her ribs were very prominent but
her both legs were oedema. Based on this information, Meri was likely to be classified in
which condition below?
a. marasmus
b. kwashiorkor
c. marasmic-kwashiorkor
d. energy malnutrition
e. protein malnutrition

58. Cewe 58 tahun keluhan ada darah saat bab. Penampang pa lupa ??? SOAL GK LENGKP
A. Hodkins
B. Non hodkins
C. Adeno ca
D. Colon ca
59. 20 months old girl ada diare 2 hari lamanya trus ada vomit tp udh solve. Ada watery
diare juga. Infeksinya krn apa?
A. bacteria
B. Protozoa
C. Rotavirus
D. Corona virus
E. Adenovirus
Jawab: C

61. 7 month old baby boy presents with 3 days of diarrhea. He has been fed only with
breastmilk until 4 days ago when his mom decided to add formula to his daily milk intake.
What kind of diarrhea do you think the baby has?
A. Secretory
B. Osmotic

62. 31 yr old woman, with 10 years of bloody diarrhea. No other medical symptomps. In
digitar rectal exa no palpable lesions bu stol sample (+) for occult blood.
A. Acutepancreatitis
B. Diverticulitis
C. Cholangitis
D. Appendicits

63. Mr X, 63 years old. Upper back pain. Urination normal but decrease in volume. Physical
examination is normal but suprapubic pain on palpation.
Ureum 50
Creatinine 1.4
Crystal oxalate: +3
WBC +2
A. Ureterolithiasis
B. Urethrolithiasis
C. Cystitis
D. Pancreatitis
E. Vesicolithiasis

64. Mrs. X, 40 years old, came to the ER due to edema on both of her extremities that
became worse since 2 days ago. On history taking, she complained of recurrent arthralgia
with 'muka sembab' since 5 months ago. She is alert, compos mentis, BP 160/90, RR
32x/minute, HR 92x/minute, puffy face, kussmaul breathing, malar rash, anemic
conjunctiva, normal cardiac sounds, normal percussion, normal abdomen, normal JVP,
ronchi +/+, pitting edema +/+. What is the diagnosis?
A. Nephritis Lupus
B. Nephritis Interstitial
C. Chronic Pyelonephritis
D. Acute Tubular Necrosis
E. Low Renal Perfusion

66. A 12 yo girl come with temperature 36.8 C. Urinalysis result : RBC (+), neutrofil (+), and
no cast. What is the possible diagnosis?
A. Ureterolithiasis
B. Acute cystitis
C. Pyelonephritis
D. -
E. Acute glomerulosclerosis

67. 45 years old male came with dysuria, frequency, and slight fever. The urinalysis was
pyuria, positive bacteria. negative nitrite. The bacterial culture was negative. Most possible
microorganism was...
A. E. coli
B. P. mirabilis
C. P. aeruginosa
D. S. aureus
E. M. tuberculosis

68. 5 year old boy is consulted by mother to hospital for possible nephritic syndrome. Renal
biopsy is performed. Results is normal on microscopic or immunofluorescence examination.
What is the most likely diagnosis?
A. Focal glomerulosclerosis
B. membranous nephropathy
C. Diabetic nephropathy
D. Lipoid nephrosis
E. Amyloidosis

70. A 63 yo man came with no past medical condition otherwise normal. Came with sudden
increase in prostate specific antigen 2.2 to 4.3 digital rectal examination revealed nodule
0.5cm on left lobe of prostate. What next step evaluation is need for this patient??
A. CT and bone scan
B. Biopsy
C. Radical prostatectomy
D. 7 day AB treatment, recheck prostate specific antigen after 3 months
E. Urinalysis

71. 55 year old man come with colic pain on his left flank. No fever but urine output is
slightly reduced. From Physical examination: all vitals sign are on normal limit. Murphy
kidney punch (+) at the left side. other exams are normal. Lab findings: Ureum:50, serum Cr:
1.4. Urinalisis 2-4/HPF. Plain abdominal xray shows radiopaque structure at paravertebral,
shows deer antler appearance. Whats your diagnosis?
a. Uretherolitiasis
b. Nephrolitiasis (ada staghorn)
c. Pyelonephritis
d. Urethrolithiasi
72. 40 yo old man come with pain, sharp and intermittent 8/10. 36 celcius, heart rate 92,
and xray show radioopaque on right t10-12. He doesnt consume 2L as usual.
A) urolithiasis
B) nephrolithiasis
C) pyelonephritis
d) cholelithiasis
E) pancreatitis

73. 56 taun, cewe, longstanding OA, chronic used of analgesics. General exam kidney
function abnormal with elevated ureum and creatinine. Apa penyakitnya skrg ?
B. Interstitial nephritis
C. Glomerular nephritis
E. Urolithiasis

74. 67 year old, DM 5 tahun. Minum metformin 2x500mg. Comorbidity urolithiasis +

hypertension selama 2 tahun. Pernahdirawat di RS berulang. Lab test ureum 105, creatinin
3,4. Urinalysis proteinuria +3. USG terlihat contracted kidney dangakadahydronephrosis.
Cause dari kidney damagenya?
A. Hyperglycemia
B. Urolithiasis
C. Hypertension
E. obat antidiuretic oral

75. A 35 yo - sexually active man comes to a doctor with no sperm production during
ejaculation. No abnormality on urination. Where is the most possible location of the stone?
A. Left ureter
B. Right ureter
C. Vas deferens *gak yakin
D. Urethral pars prostatica
E. Urethral pars membranosa

77. A girl 8 years old presents with generalized edema. On examination, she has palpebral
edema, positive shifting dullness, and pretibial edema. Urinalysis shows Protein (+4) with
oval cyst bodies. The pathophysiology of the disease is:
a. Minimal change disease
b. Focal segmented Glomerulosclerosis
c. Membranous Glomerulopathy
d. Diffuse Glomerulosclerosis.
e. Interstitial Nephritis

78. A 5 years old boy with 1 testis came to the hospital. His physical examination confirmed
the absence of testis in his right scrotum and noticed the presence of hernia in his right
abdomen. These abnormalities describe:
A. Epispadias
B. Hipospadia
C. Phimosis
D. Cryptochirdism (aku jawab ini)
E. Orchitis

79. A 76 years old woman came to the hospital with a complain of inability to urinate since a
month ago. She use diapers since then. She feels the urgency to urinate before she goes to
the restroom. She feels pain everytime she urinates. Her urinalysis is fine. What is the
pathophysiology of her disease?
A. Stress incontinence
B. Urethral obstruction by stone
C. Urethral fibrosis
D. Hyperactive bladder
E. Neurogenic bladder

81. A 19-year-old boy has impaired adrenal gland function which leads to absence of insulin
secretion. How does glucose homeostasis maintain this condition?
A. Decreases gluconeogenesis
B. Reduces glucose uptake in tissues
C. Decreases glycogenolysis
D. Increases glycogenesis
E. Reduces mobilization of stored precursors

82. Blurred vision pada orang diabetes.

A. Katarak
B. glaucoma
C. retino mikroaneurisma
D. periferal...
E. arteriosclerosis

83. Cwe 40 thn complains parethesia over extremities of hands and feet about 1 mo after
thyroidectomy procedure. Most appropriate clinical manifestation to diagnose this patient?
A. Pemberton's sign
B. Murphy's sign
C. Maroni's sign
D. Cullen's sign
E. Trousseau's sign

86. 35 years old Male came with BP: 190/110. He has experienced abrupt onset of anxiety,
headache, palpitation, facial pallor 2x within a month for 10-15 minutes. No exopthalmus
found. Optic fundi found to have moderate narrowed arterioles, no hemorrhage or exudate.
Routine hematology and chemistry N. Chest x-ray and ECG N. What is the possible cause of
A. Cathecholamine excess
B. Thyroid hormon excess
C. Mineralocorticoid excess
D. Glucocorticoid excess
E. Idiopathic

87. 54 years old Female has a history of lymphoma. One of the treatment includes radiation
to the neck. Over time, she noticed weakness, fatigue, cold intolerance, constipation, weight
gain. On physical examination found HR: 65, BP: 120/80, slow pulse, thyroid gland not
palpable, dry skin, swollen, and pale. Thyroid function test result still pending. What is the
most likely diagnosis?
A. Myxedema
B. Cretinism
C. Grave's disease
D. Jod-Basedow phenomenon
E. Riedel's thyroiditis

88. A 67 year old woman come after finished her thyroid cancer treatment. What is the best
lab exam to monitor the effectiveness of her treatment and to monitor recurrence of
thyroid cancer?
A. reverse T3 level
B. Thyroglobulin
C. Total T3 T4 level
E. Free T3 T4 level
Jwban : B

89. Cewe 45 tahun general check up tanpa symptom. Hasil lab : tsh naik, t3 t4 normal.
Interpretasi :
A. Subclinical hypothyroid
B. Subclinical hyperthyroid
C. Variasi dari normal value
D. Hypothyroid
E. Hyperthyroid

90. A 60 years old man come to OPD. On the physical examination, the doctor found multi
nodular mass. To confirm whether the mass is benign or malignant. What examination
should be done next?
A. Thyroid CT
B. Thyroid Ultrasound
D. Fine needle aspiration

93. A 55 years old man had history of uncontrolled DM was admitted to ER with
unconciousness since 4 hours prior to admission. There were history of fever and productive
cough for last 2 days. Physical examination revealed general conditions weak and
unconciousness, BP 120/80, HR 120, RR 30x/min, Temp. 38,2 C. Fruity odour breath, dry
skin. What is the INITIAL treatment should be given for this patient?
A. Insulin IV injection
B. Crystalloid Fluid
C. Sodium Bicarbonate
D. Potassium
E. Calcium Gluconate

94. cewe umur 29 lagi hamil , loss of weight , t4 naiik , tsh nya turun , dikasi obat apa??
pilihannya lupa tp jawabannya PTU

96. 40 y o female complains of paresthesia over the extremities of hands and feet about 1
month after thyroidectomy procedures. Which is the most appropriate clinical examination
to diagnose this patient?
a.Pemberton’s sign cek venous obstruction
b. Murphy’s sign cek cholelithiasis
c. Cullen’s sign cek pancreatic necrosis
d. Maroni sign
e. Trousseau’s sign test hypoca

97. Wanita weight gain 12.5 kg in 6 months. Hirsutisme, acne, poor libido. DST low dose
positive. The role of hormones involved?
A. Decrease glucose uptake by muscle
B. decrease proteolysis
C. Decrease lipolysis in adipose tissue
D. Increase glyconeogenesis in liver

99. 30 years old woman feeling intolerance to heat, excessive sweating, tremor, sudden
weight loss and hirsutism. Doctor diagnose her as hyperthyroidism thyrotoxicosis. How is
thyroxine hormone produce?
A. Coupling, Iodine formation, Thyroglobulin
B. Iodine formation, Coupling, Deiodination
C. Iodine formation, Thyroglobulin Synthesis, Iodination, Coupling
D. Coupling, Deiodination, Thyroglobulin Synthesis, Iodine Formation
E. Thyroglobulin Synthesis, Iodination, Coupling, Iodine Formation

100. 45 yo woman present with diffuse and nonpainful of thyroid gland. PE: sinus
bradycardia, coase dry skin, cold intolerance and there was no cervical adenopathy. which
of the following lab result show the condition above
a. serum T4 n T3 normal, free T4 high and TSH high
b. serum T4, T3 n free T4 normal, TSH high
c. serum T4 low, T3 norml, free T4 normal, TSH low
d. serum T4, T3 n free T4 low and high TSH
e. serum T4, T3, free T4 n TSH low

Anonymous number :
42 year fatigue for 2 months,ureum and creatinine rise,dia ckd :
A.waxy cast
C.oval cast
D.myogoblin cast
E.leukocyte cast


1. A 40 y o female complains of paresthesia over the extremities of hands and feet about 1
month after thyroidectomy procedures. Which is the most appropriate clinical examination
to diagnose this patient?Komplikasi dari thyroidectomy itu pada umumnya kelenjar
parathyroid juga keangkat yang menyebabkan kadar calcium darah rendah. Cek
hypocalcemia itu ada 2 satu Trousseau satu lagi Chovtek
a. Pemberton’s sign
b. Murphy’s sign
c. Cullen’s sign
d. Maroni sign
e. Trousseau’s sign(ditangan di tensi ditahan di atas tekanan systolic selama 3 menit trus
nanti kalo positif jari2nya bakal nguncup, ada bahasa perancisnya apa gitu namanya lupa.
Cek di internet coba gambarnya)

2. To compensate for the lack of energy due to defective carbohydrate metabolism, his body
has to switch to alternative mechanism for his energy need. At an early state of energy
deficiency, the alternative is
A Increased lipolysis
B Fatty acid esterification
C Transamination
D Proteolysis
E Ketogenesis

3. A 24-year-old woman is found to have thyrotoxicosis. She appears to be in good health

otherwise. It is decided to place her on antithyroid drug therapy. The patient is lost to
follow-up before therapy is begun, but she returns 6 months later for a prenatal work-up.
Although 3 months pregnant, she has lost weight and has a marked tremor, and her resting
heart rate is 120/min. Her thyrotoxicosis is obviously worst, and the gland is larger and more
vascular. It is decided to correct her thyroid abnormallity surgically. Before surgery can be
done, her gland should be reduced in size and vascularity by administering Pasien thyroid
pilihan utama adalah Radioactive iodine,, tp ini haram pada ibu hamil karena radioactive
iodine bisa nembuh placenta dan nyebapin bayinya juga thyroid hormonenya turun padahal
crusial buat pertumbuhan yang normal.. Jadi pilihan kedua adalah obat anti thyroid : pilihan
pertama juga harusnya methimazole tp obat ini juga haram buat ibu hamil (termasuk
kategori D), jadi pilihan untuk ibu hamil itu PTU.. Harusnya D
A. Iodide ion
B. Ipodate
C. Propanolol
D. Propylthiouracil
E. Radioactive iodine

4. A 45 year old man suffers from muscle spasm after a thyroidectomy. On physical
examination his Chvostek’sign in positive. A deficiency of parathyroid hormone was made.
The physician could not get the hormone preparation. The alternative for management of
the patient hypocalcemia is:karna ga ada sedian hormonnya berarti ga bisa pake PTH jadi
buat ningkatin calcium darah cara lainnya adalah dengan bantuan dari vit D, yang
meningkatkan absorpsi Calcium.. inget MSK dl
A. High dose vitamin D (ergocalciferol)
B. Oral calcium salt
C Calcitonin
D High dose vitamin A
E Fluoride salt

5. A 35-year-old man presented with elevated seated blood pressure 190/110. He admitted
episodes about twice a month of anxiety, severe headache, perspiration, rapid heartbeat,
and facial pallor. These episodes had an abrupt onset and lasted 10-15 minutes. 30 min after
the initial blood pressure measurement, the seated blood pressure was 178/110 with a
heart rate of 90. The blood pressure after 3 min of standing was 152/94 with a heart rate of
112. No exophtalmus was found. The optic fundi showed moderately narrowed arterioles
with no hemorrhages or exudates. His routine hematology and chemistry studies were
within the reference ranges, and a chest film and EKG were essentially normal. What is the
probable cause of hypertension in this patient? Ini kelebihan katekolamin karna disitu ga
ada penonjolan bola mata, tremor,penurunan berat badn (ngarah e thyroid), kalo kelebihan
glucocorticoid dia bakaln focus di gula darah, kalo mineralcorticoid dia ada masalah sama
perpipisan. Ahaha..

A. catecholamine excess
B. thyroid hormone excess
C. mineralocorticoids excess
D. glucocorticoids excess
E. idiopathic

6. A 54 year old female has a history of lymphoma. One of the treatments that had
been employed was radiation to her neck. Much later, over a period of time, she starts to
notice weakness, fatigue and cold intolerance. She complained of constipation. She starts to
put on some weight. On physical examination her heart rate is 65 and her blood pressure is
120/80. She has a slow return of her Achilles tendon reflex. Her skin is dry, somewhat
swollen, and pale. Her thyroid is not palpable. Thyroid tests are done, but the results are
pending. What is the most likely diagnosis? Abis treatment dengan radiasi , thyroid ikutan
mati, jadi pasiennya hypothyroid, disebut juga myxedema, karena khusus hanya terjadi pada
hypothyroid .

A. Myxedema
B. Cretinism
C. Graves disease
D. Jod-Basedow phenomenon
E. Riedel's thyroiditis