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BLOK 9 2020

Total questions: 57

Worksheet time: 39mins

Name
Class
Date
1.

A 54-year-old woman comes to the clinic with complaints of small bowel movements resembling goat droppings for the past 6 months. The patient also reports a drastic weight loss over the last 3 months, accompanied by intermittent pain in the right lower abdomen. Physical examination reveals vital signs within normal limits, weight 40 kg, height 158 cm. What organ is likely affected due to this condition?

a)

Corpus pancreas

b)

Transverse colon

c)

Descending colon

d)

Ascending colon

e)

Stomach

2.

A mother comes to the health center with her one-year-old daughter, Raissa. She is concerned about the increasing brown spots on her daughter's body, along with the appearance of small brown spots in the armpit area. The mother is worried because none of the family members have had a similar condition. What are the possible mechanisms causing this condition in Raissa despite no previous family history?

a)

Familial mutation and somatic mutation

b)

De novo mutation/spontaneous mutation and germline mutation

c)

Autosomal dominant inheritance

d)

De novo mutation and familial mutation

e)

Somatic mutation and germline mutation

3.

Line parasternalis

a)

A vertical line parallel to the axillary fold at the front

b)

A vertical line that bisects the clavicle exactly in the middle

c)

A vertical line located exactly between the midclavicular line and the sternal line

d)

A vertical line parallel to the right and left borders of the sternum

e)

A vertical line that bisects the sternum exactly in the middle

4.

A baby boy,

4 lines
5.

What is the name of the condition observed in the newborn?

a)

Fracture of the temporal bone

b)

Subgaleal hematoma

c)

Intraventricular hemorrhage

d)

Cephal hematoma

e)

Caput succedaneum

6.

What is the sign in the above case?

a)

Icteric sclera

b)

Spleen palpable at S2

c)

Shivering

d)

Travel history

e)

Medication history

7.

If the doctor plans to perform a thick blood smear, what will be sought?

a)

Pathogenesis of the disease

b)

Epidemiology of the disease

c)

Etiology of the disease

d)

Pathophysiology of the disease

e)

Prognosis of the disease

8.

The anamnesis in children differs from that in adults in which aspect?

a)

Birth history

b)

Relevant habits

c)

Additional complaints

d)

Number of children

e)

Previous treatment history

9.

How soon following a positive malnutrition screening should a patient receive a nutrition assessment?

a)

Within 36 hours

b)

Within 48 hours

c)

Within 72 hours

d)

Within 24 hours

e)

Within 12 hours

10.

What data is needed to estimate fluid loss in a child with diarrhea?

a)

Presence of blood/mucus in stool

b)

History of previous watery stools

c)

History of bloody stools

d)

Frequency and amount of watery stools

e)

Presence of abdominal cramps or pain

11.

The type of DNA sequence repetition - GATA shown in the three sample examples above can be used in DNA Fingerprinting technology. This type of DNA repetition is known as:

4 lines
12.

The DNA sequence repeat - GATA shown in the three sample examples above can be used in DNA Fingerprinting technology. What is this type of DNA repeat known as?

a)

VNTR

b)

Minisatellite

c)

STR

d)

SNP

e)

Duplication sequence

13.

Mr. Harun, 50 years old, experienced an acute myocardial infarction despite having received clopidogrel to prevent thrombus formation. Upon examination, the level of clopidogrel in the serum was found to be lower. If the doctor suspects polymorphism, which gene should be examined?

a)

CYP2C9

b)

CYP2A6

c)

CYP2E1

d)

CYP2D6

e)

CYP2C19

14.

A 35-year-old man came in with complaints of generalized seizures lasting 5-10 minutes since 1 hour ago. Before the seizure, the patient complained of stiffness and cramps in the neck, tingling in both legs, and twitching in both cheeks. The patient has a history of total thyroidectomy 1 year ago and has since been diagnosed with hypoparathyroidism. The physical examination of the face related to the patient's clinical condition is?

a)

Swabach test

b)

Tabes dorsalis facies

c)

Chvostek's sign

d)

Trousseau sign

e)

Weber test

15.

The main symptom that occurs in cases of hypoxia is....

a)

Hyperthermia

b)

Decreased GCS

c)

Tachycardia

d)

Hypotension

e)

Dyspnea

16.

A child is brought to your practice because of a fever. To search for and rule out a diagnosis, you will conduct an anamnesis. The important anamnesis techniques are as follows:

a)

Cannot be done on a child only with parents

b)

Greeting, introducing oneself, and asking permission to examine is important

c)

Using medical terms in anamnesis is useful so that the patient does not misunderstand

d)

Communication must be brief and concise, with yes or no answers

e)

Anamnesis must continue even if the child is in an emergency

17.

A 20-year-old man comes to the doctor's practice with complaints of weight loss accompanied by a lump in the upper left abdomen. Physical examination shows vital signs within normal limits, weight 45 kg, height 167 cm, spleen palpable S.lV. Which statement below can confirm the lump from the abdominal examination?

a)

Positive Murphy's sign

b)

The lower border of the spleen is located at 1/4 medial umbilicus-SIAS left

c)

Positive Traube space

d)

The lower border of the spleen is located at 1/5 SIAS right umbilicus

e)

The lower border of the spleen is located at 2/4 umbilicus-SIAS right

18.

A 45-year-old man enters the emergency room with complaints of anxiety, severe shortness of breath accompanied by cough for the past 4 hours. The examining doctor diagnosed him with acute pulmonary edema. What are the symptoms of cough that occur in this case?

a)

Cough accompanied by frothy, pink tinged sputum

b)

Dry cough

c)

Productive cough

d)

Non-productive cough

e)

Starts with dry cough then productive cough

19.

Anto, 45 years old, a private employee with a weight of 90 kg has been diagnosed by a doctor with type II DM for 1 year. What is the possible agent of Anto's disease?

a)

Nutritional agents

b)

Biological agents

c)

Physical agents

d)

Insufficiency of a factor necessary for life

e)

Social agents

20.

A 34-year-old woman is brought to the emergency room with complaints of decreased consciousness for the past hour, accompanied by severe abdominal pain for the past day. The patient is known to have not menstruated for the past 2 months. Physical examination found bruising and edema in the umbilical area. What clinical signs might be found on abdominal examination in this case?

a)

Dilation of veins in the umbilicus

b)

Turner's sign

c)

Discoloration around the umbilicus

d)

Cullen's sign

e)

Sunken umbilicus

21.

There are several terms as guidelines for the limits of the amount of nutrients needed by the body. The amount of nutrients that meets the needs of 97-98% of healthy individuals in specific conditions based on age, sex, life stage, and certain physiological conditions is known as...

a)

Estimated energy requirement

b)

Tolerable upper intake level

c)

Adequate intake

d)

Estimated average requirement

e)

Recommended dietary allowance

22.

In general, there are three main functions of antibodies, namely precipitin, antitoxin, and lysin. The function of precipitin is to slow down the movement of virus cells or other pathogenic microorganisms so that they are more easily captured by the immune system through phagocytosis. The antigen-antibody reaction related to the function of precipitin for insoluble antigens is...

a)

Neutralization of toxins

b)

Complement activation

c)

Opsonization

d)

Agglutination

e)

Precipitation

23.

A child is brought by his mother with a suspected case of dengue fever. You are currently interviewing the mother further to find data on the possibility of transmission. The data that you should obtain is:

a)

History of traveling to endemic areas

b)

Medications that have been consumed

c)

Immunization history

d)

Family or neighbors with the same illness

e)

Habits of playing outside

24.

A male baby, weighing 3000 grams, was born spontaneously to a 17-year-old primi gravida mother, at 38 weeks of gestation. The baby was born but did not cry immediately. After actions were taken...

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25.

What is the APGAR score at the fifth minute for the baby?

a)

9

b)

7

c)

6

d)

10

e)

8

26.

What is the anterior axillary line?

a)

A vertical line parallel to the right and left borders of the sternum

b)

A vertical line parallel to the axillary fold at the front

c)

A vertical line that bisects the sternum exactly in the middle

d)

A vertical line that bisects the clavicle exactly in the middle

e)

A vertical line that is exactly between the midclavicular line and the sternal line

27.

What important data should be asked from the mother to investigate the possible cause of the congenital disorder?

a)

Child's immunization history

b)

Assistance during delivery and APGAR score

c)

History of seizures in the child

d)

History of delivery

e)

History of maternal illness/medications during pregnancy

28.

According to the guidelines, how should nutrition be fulfilled?

a)

Seek food with the highest nutritional content

b)

Eliminate certain food sources of nutrients

c)

Require choosing a specific diet

d)

Consume certain foods regularly at every meal

e)

Choose a variety of foods every day

29.

If the mother is pregnant, what is the percentage chance that the fetus will have the same condition as Raissa?

a)

50%

b)

0%

c)

25%

d)

75%

e)

100%

30.

What physical finding can you identify as a characteristic of Fragile X Syndrome?

a)

Rounded chin

b)

Large protruding ears

c)

Slanted eyes

d)

Sparse/thin eyebrows

e)

Large front teeth

31.

A couple brings their 2-year-old child, Niall, who is still crawling and tends to walk on tiptoes. What is the most accurate preliminary diagnosis for this case?

a)

Huntington disease

b)

Fragle X Syndrome

c)

Duchenne Muscular Dystrophy

d)

Becker Muscular Dystrophy

e)

Neurofibromatosis Type 1

32.

A doctor must become a behavior consultant for their patient. What does behavior consultant mean in the context of anamnesis?

a)

Requires expertise to derive meaning from the patient's medical history

b)

The doctor must gather complaints expressed by the patient to collect as much data as possible on the status

c)

Patients do not need assistance in their thinking as they are hindered by their knowledge limits

d)

If the patient's response frustrates the doctor, the doctor may interrupt the conversation with the patient

e)

Patients may be criticized when they conclude their symptoms as a certain disease

33.

Linea midsternalis

a)

A vertical line parallel to the axillary fold at the front

b)

A vertical line located exactly between the midclavicular line and the sternal line

c)

A vertical line that cuts through the sternum bone right in the middle

d)

A vertical line that cuts through the clavicle bone right in the middle

e)

A vertical line parallel to the right and left borders of the sternum bone

34.

In the case of Mr. Harun, it is known that at base sequence 636 there is a polymorphism substitution of Alanine (A) to Guanine (G), with the DNA sequence GACTTGTTTTCAATTGCGCTTAATT. If to determine the polymorphism using the RFLP method, which restriction enzyme can recognize the polymorphism?

a)

Smal (5'-TTAATT-3')

b)

Hoell (5'- CAATTG-3')

c)

Alul (5'-AGCT-3')

d)

BamHl (5'-CATTCA-3')

e)

EcoRl (5'-GTTTTC-3')

35.

Which of the following types of older adult patients should receive a malnutrition screening?

a)

All patients 65 years and older, excluding surgical patients

b)

All patients 65 years and older

c)

Just late Elderly

d)

Patients 65 years and older with a malnutrition related index

e)

Patients 65 years and older at high risk of malnutrition

36.

A 20-year-old woman comes with complaints of abdominal pain all over for the past day, accompanied by continuous fever for the past 10 days and vomiting. Upon examination, the abdomen is found to be distended, bowel sounds decreased, and when pressing the abdominal wall and then suddenly releasing, the patient feels pain. What is the clinical condition of the above case?

a)

Positive Rovsing sign

b)

Rebound tenderness

37.

In a convex abdomen, bowel sounds decrease and when pressing the abdominal wall and suddenly releasing, the patient feels pain. What is the clinical condition of the above case?

a)

Positive Rovsing sign

b)

Positive rebound tenderness

c)

Positive Cullen's sign

d)

Positive Turner's sign

e)

Positive shifting dullness

38.

What is the midclavicular line?

a)

A vertical line parallel to the right and left borders of the sternum

b)

A vertical line that cuts the sternum exactly in the middle

c)

A vertical line parallel to the axillary fold at the front

d)

A vertical line that cuts the clavicle exactly in the middle

e)

A vertical line that is exactly between the midclavicular line and the sternal line

39.

A 25-year-old woman comes to the clinic complaining that her face is asymmetrical on the right and left. The left side of her face appears higher and the right eyelid does not close completely. Vital signs are within normal limits. What is the clinical sign of the abnormality in the eye?

a)

Nystagmus

b)

Exophthalmos

c)

Lagophthalmos

d)

Hypotropia

e)

Mydriasis

40.

A 55-year-old married male farmer comes to the emergency department with complaints of a dry cough for 3 months, decreased appetite, and inability to work. The patient always appears gloomy after he can no longer work. Six hours before entering the hospital, he complained of coughing up blood accompanied by high fever. Five years ago, the patient had taken anti-tuberculosis medication for 1 month and then stopped because he felt better. The patient has been hospitalized several times in the last 2 years due to shortness of breath. He has seven unmarried children. What is the framework of the medical history in this case?

a)

Economic problems, psychological issues do not need to be considered

b)

The concept of illness is the same as disease

c)

Unable to plan further examinations

d)

A synthesis of diagnosis

e)

Cannot determine prognosis because further examination is needed

41.

If you, as a general practitioner, find clinical findings like in the two photos below on a 2-year-old child, what is the possible diagnosis for this patient?

a)

Von Recklinghausen disease

b)

Plexiform Neurofibroma

c)

Neurofibromatosis Type 2

d)

Suspect Neurofibromatosis Type 1 because it does not meet the criteria

e)

Frecklings and Neurofibromas

42.

The organ that most determines the survival of a patient experiencing an emergency case is...

a)

Airway

b)

Heart

c)

Brain

d)

Kidney

e)

Lung parenchyma

43.

Since 28 months ago, a 46-year-old man has suffered from diarrhea without cause and alternating constipation that has never healed. Colon biopsy results show the presence of a malignant tumor in the colon. Which of the following is the last 'hit' of multistep carcinogenesis?

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44.

Which of the following is the last 'hit' of multistep carcinogenesis that ultimately causes malignant tumors in the colon of the patient?

a)

Homozygous loss of DCC locus on 18q

b)

Homozygous loss of APC locus on 5q

c)

Mutation of ras on 12p

d)

Homozygous loss of APC locus on p21 on 11q

e)

Homozygous loss of APC locus on p53 on 12p

45.

In cases of trauma, which cause of death occurs the fastest?

a)

Obstruction in the pharynx

b)

Intracranial hemorrhage

c)

Musculoskeletal fracture

d)

Lung collapse

e)

Severe bleeding

46.

The following substance can inhibit oxidative processes within the cell...

a)

Glucose-6-Phosphate Dehydrogenase

b)

Carbon monoxide

c)

Carbon dioxide

d)

Cyanide

e)

Lactic acid

47.

Based on what does the on-call doctor make a diagnosis in this case?

a)

Alloanamnesis, physical examination, and supporting examination

b)

Alloanamnesis and laboratory examination

c)

Autoanamnesis and alloanamnesis

d)

Alloanamnesis and supporting examination

e)

Alloanamnesis and physical examination

48.

A 25-year-old woman comes to the emergency department with complaints of weakness for the past month accompanied by shortness of breath. For the past 6 months, the patient has frequently experienced intermittent fever, joint pain, and easy fatigue. Physical examination reveals blood pressure 160/90 mmHg, pulse rate 90x/min, respiratory rate 24x/min, temperature 38°C, malar rash, pale conjunctiva, jaundiced sclera, splenomegaly, and left heart border enlargement. The patient must be referred to a referral hospital because she needs supporting examinations to determine the cause. The importance of supporting examinations in this case is...

a)

Required because bedside clinical examination differs now and before

b)

Needed for handling with advanced facilities

c)

Required because the disease is severe

d)

Required because anamnesis cannot establish a diagnosis

e)

Required to assess the prediction of a symptom

49.

Morphologically, the structure of antibodies consists of a variable region and a constant region. The characteristic of the variable region is...

a)

Able to recognize various types of antigens

b)

Functions as a crystallizable fragment

c)

Has two light chain fragments with a molecular weight of 25,000 daltons

d)

Has two heavy chain fragments with a molecular weight of 50,000 - 70,000 daltons

e)

Has two types of fragments simultaneously, namely kappa and lambda

50.

One of the current therapeutic approaches based on nutritional genomics. This branch of science believes in individual differences. Nutritional genomics studies the interaction between...

a)

Nutrients and genomics

b)

Nutrients and supplements

c)

Nutrients and deficiencies

d)

Nutrients and health

51.

What is the difference at the individual level according to nutritional genomics?

a)

Nutrients and genomics

b)

Nutrients and supplements

c)

Nutrients and deficiencies

d)

Nutrients and bioactives

e)

Nutrients and diseases

52.

A 66-year-old man comes to the emergency department with complaints of weakness and further alloanamnesis with the patient's child states that the patient has experienced watery stools more than 10 times, like rice washing for the past 2 days. What physical examination is most likely found in this patient who is experiencing severe dehydration?

a)

Facies hipocrates

b)

Facies tabes dorsalis

c)

Facies coli

d)

Facies sardonicus

e)

Facies leonina

53.

DNA fingerprinting technology utilizes short repeating DNA sequences found inside or outside genes called:

a)

Multiple Nucleat Elements

b)

Multi-copies Elements

c)

Tandem Repeat Elements

d)

Micro Molecul Elements

e)

Duplication Repeat Elements

54.

In general, there are two functions of antigens, namely as immunogens and as haptens. If someone experiences an allergic reaction due to food, the source of food that causes the allergic reaction is usually the nutritional content...

a)

Carbohydrates and lipids

b)

Lipids and proteins

c)

Carbohydrates and proteins

d)

Lipids and nucleic acids

e)

Proteins and nucleic acids

55.

A man with Achondroplasia comes to consult with you as his family doctor. The man states that he will marry next month. However, he is worried about the possibility of having a child who also suffers from achondroplasia like himself. What is the probability that the man will have a child who also suffers from achondroplasia like himself?

a)

25%

b)

100%

c)

50%

d)

75%

e)

0%

56.

Which of the following is not a recommended type of data to inform whether a patient is diagnosed as malnourished?

a)

Serum albumin level

b)

Gastrointestinal symptoms

c)

Body mass index

d)

Dietary intake

e)

Functional capacity

57.

A baby boy, weighing 3000 grams, was born spontaneously to a 17-year-old primigravida mother, at 38 weeks of gestation. The baby cried immediately after birth, with an APGAR score of 8 at 1 minute and 9 at 5 minutes. At one day old, the baby was referred by the midwife due to complaints of stools accompanied by a little fresh blood. From the midwife's information at birth, a rectal temperature examination was performed. On physical examination, the baby appeared active and cried strongly. The abdomen appeared slightly distended. Around the anus, redness was found. What is the possible diagnosis for this baby?

a)

Internal hemorrhoids

b)

Anal atresia

c)

Anal fissure

d)

Rectal cyst

e)

Rectal polyp