Multiple Choice Questions

TROPICAL MEDICINE
FK UPH 2014
Friday, 31 Maret 17
08.10 – selesai
[Missed questions : 0 numbers]

1. Patient with infective endocarditis. Which of the following is the most appropiate for blood
collection?
A. Draw 2-3 blood sets in day 1.
B. Draw 1 blood set in separate site.
C. Draw 2 blood sets in separate sites with evaluation 1-2 hours. 2-3 jam dalam waktu
1jam
D. Draw 1 blood set with evaluation 1-2 hours.

2. Orang kena malaria, dicek demam tinggi, parasitemia +++. Diberikan Artemissin 3 hari,
kemudian saat dicek masih ada demam dan parasitemia ++++. Keadaan seperti ini disebut apa?
A. Early parasitemia
B. Late parasitemia
C. Early treatment failure kurang dari 3 early
D. Late treatment failure labih dari 3 late= 4HARI KEATAS
E. Late manifestation

3. A 34 y old male came to a clinic wih a chief complaint of 7 day fever. His fever occured every
3 days. His high fever preceeded by chills and afterward he sweat profusely. He had a
vacation to the jungle of borneo a week prior to his fever. He had taken chloroquine as
propylaxis before he went to Ujung Kulon. What factor contributing to his fever?
KLOROQUIN SUDAH RESISTEN MAKANY PROFILAKSUS HARUSNYA
DOKSISIKLIN
A. Evolution of the pathogen
B. Resistance of vectors to insecticide
C. His susceptibility to infections
D. Resistance of the pathogen to the prophylaxis drug KLOROKUIN SUDAH RSISTEN
MAKANYA DIGANTI MEFLOKUIN

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4. A 47 years old Egyptian man came to the clinic with chief complain of hematutia. On the urine
analysis shows many red blod cell and a few of WBC, oval shapped egg with terminal spine.
Which parasite can cause the disease?
A. Schistosoma hematobium TERMINAL SPINE HEMATURIA
B. Schistosoma mansoni LATERAL SPINE
C. Plasmodium falciparum
D. Wuchereria Bancfrofti
E. Trichinella spiralis
JAPONICUM NO SPINE DANAU LINDU NAPU
5. Patient brought to clinic because of some nodules on his arm and body and sometimes feel pain
with pressure. On examinations, we found erythematous nodules, smooth and shiny, diffuse
infiltrate with ill define border, no fluctuation or erosion. There were pain on his elbow with
nerve enlargement. What is the best stain for examination? MYCOBACTERIUM LEPRA 5A.
A. KOH JAMUR
B. Giemsa BAKTERI
C. Zn stain BTA
D. Gram
E. NaCl

6. Ada orang kayak sekarat gitu DBD. Apa yang dilakukan KASI CAIRAN YANG BANYAK
A.
B.
C. Infus dengan ringer lactate 3-5 ml/kgBB mild 3-5
D. Infus dengan ringer lactate 10-20 ml/kgBB severe 10-20

7. Refer to the previous case, further questioning reveals that he frequently gardens in
backyard. Of the following, which one is the transmitted form? Cutaneus larva migrans
A. Fecal – anal transmission
B .Fecal – oral transmission
C. Fecal – cutaneous transmission DIA FECALNYA ANJINGNYA
D. Intravenous drug abuse
E. Direct contact with skin scales CLM CUTANEUS CDC MEDSCAPE

8. A 37 year old man intermittent fever, nausea, abdominal discomfort especially at the right side
of upper abdomen. Chills rigor sweats when fever comes. Liver enlargement and tenderness,
same sign and symptomps last year. Never been occured in a year after the treatment.
What is the causes?

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 A. Sporozoit masuknya
B. Merozoit bikin syhmptom
C. Hypnozoit dorman KARENA DORMAN 1 TH
D. Trophozoit

9. A surgeon complains to his chief that he cannot concentrate during surgery. After the
operating theatre was surveye, it was found that the OT was too cold, too bright, and too
noisy. What kind of hazard?
A. Ergonomic Hazard
B. Psychological Hazard
C. Biological Hazard
D. Biochemical Hazard
D. Physical Hazard pasti nimas

10. 12 year old girl, came to clinic with her mother with fever since 12 days ago. She is also
difficulty swallowing and diarrhea. 2 weeks ago buy snack from the roadside. Physical
examination reveals temperature 40, pulse 90x per minute. Ada liver enlargement, hyperemic
throat, coated tongue. but chest examination was normal. She deny contact with animals.
What is the etiology of her illness?
A. Shigella flexeneri eek darah

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 B. Ecoli ehce darah etec traveler
C. Salmonella typhii coated tongue, fever, LIVER ENLARGE DIARHEA,
DISFAGIA
D. Serratia marescens
E. Proteus mirabilis

11. What is the laboratorium examination for the previous number?

A. Stool culture
B. Urine culture
C. ...
D. Blood culture udah 2 minggu kalo dibawah 1 minggu serology cari lagi
E. Liquor culture
SALMONELLA WEEK 1 SEROLOGY WEEK 2 BLOOD TEST

12. A 39 y.o. poultry farmer comes with fever and difficulty breathing since 3 days ago. A week
ago there are died poultry in his farm. On physical examination found the patient is pale, BP
140/80, hr 130 bpm, rr 44x/min and temp 40C. His throat shows mild congestion and exudate
in nasopharynx. Chest examination auscultation similar in both lungs where bronchial sound
with rales. Chest percussion is dull and increased tactile fremitus. What is the type of virus
causing the disease?
A. Paramyxoviridae
B. RSV
C. Orthomyxoviridae flu burung
D. Coronavirus
E. CMV

13. Zat apa yang digunakan untuk membersihkan feses burung?

A. Chlorine bayclean
B. Ethanol 70%
C. Ethanol 90%
D. Iodine
E. Chlorhexidine

14. Best virus isolation for the case above?

A. Blood
B. Nasopharyngeal aspirate paling best dari nasopharyngeal ato throat swab vrisunya
reside disitu dl

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 C. Hand swab
D. Anal swab
E. Nasal swab

15. Demam 2 hari, suspect DBD. Cek apa?

A. NS1 ns1 positiv 1-3 hari
B. Hematocrite
C. IgM
D. Platelet count

SOAL NOMOR 16-17

A 45 year old businessman datang dengan abdominal upper quadrant pain and fever 39.9oC. 3 week di
papua baru pulang 1 minggu lalu. Suffering intermintent chills and sweats durring fever episodes.
Liver enlargement and tenderness in PF. Thin blood smear shows ring forms of inside the
erythrocytes at 3.5% parasitemia.

16. What is the cause of parasetemia?

A. Release of sporozoit to tissue
B. Release of merozoit MEROZOIT YANG BIKIN PARASITEMIA
C. Repeated cycle schizon from liver to erythrocyte
D. Org nya immunocompromised

17. According to the case above, which of the following is the most appropiate treatment?
A. Intramuscular chloroquine HCL 1.5g single dose
B. Intravenous metronidazole 500mg 3x1
C. Oral primaquine 30mg 1x1 14 day PROFILAKSIS ONLY
D. Oral artemether/ lumefantrine 4x2 3 day ACT FIXED DOSE
E. Intravenous quinidine gluconate 15mg/kgBB continues 7.5mg/kgBB over 4 hours

18. A 4-month-old baby boy has had fever (38,5oC), increased frequency pf cough with forceful
inspiratory gasp and postussive vomiting. What is the best laboratory study for this
diagnosis?
A. CBC
B. Serum Ab titer
C. On Regan-Lowe medium CHARCOAL BLOOD AGAR FOR BORDATELLA
PERTUSIS

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 D. FAT
E. PCR

19. A 12 year-old girl got an open minor wound from walking in the garden. Her father brought her
to the emergency unit for suturing the wound. She had the last immunization when she was
18 months old and she had not repeated her DPT at 4-6 year-old. Appropriate tetanus
prophylaxis? KOMPLIT DIKASI TT ONLY GA KOMPLIT DIKASI IMUNISASI JG
A. Penicillin G
B. Anti-tetanus serum
C. Tetanus toxoid GA KOMPLIT KASI VKASIN JG
D. Tetanus Immunoglobulin
E. Human Intravenous Immunoglobulin

20. Anak cowo 3 tahun, dibawa ke emergency karena weakness di kaki kirinya. Sudah 5 hari
demam. Mamanya bilang kalo anaknya gak pernah diimunisasi. Lab exam untuk bantu
diagnosis. POLIO KALO KENA NENEK BISA FECAL ORAL
A. Viral isolation feses POLIO VIRUS DI EEK
B. Viral isolation urin
C. Viral isolation serum
D. Viral isolation CSF OCCASIONALY
E. CBC
oliovirus can be detected in specimens from the throat, and feces (stool), and occasionally
cerebrospinal fluid (CSF), by isolating the virus in cell culture or by detecting the virus by
polymerase chain reaction (PCR)
21. A 32 years old man come to dermatology with red and soreness in skin lesion. He's on MDT
for 1.5 year, on examination painful erythematous nodule spread over his body especially
on arms and legs. Diagnosis?
A. Cellulits
B. Furuncle
C. Multibacillar leprosy
D. Paucibacillar leprosy
E. Erythema nodosum ADA NODUL2
REACTION OF THERAPY = REVERSAL RACTION, ERYTHEMA NODOSUM,
LUCIO PHENOMENON/ ERYHTEMA ULCERATION

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22. 34 tahun farmer, dtg ke emergency dengan insidious fever, night sweats, malaise dan arthralgia.
Lagi liburan di Tangerang dan kerja di barn di iran. Suka makan susu dan keju dari goat.
Culturenya gram (-) coccobacil. Diagnosis?
A. Acute brucellosis UN PASTERUIZES MILK= BRUCELLOSIS
B. Bubonic plague
C. GI Anthrax
D. Thypoid tularemia

23. 4 thn sore throat, difficult swallowing, hoarseness, malaise, headache. Tonsil dan uvula ada
adherent membrane. Ada lymphadenopathy dan bull neck appearance. Treatment as soon as
posible? DIPHTERIA ANTITOXIN+ANTIBIOTIK(mycin2)
A. Eritromisin
B. Clindamycin
C. Diphtheri antitoxin 1st
D. Azitromycin
E. Clarithromycin

24. A 45 years old male came to a clinic with chief complaint of fever for 4 days. His fever was
high all day long. He had retroorbital pain and headache. He felt weak and was not able to eat
or drink anything because he felt abdominal pain. There is petechie on both forearm. BP
120/90; HR 100; RR 21; temperature 39,5oC; WBC 1800; Platelet 68000/ml. What is the
diagnosis of this patient based on guidelines of WHO 2009?

A. Dengue Hemorrhagic Fever

B. Dengue fever with hemorrage
C. Dengue fever
D. Dengue fever with warning sign abdominal pain lethargy bleeding liver enlarge

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 E. Severe dengue

25. A 28 years old woman, 3rd pregnancy. In the 39th week of gestation, she give birth to a small
for gestation age infant with chorioretinitis, intracerebral calcification, jaundice,
hepatosplenomegaly, and anemia. Infant displays poor feeding. She denies eating
raw/undercooked meat and doesn’t have cats at home. She work as a nurse in pedi. Intensive
care. Most possible diagnosis?
A. Congenital herpes simplex
B. Congenital rubella BLUEBERRY MUFFIN KATARAK PDA
C. Congenital toxoplasmosis MICRO/HYRDOCEPHALUS , KUCONG
D. Congenital varicella
E. Congenital cytomegalovirus CHORIORETINITIS NO KUCONG
3C RUBEOLA
26. 8 day old infant, any loud noise appears to cause him pain, ada muscle tightening and back
arching, causing the head to nearly touch his feet. PF reveals only dried packing on his
umbilical cord as is the local custom. He appear normal until stimulated by loud noise ot
touch and then began to cry, stiffens and arches his back. The stiffness continues until he
calm down. Most likely diagnosis: STIFFNES ARCH BACK TETANUS
A. bacterial meningitis
B. botulism
C. generalized seizure
D. tetanus TETANOSPAMIN
E. viral encephalitis

27. Cowo 25thn, orang jakarta tapi mau tugas ke Papua 2 minggu. Which medication (WHO
recommended) would be given to this patient for prophylaxis?
A. Amodiakuin
B. Sulfa-pyrimethamine
C. Chloroquine
D. Doxycycline KALO IBU HAMIL DIKASI MEFLOKUIN. KALO
KLOROKUIN UDAH RESISTEN
E. Primaquine

28. Best time for draw a blood?

A. Before giving antimicroba
B. At Fever spikes
C.

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 D.
E.

29. A 19 years old woman comes to Emergency Department with signs and symptoms of
poisoning of an agent include nausea, vomiting, abdominal cramps, diarrhea, excessive
salivation, headache, giddiness, rhinorrhea, tightness in chest, pin-point pupils,
parasymphatetic activity, mental confusion, and muscle twitching. Which of the following
is the most likely agentt caused those symptoms?
A. Acetaminophen
B. Barbiturate
C. Carbamate ATAU ORGANOSPHOSPAT ITU SLUDGE DUMBELL TANDA
TANDA PNS
D. Cyanide
E. Opiate

30. A mother delivers a baby with a rash identical. Questioning reveals that the mother had a flu-
like syndrome with rash during the second trimester of pregnancy. Examination reveals diffuse
raised purple skin lesions. There is no pallor, jaundice, or cyanosis. The Eyes are cataract, the

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 heart has a 3/6 systolic murmur and there is enlargement of both the liver and spleen.
There is no lymphadenopathy. Of the following, the most likely diagnosis is? MYRIAD
SYNDROM KATARAK PDA HEARING LOSS
A. Congenital toxoplasmosis KUCONG
B. Congenital rubella RAISED PUPLE SKIN LESION
C. Congenital CMV CHORIORETINITS
D. Congenital malaria
E. Congenital varicella

31. A 7 years old girl was taken to emergency department by her father with feeling of itching all
over her body and swolleh eyes. Her father said that she was playing in the yard and was
contacting with hairy caterpillar. What is the cause of the disease?
A. Erucism ULAT BULU ERU
B. Lepidopterism KUPU2 LEPTI
C. Tick paralysis KUTU
D. Arachnidism LABALABA ARACH
E. Delusional Parasitosis PIKIRAN DOANG

32. Anak, 4 thn. 4 hari develop malaise. He is partial immunized. Gabisa jalan asimetris
paralisis. Diagnosis?
A. GBS
B. Tranverse myelitis
C. Poliomyelitis MYELITIS BIKIN JALAN ASYMETRY
D. Encephalitis
E. Meningitis

33. A 28 years old man presented with 2 days history of increasing fever, malaise, headache, and
constipation. He did not receive any prior vaccinations. His vital signs revealed temperature
39oC; BP 130/90; Pulse 72x/menit. His physical examination revealed mild
hepatosplenomegaly and faint erythematous macules. Which is the following is most likely
to have caused this man’s illness? ERYTHEMATOUS MACULE ITU ROSE SPOTS
A.Vibrio Cholerae
B. Shigella dysentriae
C. Salmonella Typhi HEPATOMEGALI COATED TONGUE, FEVER
D. Entamoeba hystolitica
E. Giardia Lambia
 high temperature, which can reach up to 39-40C (103-104F)

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 headache.
 muscle aches.
 stomach pain.
 feeling sick.
 loss of appetite.
 constipation or diarrhoea (adults tend to get constipation and children tend to get
diarrhoea)

34. Which is the following specimen is most appropiate for case above?
A. Feces
B. Blood BEST BLOOD
C. Urine
D. Throat Swab
E. Biopsy
BLOOD DIBAWAH 1 MINGGU KALO UDAH MINGGU KE DUA WIDAL

35. A worried mother bring her 18 months old son to ER due to rash that developed today. she
reports that he has had a runny nose, conjunctivitis and diarrhea. on PE, he looks ill,
temperature 40oC and diffuse 2-3 mm erythematous rash begin from hairline behind ears and
spreading to face and body. On buccal mucosa, red spots are noted. = KOPLIK SPITS
What is the most likely causing agent? MORBILI VIRUS RUBEOLA 3C BEHIND EAR
A. rubella
B. coxsackie
C. morbili
D. hsv-6
E. parvovirus b19

36. A 26-year-old nulliparous woman, in her seventh month of pregnancy complains of a 7 days
history of fever especially at night. As she recall, 2 weeks ago she ate gado-gado in coastal area
when she out for duty for several days. She also had diarrhea and abdominal discomfort. On
physical examination reveals blood pressure 110/70 mmHg, heart rate 60 ×/min, RR 20x/min,
temp. 39.1°C. Tongue is coated and tremor. Fetal USG shows normal. The Causative agent
causes perforation in?
A. Ascenden colon
B. Descenden colon
C. Appendix
D. Ileum TERMINAL ILEUM TEMPAT PROLIFERASINYA

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37. A 35 years old female came to the outclinic with bloody diarrhea with watery consistency 4-
5x daily since 4 days ago, abdominal cramp and uncomfortable after defecation. What is the
possible pathogen?
A. Staphylococcus aureus
B. Giardia lamblia SLIMMY DIAREA
C. Salmonella typhii FEVER
D. Shigella sp BLOODY DIARHEA
E. Campylobacter sp

38. Cowo 21 tahun, keluhannya chronic intermittent diarrhea. Karakteristiknya foul smelling
dan slimy diarrhea. Riwayat travel di india balik 6 hari yg lalu. Organism?
A. Cryptosporidium parvum
B. Aeromonas hydrophila
C. Giardia lamblia FOUL SLIMY
D. Shigella dysentriae BLOODY
E. Vibrio cholerae RICE WATER STOOL

39. A 41 year old man was admitted to the hospitall due to high fever since 6 days. He complains
nausea and vomiting, headache, and black coloured urine. PF revealed lethargic patient,
jaundice, conjunctival injection and petechiae in soft palate region. Urynalisis shows
microscopic hematuria and leucocyte +2. Liver enzymes and creatinine is elevated. What is
the diagnosis of the patient?
A. Amebic liver disease
B. Piogenic liver disease
C. acute viral hepatitis
D. Leptospiriasis MUSCLE ACHE, JAUNDICE, BLACK URIN,
E. Amebiasis

40. Anak cowok 10 tahun datang dengan keluhan sore throat dan fever. Dia juga bilang ada
runny nose, mild cough dan abdominal pain. Pada pf, suhunya 38 derajat celcius dan ada
makular lesion di soft palate. Gak ada cervical adenopathy dll. Diagnosisnya?
A. Adenovirus
B. Coxsackhie HAND FOOT AND MOUTH DISEASE
C. Lupa
D. Sinusitis
E. Lupa

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41. A 28 years old female works at shoe factory datang ke outpatient dengan complain difficulty of
breathing. She complains of wheezing and heaviness on chest and it was getting worse. She
works at shoe factory for 7 years and rarely wears her mask while working. On physical
examination normal vital signs and wheezing sound on chest examintaion. Which reaction
caused her symptoms?
A. Immediate repond
B. Acute responds TIMBUL AKUT
C. Gradual reactions MAKIN PARAH
D. Delayed reactions TIMBUL KRONIS
E. No reactions

42. In the case above, which route the hazardous material entered the body ?
A. Inhalation DIHIRUP
B. Ingestion DITELAN
C. Skin absorption
D. Eye contact
E. Ear contamination

43. 55 year old women came to the clinic with difficulty to breathe since 7 days ago. She felt fever
and chills, and cough with productive sputum. On physical examination: decreased
consciousness, BP 90/70 mmHg, HR 120x/min., RR 24x/min. On auscultation rales were
heard on both lungs. Chest x-ray: infiltrate on both lungs. What do you do next?
A. Blood culture
B. Sputum culture INFILTRAT LUNG PRODUCTIVE SPUTUM
MAKANYA DIKULTUE
C. Abdominal USG
D. Give paracetamol 200 gram IV
E. Give meropenem 2 gram IV

44. A 21 year-old male came with unconciousness since 12 hours before admission. He and his
friends drank wine 75% and "Kratingdaeng". After 2 days in the hospital, he's awake but
he cannot see firmly. What is his problem?
A. Cortical blindness total or partial loss of vision in a normal-appearing eye caused
by damage to the brain's occipital cortex.
B. Retinopathy DEGRADATION
C. Bleeding in his eyes

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 D. Optica Neuritis KARENA ALKOHOL
E. Wernicke Encelopathy

45. A 32 years old man complaint with tingling and itching of legs 30 minutes after swimming in
Lindu lake. The next day, small papules develop followed by blisters of legs. What paracyte
infected him?
A. Schistosoma Japonicum DANAU LINDU LEMBAH NAPU
B. Fasciolopsis Buski
C. Fasciola Hepatica
D. Hymenoptera
E. Dermacentor Andersoni

46. According to the previous case above, which larval stage of the organism causing the infection?
A. Filariform
B. Cysticercus
C. Maridiform
D. Cercaria STADIUM INFEKTIF

47. Of the following which manifestation of infection known to occur?

A. Creeping Eruption CLM
B. Billiary cirrhosis SCHISTOSOMA JAPONICUM PASTI JADI CIRRHOSIS
C. Cholecystitis CHLORNOSINESNIS
D. Pruritus Ani ENTEROBIUS VERMICULARIS
D. Visceral Larva Migran TOXOCARA CANIS
BACA CLORNICHINESIS
48. A 57 years old woman came with unconsciousness to the emergency ward. She had fever,
tachicardia, RR 21 bpm, with a BP 80/60; extremity warm; have history of chemotherapy 2
weeks ago for breast cancer. Neutrophil 540/ul. She had been given 1L ringer lactate, but BP
only increased to 90/60. What should you do next?
A. Take blood culture SLIDE DR ANDERE
B. Another bolus 2L ringer lactate
C. 2gr Ceftriaxone
D. Central Venous Line insertion
E. Give dobutamine`` NAIKIN BP KARENA BP RENDAH

49. A 52- year-old man is brought to the emergency department in an unconscious condition. On
examination, he was death form more than one hour. On autopsy of the brain, there is cysts

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 fluid containing protoscoleces with hooklets and many daughter cysts were found. What is
the most likely diagnosis of this disease?
A. Hydatidosis ECHINOCCCUS GRANULSOS
B. Cysticercosis KISTA OTAK TAENIA SOLIUM
C. Cerebral malaria
D. Hstoplasmosis
E. Toxoplasmosis

50. A frustated patient was diagnosed with leprosy. He is afraid that he is cursed and goint to
die. As a medical doctor, what will you say to the patient?
A. Rest all day and don’t do his job
B. It cannot be cured
C. Treatment in leprosy house
D. Look out for the wound
E. Highly contagious and contact his family LECTURE NOT HIGHLY CONTAGIOUS

51. A 32 years old man from South Borneo comes to ER with abdominal pain and diarrhea. Stool
specimen shows large, elipsoidal, operculated with thin transparent shells 140x85. What is
the parasite?
A. Fasciolopsis buski ELLIPSOIDAL EGG
B. Trichinella
C. Echinococcus
D. Schistosoma japonicum
E. Clonorchis

52. Indonesia daerah yg punya penderita lepra. Sebagai dokter di Indonesia, kita harus tahu
bagaimana cara mengidentifikasinya, gejalanya adalah?
A. Some boils that spread rapidly over the face
B. A wound on the foot that dirty, have a lot of pus
C. A swollen leg that is red, have a sharp border
D.
E. A white patches which is not itchy, but numb NOT ITCHY MATI RASA (5A) TANDA
LEPRA

53. A 21 year old college student comes with rash, mainly centripetal distribution, starting from the
trunk, to the face and spreading to other parts of the body. The rash was mainly papules,

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 vesicles, and scabs. Many of her friends have the same symptoms. Which of the following
health intervention is the best approach to reduce the transmission of the disease?
A. Preventive PENYAKTINYA VARICELLA
B. Curative
C. Rehabilitative
D. Promotive
E . Environmental modification

54. A 4 years old boy came to dermatovenereology clinic because of itching all over the body
especially at palms, side of fingers, abdomen, and buttocks. Clinical manifestations: papules,
vesicles, pustules, erotion, and excoriation on his finger webs, sides of palms and feet, hands,
abdomen. Itchy especially at night. His neighbors have the same problem, and he often
plays with them. What is the most likely diagnosis?
A. Psoriasis
B. Scabies NIGHT ITCHY
C. Dermatitis atopik
D. Tinea corporis
E. Pedikulosis corporis

55. A 30 years old male sexually active and use protection. He want to do screening. What to
do? SCREENING RAPID TEST
A. HIV-RNA
B. CD4 count
C. Rapid test SCREENING MSM RAPID TEST
D. western blot
E. HIV-ELISA

56. When a clinician does a blood culture examination, what should be concerned to create the
best results?
A. The most critical step in collecting is the proper cleaning of site TEMPATNYA
BENER DARAHNYA OTIMAL HASILNYA
B. Draw the blood at fever spikes
C. Determine type of culture bottles as indicated per physician order
D. Amount of blood for culture drawn less than 10 ml.

57. A 7 years old girl had runny nose that developed a yellowish-honey coloured scab around her
nose and mouth since 2 weeks ago. Her parents consulted with their family physician whether

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 they should ignored this condition because it was related to the changing whether and would
disappear by itself and that there is no need to give any medication. As family physician, what
information would you give to the parents?
A. It will recure in the future and cannot be healed completely.
B. This is kind of allergy and need anti allergy drugs
C. It is self- recovery diseases and no need medication
D. This can cause glomerulonephritis BACA IMPETIGO BISA BIKIN GN
E. This is inherited and no need treatment

58. A man living in Bali came to the ER presenting with generalized seizure. CT of the brain
shows calcification. On brain biopsy reveals scolex with rostelum. Causative agent is:
A. T. Solium
B. E. Granulosus
C. T. Spiralis
D. T. Saginata
E. T. Cati

59. Of the following, which one is the most likely mode by which this disease in the above clinical
case acquired?
A. Ingestion of larvae in contaminated food
B. Ingestion of cyst in contaminated food
C. Ingestion of egg in contaminated food MAKAN TELOR JADI KISTA OTAK
MAKANYA SEIZRUE DAN KALSIFIKASI
D. Ingestion of poorly cooked beef
E. Ingestion of poorly cooked pork

60. A laboratory examination of a leprosy patient afte N4 months M D T therapy revealed Bacterial
index 6+ and morphological index 50%. What is your conclution for this result ?
A. Pausibacillar leprosy patient sensitive to treatment
B. Multibacillar leprosy patient sensitive to treatment
C. Multibacillar leprosy patient resistent to treatment
D. Pausibacillar leprosy patient resistent to treatment
E. Pausibacillar leprosy patient prone to nerve damage

61. A 5 years old boy came to a paeditrician because of poor appetite. Physical examination shows
he is small for his age and had a slightly enlarged liver. Lab examination found marked
eosinophillia. When questioned about pets her mother reported her son likes to spend a

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 gread deal of time with his puppy. Of the following, which of the parasitic below is
responsible ??
A. Echinococcus granulosus
B. Strongyloides stercoralis
C. Enterobius vermicularis
D. Trichinella spiralis
E. Toxocara canis VLM OLM PUPPY

62. From the case above, what is the clinical manifestation of the infection is known to occur?
A. Creeping Eruption
B. Pruritus ani
C. Biliary cirrhosis
D. Cholangitis
E. Visceral Larva Migrans TOXOCARA

63. A 9 years old boy was brought to ER on your night shifts with chief complaint breathing
difficulty and noisy breathing since 3 days prior. He also had fever, cough, hoarseness,
myalgia, and headache. He refused to eat because of very painful sore throat. You found
bilateral neck lymph node enlargement and white membrane on his tonss during oral
examination. What additional exam would you order to establish the diagnosis of this case?
DIPTHERI ADA PSEUDOMEMBRAN PALING BAGUS THROAT SWAB
A. Neck X-ray - to reveal any laryngeal edema
B. Complete blood count - searching for any clue of bacterial infection
C. Throat swab - check gram staining and swab culture
D. Bronchoscopy - you to check any airway obstruction
E. Consult to ENT specialist

64. A 56 years old sheep farmer presents with abdominal pain. Liver is enlarged with palpable
mass at righr upper quadrant. CT scan reveals a large encapsulated lesion consistent with
hydatid cyst. What organism may have caused this?
A. Echinococcus granulosus
B. Trichinella spiralis
C. Clonorchis sinesis
D. Schistosoma japonicum
E. Fasciolopsis buski

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65. What is the most dangerous manifestation of the case above when we perform surgical
removal?
A. Seizure
B. Hemorrhage
C. Peritonitis
D. Anaphylactic shock PECAH BIKIN ANAFILATIK SHOCK
E. Cardiac arrest

66. A 39 years old woman whose husband has a pig at home kept for house purposes come to the
family doctor with symptoms of periorbital edema, weakness, and muscle pain. What is the
most probable parasite causative in this case? BABI MYALGIA TRCHINELLA SPIRALSI
A. Schistosoma japonicum
B. Fasciolopsis buski
C. Trichinella spiralis KISTA DALAM DAGING BABI = NYERI OTOT
D. Echinococcus granulosus
E. Clonorchis senesis

67. Of the following disease, most likely source: KISTA DAGING BABI
A. Undercooked pork LARVA DALAM DAGING BABI DARI SLIDE
B. Undercooked beef
C. Ingestion of larvae on the organism contaminated food
D. Ingestion of cystic on the organism contaminated food
E. Ingestion of egg on the organism contaminated food

68. A 36 y.o man attended out patient clinic with complains of fever more than 1 week. Blood
smear examination shows erythrocyte with ring form, and infected red cell is enlarge. Of the
following, which is the most likely diagnosis of this patient?
A. Vivax Malaria PASTI MEMBESAR
B. Falciparum Malaria
C. Malariae Malaria
D. Ovale Malaria MEMBESAR TAPI TIDAK SEBESAR VIVAX
E. Knowlesi Malaria

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 V
69. A woman came with the complaint of being uncomfortable and hardened in the left upper side
abdomen. Every 4 days, she is intermittently feverish. On the blood smear exam, plasmodium
parasite (+). Of the following, which parasite can cause this?
A. Plasmodium falciparum PALING PARAH TERTIANA
B. Plasmodium vivax TERTIANA
C. Plasmodium malariae KUARTANA
D. Plasmodium Ovale TERTIANA INDONESIA TDK ADA
E. Plasmodium Knowlesi

70. From previous case, what is the pathogenesis of fever in this patient?
A. Sporozoit in blood
B. Hypnozoid in liver is formed
C. Process of gametocyte in blood
D. Pigment of parasite is formed

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 E. Merozoits released from schizont enter the blood MAKANYA PRODUCE SYMPTOM

71. Patient on MTD MULTIPLE THERAPY DRUG complain of red pink urine on first day of
medication. What to do?
A. Stop clofazemin, cause dark brownish discolouration
B. Stop medication cause of nephrotoxicity
C. Stop dapsone, cause hemolytic anemia
D. Continue medication, it's not medication adverse effect RIFAMPIN
E. Change to singe angent therapy

72. A 23 years old man presents with extreme swelling of his legs and scrotum. The skin
associated with the swollen area is thick and scally. The patient admits to an episode of fever
associated with enlargement of inguinal lymph nodes some times ago, but did not think
much of it.Which of the following is the best method to make diagnosis?
A. Examine the stool for the presence of egg
B. Examine the stool for the presence of larvae
C. Examine the blood smear for the presence of Adult worms
D. Determine the titer of IgE antibody against the parasites
E. Examine the blood smear for the presence of microfilaria YANG BUAT DX
MICROFILARIANYA

73. On the following, which is the most appropiate treatment for this condition on case above?
A. Surgical excision
B. DEC FILARIASIS PASTI DEC
C. Metronidazole
D. Mebendazole
E. Thiabendazole

74. A 51 years old man came to OPD with eruption in his left elbow since 3 days of his trip. The
area 6 cm, linear, erythema to bulbous lesion. The possible causes?
A. Dermacentor andersoni LABA LABA
B. Paederus peregrimus TOMCAT ERYTHEMA BULBOSUS
C. Lactrodectus mactans LABA LABA
D. Loxoxceles laeta
E. Lytaa versicatoria

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75. Ada pembesaran di kaki kanan. Pada pemeriksaan mikroskopik, ada mikrofilaria dengan ciri
deeply stained with giemsa, nuclei from tip to tail, in tail there is 2 separated nuclei.
A. Brugia timori 3 NUCLEI
B. Brugia malayi 2 NUCLEI DEEPLY STAIN
C. Ovavulus
D. Wuchereria bancrofti TIDAK ADA INTI TAMBAHAN

76. Referring to the previous cases, causes of the symptoms (elephantiasis) is:YANG BIKIN
ELEFANTIASIS ITU ADULT WORMNYA
A. Obstruction of arteries by microphilariae
B. Obstruction of arteries by adult worm
C. Obstruction of lymphatic by microphilariae
D. Obstruction of chronic lymphatic by adult worm
E. Fibrosis in lymphatic vessel

77. A male, MSM, datang ke poliklinik mau evaluasi treatment HIV nya. CD4+ 320. What is the
next step management? HARUS CEK TB DULU
A. Start ARV DIBAWAH 350
B. Check Tb DISOAL ADA KENA TB NYA TRUS HARUSNYA TREAT TB DULU
C. Give Prophylaxis serum
D. Don’t give ARV until the CD4+ <200
E. Give prophylaxis Claritomycin

78. 6-month-old baby boy has had fever, increased frequency pf cough with forceful inspiratory
gasp and postussive vomiting, and crackles both lungs. Treatmentnya? PERTUSIS
A. Cefuroxime
B. Cefixime
C. Clarithomycin BORDATELLA PERTUSIS MYCIN2
D. Pencillin G
E. Penicillin V
hemoprophylaxis of pertussis are azithromycin*, clarithromycin, and erythromycin.
Trimethoprim-sulfamethoxasole can also be used
79. HIV +, dalam pengobatan tb sejak 1 bulan lalu, dan Hep.B +. Initial antiretroviralnya? TEE
A. Zidovudine + Lamivudine + Efavirenz
B. Tenofovir + Emtricitabine + Efavirenz KALO TB TEE
C. Tenofovir + Emtricitabine + Nevirapine
D. Zidovudine + Lamivudine + Nevirapine

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 E. Zidovudine + Lamivudine + Ritonavir/lopinavir

80. A 45 tahun wanita, datang ke rs karena diare selama 3 hari, sebanyak 5-6x, sebelumnya dia
dirawat di rs karena pneumonia. Ada riwayat nasopharinx CA, faktor yg mempengaruhi
diare?
A. agent not usually cause disease in healthy person CHEMOTHERAPY JADI
IMNOSUPRESAN
B. evolution of pathogen shg bisa ke new host
C. development of drug resistant of pathogen
D. non-adherence pasien dlm minum penumonia drugs
E. pake counterfeit drugs

81. A 29 years old Female come to her family physician for a consult. She will go to Papua next
one week. She is married, and have not had her period for 2 months. What drugs for
prophylaxis?
A. Atovaquon/proguanil 2 days before departure
B. Doxycycline 2 days before departure GABOLEH HAMIL DAN ANAK KECIL DOC
PROPHYLAXIS
C. Mefloquine, a week before departure MEFLOQUIN PROPHYLAXIS UNTUK IBU
HAMIL
D. Primaquine, a week before departure
E. Sulfadoxine-Pyrimethamine, a week before departure

82. A boy 8 y.o. was brought to the emergency department by his mom because of vomiting and
dyspnea. He has fever 39.9°C. He was playing in the backyard, on examination the were
several stings mark on his backs. What is the most possible insect bites:
A. Permacentos andersoni LABA2
B. Lactodectus mactans LABA2
C. Loxoxceles laeta LABA2
D. Hymenoptera sp. LEBAH
E. Lytta vesicatoria

83. Orang tertusuk jarum suntik orang lain, langkah selanjutnya?

A. Rapid test
B. Post-exposure HIV prophylaxis TANYA GERAL
C. Start antiviral
D. Do nothing

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84. A patient come with an itchy recured fungal infection on the feet and need some
advice to be cured and some prevention measures so the diasease will not occure again,
doctor already gave him some medication for fungal infection. What kind of advise can
make him healthy?
A. Don't eat seafood
B. Use always sandals
C. Keep the skin dry and clean
D. Don't use shoes all day long
E. Don't scratch, will spread the infection

85. A 33 years old businessman has been reported died in mexico because of spiders bite, what is
the possible cause ?
A. Arachnidism
B. Erucism ULAT BULU
C. Leptidopterism KUPU2
D. Tick paralysis UTU
E. Delusional parasitosis

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