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Worksheets

Soal McQ Kesehatan

Total questions: 52

Worksheet time: 26mins

Name
Class
Date
1.

A patient with TB RO is given bedaquiline. After 2 months, he experiences heart palpitations. EKG: QTc 520 ms. What is the initial management?

a)

Stop all medications

b)

Replace bedaquiline with linezolid

c)

Stop bedaquiline

d)

Add antiarrhythmics

e)

Give beta blockers

2.

A 45-year-old man has COPD. Spirometry: FEV₁/FVC <70%, FEV₁ 55%. What is the GOLD category?

a)

GOLD 1

b)

GOLD 2

c)

GOLD 3

d)

GOLD 4

e)

Not included in GOLD

3.

The Bohr effect shows that low pH causes...

a)

Increased affinity of Hb for O₂

b)

Decreased affinity of Hb for O₂

c)

Increased saturation of Hb

d)

Decreased diffusion of O₂

e)

Pulmonary shunt

4.

A 28-year-old man has fever, cough, and lower lobe infiltrate. Leukocytes 17,000, high CRP. What is the initial antibiotic choice?

a)

Rifampicin

b)

Amoxicillin-clavulanate

c)

Oseltamivir

d)

Fluconazole

e)

Azithromycin

5.

A 35-year-old man with HIV+, active pulmonary TB, CD4 60. When to start ARV?

a)

Immediately

b)

After 6 months

c)

After 2 weeks of OAT

d)

After the advanced phase

e)

After BTA is negative

6.

AGD results: pH 7.29, PaCO₂ 49 mmHg, HCO₃ 23. What disorder is occurring?

a)

Respiratory acidosis

b)

Metabolic alkalosis

c)

Metabolic acidosis

d)

Respiratory alkalosis

e)

Respiratory compensation

7.

Effects of surfactant except...

a)

Reduces surface tension

b)

Produced by type II cells

c)

Prevents alveolar collapse

d)

Reduces compliance

e)

Involved in stabilizing small alveoli

8.

A 67-year-old man with lung cancer has hemoptysis. Imaging shows an obstructive mass. What is the initial action?

a)

Radiotherapy

b)

Interventional bronchoscopy

c)

Steroids

d)

Open biopsy

e)

VATS

9.

A child with asthma, skin prick test (+), high IgE. What is the endotype?

a)

Non-allergic

b)

Late-onset

c)

T2-low

d)

T2-high

e)

Eosinophilic-negative

10.

A TB patient has a follow-up BTA still positive at 5 months of therapy. Rifampicin is sensitive. What is the next action?

a)

Add levofloxacin

b)

Change to category 2

c)

Stop OAT

d)

Repeat regimen from the start

e)

Add ethionamide

11.

A 56-year-old man, smoker, has chronic cough and infiltrate on CT scan. What examination is needed to confirm lung cancer diagnosis?

a)

Sputum test

b)

Bronchoscopy + biopsy

c)

Chest X-ray

d)

PET scan

e)

Tumor marker

12.

Bone TB most often affects...

a)

Femur

b)

Tibia

c)

Vertebra

d)

Radius

e)

Humerus

13.

A 4-year-old child, close contact with adult TB, TST (+), IGRA (+), has no symptoms. What is the diagnosis?

a)

Active TB

b)

Latent TB

c)

Pneumonia

d)

Bronchiolitis

e)

Normal

14.

A TB RO patient is on a regimen with linezolid. What is the common hematological side effect?

a)

Normochromic normocytic anemia

b)

Leukocytosis

c)

Polycythemia

d)

Increased platelets

e)

Erythrocytosis

15.

A patient is short of breath, AGD: pH 7.45, PaCO₂ 30 mmHg, HCO₃ 20. What is the interpretation?

a)

Respiratory alkalosis

b)

Metabolic alkalosis

c)

Respiratory compensation

d)

Metabolic acidosis

e)

Normal

16.

A man with TB RO, Hb <8 g/dL, is treated with a bedaquiline regimen. Which drug should be reevaluated?

a)

Clofazimine

b)

Linezolid

c)

Levofloxacin

d)

Ethionamide

e)

Pyrazinamide

17.

The respiratory control center is located in...

a)

Hypothalamus

b)

Medulla oblongata

c)

Cerebellum

d)

Cerebral cortex

e)

Cerebrum

18.

A COPD patient has desaturation while walking. What is the confirmatory test for functional capacity?

a)

Treadmill test

b)

Shu test

19.

What is the confirmation test for functional capacity in a patient with COPD who desaturates while walking?

a)

Treadmill test

b)

Shuttle test

c)

Six-minute walk test (6MWT)

d)

Spirometry

e)

Bronchodilator reversibility

20.

What is the likely cause of transudative pleural effusion?

a)

TB

b)

Cancer

c)

Pneumonia

d)

Heart failure

e)

Empyema

21.

What is the initial therapy for a patient with Rif-resistant TB?

a)

2RHZE/4HR

b)

3HR

c)

3HP

d)

Regimen 6 Bdq-Lfx-Lzd-Cfz-Cs

e)

Add ethambutol

22.

What is the interpretation of a patient with hypoxemia, AGD results: PaO₂ 55 mmHg, PaCO₂ 38 mmHg?

a)

Hypercapnia

b)

Hypocapnia

c)

Normocapnic hypoxemia

d)

Hyperventilation

e)

Respiratory alkalosis

23.

What is the most appropriate biological therapy for an asthmatic patient with high IgE and positive skin prick test?

a)

Benralizumab

b)

Omalizumab

c)

Dupilumab

d)

Mepolizumab

e)

Prednisone

24.

What is the long-term intervention for a patient with COPD FEV₁/FVC <70%, FEV₁ <30%?

a)

Pulmonary rehabilitation

b)

Long-term oxygen

c)

Inhaled bronchodilator

d)

Roflumilast

e)

ICS-LABA

25.

What does a rightward shift of the Hb dissociation curve mean?

a)

Oxygen is harder to release

b)

Oxygen is easier to release

c)

Saturation increases

d)

Hb affinity for O₂ increases

e)

Hb is more stable

26.

What is the suspected drug for a patient with TB RO experiencing vision disturbances?

a)

Rifampicin

b)

Levofloxacin

c)

Ethambutol

d)

Clofazimine

e)

Pyrazinamide

27.

What is the diagnosis for a patient with CT scan showing subpleural fibrosis and honeycombing?

a)

Hypersensitivity pneumonitis

b)

IPF (Idiopathic Pulmonary Fibrosis)

c)

Pulmonary TB

d)

Sarcoidosis

e)

Pneumonia

28.

What is the most common diagnosis for an HIV+ patient with cough and desaturation who does not respond to antibiotics?

a)

TB

b)

Pneumocystis jirovecii

c)

Bacterial pneumonia

d)

Influenza

e)

Cryptococcus

29.

What is the choice of therapy for a patient with TCM: MTB detected low, Rifampicin sensitive?

a)

2RHZE / 4HR

b)

3RH

c)

4RH

d)

6RH

e)

2HRE / 4HR

30.

What is the main effect of chronic hypercapnia on the respiratory center?

a)

Hypersensitivity

b)

Decreased response

c)

Not affected

d)

Bradycardia

e)

Increased compliance

31.

What is the best therapy for a 40-year-old woman with active TB in the first trimester of pregnancy?

a)

Complete OAT (HRZE)

b)

Only INH and RIF

c)

INH and EMB

d)

Rifampicin and streptomycin

e)

No therapy given

32.

What is the diagnosis for a 25-year-old male mountaineer who suddenly experiences shortness of breath and frothy cough after high altitude?

a)

Pulmonary embolism

b)

High altitude pulmonary edema (HAPE)

c)

Pneumonia

d)

Asthma

e)

COPD exacerbation

33.

In which condition does DLCO decrease except for?

a)

Emphysema

b)

Anemia

c)

Pulmonary fibrosis

d)

Hyperventilation

e)

Pulmonary hypertension

34.

What is the criterion for long-term oxygen therapy in a patient with COPD, FEV₁ 28%, PaO₂ 57 mmHg?

a)

PaO₂ < 70 mmHg

b)

PaO₂ < 65 mmHg

c)

PaO₂ < 60 mmHg

d)

PaO₂ < 55 mmHg

e)

All COPD

35.

What is the interpretation of a patient with AGD results: pH 7.48, PaCO₂ 28, HCO₃ 24?

a)

Metabolic alkalosis

b)

Metabolic acidosis

c)

Respiratory alkalosis

d)

Compensated acidosis

e)

Mixed disorder

36.

What is the action for a 33-year-old woman with IGRA (+) and no symptoms?

a)

No therapy needed

b)

3HP (isoniazid + rifapentin)

c)

OAT for 6 months

d)

Rifampicin only for 2 months

37.

A 33-year-old woman, IGRA (+), no symptoms. Action?

a)

No therapy needed

b)

3HP (isoniazid + rifapentin)

c)

OAT 6 months

d)

Rifampicin only 2 months

e)

Rifampicin + ethambutol

38.

Patient with chronic dyspnea, lung function results: FEV₁/FVC < 70%, DLCO normal. Diagnosis?

a)

ILD

b)

Emphysema

c)

Chronic bronchitis

d)

Pulmonary fibrosis

e)

Aspiration pneumonia

39.

A patient with COPD given ICS-LABA, but recurrent exacerbations. Eosinophils <100. Step?

a)

Add LAMA

b)

Stop ICS

c)

Add roflumilast

d)

Switch to ICS-LABA-LAMA

e)

Repeat spirometry

40.

A COPD patient, exacerbation, saturation 87%. Initial management?

a)

Low flow oxygen

b)

CPAP

c)

Non-invasive ventilation

d)

Intubation

e)

ICS

41.

In hypoventilation, the effect directly seen on AGD is...

a)

PaCO₂ ↓

b)

pH ↑

c)

HCO₃ ↑

d)

PaCO₂ ↑

e)

pH remains

42.

Spinal TB patient with neurological deficit. Therapy?

a)

OAT 6 months

b)

OAT + orthopedic surgery

c)

OAT + steroids

d)

Physiotherapy

e)

Routine monitoring

43.

65-year-old man, chronic cough, purulent sputum, history of pulmonary TB. CT scan: bronchiectasis. Main management?

a)

Steroids

b)

Prophylactic antibiotics

c)

Postural drainage + chest physiotherapy

d)

ICS

e)

Bronchodilators

44.

HIV positive patient, progressive dyspnea, dry cough, SpO₂ decreases with activity, LDH ↑. Suspected infection?

a)

Pneumocystis jirovecii

b)

Influenza

c)

TB

d)

CMV

e)

Dimorphic fungi

45.

Patient with recurrent pleural effusion, advanced lung cancer. Best management?

a)

Pleurodesis

b)

VATS

c)

IV antibiotics

d)

Steroids

e)

Serial thoracentesis

46.

A 38-year-old woman with sarcoidosis. Characteristic finding on chest CT is...

a)

Basal subpleural fibrosis

b)

Perilymphatic nodules

c)

Peripheral consolidation

d)

Tree-in-bud

e)

Ground-glass pattern

47.

A man with pleural effusion. pH 7.1, low glucose, high LDH. Diagnosis?

a)

Empyema

b)

Viral pleuritis

c)

Transudative effusion

d)

Chylothorax

e)

Kilothorax

48.

The mechanism of transudative pleural effusion is...

a)

Increased capillary permeability

b)

Increased fluid production

c)

Increased hydrostatic pressure

d)

Direct pleural infection

e)

Neoplastic process

49.

Light's criteria for exudate include, except...

a)

Pleural/serum protein > 0.5

b)

Pleural/serum LDH > 0.6

c)

Pleural LDH > 2/3 normal value

d)

Pleural glucose < 30 mg/dL

e)

All are correct

50.

A woman with severe asthma, unresponsive to standard therapy. Th2-high endotype. Biologic drug targeting IL-5?

a)

Omalizumab

b)

Mepolizumab

c)

Dupilumab

d)

Benralizumab

e)

Tezepelumab

51.

TB patient, 1 month on OAT, severe nausea, SGPT >5x normal. Action?

a)

Temporarily stop all OAT

b)

Continue OAT

c)

Switch to streptomycin

d)

Only stop INH

e)

Only stop RIF

52.

A 50-year-old man with chronic cough, culture shows NTM (Non-tuberculous mycobacteria). Initial therapy?

a)

Isoniazid + Rifampicin

b)

Azithromycin + Rifampicin + Ethambutol

c)

Rifampicin + Ethionamide

d)

INH + Levofloxacin

e)

Only Rifampicin

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