musculoskeletal

Multiple Choice

A 38-year-old woman has recent onset of cold fingers, joint pain, fever, weight loss, and a facial rash. Examination reveals a symmetrical inammatory arthropathy, a rash over her face and neck, and lymphadenopathy. Investigations reveal thrombocytopenia, normal urine examination, and a strongly positive anti nuclear antibodies (ANA). What is the most likely diagnosis?

• Rheumatoid arthritis

• Gout

• Systemic lupus erythematosus

• Acute osteoarthritis

Multiple Choice

A male 60 years old complained of a sudden swelling of the left knee. The patient sometimes felt calf muscle spasms, otherwise healthy. He suffered several times left knee swelling before. There was a palpable bony enlargement of the knee. Synovial uid analysis is taken on the above case. The result is:

• Increase white blood count

• Appearance of Bacteria

• The appearance of Calcium pyrophosphate dihydrate crystals

• Increase red blood count

Multiple Choice

A 44-year-old man presents to your ofce with pain and swelling of the small joints in his hands and wrists. He reports stiffness in his both hands that occurs every morning and lasts for 2 hours. On examination, he has symmetrical involvement of both wrists and proximal interphalangeal joints. The involved joints are swollen and tender. Laboratory tests show high ESR, negative rheumatoid factor, and a positive anti-CCP antibody. X-ray of the wrist and hands reveal erosions in the proximal phalanges and ulnar styloid process. Which is the most appropriate drug to halt the disease progression?

• Prednisone

• NSAID

• Hydroxychloroquine

• Methotrexate

Multiple Choice

A 25-year-old woman presented with a rm mass in her left lateral pelvis. She felt pain in the area of the mass when lying on her side. Her past medical history was signicant only for hypertension. Family history was negative for bone diseases.Physical exam revealed a bony mass that was immovable and attached to her left iliac wing. The mass was approximately 7 cm in greatest dimension. She felt mild pain with extremes of abduction and adduction of her left hip. A radiograph showed a mushroom-shaped bony excrescence joined to the iliac wing by a broad stalk. Computed tomography conrmed this and showed that the mass did not have a brous capsule. The patient underwent surgical removal of the suspicious bone lesion. Microscopic examination shows the ndings in the gure. What is the most likely diagnosis?

• Osteomielitis

• Ewing sarcoma

• Osteosarcoma

• Osteochondroma

Multiple Choice

While moving into a new apartment a student lifting a heavy box of books experiences a sharp pain in his back, radiating down the anterior thigh and medial side of his leg. After several days of misery, he nally goes for treatment and is told that he has a herniated intervertebral disk at the L 3 level which is compressing a spinal nerve where it exits the vertebral column. Where is the point of compression?

• Central canal

• Hiatus of the sacral canal

• Vertebral foramen

• Intervertebral foramen

Multiple Choice

A 20 year old girl had fractured her right humerus in a car accident 2 weeks ago. The fracture did not heal properly, and developed a purulent infection of the skin around the site of fracture. An X–ray revealed a focus bone loss near the lower end of the humerus. Curettage biopsy was performed. Microscopic appearance showed a sequestrum, inammatory cells proliferation and granulation tissue. What is the most likely diagnosis base on microscopic appearance?

• Chronic non spesic osteomyelitis

• Osteoarthritis

• Acute Osteomyelitis

• Chronic spesic osteomyelitis

Multiple Choice

What will happen in the forcible over stretch muscle?

• Muscle injury

• Muscle atrophy

• Musclespasticity

• Muscle dystrophy

Multiple Choice

While examining a piece of tissue taken from the epiphyseal plate, you noticed large cells arranged in rows. Which of the following layers are you examining?

• Proliferative zone

• Calcied zone

• Resting zone

• Hypertrophy zone

Multiple Choice

When helping a baby delivery, a midwife noticed that there’s assymetric number of thigh skinfolds, uneven knee levels and limitation of hip abduction. What diagnosis should be checked on the newborn?

• Osteogenesis imperfecta

• Developmental dysplasia of the hip

• Athrogryphosis

• Congenital perthes disease

Multiple Choice

What is the neurotransmitter in neuromuscular skeletal muscle junction?

• Ephineprine

• Acetyl choline

• Norephinephrine

• Dopamine

Multiple Choice

On first prenatal ultrasound exam, the fetes seems to have normal and complete limb, however when born the infant have only one hand. What error that most probably happen in growth and development?

• Disruption

• Malformation

• Deformation

• Dysplasia

Multiple Choice

The major lubricant for diarthrotic joints is synthesized by

• annulus brosus

• synovial membrane

• brous capsule

• nucleus pulposus

Multiple Choice

A female, 60 years old, complained about swelling on the right knee. No inflammation sign was found, and uid is detected on suprapatellar space—no other joint involvement. In this case, the synovium is predominance by:

• Lymphocyte T

• Neutrophil

• Lymphocyte B

• Macrophage

Multiple Choice

While examining a piece of supportive tissue taken from the vertebral column, you noticed rows of cells, in lacunae, between collagen fibers. Which of the following supportive tissue are you examining?

• Fibrous cartilage

• Elastic cartilage

• Compact bone

• Hyaline cartilage

Multiple Choice

A 76 year-old lady developed vertebral osteomyelitis. Her blood culture grew Gram-positive cocci arranged in clusters. What is the most likely etiological agent?

• Staphylococcus aureus

• Viridans streptococci

• Streptococcus pneumoniae

• Streptococcus pyogenes

Multiple Choice

35 years old man come with complaint of backpain and stiffness. The pain is chronic, not radiating and not changed with movement. On physical examination there’s only slight tenderness and gibbus. What the most probable diagnosis?

• Spondylolisthesis

• Spondylarthrosis

• Degenerative disc

• Spondylitis

Multiple Choice

A child, 6 years old, present to emergency room with fever and pain over his left knee since yesterday. There is exquisite tenderness on left proximal tibia and mild local swelling. No history of injury. What is the most appropriate laboratory work up should be done?

• Blood culture

• Electrolytes

• Rheumatoid factor

• Liver function

Multiple Choice

While examining a “bony” tissue taken from the epiphyseal plate, you noticed several layers of cells. One of these layers consists of rows of attened cells, arranged like a stack of coins. Which of the following layers are you examining?

• Reserve/resting zone

• Calcied zone

• Hypertrophied zone

• Proliferative zone

Multiple Choice

What distinguishes cartilage from most other connective tissue?

• Computed tomography

• Magnetic resonance imaging

• Plain radiograph

• Radio-isotope scan

Multiple Choice

A mother come to outpatient department because of concern that her 9 months old baby boy seems to have bow leg. When the boy starts to stand she noticed that both of his leg seems bowing on the knee. There’s no history of trauma or other anomaly. What would probably be the problem?

• Congenital demoral deciency

• Post traumatic bow leg

• Unilateral blount disease

• Normal knee

Multiple Choice

Female, 60 years old, complaint about pain and stiffness of her left knee. The doctor finds cartilage softening during knee arthroscopy. What is the earliest change that happened at the cartilage?

• Decrease proteoglycan

• Decrease collagen

• Chondroblast death

• Vascular invasion

Multiple Choice

A male 70 years old presents with chronic left hip pain with osteophyte and joint space narrowing. The patient also has a history of peptic ulcers. What is the rst line of pharmaceutical management in this patient?

• COX-2 inhibitor

• Hyaluronic acid injection

• Tramadol

• Topical NSAID

Multiple Choice

A 20 years old man worked a clerk for 5 years, since last month he has loss of sensation in his palmar and the 3 rst digit. Some of the exor muscles has no strength to move. The doctor diagnosed with Carpal Tunnel Syndrom. What nerve is most likey compressed?

• N. radialis

• N ulnaris

• N. medianus

• N. digitalis ventralis

Multiple Choice

A 8 year old boy came with pain on left hip and inability to walk. He was diagnosed with leg-calves and perthes disease. Which of the following happened on his left hip?

• Displacement of the capital femoral epiphysis from the metaphysis through the physis

• Dyschondrosis of medial physis of proximal femur

• A decrease in the amount of normal Type I collagen

• Avascular of capital epiphysis of the femur

Multiple Choice

A 45 year-old man presented with acute pain of big toe and knee at night. Physical examination revealed inammation of joints and a nodular lesion adjacent to the big toe. Joint uid aspirate is performed. What uid analysis test most likely establishes the diagnosis?

• Crystal identication by polarized microscopy

• Gram stain and bacterial culture

• Gross appearance with assessment of viscosity

• Total cell count and differential count

Multiple Choice

A 60-year-old man has suffered a swelling in his right great toe after over eating blinjo crackers. He has a history of acute arthritis episodes affecting ankle and heels. The biopsy was then performed over him. The microscopic showed large collections of uric crystals and foreign body giant cells ll in the nodule. Your best diagnosis will be:

• Osteo Arthritis

• Gout disease

• Rheumaoid arthritis

• Rheumatic fever

Multiple Choice

An 85-year-old woman has been conned to a nursing home for the past 6 years. Bone density scans suggest that she has osteoporosis. Although the amount of calcium in her diet is adequate, she cannot absorb enough of it to maintain bone mineral density. One factor likely contributing to her condition is insufcient production of which substance in the dermis of her skin?

• Vitamin A

• Parathormone

• Vitamin D

• Melanin

Multiple Choice

A 30-year-old woman has experienced pain in the area of hands and feet. On physical examination, there is a mass and slowly growing, no erythema or warmth. A radiograph shows a 7-cm mass in the metaphyseal region of small tubular bones of the hands and feet. Microscopic examination shows the ndings in the gure. What is the most likely diagnosis?

• Giant cell tumor

• Osteoblastoma

• Osteitis brosa cystica

• Chondroma

Multiple Choice

What is an appropriate characteristic for type 1 skeletal muscle?

• Fast twitch glycolytic

• Rich vascularization

• Low Oxydative capacity

• Large Diameter

Multiple Choice

A patient, male 50 years old, presents to a clinic with briey left knee stiffness in the morning and pain following prolonged walking. On x-ray examination, a knee osteophyte was found. The disease processes arise from all these tissue, except:

• Synovium

• Intraarticular fat

• Peripheral blood vessels

• Bone

Multiple Choice

While examining a piece of supporting tissue taken from a knee joint, you noticed many cells located in lacunae, some of which are grouped into clusters of two or more cells. The matrix is homogenous. Which of the following supportive tissue are you examining?

• Elastic cartilage

• Fibrous cartilage

• Compact bone

• Hyaline cartilage

Multiple Choice

A 45-year-old man has experienced pain in the area of the left hip and upper thigh for the past 7 months. On physical examination, there is tenderness on deep palpation of the left side of the groin. The range of motion at the left hip is decreased, no swelling or warmth on palpation. Pelvic and left leg radiographs show an upper femoral metaphyseal mass lesion that erodes into the surrounding bone cortex. The proximal femur is excised and on sectioning has the gross appearance shown in the gure. Which of the following cell types is most likely to be proliferating in this mass?

• Osteoclast

• Chondrocyte

• steoblast

• Primitive neuroectodermal cell

Multiple Choice

A man 38 years old had upper arm muscle sore after he exercised weight training. He went to the doctor and doctor suggested weight training with the multigym and also aerobic training. What is the eccentric isotonic contraction?

• The muscle lengthens as it contracts maintaining force and movement

• Tension remains constant as the muscle shortens or lengthens

• The length of muscular remains constant during contraction

Multiple Choice

Herniated intervertebral disc characterized by radiating pain due to compression of spinal nerve. Part of the anatomical structure that compresses the spinal nerve at herniated intervertebral disc is:

• Vertebral body

• Nucleus pulposus

• Vertebral arch

• Intervertebral disc

Multiple Choice

Amin 15 years old boy felt down from the stairs then the radiograph showed that his joint between clavicle and scapula was fracture. What part of the scapula articulates with the clavicle?

• Acromion

• Supraglenoid tubercule

• Inf raspinous fossa

• Spine process

Multiple Choice

Mr. Adi, 34 years old was felt down when he climbed the tree. The radiograph demonstrated the fracture of talus. What is the most appropriate reason that fractures of the talus have minimal displacement?

• It is an irregular bone

• It is place over the calcaneus

• Malleoli hold the fragments in place

• Attached muscles pull the fragments apart

Multiple Choice

A 10-year-old boy was brought to a clinic because of back pain for around one month especially while bending. His mother also noted that her son’s left shoulder is slightly higher than the right. On physical exam the doctor found that Adam’s test was positive but no length discrepancy. What is the most appropriate examination do diagnose this patient?

• Spine CT-scan

• Supine lateral X-ray

• Standing PA & lateral X-ray

• Left lateral decubitus X-ray

Multiple Choice

A female 60 years old presents with severe bowlegs and pain in both knees during activities. What is the force change in this condition?

• Increase Adduction moment

• Decrease Extension moment

• Increase Abduction moment

• Decrease exion moment

Multiple Choice

A 65-year-old woman reports pain on her knees and difculty walking. She can walk in the grocery store, but the pain come when she tries to go up and down the stairs and when standing from a sitting position. She also felt stiffness on both of her knees. After seeing a doctor, she is diagnosed with 3rd stages of knee osteoarthritis. What pathology in the knees that is the main cause that the knees become stiff?

• Cartilage destruction

• Subchondral bone destruction

• Osteophyte formation

• Capsular brosis

Multiple Choice

A 6 months old baby presents with fever, drowsy, irritable, and swelling of her left hip. She doesnt want to move her left extremity. X ray show metaphyseal proximal femoral bone destruction and hip joints swelling. The most common cause of this condition is

• Streptococcus group B

• Gram negative bacilli

• Staphylococcus aureus

• Pseudomonas aeroginosa

Multiple Choice

A female, 60 years old, presented with pain in the right hip, especially during prolonged walking, since 3 years ago. She had painful and limited right hip internal rotation. What is the appropriate next step to conrm the diagnosis in this case?

• Rheumatoid Factor and anti-CCP

• Hip x-ray

• CRP and ESR laboratory

• Hip Ultrasound

Multiple Choice

Which of the following most accurately describes compact bone?

• Forms the diploe in cranial bones

• Lines the medullary (marrow) cavity

• Predominant bone type in the epiphysis of adult long bones

• Characterized by the presence of osteons

Multiple Choice

A 65-year-old woman reports pain on her knees and difculty walking. She can walk in the grocery store, but the pain come when she tries to go up and down the stairs and when standing from a sitting position. She also felt stiffness on both of her knees. After seeing a doctor, she is diagnosed with 3rd stages of knee osteoarthritis. On physical examination, which muscles that most probable to became atrophy?

• Gastrocnemius

• Quadriceps

• Hamstrings

• Anterior tibialis

Multiple Choice

A male 60 years old complained of a sudden swelling of the left knee. The patient sometimes felt calf muscle spasms, otherwise healthy. He suffered several times left knee swelling before. There was a palpable bony enlargement of the knee. What is the possible condition?

• Rheumatoid

• Infection

• Gout

• Knee osteoarthritis

Multiple Choice

A 54 year-old nurse presents for evaluation of her arthritis. Her symptoms began several years ago with acute pain and swelling in the left ankle. This was followed 8 months later by pain and swelling in the left wrist and several joints of the ngers. Functional inquiry is otherwise completely negative. Physical examination reveals swelling and tenderness in the right 2nd, left 2nd 3rd metacarpophalangeal joints (MCPs), and the right 2nd, left 3rd and 4th proximal interphalangeal (PIP) joints. There is no swelling in the elbows, wrists, knees or ankles. There are no cutaneous ndings. Her general physical examination is normal. Which of the following tests will be most helpful in conrming diagnosis?

• Rheumatoid factor

• Erythocyte sedimentation rate (ESR)

• Serum uric acid

• HLA-B27 antigen

Multiple Choice

A 75 year-old widow complains of generalised aching in her bones, and a gradually increasing curvature of her upper spine. An X-ray shows osteopenia and vertebral changes. Serum calcium, phosphate, alkaline phosphatase and a blood screen, including ESR, are all normal. What is the most likely cause of this condition?

• Osteoporosis

• Hyperparathyroidism

• Vitamin D deciency

• Hyperthyroidism

Multiple Choice

30 years old woman have a chronic back pain and weak both lower legs, after series of examination the woman is diagnosed with tuberculous spondylitis. Which of the following test can set the denitive diagnosis?

• Inhomogeneous appearance abscess in MRI

• Positive result on tuberculin skin test

• Positive culture of mycobacterium in biopsy result

• End plate destruction on vertebral x-ray

Multiple Choice

A 58 year-old woman was admitted to the hospital with a two-month history of pain, swelling and purulent discharge to her left lower leg. This occurred one year after sustaining a fracture to that area. Colonies grown from the purulent discharge on blood agar were convex and appeared golden yellow. What is the most likely diagnosis?

• Osteoarthritis caused by Neisseria gonorrhoeae

• Osteomyelitis caused by Staphylococcus aureus

• wound infection caused by Sporothrix schenckii

• Osteomyelitis caused by Haemophilus inuenzae

Multiple Choice

A 36-year-old woman has noted a nodule beneath the skin in her left groin since adolescence. On physical examination, the lesion has a 2-cm diameter and is nontender, soft, rubbery, and movable. Microscopic examination shows the ndings in the gure. Which of the following cell types is most likely to comprise this lesion?

• Smooth muscle

• Fibroblast

• Adipocyte

• Skeletal muscle

Multiple Choice

A 10 year-old boy developed high fever, chills, and worsening leg pain. His upper left leg started to hurt 3 to 4 days ago, and last night he began limping. His parent reports no history of trauma to the area. His only past medical history is two episode of otitis media (infection in the ear) at age 2 and 7. There were localized tenderness and swelling over the left distal femur. WBC count is 11.500 cells/uL; normal differential count, but ESR is 58 mm/hour. The blood cultures obtained and revealed Gram (+) cocci. How is the boy getting this illness?

• Air-borne

• Hematogenous

• Direct spread

• Lymphogenic

Multiple Choice

A 15-year-old adolescent boy presented with a swelling of the distal femoral that was growing slowly during the 3-month period prior to presentation. The swelling became painful after a minimal injury caused by a fall. A rm, palpable mass was present on physical examination.. Radiography showed a heterogeneous mass measuring 8 cm in length on the distal femoral metaphysis. Magnetic resonance imaging demonstrated a well-dened periosteal lesion with a cortical lysis but without involvement of the medullary cavity. The gross appearance shown in the gure. What is the most likely diagnosis?

• Osteosarcoma

• Fibrous dysplasia

• Enchondroma

• Leiomyosarcoma

Multiple Choice

A 5 years old boy fall down when jumping on the bed. His mom brought him to ER few hour after the fall. The doctor diagnosed him with fracture of the forearm. What is the phase of bone healing happening when this boy come to the ER?

• Callus formation

• Consolidation

• Remodelling

• Haematoma and inflamation

Multiple Choice

Mrs Rani is 66 years old and has four adult children. She is on Hormone replacement therapy. She has always been a homemaker and a life-long non-smoker. She developed late onset asthma 5 years ago, requiring regular oral as well as inhaled steroid therapy. Asthma has limited her physical activity, although she was never someone who enjoyed exercise anyhow. Two weeks ago, she tripped over her cat and fractured her left hip. Which investigation is the most useful to diagnose this patient?

• Dual X-ray absorptiometry

• Femoral neck ultrasound

• Multiple-site magnetic resonance imaging

• Plain X-ray of the spine

Multiple Choice

A 60-year-old woman came with complete left femoral neck fracture after fell from tricycle (becak). The bone mineral density examination showed it is less than -2.5. Microscopic examination showed that the bone cortex becomes thinner and the trabeculae have less complex branching. The most signicant contributing factor for this fracture is:

• Immobilization osteoporosis

• Vitamin D deciency

• Senile osteoporosis

• Multiple myeloma

Multiple Choice

30 years old male has a chronic discharging sinus from his left leg. He had tibia fracture 1 year before and was taken care by traditional bone setter. He is able to walk with some bowing and shortening of the left leg, only sometimes he feels pain on the leg. What is the most probable finding on leg x ray?

• Fracture nonunion

• Sun burst appearance

• Brodie’s lesion

• Involucrum

Multiple Choice

A radiographic lm from a 60-year-old woman shows a complete right femoral neck fracture just only caused by a minor fall. In Examination serum calcium level is normal. Bone density examination shows T– score = -2.5 Which of the following condition factor is the most contributing factor for this fracture?

• Osteomyelitis chronic

• Post-menopausal bone loss

• Parathyroid adenoma

• Calcium deciency

Multiple Choice

A 5 years old boy fall down when jumping on the bed. His mom brought him to ER few hour after the fall. The doctor diagnosed him with fracture of the forearm. Which fracture is common in children?

• Coles' fracture

• Burst fracture

• Bennet's f racture

• Green stick f racture

Multiple Choice

Which of the following statements about pathogenic mechanisms in autoimmunity is CORRECT:

• Cytotoxic T cells do not play a major role in autoimmune diseases because the auto-antigens involved are either nucleic acids or carbohydrates

• In Graves' disease, an auto-antibody found commonly in patients binds to the TSH receptor and kills the thyroid cell

• In systemic lupus erythematosus, the various anti-nuclear antibodies produced in the patient are highly pathogenic because these can bind to the nuclear antigens and cause the cell to undergo apoptosis

• Relief can be obtained in some autoimmune diseases by blocking the effects of the inammatory cytokines produced

Multiple Choice

65 years old lady came to your ofce with complain if pain on her lower back. The pain especially felt after she plays with her 1 years old grandson. Low Back Pain is always associated with:

• Chronic Stress to the lumbar spine

• Back muscle tightness or spasm

• Prolapsed intervertebral disc

• Arthritis of facet joints

Multiple Choice

A 52 year old man has been taking aspirin for rheumatoid arthritis for 8 months. Exacerbations are becoming worse, and she asks her physician about drugs that might stop the progression of the disease. Which of the following is the most appropriate drug of choice?

• Cholchicine

• Sodium diclofenac

• Methotrexate

• Celecoxib

Multiple Choice

A 20 yrs old tennis champion complains a paralyzed to extend his antebrachii and his hand. What nerve is the most likely injured?

• Radial n

• Ulnar n

• Median n

• Axillar n

Multiple Choice

Which area in cartilage is relatively proteoglycan-rich and collagen-poor?

• Interterritorial matrix

• Fibrocartilage

• Perichondrium

• Territorial matrix

Multiple Choice

An overweight female 60 years old presented with bilateral knee pain during activity, bowleg, and knee joint osteophyte on x-ray. What is the rst-line treatment for this condition?

• Weight loss

• Steroid injection

• Knee unloading brace

• Knee tapping

Multiple Choice

A 19-year-old girl came to the clinic due to joint pain and swelling on both knee and left ankle with stiffness in the morning since 6 weeks ago. On physical examination, the involved joints were erythematous, warmth, slight tender on palpation, and limited active–passive motion. Laboratory ndings showed hemoglobin 11 g/dL, leukocytes 11,500/mm3, platelets 400,000/mm3, negative ANA, positive RF, elevated C3, ESR and CRP. Which cytokine is the major target of treatment in this case?

• TNF alpha

• TGF beta

• IL-1

• IL-6

Multiple Choice

A 55 year old male has a history of episodes of a painless nodule with overlying ulcerated skin at his big toe. Beneath the eroded skin is a chalky white deposit of soft material surrounded by erythematous soft tissue. Microscopic appears a collection of lamentous urate crystals. This nodule is most consistent with which of the following lesions?

• Osteophyte

• Tophus

• Pannus

• Granuloma

Multiple Choice

What is the neuro muscular junction?

• The part of the sarcoplasmic of the muscle cell that is in closest proximity to the synaptic end bulb

• The production place of the neurotransmitter acetylcholine (ACh) in post synaptic terminal

• The meeting point of a nerve bre and the muscle bre that it supplies

• The the releasing place of the neurotransmitter acetylcholine (ACh) from post synaptic terminal

Multiple Choice

A 34 year old man came with pain in his left knee since 2 weeks especially in the morning more than 1.5 hours. He also felt pain in his achilles. 1 month before there was history of chronic diarrhea. The rheumatic factor was negative. What is the most probable diagnose for his problems?

• Gout arthritis

• Reactive arthritis

• Osteoarthritis

• Rheumatoid arthritis

Multiple Choice

A 60-year-old man complains about stiffness and pain in the back after activity. Radiographic examination reveals narrowing of L4-5, L5-S1 disc space. What is the most possible cause of the complaint?

• Annulus brosus tear

• Facet joint degeneration

• Increase disc water content

• Osteoporosis

Multiple Choice

A 5 years old boy fall down when jumping on the bed. His mom brought him to ER few hour after the fall. The doctor diagnosed him with fracture of the forearm. This boy was put on an arm cast for 4 weeks, on the 3rd weeks what would you probably see on the plain x ray of the forarm?

• Osseous callus

• Normal bone with periosteal thickening

• Undistinguished f racture site

• Clear fracture line

Multiple Choice

A female, 60 years old, complained about swelling on the right knee. No inammation sign was found, and uid is detected on suprapatellar space—no other joint involvement. What type of immune system is reect the predominance cell in the case above?

• Memory

• Neutralizer

• Killer

• Innate

Multiple Choice

A female, 60 years old, presented with pain in the right hip, especially during prolonged walking, since 3 years ago. She had painful and limited right hip internal rotation. What is the most appropriate diagnosis in this case?

• Psoriasis

• Osteoarthritis

• Gout

• Rheumatoid arthritis

Multiple Choice

Mr. Bachtiar, 75 years old, he suddenly could not walk because fell very pain in his right Leg. Which of these nerves make the basis of the lumbar plexus?

• L2-L4

• L1-L4

Multiple Choice

Mr. Budi, 54 years old was felt down when he was hit by the truck. The radiograph demonstrated the fracture of bula. Which nerve of the leg wraps around the neck of fibula?

• Common bular

• Supercial bular

• Deep bular

• Tibial