Example Questions for Doctor Competency Test

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A 32-year-old woman who suffers from diabetes

type 1 diabetes mellitus experiences progressive kidney failure over time
The last two years. Dialysis has not been performed on this patient.
The physical examination did not show signs of abnormalities. Results
laboratory tests show hemoglobin level = 9
dan g/dl, hematocrit = 28 %, m3. Peripheral blood smear shows cells-
the red blood cells MCV 94 normocytic and normochromic. Which answer is in
The following is the most likely cause of the patient's condition.
that?
A. Acute bleeding
B. Chronic lymphocytic leukemia
C. Sideroblastic Anemia
D. Erythropoietin deficiency
E. Erythrocyte enzyme deficiency

A 30-year-old man who was previously in a state of

healthy, suffering from fever and pruritus, night sweats, and
found a lump above the left clavicle for three weeks.
Physical examination showed enlargement of the lymph nodes that
no pain, diameter 3 cm, elastic consistency and located at
supraclavicular region. Chest X-ray examination shows an effect
the presence of mediastinal lymphadenopathy. Which answer is the most
directly below this is the cause of the disease in the patient
such?
A. Tuberculosis
B. Metastatic carcinoma
C. Hodgkin's disease
D. Sarcoidosis
E. Infectious mononucleosis
3. An 8-year-old boy was bitten by a bee. In
five minutes later, a swollen lesion, measuring 2 cm, was observed,
reddish in the bite area. Among the following answers,
Which findings are dominant in the bite lesion?
A. Reaction to foreign body
B. Bleeding
C. Lymphocytic infiltration
D. Neutrophilic migration
E. Vasodilation

An 80-year-old man is suffering from a carcinoma.

ulcerative on the right scrotal skin. Which gland group is below
this is the first to receive metastatic cells from carcinoma
that?
A. External iliac
B. Internal Iliac
C. Superficial inguinal
D. Deep inguinal
E. Lumbar (para-aorta)

A 4-year-old girl cannot eat.

for two days due to gastrointestinal illness. From the answer in
Below, which one is the main source of energy that will
oxidation in the skeletal muscles of the patient?
A. Creatine Phosphate Muscle
B. Muscle glycogen
C. Muscle Triglycerides
D. Serum fatty acids
E. Serum glucose

6. Male, 60 years old, palpitations, thin body, loss of appetite

increased, emotional, increased sweating, difficulty sleeping.
hyperthyroid
hypothyroid
Diabetes Mellitus
Diabetes Insipidus
Cushing's Syndrome

7. Male, 24 years old, there is a lump in the front of the neck, not painful.
The villagers have the same illness as this.
a. Chromium Deficiency
b. Vitamin B1 deficiency
Iodine Deficiency
d. Occlusion of the fat glands

e.Lymph node tumor

8.25 years
A while ago the patient was anxious, had a lot of mucus, what condition is it?
that is in accordance with the above condition....

a. Withdrawal Syndrome
b. Overdose
c.Chronic poisoning
Addiction
Tolerance

What condition is most suitable for the use of putow?

case:
a.Addiction
b. Tolerance
c.Abstinence
d.Suggestion
e. Overdose

A 20-year-old man complains of yellow urine for 2 days.

The physical examination showed an icteric sclera and skin color.
king. What further examination do you suggest for the patient?
this?
a.SGOT/PT
b. Urea/creatinine
c.As. Urat
d.GDS and GDP
Total cholesterol and LDL
11. A 30-year-old woman was brought to the emergency room by her family due to vomiting.

Blood. This patient's history suffers from chronic Hepatitis B. Examination

the patient appears weak, blood pressure 140/90, pulse 90 bpm, conjunctiva eyelid

+
span 5 cm. What is the cause of hematemesis in this patient?
a. Are. Mallory Weiss
b. Rupture of Esophageal Varices
c.Esophagitis
d.Gastric Ulcer Perforation
Perforation of duodenal ulcer

12. Routine Radiological Examination for a 2-month-old child:

a. Chest X-ray PA
b. Lateral left thorax photo
c.Photo top lordotic
d.photo
e.Photo right lateral thorax

13. Shortness of breath for 2 days, cough, high fever, flu for 3 days. Respiration 53 times/minute.

390C nose cupping (+).

Pleural effusion
b.Bronchopneumonia
c.Pneumonia
d.Is skin
e.Atelectasis

14. A 29-week pregnant woman came for ANC. Blood pressure 150/90,
proteinuria +2. Platelets, hepar Normal. Actions taken:
a.SC
b. Induction of Labor
c. Administration of Mg SO4

d.Administration of Diazepam

e.????CONSERVATIVE

15. Woman G3P2A0 history of SC, term pregnancy, 20 hours in labor not yet
born, 3 hours led not yet born. VT: how many hands, position back
head. CPD relative Action?
a.SC
b. Trial Delivery
c.Vacuum
d.Forsep
e.Kristeler

16. Male, 50 years old. Hypertension for 5 years T= 170/100 mmHg,

your advice as a family doctor:
a.Eating habits
b.Aerobic exercise
c.Reduce stress
d.Quit smoking
Replacing medication

17. An incident involving a 5-year-old child where the mother has never ...

TT vaccination, choose one that is correct:

a.epidemic
b.endemic
c.pandemic
d. epidemic
e.KLB

18. A 13-year-old girl was taken to the clinic by her mother with complaints
continuous body temperature for the past 3 days (cold sweat (+).. ?
unclear writing) headache, muscle pain in the limbs, nausea, vomiting,
blood coming out of the nose, red spots. Next steps for the patient?
a. Your RL
b.Widal
c.Routine blood test

d. Throat
Mantoux test

19. Suntika PP 1.5 million unit i.m on male 50 years old. Suddenly the patient collapsed to

floor. PF: consciousness decreased, BP 60/palp, N: 120x/min,

RR=24x/min. Cause:
a.Ggg heart pump
b. Heavy bleeding
c. Severe pain
i.e. Hypoglycemia
Great vasodilation

20. male, 25 years old, itching all over the body after eating shrimp. For the past 5 years.

What is the number that is increasing?

a.sel plasma
b.mast cell
c.fibrositis
d.macrophage
e.PMN

21. Woman, 35 years old, pregnant with her 4th child, came to the hospital with complaints

easily fatigued and lethargic. PF: no organ enlargement, Hb = 8, Leu 12

rb, Tr 350rb, microcytic hypochromic, anisopoikilocytosis, elliptocytes, Hit type
dbn, reticulocyte dbn. What is the appropriate lab examination?

so much iron
b.diff count
c.electrophoresis Hb
d.stool analysis
e.?? (unclear writing)

22. an unconscious patient was brought to the emergency room after becoming a victim

traffic accident. N >120 TD down, blood loss 30-40%. According to ATLS,

classification of hemorrhagic shock?

23. 40-year-old male cardiac arrest, resuscitation and ...?, if the action is correct,
blood pressure measurement:

a.110/10 -> MAP > 40mmHg

b.B. 110/80
c.110/50
d.100/40
e.110/79

24. woman 40th, palpitations, heavy, stressed, left chest pain, fearful
death.
a.AMI
b. Pneumothorax
c. Pericarditis
d.Kataton
Acute anxiety

25. Baby 8 months, stools 4-5 times/day and undigested food residues.
For 2 mg. The mother works to give breast milk once before and 3-4 times after.
Work. MPASI 3x milk porridge, 1x freshly squeezed orange juice. Father does not work.
And the grandmother helps to take care of the baby. What underlies that statement?
the baby is left by the mother to work

Grandma helps with the care

c. milk porridge 3x
1x orange juice
The mother is not working.

26. A 25-year-old man has had a fever for 10 days, initially not high but increasing over time.

getting higher especially in the evening and at night. The first 3 hours are hot and
diarrhea, appears apathetic. 3 hours received paracetamol and ampicillin
not improving. Examination to establish the etiological diagnosis?
a.widal, gal/broth, blood culture, serological
b.haemagglutination inhibition
thick blood
d.serologies leptospirosis, Widal
e.widal, culture gal/bouillon, culture feces

27. Baby, unusual urinary opening, clitoral enlargement, urethral opening

..., plan?
X-ray photo
blood lab
c.observations in the health center

d. insert catheter
surgical recovery

28. Swelling in the eyes, eyelids, 2mg appearing on the legs and abdomen,
red urine, protein in urine 4+
GGK
23. Male, wounds on the genitals, 2-day ulcer around the hard glans penis.
dirty (-), clean, flat, PSK 1 month.
a. Banal taste
b. Mole ulcer
c. Ulcer condition

d.Complex primer
Bubonic ulcer

29. A 45-year-old male infant was brought to the emergency room with difficult bleeding.

stop at the former hepatitis B injection site. At PF: KU good, bleeding

There is seepage on the left thigh from the injection site, no bleeding elsewhere.

anemia (-), jaundiced (-), hepatomegaly (-), splenomegaly (-)

lymphadenopathy (-). Blood lab: Hb 11, Leu 8500, trom 170k, PT PTTK
increases. Dx?
ITP

30. Which of the following is most likely to underlie anemia?

in the above case?
a.ggg prod
b.destruction
c.chronic bleeding
acute
congenital

A lump in the lower left jaw, not painful, 5 cm, pressing the area
ear up, not paralyzed n.7
Otherwise, to the parotid gland

b.tm gains the parotis

c.sialadenitis
d.TBC of the parotid gland

e.Hemangioma of the parotid

32-year-old man has had discharge from the left ear for 10 years, white, thick, smelly.

bad. Ear pain (+), fever (+), mouth twisted to the right, CAE
granulation
a.OMA
b.OMSK
c.Cholesteatoma
Malignant otitis
e. Granuloma

33. The patient came to Dr. A with a late period of approximately 3 months.
G3P2A0, the youngest child is 7 months old. Doctor A refused to provide therapy.
and recommended going to Dr. B. Doctor B prescribed medication and requested
check after 5 days. The doctor's action is...
a. true, breaking the law
b. true, unlawful
c. wrong, breaking the law
d. wrong, against the law

34. Male, chest trauma, shortness of breath, wheezing. Left chest percussion.
hypersonor. When breathing, the left chest is lagging. Pulse not palpable, acral
cold. What is done in the emergency room?
a. give O2 mask, spontaneous breathing & needle decompression
b. give O2 mask, assist breathing & needle decompression
c. intubation, O2 mask, spontaneous breathing & needle decompression
d. intubation, O2 mask, assisted breathing & needle decompression
e. direct needle decompression

35. Male, 40 years old, due to experiencing unbearable pain.

Due to suffering from a malignant tumor, the patient requests euthanasia. What
What are the reasons doctors allow euthanasia?
old age
b. alleviate the suffering of patients
at the patient's request
d. human rights to determine their own life and death
e..
36. Male, shortness of breath, fever for 3 days. History of neighbor's chickens dying.

sudden in farming. Lung X-ray: extensive infiltrate in the field

fingers. Below is the correct one:
a. there are no reservoir animals
b. including type B influenza virus
c. reproduce in the host cell's cytoplasm
d. antigenic variation of Ag H and Ag N

37. 7 years old, vaginal bleeding, secondary sexual characteristics (+).

Genital trauma history denied.
menarche
b. precocious puberty
c. delayed puberty
d. climacterium

38. 20 tahun, primi, hamil 37 minggu. T = 180/110, udem anasarka.

High AKI besides being caused by the above diseases is...
a. DM
b. postpartum hemorrhage
c. breast tumor
d. cervical tumor

39. 15-year-old child. Often had fever and convulsions when younger. Now
It is challenging to move up a grade while still being in the second grade of elementary school. Possible diagnoses are

is...
a. mental retardation
b. mental deprivation
c. hyperactive
d. epilepsy
e. mental determination

40. A mother, 8-month-old baby girl, has a bowel movement approximately 4-5 times a day accompanied by

Leftover food that has not been properly digested in the last 2 weeks.
Mother works as a teacher & gives breast milk once before departing.
work & after work 3-4 times. Additional food milk porridge 3 times/day
and squeezed orange juice once a day. Dad doesn't work, grandma helps take care.
baby. Best recommendation?
a. Meanwhile, mother stopped working
b. The provision of milk porridge is stopped.
The administration of fresh orange juice is stopped.

D. Given immunization
Consult at the community health center

41. The child has shortness of breath, a high temperature, and there is nasal flaring.
What is the most appropriate medicine?

Ampicillin
B. Amoxicillin
C. Cefotaxime
D. Cotrimoxazole
E. Erythromycin

5-year-old child fell, 2 x 1 cm laceration treated with povidone

iodine makes the type of healing for the wound is ..........
A. primary intention
B. secondary intention
C. tertiary intention
D. Delayed intention
E. acute intention

43. An 18-year-old male patient complains of itching. There is

a macular patch of fine scaly hypopigmentation on the neck, shoulder and
the back has various shapes and will be scaly when scratched,
Examination with 10% KOH showed short hyphae, then
the diagnosis is ........
A. Tinea capitis
B. Pityriasis alba
C. Ptiriasi versicolor
D. Tinea corporis
E. Pityriasis rosea Gilbert

44. An adult male who enjoys swimming then complains of cramps in

betis. The structure that plays a role in muscle contraction.........

A. Myofilament
B. Sarcomere
C. actin and myosin protein
D. lactic acid
E. mitochondria

A 17-year-old male was taken to the community health center due to a traffic accident.

open fracture of both legs, blood is flowing heavily. In

The health center of the suffering is calm, asleep, and making sounds.
snoring like gargling. The radial pulse is rapid and
weak, cold fingertips. What action should be taken
first time?
A. freeing the airway and positioning the head
B. giving artificial respiration mouth to mouth
C. lifts both legs, the body is supported by a hard board
D. install an infusion line for colloid fluid and vasopressor
E. apply splints to both legs

A 7-year-old child came with his younger sibling, both of them with
itching all over the body, between the toes and fingers.
There are bumps and several forms of vesicles. Which layer of skin?
who experiences pathology in the early phase of the disease?
A. stratum corneum
B. basal layer
C. stratum granulosum
D. lucid layer
E. spiny layer

A woman came, there have been spots for 2 days.

redness around the mouth, crust on the lips. PF: Erythema, vesicles,
blisters around the lips and oral mucosa. History of taking medication for 5 days
last time. The most likely triggering factor.........
A. drug allergy
B. infection
C. neoplasm
D. inflammation
E. infestation

48. The complications of the aforementioned disease that can cause

death..........
A. meningitis
B. hepatitis
C. gastrointestinal bleeding
D. DIC
E. sepsis

49. Mother P2A1, after 1 month of KET, comes for 3 years of family planning. The husband does not want to.

condom/periodic abstinence. Effective family planning:

a. IUD
b. Depoprovera KB
c. KB Estrogen
d. KB Pil

50. A patient, 40 years old, complains of tingling in the lips.

below after the lower back tooth operation 2 weeks ago. What now?
What is the cause?
a. Allergy to anesthetic drugs

b. Excessive drug dosage

c. Anesthetic drugs enter the bloodstream
d. Jaw anatomical abnormalities
e. Trauma jar. Nerve

51. Male, 26 years old, easily fatigued, sweating >> examination mother
melotot, tremor T3T4TSH What supporting actions need to be taken?
DM type I. 27 years old, female, has been using insulin injections since childhood. Basis of abnormalities

that metabolic: life

a. Enhancement of proteolysis
b. Increased lipogenesis
c. Increase in cholesterol secretion
d. Decrease in glycogenolysis
e. Beta oxidation reduction

53. Male, 61 years old, retired, experiencing difficulties in memory.

the order of the child's birth date. Is that a disturbance?

a. Depression
b. Delirium
c. Paramnesia
d. Amnesia
e. Dementia

54. 1-month-old child, white in the center of the eye, after being diagnosed with Congenital Cataract.

Should cataract surgery?

6-8 billion
b. After the age of 1 year
c. After the age of 2 years
d. After the age of 5 years
e. Before the age of education

A 32-year-old woman suffering from diabetes

type 1 diabetes experiences progressive kidney failure over a period of time
The last two years. Dialysis has not been performed on this patient.
The physical examination did not show any signs of abnormalities. The results
laboratory examination shows hemoglobin level = 9 g/dl,
28 and MCV 94 normocytic and %, m3. Edge blood apus
shows normochromic red blood cells. Which answer is in
the following is the most likely cause of the patient's condition
that?
A) Acute bleeding
B) Chronic lymphocytic leukemia
C) Sideroblastic Anemia
D) Erythropoietin deficiency
E) Deficiency of erythrocyte enzymes
A

56. A 30-year-old man who previously in

in good health, suffering from fever and pruritus, sweating at night,
also found a lump on the left clavicle for three
Sunday. Physical examination shows enlargement of the lymph nodes.
non-painful lymph node, measuring 3 cm, with a soft consistency
and located in the supraclavicular region. Chest X-ray examination
indicating the presence of mediastinal lymphadenopathy. Which answer?
the most accurate below is the cause of the disease
on that patient?
A) Tuberculosis
B) Metastatic carcinoma
C) Hodgkin's disease
D) Sarcoidosis
E) Infectious mononucleosis
C

A boy aged 8 was bitten by a bee.

five minutes later a swelling lesion appeared, measuring 2 cm, and
red in the bite area. Among the following answers,
Which finding is dominant in the bite lesion?
A) Reaction to foreign body
B) Bleeding
C) Lymphocytic infiltration
D) Neutrophilic migration
E) Vasodilation
E

A man aged 80 has been diagnosed with a carcinoma.

ulcerative on the right scrotal skin. Which gland group is below
this is the first that will receive metastatic cells from carcinoma
it

A) External iliac
B) Iliaca Interna
C) Superficial inguinal
D) Deep inguinal
E) Lumbar (para-aorta)
Jwb: C
A 4-year-old girl cannot eat.
for two days due to gastro-intestinal illness. From the answer in
Below, which one is the main source of energy that will
oxidation in the skeletal muscles of the patient?
A) Creatine Phosphate muscle
B) Muscle glycogen
C) Muscle triglycerides
D) Serum fatty acids
E) Serum glucose
Answer: B

A 35-year-old man suffered burns on

the entire thickness of the skin in the dorsum of the hand. A rotation flap
from normal skin and subcutaneous tissue created to cover
the defect. From the answers below, at which layer
arterial blood vessels that will provide vascularization to
that flap?
A) Basal Layer
B) Inner dermis
C) Stratum corneum
D) Stratum lucidum
E) Subcutaneous fat
A

A 24-year-old man was referred to the emergency unit.

hospital after being pierced by a sharp object in the anterior thorax on the side
medial papilla of the left breast. Upon arrival, blood pressure was noted.
= 70/50 mmHg. The neck veins appear distended. Breath sounds
normal vesicular in both lungs. From the options below,
the next most appropriate management step is:
A) X-ray photo of the thorax
B) Endotracheal intubation
C) EKG
D) Insertion of a tube into the thoracic cavity on the left side.

E) Pericardiocentesis
A

A 22-year-old woman visited the doctor 3 months ago.

after finding a lump in the lower lateral quadrant
right breast. Physical examination shows a mass with a diameter of 2
cm, oval-shaped, solid, smooth, and mobile on the breast.
No enlargement of the axillary lymph nodes was found. If biopsy
a biopsy performed on the lump is likely to be
will show signs of illness:
A) Fat necrosis
B) Fibroadenoma
C) Fibrocystic breast changes
D) Intraductal carcinoma
E) Intraductal papilloma
Answer: B

A 54-year-old woman was brought to the emergency unit.

by his family due to being weak and feeble in his left hand and both
his feet for 2 hours. He has a history of high blood pressure and
the use of alcohol and smoking two packs of cigarettes every
The day for 30 years. The sensation in the left hand and both legs has decreased.
and muscle strength is 0/5. A bruit is heard in the carotid artery
right
Which of the following examinations is the most appropriate for
enforcement of early diagnosis?
A) Electroencephalography
B) Carotid duplex scan
C) CT scan of the head
D) Echocardiography
E) Carotid angiography
Answer: C

64. One day after the repair of the aortic aneurysm rupture that
carried out in an emergency situation, a 66-year-old man
producing urine of 35 mL over a period of 4 hours, a
Foley catheter is still in place. He has received 14 units of blood during
operation. Temperature C (100 body 37.8 126x/minute. Examination F),
blood pressure 104/68 mmHg, and the physical pulse indicates the presence of

widespread peripheral edema. Normal heart sounds. Upon examination

with auscultation, the lung sounds are clear. The abdomen feels soft.
Laboratory test results show: Hematocrit 27%,
Serum Na+ 143 mEq/L, K+ 5.0 mEq/L, Urine Na+ 6 mEq/L. Which one?
from the statement below which is the cause of oliguria that
the most appropriate for the patient?
A) Heart failure
B) Hypovolemia
C) Occluded Foley catheter
D) Renal artery thrombosis
E) Transfusion reaction
Answer: B

65. Male, 38 years old, for 2 weeks has been experiencing severe pain in his left leg.

sleep time. actually felt pain for the past year, but
only felt when walking. The patient complains of the distance traveled
getting shorter and often stopping due to pain. If
The pain relief has been achieved. The patient is a heavy smoker. PF is as follows.
normal general, on the left inf. exam. no pulsation of the dorsalis a. felt
pedis and tibialis posterior. normal lab examination.
What is the most likely diagnosis?
A. Acute arterial occlusion -> acute arterial occlusion has been present for 1 year

B. Thromboangiitis obliterans
C. Diabetic arteriopathy
D. Chronic arterial thrombosis
E. atherosclerotic peripheral arterial occlusive disease
Answer: B

66. male, 31 years old, suffering from Buerger's disease. complains of the tips

His right pinky toe is black and smells. It also feels very.
nyeri. Normal general PF, localized status: dry gangrene appears on
tip of the right little toe. Lab: Hb 13.1 Leu 12,100 other labs normal
Actions on the patient:
A. Necrotomy & debridement, then prepared for elective amputation
B. Necrotomy & debridement, followed by administration of analgesics, antibiotics, &

oral vasodilator
C. incision & drainage, --> analgesics, antibiotics, oral vasodilators
D. no necrotomy & debridement --> but analgesics, antibiotics,
oral vasodilator?
E. amputation with local anesthesia --> antibiotics, analgesics, vasodilators
oral
Answer: B

67. 35-year-old woman, right leg swollen for the past 2 years, no
pain. most likely diagnosis?
A. deep vein thrombosis
B. Lipedema
C. Lymphedema
D. Stasis edema
E. Edema
Answer: C

68. 18-year-old female, pain in the tip of the left foot for the past 5 days, that toe
looks pale and cold compared to the right leg. the pulse is only clear
Swollen in the groin but weak. Since a month ago, experiencing continuous headaches.
blood pressure in the left and right arms is the same, but the blood pressure in the left leg is higher

weaker than the others.

most likely diagnosis?

A. Arteriosclerosis
B. Obliterative atherosclerosis
C. Thrombophlebitis
D. Obliterative thrombangiitis
E. Takayasu arteritis
A

69. What are the most important signs and symptoms of Volkmann's ischemia?
A. Pallor
B. Coolness
C. Swelling
D. Numbness
E. Pain
A

70. A beautiful girl came to your practice hoping for

her height increased because she aspired to be a flight attendant.
suggesting / X-ray of the knee area. what is primarily observed from
What is the result of Ro in the above case?

A. Periosteum
B. Epiphysis
C. Metaphysis
D. Epiphyseal plate
E. Perichondrium
A

71. Male, 25 years old, traffic accident (TAC) --> motorcycle, taken away
the bone shaman. 1 week later taken to the emergency room & was found to have experienced

open fracture (Fx) 1/3 upper tibia grade 3A. Action?

A. administration of antibiotics (AB) and tetanus antitoxin serum (ATS)
B. Immobilization is done with a plaster cast
C. a culture and resistance test of the bacteria from the wound was conducted.
D. Debridement was performed, external fixation, appropriate antibiotics
E. Amputation of his leg
D

For the following 3 questions, use the scenario below.

72. at the time help was provided in the ER to the KLL victim,
Primary survey obtained: A clear, B clear. At the time of C, what fluid is
should be given to this patient?
A. 5% D solution
B. Hemasel solution
C. 0.9% NaCl solution?
D. 5% HES solution
E. RL solution
A

73. suspected that this patient is experiencing partial airway obstruction

which is caused by the root of the tongue, during the examination what sound is

heard?
A. Snoring
B. Crowning
C. Gurgling
D. Wheezing
E. Grunting
A

74. Does this patient need a nasopharyngeal airway?

A. No, because it is not major oro-maxillofacial trauma.
B. No, because there is no coagulation disorder
C. Necessary, because there is a kranii fx basis.
D. Necessary, because of nasal fx os
E. Necessary, because surgery will be performed in the nasal area
Answer: A

for the questions below use the following scenario:

A car driver experienced a traffic accident on the toll road. The victim
experiencing multiple trauma. In the emergency room, primary survey stable. at

secondary survey, you will take the first Ro photo

75. In which area do you suggest the Ro inspection?

A. Head, neck, thorax, pelvis
B. Joint areas and extremities
C. Head and neck
D. Thorax and abdomen
E. Pelvis
Jwb: A

76. If lesions are found on the head and chest of this patient (px),
What airway management actions can be taken?
A. Head tilt
B. Chin lift
C. Jaw thrust -> ACLS
D. Flexible head
E. Head extension
Answer: C

77. suddenly a patient experienced cardiac arrest so it is necessary

external heart compressions are performed in CPR when compressions are done
what is the correct blood pressure produced?
A. 100/10 mmHg
B. 120/80 mmHg
C. 100/50 mmHg
D. 100/40 mmHg
E. 110/70 mmHg
Answer: A

78. What is the ratio of external heart compressions to rescue breaths?

when the patient has not been intubated, with 2 helpers?
A. 5:2
B. 5:1
C. 15:1
D. 15:2
E. Can be disordered
Answer: D

79. This patient needs intubation. What is the time limit?

What is the best installation procedure?
A. No more than 30 seconds
B. Until cyanosis occurs
C. Until bradycardia occurs
D. Until the patient begins to wake up
E. The same as how long we hold our breath
A

80. Baby girl, 4 months old. There is a bluish lump on the temporal area.
A lump appeared at one week old and is growing bigger.
slow. The baby seems undisturbed. Sometimes the lump grows larger
The patient is crying. Currently, the diameter of the lump is 4cm.
What is the most suitable therapy?
A. Observation
B. Mass Cultivation
C. Excision
D. Sclerotherapy injection
E. Corticosteroid injection
Answer: C

81. boy, 5 years old. fell from a bicycle 5 days ago. there are wounds.
a 2x1 cm wound on his left arm that he treated with povidone
iodine
which includes wound healing in the above case?
A. Primary intention
B. Secondary intention
C. Tertiary intention
D. Delayed intention
E. Acute intention
Jwb: B

82. newborn baby with labiognathopalatoschisis. Baby is healthy, weight 3500g.

there are no congenital abnormalities in other organs. Parents are a couple who
healthy, no congenital defects, as well as grandparents from both sides
party.
What is the most likely factor causing congenital abnormalities?
that?
A. Trauma during the second trimester of pregnancy
B. Genetic factors
C. Deficiency of vitamins A and E during pregnancy
D. Folate deficiency
E. the occurrence of radiation from X-rays during the mother's early pregnancy

Jwb: E

u/ 4 questions below use the following scenario:

83. Male, 46th, to the emergency room with complaints of vomiting and diarrhea

bleeding since one day ago. The incident was preceded by sudden pain.
in the stomach, vomit also contains food leftovers, but more
a lot of vomiting like ter. history of recurrent epigastric pain since
a year ago. usually pain is felt a few hours after eating
Upon physical examination, the general condition is weak, both
the limbs feel cold. on abdominal examination there is no pain.
pressure, pain relief, and muscle stiffness. The abdomen is not bloated and
Increased bowel sounds. No signs of liver failure found. Blood pressure 90/60.
mmHg, Pulse 110x/min weak and irregular.

84. What is the most accurate diagnosis for this patient?

A. Hemorrhagic shock due to acute esophageal variceal bleeding
B. Hemorrhagic shock due to gastric ulcer bleeding
C. Hemorrhagic shock due to acute variceal bleeding of the gastric fundus
D. Hemorrhagic shock due to gastric cancer bleeding
E. Hemorrhagic shock e.c. vascular malformation bleeding
Answer: B

85. What is the earliest management that should be done for this patient?
A. Fluid resuscitation, close monitoring of vital signs, --> administration
stomach ulcer medicine

B. Fluid resuscitation and blood transfusion, oxygenation, insert NGT,

stomach medicine

C. Fluid resuscitation and blood transfusion, oxygenation, NGT placement, AB

broad spectrum, laparotomy
D. Fluid resuscitation and blood transfusion, oxygenation, NGT placement,
close monitoring of vital signs, endoscopy
E. Fluid resuscitation, oxygenation, insert NGT, broad spectrum antibiotics, rinse
stomach
E

86. What is the most appropriate resuscitation fluid for this patient?
A. Packed Red Cell
B. Whole Blood
C. RL solution
D. HES solution
E. Normal Saline Solution

87. After the patient was resuscitated, there was an improvement in hemodynamics.
endoscopy of the GI tract revealed the source of bleeding, but failed
to stop the bleeding, and 750cc of blood is needed to maintain
blood pressure is sufficient for 8 hours
What is the most appropriate follow-up treatment?
A. IV Adrenaline Injection
B. Explorative Laparotomy to control bleeding
C. More transfusions to maintain Hb
D. Proton-pump inhibitor IV (omeprazole)
E. IV Pitressin drip

88. A 55-year-old man went to the emergency room with abdominal pain for the past 2 days.
starts in the heartburn area then spreads throughout the abdomen. Patient
appears sweaty and lethargic. Tenderness, pain on release, and cramps
Intestine found. The abdomen appears bloated and intestinal noises decreased.
Lung-liver boundary disappears, BP 100/60 mmHg, pulse 100 beats/min, temperature

38C, has a history of recurrent heartburn for the past year.

always take aspirin for headaches
What is the most common cause of this disease?
A. Primary peritonitis
B. Secondary peritonitis
C. Tertiary peritonitis
D. Faecal peritonitis
E. Foreign body peritonitis

For the 3 questions below, use this scenario.

2-month-old child --> to the ER, bloated stomach, vomiting, no bowel movements
since 4 days ago. There is a history of diarrhea spraying. Upon examination
slow meconium movement and recurrent constipation were found

89. What is the most accurate diagnosis?

A. Intussusception
B. Acute diarrhea
C. Enterocolitis
D. Hirschsprung's disease
E. Ulcerative colitis
90. What is the most appropriate management for the patient?

A. NGT can reduce abdominal distension

B. Rectal biopsy must be performed as soon as possible for a definitive diagnosis.

C. The most accurate examination for a definite diagnosis is a CT scan.

abdomen
D. Abdominal X-ray and barium enema should be performed after the condition
acute handled
E. Rectal biopsy can be performed in acute conditions.

What is the most appropriate handling action?

A. rectal biopsy, plain X-ray, Barium enema, NGT insertion, resuscitation
liquid and warmed saline enema
B. NGT & fluid resuscitation, AB, followed by warmed saline enema, Rectal
biopsy and Ba enema
C. Rectal biopsy, fluid resuscitation and warmed saline enema, Photo
abdominal poles, Ba enema, NGT
D. NGT and fluid resuscitation, Rectal biopsy, barium enema, Plain X-ray
abdomen, warmed saline enema
E. Rectal biopsy, NGT, fluid resuscitation, warmed saline enema, photo
abdomen poles, Ba enema

2 questions, use the following scenario

9 month old girl --> emergency room, often has bloody diarrhea and
soothe. The day before, the baby seemed restless and cried.
ringing, this happens repeatedly. There was no fever beforehand,
during the examination, a mass was found in the epigastrium and there was none

portio-like appearance in the anal opening

92. What is the most accurate diagnosis?
A. Amoebic dysentery
B. Intussusception
C. Hemorrhoid
D. Ulcerative colitis
E. Perforated Meckel's diverticulum

Which one directs the diagnosis the most?

A. bloody bowel movement and anal probing
B. Intussusception triad
C. Severe pain and anal penetration
D. Blood stool without fever
E. A mass detected without a portio-like appearance

scenario with 2 questions below

30-year-old woman --> ER, decreased consciousness 3 hours after the accident
high-speed motor. upon entering the emergency room RR 25x/min, BP 120/70
mmHg, HR 98x/min. The patient is still opening their eyes with stimulation.

can localize the pain given but cannot

making a sound
What is your first action?
A. perform a head photo examination to look for fractures
B. perform a head CT scan
C. ensures airway (intubation) with cervical control
D. performing fluid resuscitation
E. Examination for the presence of trauma in other places

95. After the patient's condition stabilized, a physical examination found

the presence of a hematoma in the left parietal area, laceration on the right chest and

abdomen
What supporting examinations are carried out?
A. plain x-ray of the head, cervical, thorax, abdomen
B. CT scan of the head, cervical, thoracic, pelvic images
C. Head CT scan, thorax photo, pelvis
D. Head AP and lateral, cervical, thorax, pelvis
E. CT scan of the head, cervical, thorax, pelvic X-ray, abdominal ultrasound

96. Male 27th --> Emergency room due to traffic accident. The patient performed movements.

the captivating body of Dila is stimulated, the voice unclear, and unable to
opens eyes even when stimulated. what is the GCS?
A. 8
B. 9
C. 6
D. 7
E. 5
97. a 65-year-old woman --> slipped in the bathroom, she held onto her body.
with the right hand. then he felt pain in the wrist
right hand. the joints of the hand look like a fork
which bone might be broken?
A. metacarpal I
B. Radius
C. Ulna
D. Humerus
E. Clavicula

98. male 35 years old, referred to the eye clinic from the endocrine clinic. he is suffering from

DM since 10th year, normal blood sugar levels. vision examination

either within or outside normal eye. fundoscopy: clear media, normal papilla,
retina data, no neovascularization, dot haemorrhages (+), hard
exudates (+), macular edema (-), foveal reflex normal
What is the most likely diagnosis?
A. proliferative diabetic retinopathy
B. nonproliferative diabetic retinopathy
C. Central retinal vein occlusion
D. Central retinal artery occlusion
E. Retinal detachment

99. child 9th --> eye clinic, itchy eyes, blepharospasm, photophobia,
secretions of the eye that are copious and mucoid, vision (N), slit lamp --> cobblestone

on the upper eyelid

management?
A. topical antibiotic
B. topical antimetabolite
C. topical acyclovir
D. topical antihistamine
E. Topical artificial tears

scenario 2 question:
35-year-old man, itchy red eyes, milk-like secretion on the conjunctiva. slit
lamp --> papilla of the superior and inferior tarsal conjunctiva. history
families with atopic disease

100. diagnosis?
A. vernal conjunctivitis
B. Atopic conjunctivitis
C. Acute conjunctivitis
D. Flictenular conjunctivitis
E. Follicle conjunctivitis

What type of hypersensitive reaction is present in the above case?

A. type I
B. II
C. II
D. IV
E. I & IV

scenario 2 question below:

102. 40-year-old woman, vision decline since 3 years ago accompanied by pain.
watery red eyes. diagnosed by general practitioner as a TB patient.
examination --> anterior chamber injection, flare in the anterior chamber (+), keratic

precipitate (+)
37. diagnosis?
A. acute uveitis
B. Vitritis
C. Choroiditis
D. Endophthalmitis
E. Pars planitis

103. therapy
A. corticosteroid and cycloplegic (cort. for its inflammatory reaction (cuz
the etiology is not very clear), cycloplegia to prevent scarring)
B. topical beta blocker
C. topical antihistamine
D. Topical mast cell stabilizer
E. Topical antibiotics
scenario 2 question:
104. 50-year-old man, red eyes, pain, tearing. At examination
peripheral corneal ulcer found
39. diagnosis?
A. Bacterial ulcer
B. Herpetic ulcer?
C. Geographican ulcer
D. Fungal ulcer
E. Mooren's ulcer

105. main therapy?

A. AB oral
B. anti-fungal
C. topical corticosteroid
D. Antihistamine
E. AB topical

scenario 2 question:
106. 55-year-old man --> eye clinic, left eye blurry. vision examination
3/60 conjunctiva calm, clear cornea, moderate AC, round pupil rx
(+), clear lens, TIO 15 mmHg, funduscopy Cup/Disc ratio 0.9,
open angle
What other examinations do you perform?
A. Retinometer
B. Octopus perimetry
C. Streak retinoscopy
D. USG
E. Refractometry

107. What is the most likely diagnosis?

A. Primary angle-closure glaucoma

B. Primary open-angle glaucoma
C. Secondary open-angle glaucoma
D. Secondary angle-closure glaucoma
E. Acute glaucoma attack
scenario 2 question
70-year-old man --> 24-hour clinic, complaint of hearing loss
left ear for 6 months now. you have had an examination
audiometric

108. u/ to know the degree of your hearing disturbance you do

A. Rinne
B. tes Webber
C. tes Swabach
D. tes tone decay
E. tes BERA

109. after conducting the Weber test, the sound was louder on
left ear, what does it mean
conductive hearing loss
conductive deafness
C. right ear --> sensorineural hearing loss
D. left ear --> sensorineural deafness
E. both ears conductive deafness

110. A 3-year-old child is accompanied by their mother because they cannot communicate yet.

Which of the following shows an impact on children?

A. parental involvement gives something very meaningful to school-age children (6-
9th
B. disabilities affect 'educational performance' and
social development
C. Deafness in children has the same impact as deafness in adults.
D. early deafness at a young age (0-3) does not affect development
talk
E. hearing loss at school age (6-9) affects speech development

111. 5-year-old boy --> outpatient clinic, left ear pain since 3 days ago.
started with an upper respiratory tract infection. consciousness clear, fever (39)

tympanic membrane bulging with middle ear suppuration

diagnosis?
A. Bullous Miringitis
B. Chronic suppurative otitis media
C. Acute Mastoiditis
D. Acute otitis media
E. Chronic mastoiditis

scenario 2 questions
8-month-old baby girl, --> emergency room shortness of breath for the past 3 days, stridor during

inspiration and mild retraction at the suprasternal area. Shortness of breath decreases when

patients sleep on their side or use a pillow. there is no fever, no

accompanied by eating/drinking disturbances. soft tissue radiological examination
the throat shows a narrowing in the laryngeal area. complaints such as
This has been felt since 2 months ago but healed on its own.
Diagnosis: Laryngomalacia

112. supporting examination?

A. nasal endoscopy
B. Posterior rhinoscopy
C. Rontgen thorax AP and Lat
Laryngoscopy -> OMEGA SHAPED EPIGLOTTIS
E. Esophagoscopy

113. In children, what are the preventive measures for the disease above? THERE ARE NONE,

CONGENITAL GITU LOWH..JUST AVOID ISPA, DON'T SLEEP

Lying down, don’t cry (how to prevent small children)
Crying, trying???
A. low-dose corticosteroids for the medium term
B. Haemophilus influenzae type B vaccination
C. Adequate oxygenation
D. Long-term low dose
E. avoid cold food and drinks and ice

114. 9th daughter, has come with a blocked nose for the past 2 months.
complaints especially in the morning accompanied by sneezing and nasal secretions
swallowed. anterior rhinoscopy --> mucosa and nasal concha that are livid and
serious secret.
What is rational treatment?
A. acclimatizing patients to contact with allergens from low concentrations
B. to improve physical fitness with exercise once a week
C. H1-receptor antagonist drugs
D. topical decongestant for 2 weeks
E. strives for treatment that can suppress symptoms in the phase
fast or slow

115. boy 8 years old --> outpatient clinic, complaint of snoring during sleep since
A year ago, it appeared and disappeared. Physical exam --> enlargement of the tonsils with tonsillitis.

not hyperemic, the crypts widen, and detritus

What physical findings indicate the presence of chronic tonsillitis?

A. Tonsil enlargement
B. not hyperemic
C. minimal detritus
D. snoring while sleeping
The E. crypta is expanding

116. woman 29th --> ENT clinic has a lump on the left cheek since 3 years ago,
negative pressure (-), diameter 5cm, and pushing the earlobe upwards.
no signs of N VII paralysis, skin appears normal. diagnosis?
A tumor of the parotid gland
B. benign tumor of the parotid gland

C. Sialoadenitis
D. TBC in the parotid gland
E. Hemangioma of the parotid gland

117. 5th girl --> pain in the left ear. 2 days

Previously, according to her mother, her child had been to the ENT clinic with complaints.

bilateral acute suppurative otitis media but has recovered. Found

cholesteatoma in the left ear. this patient is scheduled for surgery
removal of cholesteatoma.
What is the purpose of the operation?
A. hearing improvement
B. preventing hearing loss
C. elevates all pathological tissue
D. maintaining the integrity of the posterior canal wall
E. reconstruction of the tympanic membrane
118. A woman, 32 years old, G2P1A0, 12 weeks pregnant.
Hb 10, MCV and MCHC are normal
a. no need to be given anything
b. Br Fe 100 mg/day -> still nauseous (12 weeks)
c. Ferritin levels are checked
d. Give Vitamin C
e. Dietary advice containing iron

119. A 25-year-old woman reported being raped 5 days ago.

2 days later, the police asked for VeR, the doctor's attitude.
a. Based on previous medical records
b. Medical report based on previous medical records
c. Requesting the police to bring the patient back
d. VeR based on medical records according to date
examination
e. Rejecting VeR

120. If no wounds or membranes are found in that patient

red star, means
5 days ago was really raped
b. Not true that she was raped
c. Made to faint first then raped
d. Trauma of the hymen
e. Intercourse

A 32-year-old woman suffering from diabetes

type 1 diabetes experiences progressive kidney failure over a period of time
The last two years. Dialysis has not been performed on this patient.
Physical examination did not show signs of abnormalities. Results
laboratory examination shows hemoglobin level = 9 g/dl,
The edge blood sample shows a hematocrit of 28% and MCV of 94.
normocytic and normochromic erythrocytes. Which cells are the answers in
Below are the most likely causes of the patient's condition
that?
A) Acute bleeding
B) Chronic lymphocytic leukemia
C) Sideroblastic Anemia
D) Erythropoietin deficiency
E) Erythrocyte enzyme deficiency
D

122. A 30-year-old man who was previously in

in good health, suffering from fever and pruritus, sweating at night,
suddenly found a lump above the left clavicle for three
Sunday. The physical examination shows enlarged nodes.
painless lymph node, 3 cm in diameter, with a soft consistency
and located in the supraclavicular region. Chest X-ray examination
there is an effect of mediastinal lymphadenopathy. Which is the answer?
the most accurate below is the cause of the disease
on that patient?

A) Tuberculosis
B) Metastatic carcinoma
C) Hodgkin's Disease
D) Sarcoidosis
Infectious mononucleosis
C

123. An 8-year-old boy was bitten by a bee.

five minutes later a swollen lesion was observed, measuring 2 cm, and
red in the bite area. Among the following answers,
Which finding is dominant in the bite lesion?

A) Reaction to foreign body

B) Bleeding
C) Lymphocytic infiltration
D) Neutrophilic migration
E) Vasodilation
E
A man aged 80 is suffering from a carcinoma.
ulcerative on the right scrotum skin. Which gland group is below
this is the first place that will receive metastatic cells from carcinoma
that?

A) External iliac
B) Iliaca Interna
C) Superficial inguinal
D) Deep inguinal
E) Lumbar (para-aorta)
C

A 4-year-old girl cannot eat.

for two days due to a gastrointestinal illness. From the answer in
Below, which one is the main source of energy that will
oxidation in the skeletal muscles of the patient?

A) Creatine Phosphate muscle

B) Muscle glycogen
C) Muscle triglycerides
D) Serum fatty acids
E) Serum glucose
Answer: B

126. A 35-year-old man suffered burns on

the entire thickness of the skin in the dorsal region of the hand. A rotational flap

from normal skin and subcutaneous tissue made to cover

that defect. From the answers below, at which layer
the arterial blood vessels that will provide vascularization to
that flap?

A) Basal Layer
B) Inner dermis
C) Stratum corneum
D) Stratum lucidium
E) Subcutaneous fat
A

A 24-year-old man was referred to the emergency unit.

hospital after being punctured by a sharp object in the anterior thorax on the side
medial papilla of the left breast. Upon arrival, blood pressure was noted.
= 70/50 mmHg. The neck veins appear distended. Breath sounds
Normal vesicular in both lungs. From the options below,
the next most appropriate management step is:

A) X-ray photo of the thorax

B) Endotracheal intubation
C) EKG
D) Insertion of a tube into the left thoracic cavity.
E) Pericardiocentesis
Answer: A

A 22-year-old woman has been seeing a doctor for 3 months.

after finding a lump in the lower lateral quadrant
right breast. Physical examination shows a mass with a diameter of 2
cm, oval-shaped, solid, smooth, and mobile on the mammary gland.
No enlargement of the axillary lymph nodes was found. If biopsy
the excision performed on the lump will most likely
will show signs of illness:
A) Fat necrosis
B) Fibroadenoma
C) Fibrocystic breast condition
D) Intraductal carcinoma
E) Intraductal papilloma
Answer: B

A 54-year-old woman was brought to the emergency unit.

by his family because he is weak and numb in the left hand and both
his legs for 2 hours. He has a history of high blood pressure and
alcohol consumption and smoking two packs of cigarettes each
The symptoms have lasted for 30 years. The sensation in the left hand and both legs has decreased.
and muscle strength is 0/5. A bruit is heard in the carotid artery
right.
Which of the following examinations is the most appropriate for
enforcement of early diagnosis?
A) Electroencephalography
B) Carotid duplex scan
C) CT scan of the head
D) Echocardiography
E) Carotid angiography
Answer: C

130. One day after the repair of the aortic aneurysm rupture
performed in an emergency situation, a 66-year-old man
the year produced urine amounting to 35 mL over a period of 4 hours,
a Foley catheter is still in place. He is receiving 14 units of blood.
during the operation. Body temperature C (100 is 37.8 126x/minute.
Examination F), blood pressure 104/68 mmHg, and physical pulse
shows the presence of extensive peripheral edema. Heart sounds are normal.
During the examination, lung sounds were heard clearly.
The abdomen is palpably soft. Laboratory test results show:
27%
mEq/L. Which of the statements below is...
What is the most accurate cause of oliguria for that patient?
A) Heart failure
B) Hypovolemia
C) Occluded Foley catheter
D) Renal artery thrombosis
E) Transfusion reaction
Answer: B

131. Man, 38 years old, has been experiencing severe pain in his left leg for 2 weeks.
sleeping hours. actually felt pain for the past year, but
only felt when walking. The patient complains about the distance traveled
The longer it takes, the shorter it gets and often stops due to pain. If
pain relief. The patient is a heavy smoker. PF in a
Normal in general, on the left side inf. pulse of the dorsalis artery is not palpable.
pedis and posterior tibialis. lab examination normal.
What is the most likely diagnosis?
Acute arterial occlusion -> acute arterial occlusion has been present for 1 year

B. Thromboangiitis obliterans
C. Diabetic arteriopathy
D. Chronic arterial thrombosis
E. atherosclerotic peripheral arterial occlusive disease
Answer: B

132. male, 31 years old, suffering from Buerger's disease. complaining of the tips

his right pinky toe is black and smells bad. it is also felt very
nyeri. General PF normal, local status: dry gangrene is observed on
tip of the right foot digit V. Lab: Hb 13.1 Leu 12,100 other labs normal
Action on the patient:
A. Necrotomy & debridement, then prepared for elective amputation
B. Necrotomy & debridement, then given analgesics, antibiotics, &
oral vasodilator
insisi & drainase
D. no necrotomy & debridement --> but analgesics, antibiotics,
oral vasodilator?
E. amputation with local anesthesia --> antibiotics, analgesics, vasodilators
oral
Answer: B

133. 35-year-old woman, right leg swollen for the past 2 years, no
pain. most likely diagnosis?
A. deep vein thrombosis
B. Lipedema
C. Lymphedema
D. Static edema
E. Edema
Answer: C

134. 18-year-old woman, pain at the tip of the left foot since 5 days ago, the toe
pale and cold compared to the right leg. pulsation is only clear
There is a hernia in the inguinal area but weak. Since a month ago, I have been experiencing continuous headaches.
Blood pressure in the left-right arms is the same, but blood pressure in the left leg is higher.

weaker than the others.

most likely diagnosis?

A. Arteriosclerosis
B. Obliterating atherosclerosis
C. Thrombophlebitis
D. Thromboangiitis obliterans
E. Takayasu arteritis
Answer: E

135. What are the most important signs and symptoms of Volkmann's ischemia:
A. Pallor
B. Coolness
C. Swelling
D. Numbness
E. Pain
Answer: E

137. a beautiful girl came to your practice hoping

height increases because she dreams of becoming a flight attendant.
suggesting / X-ray of the knee area. what is mainly seen from it
What is the result of Ro in the case above?

A. Periosteum
B. Epiphysis
C. Metaphysis
D. Epiphyseal plate
E. Perichondrium
Answer: E

138. Laki2, 25th, kecelakaan lalu lintas (KLL) --> sepeda motor,
brought to the bone healer. 1 week later brought to the emergency room & it turns out

experienced an open fracture (Fx) of the upper 1/3 of the tibia grade 3A.
Action?
A. administration of antibiotics (AB) and anti-tetanus serum (ATS)
B. Immobilization is done with a plaster cast
C. a culture and resistance test of the bacteria from the wound was performed
D. Conducted debridement, external fixation, appropriate antibiotics
E. Amputation of his leg
A

For the following 3 questions, use the scenario below

139. at the time of assistance in the ER for the KLL victim,
Primary survey obtained: A clear, B clear. At the time of C, what liquid is
What should be given to this patient?
A. D5% solution
B. Hemasel solution
C. 0.9% NaCl solution?
D. 5% HES solution
E. RL solution
A

140. suspected in this patient experiencing partial obstruction of the airway

breathing caused by the base of the tongue, what sound is observed during examination?

Do you hear?
A. Snoring
B. Crowning
C. Gurgling
D. Wheezing
E. Grunting
Answer: A

141. Is it necessary to install a nasopharyngeal airway in this patient?

A. No, because it is not a major oro-maxillofacial trauma.
B. No, because there is no coagulation disorder
C. Necessary because there is a currency basis spread.

D. Necessary, because nasal os fx occurs

E. Necessary, because surgery will be performed in the nose area.
Answer: A

for the questions below, use the following scenario:

a car driver experienced a traffic accident on the highway. The victim
experiencing multiple trauma. In the emergency room, primary survey stable. when
secondary survey, you will take the first Ro photo

142. In which area do you propose the Ro inspection?

A. Head, neck, thorax, pelvis
B. Joints and extremities
C. Head and neck
D. Thorax and abdomen
E. Pelvis
Answer: A

143. If this patient (px) is found to have lesions on the head and chest,
What airway management actions can be performed?
A. Head tilt
B. Chin lift
C. Jaw thrust -> ACLS
D. Flexible head
E. Head extension
Answer: C

Suddenly a patient experienced cardiac arrest so it was necessary

external heart compressions are performed during CPR, when compressions are done
What is the correct blood pressure produced?
A. 100/10 mmHg
B. 120/80 mmHg
C. 100/50 mmHg
D. 100/40 mmHg
E. 110/70 mmHg
A

145. What is the ratio of external heart compressions to breaths?

when the patient is not yet intubated, with 2 helpers?
A. 5:2
B. 5:1
C. 15:1
D. 15:2
E. It can be irregular
Answer: D

146. This patient needs to be intubated. How long is the deadline?

What is the best installation procedure?
A. No more than 30 seconds
B. Until cyanosis occurs
C. Until bradycardia occurs
D. Until the patient starts to wake up
E. Same as how long we hold our breath
A

4-month-old girl, there is a bluish bump on the temporal.

A lump appeared at 1 week old and is getting bigger.
slow. The baby seems undisturbed. Sometimes the lump grows larger.
The patient is crying. Currently, the diameter of the lump is 4cm.
What is the most suitable therapy?
A. Observation
B. Mass extinction
C. Extirpation
D. Sclerotherapy injection
E. Corticosteroid injection
Answer: C

148. boy, 5 years old. fell from a bicycle 5 days ago. has wounds.
a 2x1 cm wound on his left arm which he treated with povidone
iodine
which includes wound healing in the above case?
A. Primary intention
B. Secondary intention
C. Tertiary intention
D. Delayed intention
E. Acute intention
Answer: B

149. newborn baby with labiognathopalatoschisis. Baby is healthy, weight 3500g.

there are no congenital abnormalities in other organs. The parents are a couple who
healthy, no congenital defects, including both grandparents.
party.
What is the most likely factor causing congenital disorders?
that?
A. Trauma during the second trimester of pregnancy
B. Genetic factors
C. Deficiency of vitamin A and E during pregnancy
D. Folate deficiency
E. the occurrence of radiation from X-rays during the mother's early pregnancy

u/ 4 questions below use the following scenario:

Man, 46 years old, went to the emergency room with complaints of vomiting and bloody bowel movements.

Since one day ago. The incident began with sudden pain in the pit of the stomach.
The heart, vomit also contains food remnants, but more.
vomiting like ter. history of recurrent epigastric pain for the past year.
Usually pain is felt a few hours after eating.
Upon physical examination, the general condition is weak, both
the limbs feel cold. on abdominal examination there is no pain
pressure, pain relief, or muscle stiffness. The abdomen is not bloated and
Bowel sounds increased. No signs of liver failure found. Blood pressure 90/60.
mmHg, Pulse 110x/min weak and irregular.

150. What is the most accurate diagnosis for this patient?

A. Hemorrhagic shock due to acute esophageal variceal bleeding
B. Hemorrhagic shock due to peptic ulcer bleeding
C. Hemorrhagic shock due to acute fundic variceal bleeding
D. Hemorrhagic shock due to gastric cancer bleeding
E. Hemorrhagic shock e.c. vascular malformation bleeding
Answer: B

151. The earliest management that should be done on this patient.

A. Fluid resuscitation, close monitoring of vital signs, --> administration
stomach medicine

B. Fluid resuscitation and blood transfusion, oxygenation, place NGT, -->

stomach medicine
C. Fluid resuscitation and blood transfusion, oxygenation, NGT placement, AB
broad spectrum, laparotomy
D. Fluid resuscitation and blood transfusion, oxygenation, NGT insertion,
strict monitoring of vital signs, endoscopy
E. Fluid resuscitation, oxygenation, place NGT, broad spectrum antibiotics, rinse
stomach
Answer: E

152. What is the most appropriate resuscitation fluid for this patient?
A. Packed Red Cell
B. Whole Blood
C. RL solution
D. HES solution
E. Normal Saline Solution

153. After the patient was resuscitated, hemodynamic improvement was observed.
endoscopy of the GI tract above reveals the source of bleeding, but fails
stop the bleeding, and 750cc of blood is needed to maintain
blood pressure is sufficient for 8 hours
What is the most appropriate further handling?
A. IV Adrenaline Injection
B. Explorative Laparotomy to control bleeding
C. More transfusions to maintain Hb
D. Proton-pump inhibitor IV (omeprazole)
E. IV Pitressin drip

154. 55-year-old man, went to the emergency room with abdominal pain for the last 2 days.
starts at the pit of the stomach and then spreads throughout the abdomen. Patient

appears sweaty and lethargic. Tenderness, pain upon release, and cramps
The intestines are found. The abdomen appears bloated and intestinal sounds are reduced.

Liver lung borders disappear, BP 100/60 mmHg, pulse 100x/min, temperature

38 years old, has a history of recurrent epigastric pain for the past year.
always take aspirin for headache complaints
What is the most common cause of this disease?
A. Primary peritonitis
B. Secondary peritonitis
C. Tertiary peritonitis
D. Faecal peritonitis
E. Foreign body peritonitis

For the 3 questions below, use this scenario.

2 month old child --> to the ER, bloated stomach, vomiting, not having bowel movements

since 4 days ago. There is a history of diarrhea. Upon examination

slow meconium movement and recurrent constipation were found

What is the most accurate diagnosis?

A. Intussusception
B. Acute diarrhea
C. Enterocolitis
D. Hirschsprung's disease
E. Ulcerative colitis

156. What is the most appropriate management for the patient?

A. NGT can reduce abdominal distension

B. Rectal biopsy must be performed as soon as possible for a definitive diagnosis

C. The most accurate examination for a definite diagnosis is a CT scan.

abdomen
D. Abdominal X-ray and barium enema should be performed after the condition
handled urgently
E. Rectal biopsy can be performed in acute conditions

157. What is the most suitable handling action?

A. rectal biopsy, plain X-ray, Barium enema, NGT insertion, resuscitation
liquid and warmed saline enema
B. NGT & fluid resuscitation, AB, followed by warmed saline enema, Rectal
biopsy and barium enema
C. Rectal biopsy, fluid resuscitation and warmed saline enema, Photo
abdominal poles, Ba enema, NGT
D. NGT and fluid resuscitation, Rectal biopsy, barium enema, Plain X-ray
abdomen, warmed saline enema
E. Rectal biopsy, NGT, fluid resuscitation, warmed saline enema, photo
abdominal poles, Ba enema
u/ 2 questions, use the following scenario
9-month-old girl --> ER, frequently has bloody diarrhea and
The day before, the baby appeared restless and cried.
ringing, this happens repeatedly. There was no fever beforehand,
on examination a mass was found in the epigastrium and none
portio-like appearance on the anal plug
What is the most accurate diagnosis?
A. Amoebic dysentery
B. Intussusception
C. Hemorrhoid
D. Ulcerative colitis
E. Perforated Meckel's diverticulum

Which one is the most guiding for the diagnosis?

A. blood in stool and rectal probing
B. Intussusception triad
C. Abdominal pain and rectal insertion
D. Bloody stool without fever
E. Mass without portio-like appearance

scenario for 2 questions below

30-year-old woman --> emergency room, decreased consciousness 3 hours after the collision

high-speed motor. upon entering the ER, pulse 25x/min, blood pressure 120/70
mmHg, HR 98 beats/min. The patient is still opening their eyes with stimulation.

pain and can localize the pain given but cannot

making a sound
160. What was your first action?
A. perform a head X-ray examination to look for fractures
B. perform a head CT scan
C. ensures airway (intubation) with cervical control
D. perform fluid resuscitation
E. Examination for the presence of trauma in other areas

161. After the patient's condition stabilized, a physical examination found

the presence of a hematoma on the left parietal, laceration on the right chest and
abdomen
What supporting examinations are conducted?
A. plain X-ray of the head, cervical, thorax, abdomen
B. CT scan of the head, cervical X-ray, thorax, pelvis
C. Head CT scan, chest X-ray, pelvis
D. Head AP and lateral, cervical, thorax, pelvis photos
E. CT scan of the head, cervical, thorax, pelvis x-ray, abdominal ultrasound

162. male 27th --> emergency room due to traffic accident. the patient made a movement

Dila's body is stimulated, the voice is unclear, and unable to

opening eyes even when stimulated. what is the GCS?
A. 8
B. 9
C. 6
D. 7
E. 5

163. A 65-year-old woman --> slipped in the bathroom, she is holding on.
body with the right hand. then he felt pain in
right wrist. the wrist joint looks like a fork
which bone is likely to be broken?
A. metacarpal I
B. Radius
C. Ulna
D. Humerus
E. Clavicula

164. male 35th, referred to the eye clinic from the endocrine clinic. he
suffered from diabetes since 10 years old, blood sugar levels are normal. examination
vision both from inside and outside the eye is normal. funduscopy: clear media, papilla

normal, retinal data, no neovascularization, dot haemorrhages

(+), hard exudates (+), macula edema (-), foveal reflex normal
What is the most likely diagnosis?
A. proliferative diabetic retinopathy
B. nonproliferative diabetic retinopathy
C. Central retinal vein occlusion
D. Central retinal artery occlusion
E. Retinal detachment

165. child 9th --> eye clinic, itchy eyes, blepharospasm, photophobia,
secretions of the eye that are copious and mucoid, vision (N), slit lamp --> cobblestone

on the upper eyelid

management?
A. topical antibiotics
B. topical antimetabolic
C. acyclovir topical
D. topical antihistamine
E. Topical artificial tears

scenario 2 question:
35-year-old man, itchy red eyes, milk-like discharge on the conjunctiva. Slit.
lamp --> papilla of the superior and inferior tarsal conjunctiva. history
family with atopic disease

166. diagnosis?
A. vernal conjunctivitis
B. Atopic conjunctivitis
C. Acute conjunctivitis
D. Flictenularis conjunctivitis
E. Follicle conjunctivitis

167. Which hypersensitive reaction is present in the case above?

A. type I
B. II
C. II
D. IV
E. I & IV

scenario 2 the question below:

40-year-old woman, vision loss for the past 3 days accompanied by pain in the eye.
watery red. diagnosed by a general practitioner as a TB patient. examination
injection of sclera, flare in the anterior chamber (+), keratic precipitates (+)
168. diagnosis?
A. acute uveitis
B. Vitritis
C. Choroiditis
D. Endophthalmitis
E. Planets of the Earth

169. therapy
A. corticosteroid and cycloplegic (cort. for its inflammatory reaction (cuz
the etiology is not very clear), cycloplegia to prevent scarring)
B. topical beta blocker
C. topical antihistamine
D. Topical mast cell stabilizer
E. Topical antibiotics

scenario 2 question:
50-year-old man, red eyes, pain, tearing. on examination
peripheral corneal ulcer found
170. diagnosis?
A. Bacterial ulcer
B. Herpetic ulcer?
C. Geographical ulcer
D. Fungal ulcer
E. Mooren's ulcer

171. main therapy?

A. AB oral
B. anti-fungal
C. topical corticosteroid
D. Antihistamine
E. AB topical

scenario 2 question:
55-year-old man, --> eye clinic, left eye blurry. VOS examination 3/60.
conjunctiva calm, clear cornea, moderate COA, round pupil rx (+)
clear lenses, IOP 15 mmHg, funduscopy Cup/Disc ratio 0.9, gonioscopy
open angle
What other examinations do you conduct?
A. Retinometer
B. Octopus perimetry
C. Streak retinoscopy
D. USG
E. Refractometry

173. most likely diagnosis?

A. Primary closed-angle glaucoma
B. Primary open-angle glaucoma
C. Secondary open-angle glaucoma
D. Secondary closed-angle glaucoma
E. Acute glaucoma attack

scenario 2 questions
70-year-old man --> 24-hour clinic, complaints of hearing loss
left ear for the past 6 months. have you had an examination?
audiometric

174. u/ understanding the degree of your hearing impairment

A. tes Rinne
B. tes Webber
C. tes Swabach
D. test tone decay
E. tes BERA

175. after performing the weber test, the sound was louder on
left ear, what does it mean
right ear --> conductive hearing loss
B. left ear --> conductive hearing loss
C. right ear --> sensorineural deafness
D. left ear --> sensorineural deafness
E. both ears have conductive hearing loss
A 3-year-old child was taken by their mother because they cannot communicate yet.

Which of the following shows an impact on children?

A. kindness gives something very meaningful to school-age children (6-
9th
B. disability affects 'educational performance' and
social development
C. deafness in children has the same impact as deafness in adults
D. early deafness at an early age (0-3) does not affect development
talk
E. deafness at school age (6-9) affects speech development

177. 5-year-old boy --> outpatient clinic, left ear otitis since 3 years ago.
began with upper respiratory tract infection. consciousness CM, fever (39),
bulging tympanic membrane with middle ear suppuration
diagnosis?
A. Bulous Miringitis
B. Chronic suppurative otitis media
Acute mastoiditis
D. Acute otitis media
Chronic Mastoiditis

scenario 2 question
8-month-old girl, --> Emergency room with shortness of breath since 3 days ago, stridor present.

inspiration and light retraction in the suprasternal area. shortness of breath decreases when

the patient sleeps sideways or uses a pillow. there is no fever, no

accompanied by eating/drinking disorders. soft tissue radiological examination
the neck shows narrowing in the laryngeal area. complaints such as
This has been felt for the past 2 months but has healed on its own.

Dx: LARYNGOMALACIA
178. supporting examination?
A. naso-endoscopy
B. Posterior rhinoscopy
C. Chest X-ray AP and Lat
OMEGA SHAPED EPIGLOTTIS
E. Esophagoscopy
179. In children, what are the preventive measures for the above diseases? THERE ARE NONE,

CONGENITAL GITU LOWH..JUST AVOID ISPA, DON'T SLEEP

Lying flat, don't cry (How to prevent small children)
CRY TRY???
A. medium-term low-dose corticosteroids
B. Vaccination against Haemophilus influenzae type B
C. Adequate oxygenation
D. Low dose long term
E. avoid cold food and drinks and ice

180. 9-year-old girl, came in with a stuffy nose for the past 2 months.
complaints mainly in the morning accompanied by sneezing and nasal discharge that
swallowed. anterior rhinoscopy --> mucosa and nasal concha that are livid and
a serious secret.
What is rational treatment?
A. to acclimatize patients to allergens from low concentrations
B. improve physical fitness with exercise 1x/week
C. H1-receptor antagonist medication
Topical decongestant for 2 weeks
E. is working on treatment that can suppress symptoms in the phase
fast or slow

181. 8-year-old boy --> outpatient clinic, complaint of snoring since

A year ago, there were fluctuations. Physical exam --> tonsil enlargement with tonsil.

not hyperemic, crypts widened, and detritus

What are the signs that indicate chronic tonsillitis?
A. Tonsil enlargement
B. not hyperemic
C. minimal detritus
D. snoring sleep
E. crypta widens

182. woman 29th --> ENT clinic presents with a lump on the left cheek for the past 3 years.
negative pressure (-), diameter 5cm, and pushing the ear leaf upwards.
no signs of N VII paralysis, skin looks normal. diagnosis?
A malignant tumor of the parotid gland
B. benign tumor of the parotid gland

C. Sialadenitis
D. TBC in the parotid gland
E. Hemangioma of the parotid gland

183. 5th girl --> pain in the left ear. 2 weeks

Previously, according to her mother, her child had gone to the ENT clinic with complaints.

bilateral acute suppurative otitis media but has recovered. Found

cholesteatoma in the left ear. this patient is scheduled for surgery
removal of cholesteatoma.
What is the purpose of the operation?
A. hearing improvement
B. maintaining hearing loss
C. lifts the entire pathological tissue
D. maintaining the integrity of the posterior canal wall
E. reconstruction of the tympanic membrane

184. A woman, 32 years old, G2P1A0, 12 weeks pregnant.

Hb 10, MCV and MCHC normal
a. no need to be given anything
b. Br Fe 100 mg/day -> still nauseous (12 weeks)
c. The ferritin level is checked
Give Vitamin C
e. Dietary advice for foods containing iron

A 25-year-old woman reported being raped 5 days ago.

2 days later, the police asked for VeR, the doctor's attitude.
a. VeR based on previous medical records
b. Medical report based on previous medical records
c. Requesting the police to bring the patient back
d. VeR based on medical records according to date
examination
e. Reject VeR

186. If no wounds are found on the patient, membranes

red star, means
5 days ago was truly raped
b. It is not true that she was raped

c. Knocked out first then raped

d. Trauma of the hymen
e. Intercourse