Statera - FM New Era

Semester 7
Final MDE
Family Medicine System
Tim Akademik
STATERA 2011
Semester 7 – Final Family Medicine System STATERA 2011 | 0

1. 12 years old boy bring to your offices by his parents with complaint often makes troubles in schools for bullying and being
aggressive toward other students. Since 2 yeas ago he often truants from school and steal from shop. He lives with parents, his
sister, his grandfather, his grandmother, his aunt and his nephew. His father is punitive. His mother give more attention to his
sister. His grandmother wants him to become a doctor so always told him to study hard.
What is the problem of the boy?
A. ADHD
B. Conduct disorders
C. Mood disorders in adolescence
D. Oppositional deviant disorders
E. Antisocial personal disorders
2. Which of the following situation is the most affecting the occurrence of this disorder.
A. High socioeconomic
B. Harsh and punitive father
C. Lives with extended family
D. Always encourage to study hard
E. Mothers gives more attention to her sister
3. WOTF statement is appropriate in family psychoeducation for this case?

A. Accept and care for the patient
B. Avoid too much praising or rewarding the patient
C. Confront the patient everytime he shows aggression behaviors
D. Give a hard punishment everytime he does not behave properly[Receiving Text]
4. WOTF is a correct management for this patient in primary health care?

A. Parent skill training is a core management
B. Use medications for severe disruptive disorders
C. Consider methylprenidate for aggresive disorders
D. Anticipate major changes life, arrange personal and social support
E. For confidentially, avoid involving school's teacher in management plan
5. Which neurobiological factor below hypothesized to play a role in clinical symptoms in this case?
A. Low level of plasma dopamine-alpha-hydroxylase
B. Increase noradrenergic function
C. High 5-HIAA levels in blood (low)
D. Low serotonin level in blood (high)
E. Lower right frontal EEG during rest (high)
6. 7 yo boy brought by his parents with complain of trouble at home and at school.He frequently runs around the classroom and
can,t remain in his seat for more than a few minutes. He also had a number of accident in the classroom n on d playground.He
can,t focus his attetntion on one task and is easily distracted. The other children are annoyed by his inability to wait his turn when
playing games and his intrusion during conversation. WOTF is the most likely diagnosis?
a. ADHD,
b. Deliquency,
c. conduct,
d. oppositional antisocial personality
7. Rude, hostile, suka maki2 guru2nya. Menjadi sensitif dan melanggar peraturan. Tapi tidak melanggar hak orang lain. Kenapa
langsung didiagnosis oppositional disorder, apa yg membedakan dengan conduct disorder?
A. Disobey the rule
B. Rude
C. Not violating other's right
8. A woman develops sudden blindness.. Pupil reacts to light.. Happens after witnessing violent argument of her parents.. Her
parents mid divorced.. Focus on her sister illness.. Diagnosis ?
A. Malingering: gejala fisik atau psikologis palsu atau dilebih2kan karena avoiding work, pengen obat, dsb.
Somatoform disorder: cirinya ada gejala fisik tapi tidak ditemukan physical finding
B. Hypochondriasis: fear or idea of having serious disease
C. Conversion disorder: sudden loss of neuro function karena severe stressor  tapi hasil pemeriksaan neuro, lab dan Xray tidak
sesuai dengan keluhan.
D. Facticious
E. Somatization disorder: banyak gejala somatik yang tidak dapat dijelaskan dengan PE dan LT (multiple and chronic, at least 2
gejala GI/ 1 gejala sexual/ 1 gejala pseudoneurologis)

9. Pasien wanita 41 tahun. Datang dengan keyakinan kalau ada cervical cancer,trus diperiksa ga diperoleh keanehan.pasiennya
malah mikir mungkin ada kesalahan pemeriksaan. Diagnosis?
A.malingering
B.Hypochondriasis
C.Conversion disorder
D.Factitious
E.Somatization
For Question 10-13, refer to scenario below.

A 36 years old female comes to your clinic with multiple physical complaints : her back, belly and chest pain. Her dyspareunia,her
excessive menstrual bleeding and her constipation and gluten intolerance. She states that she always been sick in her life. The patient
has a long history of doctor shopping.
10. Patient with complaint pain in belly, chest, back pain, dyspareunia, excessive menstrual bleeding. Ada masalah constipation,
glucone intolerance. Udah mengalami most of her life. Dan dia melakukan doctor shopping.
A.malingering
B.Hypochondriasis
C.Conversion disorder
D.Factitious disorder
E.Somatization disorder
11. What is the best approach ?

A.Assess her regularly for other psychiatric illness
B.Convince the patient that any physical workout is unnecessary
C.multidisciplinary approach, utilizing many different specialty service
D.Monthly visit with you, limited diagnostic testing and specialist consultation.
E.Explain to patient not to worry because there is nothing wrong with her
12. Which of the following about somatoform symptoms is correct?

A. Bodily experience of emotion are uncommon
B. Somatoform symptom should not be considered as normal
C. Families are alos shape the tendency to experience the symptoms.
D. Somatoform symptoms are modeled or reinforced by the patient itself
13. Which of the following explainantion is the most apporpiate for your patient in the beginning?
A. “Your pain isn’t real. But your psychiatric illness is.It’s called somatization disorder.
B. You have unexplained symptoms. There is nothing wrong with you.So I will refer you to the psychiatrist.
C. ”Please try to relax, because I don’t find anything wrong with your body and all your complaints is all due to stress, its all in
your head. You better see a psychiatrist.
D. You have a number of symptoms that are very real but cannot be explained by our investigation. The evidence suggest that
you don’t have any threatening illness.You have a well defined disorder and other patient have similar problems.
E. You have a lot of very serious complaints. But my physical exam is inconsistent with your complaints.Basically I don’t
believe a word you are saying.You better tell me the truth.Because the sooner you admit falsifying these symptoms, the
sooner I can help you.
14. 40 yo man comes to PHC. Complained gradually blurred vision without red eye. No complain of frequent micturition, eat, or
drink. No history of hypertension. Which of the statement can cause the blurred vision to the men?
a. Conjunctivitis
b. Keratitis
c. Episcleritis
d. Scleritis
e. Selulitis
15. Which of the following may affect the patient complaints?

A. Cornea
B. Lens
C. Sclera
D. Vitreous
E. Conjunctiva

16. Mr. Karno come to PHC. Doctor diagnose asa mature cataract. WOTF sign of mature cataract ?
a. Visus 0.8 – 0.9
b. Shadow test (-)
c. Opacity in half nucleus
d. Blurred vision occur suddenly
e. Recover with eye drop
17. According to the WHO, cataract is the leading problem of blindness and visual impairment. The criterion of blindness based on
WHO is
a. Visual accuity on better eyes 1/60
b. Person who can’t see light
c. Visual accuity on better eyes after collection is 1/60
d. Visual accuity on better eyes after collection is 3/60
e. Visual accuity on better eyes is 1/300
18. Mrs. Ratmi has been felt decrease her vision gradually since 6 month before. She went to primary health care and the doctor ask
her for the operation. what is the indication before that not indication for cataract surgery?
a. Mature cataract
b. Complicated cataract
c. Insipien cataract
d. Patient desire improve her vision
e. Patient found difficulty in daily activity
19. A 65 years old had been diagnosed with infarction stroke and had been hospitalised for 5 days, 4 weeks ago. He still has
communication disorder but still understand what people said and weakness of right extremities as a sequelae. He was bedridden
and grimaced if the right shoulder are moved. He had been diagnosed with HT and DM for 15 years ago but he didn’t control
regularly. He got the antihypertension drug from the doctor after hospitalised and he got it only if there is headache symptoms. He
always ate satay kambing in the weekend and he is a retired government officer.
Which of the following is the main problems of this patients?
A. Post stroke infarction
B. Disability and bad adherence
C. Hypertension and DM
D. DM
E. Bedridden and dyslipidemia
20. Functional diagnosis in the case above..

a. Impairment
b. Disability
c. Handicap
d. Impairment and disability
e. Impairment, disability, and handicap
For 21-25
65 yrs old man, stroke infarct. Hospitalized for 5 days 4 weeks ago. He has communication disorder but can understand what people
say. He is bedridden, looks grimace when move right shoulder. He was diagnosed with hypertension and diabetes melitus 15 yrs ago
and didn't control it. Only take his medication when he has headache. He eat sate kambing on the weekends. He is a retired
government officer
21. where is the location of stroke infarction of this patient?

A. Cerebellum
B. Medulla oblongata
C. Pons
D. Right hemisphere
E. Left hemisphere
22. Which is the following stroke complication of this patient?

A. ulkus decubitus
B. hypertension
C. contracture
D. Paralysis

E. Hyperglycemia
23. Which of the following is the communication disorder of the patient?

A. Sensoric aphasia
B. Motoric aphasia
C. Transcortical sensoric aphasia
D. Transcortical motoric aphasia
E. Global aphasia
24. Which of the following is the impact of illness to the family?

A.Bad communication
B.Dependency
C.Cost of treatment
D.Risk factor modification'
E.Disability
25. Antiplatelet for this patient?

A. Heparin
B. Warfarin
C. Streptokinase
D. Aspirin
E. Dipyridamol
For Q26-28
A 65 years old had been diagnosed with cervical cancer and had back pain for 4 weeks ago.She had radiating pain and tingling in her
left leg. From neuro exam: Laseque and Kernig of left leg limitation due to pain, normal physiological reflex, and there is no
pathological reflex.
27. What is your planning for this patient due to back pain?
A.pain management
B. Radioteraphy
C. Physioteraphy
D surgery
E. Chemoteraphy
28. What analgetic therapy you should give to this patient?

A.Acetaminophen
B.Meloxciam
C.Opiod
D.Antidepressent tricyclic
E.Anticonvulsant.
29. A 33 years old women come to your clinic complaining progressing nervousness, fatigue, palpitation and recent development of
hand tremors.
Which of the following answer are correct for her chief complaints?
A. A 33 years old women come with nervousness, fatigue, palpitation and hand tremors.
B. A 33 years old women comes with nervousness and fatigue.
C. Nervousness, fatigue and palpitation
D.A 33 years old women come with hand tremors
E.Tremors.
Q30-33
Ms. S a 32 years old women come to your clinic that comes with severe back pain ii not relieved by analgetics.She also stated that she
got abdominal pain and severe headache. She also reported general pain in all her joints and also difficulty with her balance.
30. Based on POMR, which of the following answer is correct?

A. Data base: identitas
B. Problem List: major acute illness
C.Management plans
D.History of present illness
E.Progress note.
31. During twenties, patient experience severe menstrual bleeding, and complaints of numbness and tingling in her hands. She
already seen many doctors but the complaint persist.
Which of the answer is related to statement above?
A.History of past.
B.Problem list

C.Management plans
D. History of present illness
E.Progress note.
32. From further anamnesis, for as long as she can remember, Ms. S had been poor health. She has worked as an administrative staff
with for 7 years and feels burned out with her daily task. She also felt that her multiple illness have held her back and made her
work more difficult. Based on the component of medical record, which of the following answer is correct?
a. Problem list
b. Family and social history
c. Management plan
d. Data base
e. History of pass illness
33. Ms. S stated that she is the only daughter and always lives with her parent because of her health problem. She feels her parent
very understanding and supportive based on component of medical record, which of the following answer is correct?
a. Problem list
b. Family and social history
c. Management plan
d. Database
e. History of pass illness
34. Umur 45 tahun, BP 150/90, dalam JNC VII termasuk kategori yang mana?
A. Normal
B. Prehipertensi
C. Stage 1 140-159/90-99
D. Stage 2
E. Stage 3
35. What can we do to increase adherence to medical treatment: komunikasi, sederhanakan regimen, kurangi yg diminum bareng,
lbatkan keluarga
A. Give expensive medicine
B. Educate the patient
C. Prescribe a lot of medicine
D. Poor communication
E. Watch TV a lot.
36. What is the complication of Hypertension

A. Fever
B. Stroke
C. Vomiting.
D. Headache
E. Orbital Pain
37. Blindness depends on WHO is visual acuity less than 3/60 with refraction or visual field less than 10 degree. There are some
disease that can cause blindness. If blindness happen to 45 million people, what is the most common cause of blindness?
a. Glaucoma and diabetic retinopathy (15%)
b. Trachoma, oncocercosis, deficiency vitamin A (15%)
c. Age related macular degeneration disease (10%)
d. Catarract and refractive error (50%)
e. Other
38. Vision of IAPB is a world in which no one is needlessly blind or visually impaired and where those with unavoidable vision loss
can achieve their full potential. IAPB collaborate with WHO, NGO and eye care professional lunched vision 2020.
WOTF is trends & projection of global blindness in 2020 if vision 2020 non implemented?
a. 45 million
b. 38 million
c. 76 million
d. 69 million
e. 62 million
39. WOTF is the service unit of vision 2020?

a. In district level
b. In province level
c. In country level
d. There is no service unit for vision 2020
e. In primary health care

40. IAPB promotes global initiative vision 2020 the right to sight. WOTF is the aims of the vision 2020 the right to sight?
Mencegah doubling orang yang visual impairment
A. A world in which no one is needlessly blind or visually impaired and where those with unavoidable vision loss can achieve
their full potential : vision
B. To eliminate the main cause of avoidale blindness by the year 2020
C. Brings together government & NGO to facilitate the planning, development & implementation of sustainable natural eye care
programmes
D. Based on the three core categories of disease control, human resource development & infrastructure development
E. To eliminate blindness by the year 2020
41. Tentang vision 2020: WOTF is not the characteristic of successful of 10 years of cataract
A. Low cost IOLs
B. Training in ECCE initially and now SICS
C. High volume of surgery in S.E. Asia region
D. Sustainability model
E. Training of ophtalmic nurse in surgery
42. Laki-laki berusia 75 tahun menderita infark stroke yg didiagnosis 4 minggu yang lalu. Susah menggerakkan ekstrimitas kanan.
Susah berkomunikasi tapi masih mengerti apa yang dibicarakan orang. Tinggal dengan istri, anak, menantu, dan cucu. Hanya bisa
berbaring, pensiunan PNS, tidak bisa kerja. Marah karena tidak bisa berkomunikasi dengan baik. Problem?
A. Impairment
B. Disability
C. Handicap
D. Impairment dan disability
E. Impairment, disability, dan handicap
43. What rehabilitation problems does patient have?

a. Mobilization, vocational, impairment, occupational, disability
b. Mobilization, communication, vocational, occupational, disability
c. Mobilization, communication, impairment, occupational, disability
d. Mobilization, communication, vocational, occupational
e. Mobilization, communication, occupational, social, vocational
44. Seorang ibu datang membawa anak laki-lakinya yg berusia 4 tahun ke RS. Ibunya mengeluhkan bahwa anaknya lebih pendek dari
teman-temannya. Perkembangan lainnya normal. Kedua kakak laki-laki dan orang tuanya memiliki tinggi normal. Bagaimana
Anda menjelaskan batas kriteria short stature pada anak? Height/age <-2
A. Weight/age under 2 SD on WHO growth curve
B. Height/body wieght under 2 SD on WHO growth curve
C. BMI/age under 2 SD on WHO growth curve
D. Weight/age under 2 SD on WHO growth curve
E. Head circumference under 2 SD on WHO growth curve
45. Hormonal test for short stature

A. Creatinin & ureum
B. Karyotype test
C. T4 & TSH
D. Bone age
E. Brain MRI
46. Beberapa keluarga memiliki anggota keluarga yang menderita short stature. Kita harus bisa membedakan apakah itu familial short
stature atau constitutional delay. Pemeriksaan bone age penting untuk mengetahui penyebab dari short stature tersebut. Dengan
pemeriksaan bone age kita dapat menemukan constitutional delay. WOTF is the criteria for constitutional delay?
A. Familial history of short stature
B. Normal pubertal development
C. Normal bone age
D. Late pubertal development
E. Osteogenic imperfecta

47. One of the treatment of short stature is hormonal therapy. It should be determine by the teen growth & development. It must meet
the criteria from growth hormon definition. Which criteria of short stature who receive growth hormon?
A. Weight for age below 2 SD at the WHO growth curve
B. Dysmorphic disorder found
C. There is specific hormone ....
D. Delayed bone age more than 2 years
E. Height below -3 SD
48. WOTF steps for growth curve analysis

A. Anamnesis
B. PE
C. Growth velocity
D. Determine upper & lower segment
E. Determine target height
Ringkasan Case 49-52

Ada pasien remaja, female, 15 yo, obese/overweight. Berasal dari keluarga yang harmonis dan sosioekonomi tinggi. Orang tuanya
sangat sayang. Ayahnya pebisnis punya banyak restoran ternama di kotanya. Ibunya suka sekali memasak makanan kesukaannya,
makanya dia udah comfort eating dari kecil. Dia makan 3x sehari plus banyak snack. Tiap kali ada masalah dia minta ibunya masak
makanan favoritnya atau minta uang jajan buat makan di luar. PE normal.
49. WOTF situation is most likely to be psycodynamic of the patient case?  obese
A. Patient’s mother love her too much
B. Patient’s mother love to cook her favourite food
C. Patients come from high socioeconomi
D. Patient used to obtain comfort from food
E. Her father runs most famous restaurant in town
50. WOTF that more likely to be psychiatric comorbid disease in this case?  obese
A. Depression
B. Social phobia
C. Psychotic disorder
D. Behavioral problems
E. OCD
51. Which of the following is the most appropriate management for her?
A.Counsel her about the complication of obesity
B.Reduce rice to decrease calorie intake.
C.Tell her mother not to cooks the her favourite food anymore.
D.Teach her stress management to cope uncomfortable emotions.
E.Limit her money so she cannot go to café and restaurant anymore whenever she want to.
52. WOTF statement of this patient is likely to be true?

A.if the patient doesn't has a rigid diet,she will tend to 'yo-yo' diet
B.if the patient has a rigid realistic goal she will tend to weight cycle
C. If she has self-efficacy, she will be able to maintain her weight loss better
D.If patient success to maintain diet, patient may demonstrate loss of weight initially
E.In this patient and other patient, their specific personality is due to obesity
53. 23 yo woman, mild acne, spent a lot in skin treatment and dermatologist, she felt she's "ugly like a monster", then she had social
withdrawal and she quit her job.
What disorder?
A social phobia
B adjustment disorder: maladaptive reaction terhadap stressful event
C delusional disorder: delusi aja
D adjustment disorder
E body dysmorphic disorder
54. 12 yo boy brought by his mom complaints acute diarrhea. His mother asks whether he has behaviour disorder. He's a 'lazy boy'
sometimes hard to be told to study hard & prefers play w/ peers. School grade is fine.
A. Patients diagnosis is delinquency: ada illegal behavior

B. Patients diagnosis is conduct disorder
c. Patient doesn't have behaviour disorder
d. Patients diag is opp defiant disorder
e. Patient is in high risk of behaviour disorder
55. A 33 years old complaint of not getting pregnant for 4 years married. She and her parent does not have any serious reproductive
system.But her nutritional status obese since she was teenager. Her lipid profile and blood glucose is never in normal limit.
What the influence her nutritional status to reproductive quality?
A. Anatomical abnormality in her reproductive system.
B. Hypercholestremia to HPA axis.
C. Artherosclerosis to her system.
D. Blood glucose to insulin resistance.
E. Abnormal meal pattern.
56. What is the most priority management of nutritional aspect of infertility?

A.Decrease cholesterol level
B.Decrease blood pressure
C.Insulin resistance management
D.Decrease physical activity
E.Decrease carbohydrate intake
57. The nutritional assessement from cumulative effect border line food intake in catch up growth age can assess ini parameter?
A. Developmental parameter
B.very low immune status
C.short stature
D.extreme underweight
E. No abnormality
58. What is the correct measurement to assess quantitative food intake?

A. food frequency questionnaire : kualitatif
B. food recall
C. periodic body weight measurement
D. dietary history
E. nutritional survey
59. To solve the difficulty food intake in children, more of the parent have opinion that milk can fulfill the nutritional
requirement.What is the best explaination to your patient about this opinion?
A. Its the correct action because milk is the ideal nutritional composition..
B. Give more milk can complete with vegetable.
C. Milk with multivitamin can solve the problems.
D. It is incorrect because of low intake of nonprotein calorie
E. You can add more sugar to increse the calorie intake
60. What cause combination animal and plant protein food resources is better than animal/plant food resources?
A. Animal food resources are more expensive
B. Animal food resources content more of saturated fat
C. Plant food resources need more quantity to eat
D. Balance plant and animal content with phytochemical substance
E. Plant resouces consist incomplete mineral
61. Increase food intake and improve quality of nutrient content is important to support FTT management. Advise the best method to
increase food intake?
a. Full calorie need
b. Increase step by step
c. More animal protein
d. More milk
e. Limit physical activity
62. what is the best supportive tools to make the same perception about portions of food sources and food changes?
a. Video presentation
b. Calculator
c. Food model
d. Poster
e. Real food

63. Nutritional intake can support the optimal growth and development in every step catch up growth in children. To calculate the
nutritional requirement we need the result of nutritional assessment and many correction factor that influence nutritional
requirement, for example?
a. Gender
b. Alergic status
c. Age
d. Body surface area
e. Liver function
64. The arrange menu planning important to support FTT management for provide protein&energy need. The goal of provide
adequate protein and energy needed to maintain the chief function for every nutrient, for example:
a. Protein sparring effect
b. Main function of fat as enterpreneur
c. Determine supplement need
d. Determine food processing
e. To prevent increase energy synthesis
65. To provide food choice and menu variation we need this tool to optimal explanation in nutritional therapy
a. Food recall data
b. Food frequency questionare data
c. Food list exchange
d. Nutritional requirement and data
e. Food weighing data
66. What is the next step after we determinate total calorie intake?
a. Amount of carbohydrate intake
b. Amount of protein calorie
c. Fiber source
d. Carbohydrate exchange
e. Animal food protein sources
67. Nutritional management in hypertension important to support blood pressure control.

How the management of fat intake in hypertension?
A.Low fat intake
B.Low cholesterol intake
C.The kind of fat is saturated fatty acid.
D.Omega 3 fatty acid consist in fat food sources.
E. They need only monounsaturated fatty acid.
68. Control Na intake is is important to support HT management. What food source and processing that correct to control Na intake?
a. Dairy product
b. Fresh food
c. Bread to substitute rice
d. Processing fruit
e. Processing fish
69. Kasus Hipertensi. What is micronutrient that involved in blood pressure regulation?
a. Ferrum and biotin
b. Vitamin A and C
c. Phospor and riboflavin
d. Calcium and vitamin D
e. Zinc and vitamin E
70. Anthropometric measurement is the simple step to detect nutritional assessment, the reference to determine the cut point of BMI
in teenagers is
a. CDC growth chart
b. WHO growth chart
c. NCHS growth chart
d. Disease risk factor chart
e. Depkes chart
71. Nutritional management with arrange time schedule of main course and between meal snack important to control blood glucose
and decrease risk ogf Insulin resistance.Control between meal snack and substitute kind of snack with low calorie snack and high
fibre support to control?
A, Hunger satiety
B.Protein absorption
C.Vitamin absorption

D. Increase fat utility
E.Increase mineral absorption
72. Control of food intake influence by many factor, development of personality and emotional control in teenager to puberty age
determine the amount of food intake. The role of family in weight management can improve bad habit in overweight patient.
a. decrease amount of main course menu
b. disappear between meal snack
c. behavior modification motivation
d. increase physical activity
e. pharmacological treatment
73. To assess the comprehensive dietary intake we can use this intake analysis method.
A.Food record.
B. Food Frequency questionnaire
C. Dietary history
D.Food recall
E.Nutritional screening
74. What is the most recall bias in food recall method?

A. Miss perception about food sources.
B.Inacuuracy of client memory
C.Low validity
D.The changes of food habit.
E.Not recorded of food supplements.
75. The abdominal neuroendocrine response in overweight/obese is develop to abnormal organ system activity in the long time
period.
Increase risk of these kinds of disease related to overweight is?
A,Renal stone
B.Infectious disease
C. Autoimmune disease
D.Gall bladder disease
E.Brain tumor
76. What is the main focus treatment in weight management?

a. Multidiscipline approach
b. increase daily activity
c. low calorie intake
d. behavioral counseling
e. maintenance health status
77. What is the correct role of the family in the weight management of adolescent?
A.Follow up daily activity living
B.Skip many high calori food
C.Increase physical activity
D.Motivation behavioural changes
E.Decrease sedentary lifestyle
78. Mr. Dadang 65 years old man had been diagnosed with infarction stroke and had been hospitalised for 5 days 4 weeks ago. . He
still has communication disorder but still understand what people said and weakness of right extremities as a sequelae.He was
bedridden and grimaced if the right shoulder are moved.He had been diagnosed with HT and DM for 15 years ago but he didn’t
control regularly.He got the antihypertension drug from the doctor after hospitalised and he got it only if there is headache
symptoms. He always ate satay kambing in the weekend and he is a retired government officer.
As a general physician, what should you do for this patient?
A.Education for bed positioning
B.Training communication
C.Training gait
D.Educate to bed positioning, training communication and gait.
E.Training communication and gait.
For question number 79 until 80, refer to the scenario below:

Mrs. Nunung is a 74 year old woman visited your clinic with complaining of left hip pain. She reported that she awoke with pain in her
hip approximately 2 weeks ago, after her fall. It did not radiate, initially sharp and severe and limiting her activities for first 4 or 5
days. She denied fall, trauma and unusual or new activities. Before she fall, she often felt dizziness if she stand after sitting. The pain
was occured when she was getting out of bed. Your diagnosis was left hip fracture secondary to osteoporosis. You prescribed calcium,
vitamin D, biphosphonate and educated her and her husband about fall preventiom and caring for elderly.

79. When will you refer to PM&R specialist?
A. After operating
B. One week before operating
C. Immediately
D. After she can getting out of bed
E. After she can gait
80. What intrinsic factors that may cause fall in this patient?
A. Contracture
B. Balance disorder
C. Visual impairment
D. Reduce muscle strength
E. Postural hypotension
For number 81-84

A young mother brings to you her 18 years old boy who weights 13,6 kg. This is at the 95th percentile for his height and sex. She is
concerned because her family has many numbers who are overweight and she worries that the future health are at risk.
81. Your best advice?

A. She should commit to a weight reduction program forthwith
B. The child weight related health is not an issue until he reached adolescent
C. The child should be committed to a weight loss program but not before he reach thae age 2 year
D. A child obesity related health issue involve cardiovascular disease, disease, joint health only and these problem do not begin
until adolescent
E. Obesity in childhood is not an issue
82. The subject of language development arises. What age do you alert the parents to expect the child to begin speak 2-3 words with
50 words vocabulary?  denver scale!
A. 15-18 months
B. 18-26 months
C. 2-3 years
D. 3-4 years
E. 4-5 years
83. His family is in stage ‘childbearing families’. What developmental task will be raised in this stage?
A. Adapting to the critical needs and interest of preschool children in stimulating growth promoting ways
B. Coping with energy depletion and lack of privacy as parents
C. Encouraging children’s educational achievement
D. Establishing a mutually satisfying marriage
E. Having, adjusting to, and encouraging the development of children
84. If the family success in this stage, they will enter following stage?
A. Preschool age family
B. Family with toddlers
C. School age family
D. Family with teenager
E. Family with launching young adults
For number 85-88

23 years old male, weight 81,5 kg and height 1,78 m. The patient has no family history of cardiovascular disease, hypertension, and
there is no dyslipidemia in his family. He has never smoked. He is concerned about his weight because his mother was significantly
overweight and died because of heart attack; and his father is modesty overweight. His total cholesterol: 240 mg/dL, LDL: 110 mg/dL,
and triglycerides: 130 mg/dL.
85. What is best education regarding this patient’s weight?

A. Reassure patient no weight-related health problem
B. Diet 1300 calories, 175 grams carbohydrates, 50 grams fat, and 50 grams protein
C. Very low calorie diet
D. Sibutramine for appetite control
E. No plan based on information given above
86. What is screening recommendation?

A. Blood pressure every 2 year
B. Blood pressure every 2 year for people with hypertension
C. Hyperlipidemia: total cholesterol at 45-65 years old
D. Colorectal cancer: DRE & FOB

E. Prostate cancer: DRE
87. Patient perception?

A. Lab result tends to abnormal
B. His appraisal of severity overweight
C. He has risk cardiac disease
D. He has risk obesity
E. His respond to lab result
88. What is the investigation used to explore his meaning of illness?

A. Patient explanatory model
B. Patient semantic illness network
C. Family member’s explanatory model
D. Family member’s semantic illness network
For number 89-91

5 years old female was brought to your clinic due to her height that shorter than other. Her height was under 5th percentile in growth
curves, even when correct for midparental height. There are many factors to short stature. She only speaks six-word sentences but they
are intelligible.
89. What is family influence could potential cause of her problem?

A. Psychological and social character of parent
B. Spreading infectious disease among family
C. Parental deprivation
D. Klinefelter syndrome
E. Environment condition of family
90. What is screening recommendation for this age?

A. Blood analysis
B. Hearing
C. Fluoride to prevent dental cavitations
D. Injury prevention
E. Breast
91. Which the following respond is the most appropriate:

a. Refer the child to specialized evaluation of development
b. Arrange conference with child teacher
c. Order MRI of child brain
d. Reassure the parents that the child is developing within normal limit
e. Review of the milestone of growth and development in this child
Q92-95
Family meeting antara Mr. and Mrs. Purcell, anaknya Marry 21 tahun dan Bob 17 tahun bersama dr. M. Mary spoke first and express
concern about her father’s “longs tanding” health problem. She blamed her mother for “not taking better care for him”. Bob quickly
defended his mother by saying she had been working very hard and mad a lot on her sister. Bob became upset with Mary for
“attacking” their mother. Mrs. Purcell told Dr. M that her husband had health complains for as long as she had known him. Mr. Purcell
then said that his chest pain were worse since the last doctor appointment. Family APGAR score = 3.
92. Who did acting coalition in this family?

a. Mary and Bob
b. Mr. Purcell and Bob
c. Mrs. Purcell and Bob
d. Dr. M and Mrs. Purcell
e. Mr. and Mrs. Purcell
93. How “hierarcy” taking place in this family?

a. Parents in charge to their children
b. Parents is controlled by the children
c. Overtly distributed
d. Covertly distributed
94. When a positive relationship between any two members of a system occurred, what is condition represent in the family?
a. Coalition
b. Hierarchy
c. Role
d. Alliance
e. Influence

95. Based on family APGAR score,what is the characteristics of this family?
a. Radiate a sense of integrity
b. Share power while negotiating decisions
c. Cope relatively well with adversity
d. creating coercive power differentials
e. carrying out of a crisis stronger for the experience.
96. “Satisfaction attained in solving problem by communicating” aspek APGAR yang mana?
a. Adaption
b. Partnership
c. Growth
d. Affection
e. Resolve
97. Lisa is a 48 yo woman who works in an animal laboratory. At first visit, you note that her BP has been elevated 160/95 mmHg
and 155/100 mmHg respectively. She has no history of hypertension and is not on any medications. Assuming that the initial
evaluation does turn up surprises, what should be your initial management?
a. Looking for symptoms of end-organ disease
b. Exploring cardiac risk factor
c. Starting with single drug anti hypertension
d. Starting with combination drug anti hypertension
e. Starting with lifestyle modification
Q98-99
A 51 years old business executive with a long history of high blood pressure collapsed while jogging over the lunch hour. His jogging
mate quickly contact a police officer who help carry the man to the hospital just down the road. An MRI was performed that reveal a
major blockage of a major cerebral artery and ischemic changes to a portion of brain. With quick attention, the man has stabilized and
he slowly improved over the next three weeks.The following sign and symptoms did persist however:
-Paralysis of the right leg and foot
-Loss of sensation of the right leg and foot.
-When blindfolded, unable to identified a tennis ball with his left hand, but ability to named it when in the right hand.
98. What stage of illness trajectory for this patient?

A. Onset of illness
B. Diagnosis phase
C. Major therapeutic effort
D. Recovery
E. Adjustment to the permanency.
99. What is a physician role on this stage?

A. Ease the the patient and family axiety and concern (1)
B. Responsible of making a clinical judgement about the amount of information (2)
C. Alert about potential problems that may occurred.
D. Defined psychological state of the patient and family about therapeutic plans. (3)
E. Anticipate the second crisis of adaptation to the outcome. (5)
100. What should physician do to his care giver in terms of "collaborating"?

A. Guiding patient and family through the intricacies of the healthcare delivery system
B. Advocating the patient and family members in preserving autonomy and choice regarding medical
C. Assessing family members in their decision making process
D. Gathering information, educating family members about the care of their loved ones
E. Supporting the patient and family members about the care of their loved ones
101. There are many categories to placement a patient into homecare program.
If you plan for home program for this patient, what is the category for this patient?
a. Unstable chronic illness
b. Acute exacerbations of illness
c. Patient still require rehabilitation
d. Patient stil require medical supervision
e. Advanced illness
For question 102-106.

Bambang is a 72 yo retired driver who was admitted to ur practice because of back pain. He has been a smoker for 30 years and
smokes 15 cigarettes everyday. Bill lives alone in a small house and has lost about 5 kg of weight in the past few months. His diet has
deteriorated since his wife passed away 2 days ago. Bill’s daughter accompanies him to visit his GP, as she is concerned about his
recent weight loss. His current medical history includes ramipril 5 mg once daily in the morning for well controlled hypertension. He

has no significant family medical history. On examination Bill’s blood pressure is 115/78 mmHg. A BMD test T-score in the hip is -
1.8 and in the spine is -2.7.
102. what is your diagnosis?
a. osteopenia
b. osteomalacia
c. osteoporosis
d. osteoarthritis
e. LBP
103. what is ur reccommendation for him to reduce risk of fracture?

a. HRT
b. hip protective padding
c. gait and balance training
d. high dose of vit D
104. considering his condition, he has risk of fall which is categorized as follow..
a. acute and chronic medical condition
b. social/behavioural factor
c. medication factor
d. extrinsic factor
e. activity related causes
105. what info would u provide to patient regarding physical activity?

a. low impact weight bearing exercise (WBE)
b. low impact WBE + high intensity strength (resistance) training (SRT)
c. low impact WBR + low intensity SRT
d. high impact WBR
e. high impact WBR + low intensity SRT
106. what info would you provide to patient regarding calcium intake?
a. should be taken in divided doses
b. should be taken in single dose
c. administered during waking hours
d. should be taken before meal
For question 107-109

A 60 yo postmenopausal woman is seeing u for her annual check up. She has been in good general health for the past several years.
She experienced menopause in early 50s and initiated HRT with estrogen/progestin for her menopausal symptoms; she has remained
on HRT primarily for prevention of osteoporosis. She is currently not on any chronic medication other than HRT.
Altough the patient has no personal history of fractures, her older sister experienced a hip fracture. She is 165 cm and 42 kg. She is
smoker, drink several cup of coffee a day, and rarely exercises. Her height is remain stable over the past 4 years.
107. what is the patient’s major risk of future fracture?

a. estrogen deficiency at an early age (<45 yo)
b. low physical activity
c. alcohol >2 drinks a day
d. high BMI
e. history of fragility fracture in first degree relative
108. BMD T-score -1.5, diagnosis?

a. osteopenia
b. osteomalacia
c. osteoporosis
d. OA
109. what is the treatment option for her condition?

a. discontinuation of HRT (hormone replacement therapy)
b. continue HRT
c. continue HRT and initiation of biphosphonate
d. no need treatment for his current condition
for 110-115
a 64 yo woman, p4a2, visit u with severe hip pain which is constant, boring, sometimes sharp with infrequent electric shock like
sensation radiating to left foot. She was diagnosed as cervical cancer IIIB, and receive chemoradiotherapy. Complaint accompanied by
nausea, vomit, dyspnea for the last 3 days. She has not yet received any medication for relieving pain.

110. what medication should be given?
a. codein
b. ibuprofen
c. diazepam
d. morphine
e. haloperidol
111. Administrasi obat di atas

a. Parenteral
b. Per enteral
c. Infusion
d. Injection
e. Oral
112. penyebab sakit pd pasien?

a. somatic
b. visceral
c. neuropathic
d. referred
e. somatic & neuropathic
113. After several weeks, mrs yuni looked severely ill n she was asking you to assure her family members that her condition is
better,no wories anymore. According to five stage of dying,the stage mrs yuni is..
a.denial
b.anger
c.acceptance
d.bargaining
e.depression
114. What is difference between pain and suffering ?

a. Pain is experienced by person
b. Pain is a part of suffering
c. Suffering is experienced by mind and soul
d. Suffering is physically and psychologically pain
115. Screening is one strategy to prevent cervical cancer.

If the screening were negative, what would be your recommendation?
a. It is important to be screened annualy
b. It is important to be screened every 2 years
c. It is important to be screened every 3-5 years
d. Not necessarily to be screened in the future
Q116-118
Rani is a 26 years old woman G2P1A0, present in the initial visit with a 4 week history of fatigue and nausea. She had a positive
pregnancy test 2 weeks ago. Rani has been on a multivitamin preparation with folic acid, she has been immunized against Hepatitis B
within the past 3 years.From physical examination, she is a well appearing, mildly overweight. Vital signs and other examination are
within normal limit. Your assessment is intrauterine pregnancy.
116. what do you plan to her?

a. amniocentesis
b. USG for identify the sex
c. stop folic acid,give iron tablet
d. diet,exercise,sexually active discussed
e. at least follow up 3 times during pregnancy.
117. Considering her weight, what is recommended weight gain during her pregnancy.
A. 15-18 kg
B. 12.5 – 18 kg (under)
C. 11.5 -16 kg (normal)
D. 7-11.5 kg (over)
E. Max. 6.8 kg (obese)
118. What immunization is contraindication to her

A. Tetanus
B. Hep. A
C. Hep. B
D. MMR

E. Influenza
119. You are counselling an expectant couple (women:P0A0) regarding preconception care should be performed. They are not
planning for pregnant at least in the next 3 months. No history of smoking,alcohol intake, previous disease,and family hereditary
disease.
A. Administration of MMR,Varicella,and Hep. B vaccine
B. Starting prenatal vitamin and/or folic acid supplementation
C. Education on benefits of breast feed
D. Preparing amniocentesis
E. Administration of Tetanus Toxoid vaccine
120. 25 yo woman who complained having abdominal pain, constipation, diarrhea and headache. The abdominal examination is
negative for deep and rebound tenderness. She lives with her husband and three children. She had been complaining all symptoms
since 3 years ago.
What the following statement is correct?

a. your diagnosis is depression
b. modern technology can diagnose her disease
c. understanding natural system continuum is needed to treat her
d. refer the patient to gastroenterologist
e. elaborate past medical condition is necessary to treat her
Q121-122

121. Interpret genogram from life style perspective!
A. Nuclear family, family with teenager
B. Extended family, family with teenager
C. Nuclear family, family with launching young adults
D. Extended family, family with launching young adult
E. Nuclear family, middle aged
122. interpret a genogram above from biopsychisocial perspective

A. index patient have Dm
B. Index patient have risk for hypertension
C. N.died because of old age
D. R has risk for obesity
123. Dr. Rio, a family physician plans to do a clinical audit for his clinical practice setting. He selects a structure of care to be audited.
Which of the following could be audited in term of structure of care?
a. Operating time: proses
b. Management of patients, sarana, prasarana
c. Mortality: outcome
d. Health indices: outcome
e. Patient satisfaction: outcome
124. Criterion?
a. Patient who have been diagnosed as Asthma will be recorded in practice Asthma register
b. Diagnosis of asthma has been confirmed
c. Patient education regarding warning symptom has been delivered
d. An assessment of the level of control of Asthma by the presence of nocturnal and daytime symptom
e. 95% diagnosis of asthma has been confirmed by anamnesis, PE and lab
125. After developping standard what should dr.Yono do?

Topik  standar  observasi  bandingin  implementasi
A. Reviewing literature
B. Compare practice w/ standard
C. Data collection
D. Implement change
E. Re-audit
126. Its most patriachial nature. Parenting style strict and, if the role is not allowed it end with punishment..
a. authoriterian
B. authoritative
C. permisive
D. uninvolved
E. negleted
127. Not much structure for the kid,do not have many expectation,no punishment,more nurture,lenient in misbehaviour,anak sulit
mengemukakan apa yg penting baginya. Tipe parenting?
a. authoritarian
b. authoritative
c. permissive
d. neglected
e. uninvolved
128. Authoritative dengan strict roles,but receptive to children when they broke rules. Strict but still assertive.
A. Authoritative parenting
B. Authoritarian
C. Permissive
D. Uninvolved
E. Neglected
129.The parent child positive relationship also become important when the child is in the school, when positive relations form at home
children will have an easier time forming positive relation in school.Children with communication and bonding in the home bring
positive behaviour to school which allow for good communication with peers, teachers and authorities.
Which one of the family that have better influences?
A. Single parent (maternal)
B. Single parent (paternal)
C. Blended family

D. Intact family
E. The other
130. Most of parents unclear when they give parenting for their child. Some of them believed the best time for parenting begin
from birth. What is the correct timing that the parents should give parenting to their children?
A. birth-adolescent
B. birth-young adult
C. conception-adolescent
D. conception-young adult
E. conception-middle old adult
131. 60 years old obese female is diagnosed diabetes type 2. beside of pharmachological treatment. she has been adviced to improve
her quality of life. how many time did excersice effectively reduced the obesity?
a. 15minute
b. 20minute
c. 30minute
d. 60minute
e. 120minute
132. Everyone can do endurance activities which the benefit is

A. Improve the health of the heart, lung, and circulatory
B. This exercise increase blood pressure
C. This exercise help prevent falls
D. This exercise helps keep the body limber
E. This exercise help keep the body flexible
133. A 40 y.o.male came to his family doctor with headache. BP 150/90. Dilakukan PE,lab, dan pemeriksaan lain. Dokter memutuskan
untuk mengobatinya dgn supportive therapy untuk headache dan modifikasi lifestyle trmasuk exercise. Which of the following is
the most appropriate for the target heart rate?
A. 220 / menit
B. 200 / menit
C. 153/ menit
D.135/ menit
E. 90/ menit
134. Safety endurance activity:

a. Breathing hard untill u can't talk
b. Shouldn't cause dizziness
c. Must reach max heartrate
d. Not reccomended for disability people
e. Need to warm up and cool down(easy walking)
135.Untuk melakukan continous aerobic exercise kita bisa melakukan target heart method bila pasien
A. Memiliki pacemaker
B. memiliki atrial fibrillation
C. Mengkonsumsi obat2 yg mengubah heart beat
D. Memiliki irregular heart rhythm
E. Overweight tapi memiliki normal ECG
136. What is the mechanism of pain due to cancer?

A. Tissue damage, psychological, after cancer therapy
B. obstruction
C. molecular mechanism
D. all of above
137. which of following risk factor for cervical cancer?

a. Diabetes, Sexual tranmitted disease
b. Multiple sexual partner, smoking
c. Hypertension, genetic disoder
d. None of above
138. which of following is not a complication of radiation therapy for cervical cancer?
a. cystitis
b. vaginal tissue stricture
c. diarrhea
d. none of above

139. what are the principle of palliative medicine
a. enhance quality of life
b. relief from pain and other symptoms
c. integrates psychological and spiritual aspect to prepare dying in faith
d. all of above
140. what are the most effective and effisien prevention effort for cervical cancer below?
a. Early detection by pap smear and VIA
b. Vaccination
c. Tumor marker
d. ultrasound
141. Here are the stages of emotion reaction of terminal illsess patient
a. Anger, depression, bargaining, denial, and acceptance
b. Denial, anger, bargaining, depression and acceptance
c. Anger, denial, bargaining, acceptance and depression
d. Anger, denial, guilt, depression and acceptance
142. Good communication skill doctor may help terminal stage patient feel uncomfortable talking about their illness. Here are
following sugestions communication technique?
a. Ask closed-ended question (‘yes’ or ‘no’ answer)
b. Begin by talking about personal topics then moves to general ones
c. Ask open ended question
d. Always use medical term to give explanation
143. Whom should pre-conceptional care should be performed?

a. Women with hystory of congenital anomaly child
b. Women with underlying medical problems
c. All women of childbearing age
d. Only a and b are true
144. For women who had previous child with a neural tube defect (NTD), how much follic acid supplementation recommended before
preconception?
a. 400 Mg
b. 1000 Mg
c. 4 mg  high risk kalo N 0,4
d. 1 mg
145. when should preconception councelling be performed?
a. 6 month before couple considering pregnancy
b. By the time of the first prenatal visit
c. After married
d. 1-2 years before couple considering pregnancy
146. What relative common medical condition should be identified and adressed during preconception care?
a. Diabetes, hypertension, seizure disorder, connective tissue disorder
b. Hypertension, anemia, diabetes
c. Diabetes, hypertension, seizure disorder, anemia
d. Hypertension, anemia, leukorhoe
147. What are the risk associated with advanced maternal age (>35 years)?
a. Pre-eclampsia, gestational diabetes, prolonged labour
b. Chromosomal anomalies, spontaneous abortion, pre eclampsia
c. Fertility increases, post partum hemorrhage, gestational diabetes
d. Chromosomal anomalies, fertility increases, gestational diabetes
148. increased risk of pregnancy over maternal age 35 are decreased by which of the following?
a. Preconceptional care
b. Lack of significant medical problems
c. Socioeconomic advantage
d. All of the above
149 which of the following is an important goal of preconceptional care

a. Prevent unintended pregnancy
b. Initiate preventive care measures
c. Identify genetic and obstetrical risk factor
d. All of above

150. which of the following precription is the most rational?
R/Ampisillin 500mg Cap R/Ampisillin 500mg Cap No XII R/Ampisillin 500mg Cap No XII
No XII S.4.dd.Cap I 2h.p.c S.2.dd.Cap II 2h.p.c
Paracetamol 500mg Tab R/Paracetamol 500mg Tab No …………..……”………………

No X X
S.3 d. d. Tab I R/ Paracetamol 500mg No I
Dexamethason 0,5mg Tab
No X …………..……”……………… Dexamethason 0,5mg No I
m.f.pulv.No X R/Dexamethason 0,5mg Tab m.f pulv dtd No X

No X
S 3 dd.Tab I S 3 dd.Tab I S 3 dd.pulv I
…………..……”………………
A B C
R/Ampisillin 500mg Cap

R/Ampisillin 500mg Cap
No XII
No XII
Dexamethason 0,5mg Tab
Paracetamol 500mg Tab
No X
No X
m.f.pulv.No X
m.f.pulv.No X
S 3 dd.pulv I
S 3 dd.Tab I
…………..……”………………
…………..……”………………
R/Paracetamol 500mg Tab
R/Dexamethason 0,5mg Tab No X
No X
S 3 dd.Tab I
S 3 dd.Tab I
D E
151. Ampicillin and paracetamol cannot mixed in one preparation because of the following reason?
a. Ampicillin is a causative drug and paracetamol is a symptomatic drug
b. Ampicillin need to be given in different time with paracetamol therefore it require to bewritten in different precription
c. Paracetamol can be given with dexamethasone in one prescription
d. Ampicillin can be given with paracetamol in one preparation because both has to be given before meal
e. Ampicillin can only be written in one prescription and as antibiotic the administration has to be with meal
152. The correct signature for Ampicillin as an antibiotic is?

a. S .3.d.d.Cap 2. 1. h a.c
b. S .4.d.d.Cap 1. 1. h p.c
c. S .4.d.d.Cap 1. 2. h p.c
d. S .3.d.d.Cap 1. 2. h a.c
e. S .3.d.d.Cap 1. 2. h p.c
153. A 27 year old woman using oral contraceptive, with tuberculosis infection. Which of the following is right?
a. TB drug are given but the contraceptive is changed into IUD
b. Oral contraceptive are given but the TB drug only taken for 2 months
c. Oral contraceptive is stopped but TB drug is given all the time
d. Oral contraceptive and TB drug is taken both
e. Oral contraceptive is changed into another drug that have interaction with TB drugs
154. Mrs. Irna,30 years old woman work as a secretary at an oil company and diagnosed with pharyngitis and given amoxicillin
without asking about her allergy condition. Later on, she return to the doctor with rash all over the body.
Which of the following sentences is right for next therapy planning?
a. Stop amoxicillin, replace with ampicillin tablet 500mg 4 times a day, + antihistamine
b. Stop amoxicillin, replace with Erythromycin capsule 250mg 4 times a day, + antihistamine
c. Stop amoxicillin, replace with Erythromycin capsule 500mg 2 times a day, + antihistamine
d. Stop amoxicillin for a while, give antihistamine, then continue amoxicillin after the rash disappear
e. Add antihistamine without stopping or replacing amoxicillin

155. Which of the following tuberculosis drug is an inducer metabolism:
a. Streptomycin
b. Isoniazid
c. Rimpamycin
d. Pirazynamid
e. Ethambutol
156. Which of the following drug cannot be given with antacid?

a. Amoxcycillin
b. Propanolol
c. Salbutamol
d. Glibenclamid
e. Cyprofloxacin
157. Which of the following drug should be avoided to be given with salbutamol:
a. Theophylin
b. Amoxcycillin
c. Ephedrin
d. Diltiazem
e. Simvastatin
158. How is the mechanism of hypertension caused by anxiety?

a. Behavioral effect
b. Physical effect
c. Emotional effect
d. Cognitive effect
e. Social effect
159. Nutritional management of hypertension is?

a. High fat diet
b. Low salt diet
c. High protein diet
d. High carbohydrat
e. Low calcium
For question number 160-162, refer to the scenario below:

A 45-year old man presents to his primary care physician complaining of occasional episodes of palpitations, sweating, and headaches
which resolve spontaneously. He is found to have a blood pressure of 150/90.
160. According to JNC VII Calssification, this blood pressure match to?
a. Normal
b. Prehypertension
c. Stage 1
d. Stage 2
e. Stage 3
161. Which one of the following is the risk factor of primary hypertension?
a. Hypocholesterolemia
b. Obesity
c. Young age
d. Vegetable consumtion
e. Vacation
162. Complication of hypertension is:

a. Fever
b. Stroke
c. Vomitus
d. Fatigue
e. Infection
163. Family health beliefs about illness perception?

a. Biological aspect
b. Physiological aspect
c. Clinical aspect
d. Comprehensive aspect
e. Cultural aspect

164. What is the best describe anxiety?
a. Emotional response
b. Escape behavior
c. Avoidance behavior
d. Mood condition
e. Short lived
165. What can we do to increase adherence in consuming medical treatment?

a. Give expensive medicine
b. Education to the patient
c. Prescribed a lot of medicine
d. Poor communication
e. Watch TV a lot
For question number 166-167, refer to the scenario below:

A 55-year-old obese male has been diagnosed as a diabetes melitus type 2. His doctor told him about his management plan. Beside
pharmacology treatment, he also has to modify his life style especially about routine exercise. The doctor told him that exercise can
help him to decrease body weight and increase cardiovascular fitness.
166. Which of the following statement that most appropiate reason for that management plan?
a. Insulin stimulates the liver and muscles to take in sxcess glucose
b. Exercise stimulates the insulin to change fat deposit into glucose
c. Exercise can stimulate the insulin sensitivity
d. Intense exercise stimulates stress hormone
e. Exercise can increase his heart rate
167. Which of the following type of exercise that most appropiate for him?
a. Aerobic
b. Anaerobic
c. Weight training
d. Endurance
e. Resistance
168. A 60-year-old female with diabetes mellitus type 2 want to ask exercise prescription advice from her family doctor. She realizes
that exercise helps her to maintain her health condition, so she always takes jogging for minimum 30 minutes, 3 times a week at
nearby park. But recently she just diagnosed having peripheral neuropathy at her lower limb.
Which of the following type of exercise that most appropriate for her recent condition?
a. Jogging, but only for 20 minutes
b. Jogging on the treadmill
c. Tennis
d. Golf
e. Swimming
169. A 58-year-old male with nephropathy diabetes want to start exercise program. He takes insulin for controlling his blood glucose
level. The doctor plan to do blood glucose monitoring before, during, and after exercise before arrange his exercise program.
Which of the following reason that most appropriate for the blood glucose monitoring?
a. Exercise has insulin-type effect
b. Exercise can alter the glucagon leve
c. Carbohydrate will abruptly decrease during exercise
d. Exercise dosage is dependend on the glucose blood level after exercise
e. Exercise for nephrophathy diabetes is only can be done under doctor monitoring
170. A 55 yo male with type 2 DM ome to his family doctor. He likes playing tennis for exercise. He play tennis almost everyday at
least 2 hours a day. After some history taking, PE, and random blood glucose exam, the doctor told him that he should sto his
exercise activity for a while. Which of the following condition that most appropriate for the doctor suggestion ?
a. Systolic BP more than 160 mmHg
b. Blister at his feet
c. Decrease of visual activity
d. Blood sugar level > 250 mg/dl
e. Blood sugar level < 200 mg/dl
171. A 55 yo male, former tennis athlete, with type 2 DM come to his family doctor. He also diagnose has moderete cardiovascular
disease. He told his doctor that he still want to do some sport. Which of the following aspect must be done before start his
exercise program ?
a. ECG

b. Stress testing
c. CKMB
d. Cardiovascular fitness test
e. Angiography
172. A 56 yo female with proliferative retinopathy and controlled type 2 DM come to the doctor and ask an advice about her exercise
program that most suitable for her. Except her visual activity, her body weight, PE, dan blood glucose level is normal. WOTF
exercise program that most approriate ?
a. 30 minutes a day, 3 times a week, mild intensity jogging or swimming
b. 30 minutes a day, 2 times a week, mild intensity jogging or swimming
c. 60 minutes a day, 2 times a week, high intensity weight training
d. 60 minutes a day, 3 times a week, moderate intensity treadmill
e. 30 minutes a day, 3 times a week, mild intensity of static cycling
173. A 56 yo female with proliferative retinopathy and controlled type 2 DM come to the doctor and ask an advice about her exercise
program that most suitable for her. Except for her BMI (obese), her E and blood glucose level is normal. WOTF exercise program
that most appropriate ?
174. A 35 yo female with prediabetes come to the doctor and ask an advide about her exercise program that most suitable for her. Her
BMI, PE, and blood glucose level is normal. WOTF exercise program that most appropriate ?
175. A 50 yo with hyertension stage 2 now have management plan from his family doctor. The management plans include lifestyle
modification such as exercise. He told the doctor that he always does sport. He was playing badminton twice a week, but
uncertain about the duration beause he must did it alternately wih his other friends. The doctor told his that that kind of sort is not
enough for imroving his health condition. WOTH that most appropriate reason for dotor explanation ?
a. Badminton is not aerobic exercise
b. His sport activity is not done regullary
c. There is no weight training in badminton
d. Lack of frequency
e. Badminton make him prone to injury
176. A 45 yo female with obese and hypertension stage 1 want to ask some advie about suitabel exercise program beside her diet
program. She told the doctor that she enjoy swimming and bowling. But she has difficulty to spare enough time to do that activity
because her activity as a business woman. WOTF exercise program that most approriate for her?
a. 60 minutes, jogging or treadmill, 3 times a week
b. 30 minutes jogging in the morning, 30 minutes swimming at the evening
c. 60 minutes bowling (once a week), 60 minutes swimming (twice a week)
d. 60 minutes of any kind moderate intensity (free to chose by herself), 3 times a week
e. 60 minutes of any kind high intensity exercise (free to chose by herself), once a week
177. A 35 yo male had hypertension. But after do some diet program and adequate exercise for 6month now his condition was
improving. The blood pressure is normal and there is no abnormality at his cardiovascular condition. WOTF that most apropriate
reason for his improvement ?
a. Increasing the symphatetic tone
b. Increasing the blood cathecolamin
c. Lower cardia output and peripheral vascular resistance
d. Altered renal function lead to derease elimination of sodium
e. Increasing submaximal exercise peripheral vascular resistance

178. A 40 yo male come to his family doctor with headache. His blood pressure was 150/90 mmHg. The family doctor then does head
to toe PE, lab exam and other supportive examination. The doctor then decides to treat him with supportive therapy for headache
and lifestyle modification including exercise. WOTF that most apropriate reason for the management plan ?
a. Age is < 60 yo
b. There is no renal insufficiensy
c. There is no target organ damage
d. No family history of hypertension
e. Cardiovascular condition is within normal limit
179. A 55 yo men with hypertension stage 2 with susected cardiovasular disease need exercise prescription for his family doctor.
WOTF exercise program that most approriate for him?
a. 20-30 minutes/day continuous aerobic activity at maximum heart rate 50-65%
b. Light moderate intensity untill evaluated and conditioned with periodi monitoring
c. Light moderate startwith 20-30 minutes lower intensity/day with periodic monitoring
d. 60 minutes/day of aerobic exercise without periodic monitoring
e. Start with 60 minutes/day of resistance training
180. A 45 yo female with prehypertensive and no cardiovascular disease need exercise prescription from her family doctor. WOTF
exercise program that most approriate prescription for her?
181. A 48 yo female with stage 2 hypertension and no cardiovascular disease need exercise prescription from her family doctor. She
was feeling uncomfortabel about exercise. WOTF that most appropriate exercise presription for her?
182. In referring the patient for surgery, if the patient develop a respiratory infection following surgery, the surgeon can ask for family
physician’s advice in dealing with that respiratory problem. What type of referral for this case ?
a. Formal consultation
b. Informal consultation
c. Interval referral
d. Collateral referral
e. Cross referral
f. Split referral
183. Dr. Amin intend to ask for the second opinion and he writes the letter for his colleague including all patient’s significant problem,
state the physician’s main finding, the investigation that have been carried out, all medication, and the purpose of the
consultation. What type of referral for this case ?
e. Cross referral
f. Split referral
184. Mr David is referred by Dr. Henri because of his prostate cancer. For better care, it is essential that after referral only a surgeon
should prescribe treatment.
What type of referral for this case?

e. Cross referral
f. Split referral
185. The responsibility of patient is divided more or less evenly between two or more physician.
e. Cross referral
f. Split referral
186. Mrs. Ani is referred by Dr. Nadia for long term treatment of chronic glaucoma. Dr. Nadia retain overall responsibility , but refers
the patient only for care some specific problem.
e. Cross referral
f. Split referral
187. A 22 yo woman has been brought home from a private college because of the occurance of seizure that often occurred in her
room in woman’s dormitory. She is hospitalized and her family doctor visits her at the hospital suspect that they are not
organically based; that is “hysterical” or pseudo seizure.
Which of the following somatoform disorder is present to the patient?
a. Conversion disorder
b. Somatization disorder
c. Pain disorder
d. Hypochondriasis
e. Malingering
188. A 35 yo woman complains of vague abdominal sensations attributed to hepatic cyst that has been diagnosed on a previous
abdominal CT scan. She has been followed for several years for gastrointestinal problems. When she comes to the doctor, she
invariably invokes a sensation with anatomic attachment, not usually involving pain. In addition to hepatic cyst, she has also cited
a posterior lung field cyst.
Which of the following somatoform disorder is present to the patient?
a. Conversion disorder
b. Somatization disorder
c. Pain disorder
d. Hypochondriasis
e. Malingering
Q189-192
A 48 yo man has manifested BP levels of 150/100, 145/95, and 170/105 on consecutive separate days over 3 weeks period. He has a
family history of deaths by stroke and renal failure.
189. WOTF may be the single most appropriate drug to be prescribed?

a. Hydrochlorothiazide
b. ACE inhibitor
c. Beta-adrenergic blocker
d. ACE receptor blocking agent
e. Vasodilator
190. WOTF is the examination to obtain before starting the patient on chosen drug therapy?
a. ECG
b. Blood urea nitrogen

c. Electrolytes
d. Complete blood count
e. Liver function test
191. WOTF is the screening should be performed by his children?

a. Blood pressure every 6 months for people with hypertension
b. Blood pressure every 12 months for people with hypertension
c. Blood pressure every 2 years for people with hypertension
d. Blood pressure every 18 months for people with hypertension
e. Blood pressure every 18 months for people without hypertension
192. If the patient was suggested to do physical exercise, WOTF is a valid reason to terminate an exercise session?
a. The systolic BP rises and the diastolic falls during strenuous exercise
b. The pulse rate doubles during strenuous exercise
c. The patient experience persistent headache during exercise
d. The patient is fatigued during strenuous exercise
e. Patient develops tachypnea
193. A 75 yo man is in good health and mentally competent to care for himself. He underwent a complete examination 5 years ago that
included a normal screening colonoscopy, and he has submitted fecal occult blood test in the intervening years. He lives alone
and wish to undergo a routine health maintenance examination.
WOTF would be less fruitful as a screening test?
a. Flexible sigmoidoscopy
b. Thyroid-stimulating hormone test
c. Urinalysis
d. Blood pressure reading
e. “Up and go test”
194. A 45 yo woman returns to you for routine preventive care, having not seen you except for episodic problems for the past 6 years.
Her family history is unremarkable except for the mention of colon polyps in her sister, who is 10 years older than her. Her
weight is 55 kg at a height of 165 cm. She is non smoker.
WOTF would be the most appropriate combination of screening test for her?
a. ECG, CBC, liver and kidney function test
b. Pap smear, mammogram, colorectal cancer screening, CBC
c. Chest X-Ray, pap smear, EKG and comprehensive chemical profile
d. Lipid profile, FOBT, mammogram, and blood sugar
e. Chest X-Ray, pulmonary function, lipid profile, and CBC
195. How is fever mediated through a pyrogen?

a. Pyrogen increase thrombocyte
b. Pyrogen increases IL-1 production
c. IL-1 stimulates the posterior hypothalamus
d. Prostaglandin stimulates IL-1
e. Increase prostaglandin will decrease set point.
196. What are the body heat producing mechanism and how do they work?
A.Thyroid hormone stimulate Na-K ATPase to decrease.
B.Posterior hypothalamus stimulates Beta motorneuron causeing muscle contraction
C.Posterior hypothalamus stimulates Alfa motorneuron causing muscle relaxation
D.Sympathetic nervous system activates beta receptor in brown fat to produce heat.
E.Thyroid hormone increase muscle contration.
197. What is the body mechanism to get rid of excess body heat and how do they worked?
A.PG stimulates IL-1
B.IL-1 stimulates posterior hypothalamus
C. Sweat gland stimulates by muscarinic receptor and produce heat loss
D. Sweat glands stimulates by muscarinic receptor and increase PG.
E. Increase PG will decrease setpoint.

198. People are motivated to do exercise programmes because of these reason except.
A. Weight control.
B. Increase the blood pressure
C. Reduce the risk of hypotension
D. Reduce stress and depression
E. Enjoyment.
Q199-200
A mother who decided on preventative screening for a 16 years old girl who menarche at 13 years old.Her cycle is 30 days with 4
days of moderate flow. Her last menstrual period was 2 weeks ago. She denied any sexual activities.
199.At what age pap smears should be performed on her?

A. Age 16
B. Age 17
C. Age 20
D.At the age of sexual activity
E. At the age of regular sexual activity.
200. Which of the following vaccine is due at this time?

A.DTP, sixth dose
B. MMR, third dose
C. Diphteria and tetanus booster
D. Varicella, second dose.
E. BCG second dose.

Statera - FM New Era

Загружено:

Сведения о документе

Оригинальное название

Авторское право

Доступные форматы

Поделиться этим документом

Поделиться или встроить документ

Параметры публикации

Этот документ был вам полезен?

Это неприемлемый материал?

Авторское право:

Доступные форматы

Statera - FM New Era

Загружено:

Авторское право:

Доступные форматы

Semester 7

Semester 7 – Final Family Medicine System STATERA 2011 | 0

3. WOTF statement is appropriate in family psychoeducation for this case?

4. WOTF is a correct management for this patient in primary health care?

Semester 7 – Final Family Medicine System STATERA 2011 | 1

For Question 10-13, refer to scenario below.

11. What is the best approach ?

12. Which of the following about somatoform symptoms is correct?

15. Which of the following may affect the patient complaints?

Semester 7 – Final Family Medicine System STATERA 2011 | 2

20. Functional diagnosis in the case above..

21. where is the location of stroke infarction of this patient?

22. Which is the following stroke complication of this patient?

Semester 7 – Final Family Medicine System STATERA 2011 | 3

23. Which of the following is the communication disorder of the patient?

24. Which of the following is the impact of illness to the family?

25. Antiplatelet for this patient?

28. What analgetic therapy you should give to this patient?

30. Based on POMR, which of the following answer is correct?

Semester 7 – Final Family Medicine System STATERA 2011 | 4

36. What is the complication of Hypertension

39. WOTF is the service unit of vision 2020?

Semester 7 – Final Family Medicine System STATERA 2011 | 5

43. What rehabilitation problems does patient have?

45. Hormonal test for short stature

Semester 7 – Final Family Medicine System STATERA 2011 | 6

48. WOTF steps for growth curve analysis

Ringkasan Case 49-52

52. WOTF statement of this patient is likely to be true?

Semester 7 – Final Family Medicine System STATERA 2011 | 7

56. What is the most priority management of nutritional aspect of infertility?

58. What is the correct measurement to assess quantitative food intake?

Semester 7 – Final Family Medicine System STATERA 2011 | 8

67. Nutritional management in hypertension important to support blood pressure control.

Semester 7 – Final Family Medicine System STATERA 2011 | 9

74. What is the most recall bias in food recall method?

76. What is the main focus treatment in weight management?

For question number 79 until 80, refer to the scenario below:

Semester 7 – Final Family Medicine System STATERA 2011 | 10

For number 81-84

81. Your best advice?

For number 85-88

85. What is best education regarding this patient’s weight?

86. What is screening recommendation?

Semester 7 – Final Family Medicine System STATERA 2011 | 11

87. Patient perception?

88. What is the investigation used to explore his meaning of illness?

For number 89-91

89. What is family influence could potential cause of her problem?

90. What is screening recommendation for this age?

91. Which the following respond is the most appropriate:

92. Who did acting coalition in this family?

93. How “hierarcy” taking place in this family?

Semester 7 – Final Family Medicine System STATERA 2011 | 12

98. What stage of illness trajectory for this patient?

99. What is a physician role on this stage?

100. What should physician do to his care giver in terms of "collaborating"?

For question 102-106.

Semester 7 – Final Family Medicine System STATERA 2011 | 13

103. what is ur reccommendation for him to reduce risk of fracture?

105. what info would u provide to patient regarding physical activity?

For question 107-109

107. what is the patient’s major risk of future fracture?