Anda di halaman 1dari 27

Soal Blok 7 PDU 07

1. Ditemukan anti-HIV dalam darah seseorang menandakan a. sudah sembuh dari penyakit AIDS b. pernah mendapat imunisasi HIV c. pembawa HIV virus, tapi tidak menular orang lain d. pembawa HIV virus dan dapat menular orang lain e. mengandung antibody terhadap virus HIV dan tidak menular orang lain 2. Pada masa akut suatu penyakit, imunoglobulin yang meningkat dalam darahnya berasal dari kelas a. IgA b. IgG c. IgM d. IgD e. IgE 3. Cara untuk menunjukkan adanya reaksi imunologis dengan menggunakan aktivitas enzim sebagai indikator merupakan prinsip kerja dari reaksi/ tes a. Imunoelektroforesis b. RIA c. ELISA d. Imunofluoresensi e. RPHA 4. Test Konfirmasi untuk penyakit sifilis a. RPR b. VDRL screening test c. Wasseman d. Kahn e. TPHA 5. Antigen yang berbentuk partikel bila dicampur dengan antiserum yang spesifik termasuk reaksi a. presipitasi antigen larutan b. aglutinasi c. imunodifusi d. Elisa e. Imunoeletroforesis 6. Pemeriksaan seromarker untuk mengetahui adanya infeksi hepatitis A akut adalah a. IgG HAV b. IgM HAV c. HBsAg d. Anti-HBc e. Anti-HCV 7. HbsAg can be detected quickly by a. RPHA b. PHA c. TPHA d. Coomb test e. VDRL 11. Grading of DHF patient with fever accompanied by unspesific symptoms tourniquet test (+) a. Grade 1 b. Grade 2 c. Grade 3 d. Grade 4 12. Diagnosis DHF >> 2 criteria klinis + trombositopenia + hemokonsentrasi

13. Yang benar tentang DHF c. blood test d. membran plasma leakage 17. After a few days of Bacterimia, the baciili localize mainly in the lymphoid tissue of the small intestine. The typical lesion is in a. the GALT b. the payers patch c. MALT d. crypts of lieberkulin 19. The clinical feature of toxoplasmosis is a. asymptomatic in child b. symptomatic in adult c. always symptomatic in kongenital infection d. always symptomatic in kongenital infection and usually asymptomaticin adult 20. The causative agent of espundia a. L. donovani b. L. tropica c. L. braziliensis d. Toxoplasma gondii 24. Large kinetoplast is found in a. T. gambiense b. T. rhodesiense c. T. cruzi d. amastigote 25. The shape of C is found in the parasite of a. T. gambiense b. T. rhodesiense c. T. cruzi d. Amastigote 26. The habitat of T.gambiense is in a. Connective tissue b. Connective tissue and lymph nodes c. lymph nodes and blood stream d. connective tissue, lymph nodes, blood stream, CNS 27. Xeodiagnosis is used for the diagnosis of a. Leishmaniasis b. African trypanosomiasis c. Chagas disease d. Malaria 28. Contoh Hipersensitivitas tipe 1 adalah >> asma bronkial 29. Contoh Hipersensitivitas tipe 2 adalah 30. Contoh Hipersensitivitas tipe 3 adalah >> SLE 31. Penyakit Hipersensitivitas tipe 4 adalah >> DM Tipe I 35. The pathogenesis of poststreptococcus glomerulonephritis a. Deposits in immune complex on the glomerular basal membrane b. Direct infection of streptococcus

c. IgA involved this disease d. Type IV hipersensitivity 39. The following are spesific cellular immune system a. Complement b. NK cell c. IgA d. Th2 42. Contoh imunitas seluler pade interseluler bakteri a. Th1 b. Th2 43. Mucosal layer secret >> IgA 45. Respon vaskuler untuk inflamasi akut >> neutrofil ke interstitial 48. Child with lymphadenopaty underwent biopsy histology granulomatous inflamasi 49. 52 tahun, male, massive ... 51. Anak umur 4 tahun kena paku berkarat, reaksi healing process a. formasi fibrin b. c. d. demigrasi dan emigrasi 57. Healing process ada 3 : cell proliferation, extra cellular matrix dan xxx. Yang termasuk extra cellular matrix a. Fibrin b. Elastin c. Integrin d. Laminin 59. Contoh antihistamin generasi 3 a. Etilendiamine b. piperizine c. phenodiazine d. levocetirizine 60. Obat rinitis alergika kronik a. difenhidramine b. levocabastine c. feksophenadine d. chloropheniramine 65. The drug which highest capability for reducing gastric juice a. Cimetidine b. Famotidine c. Ranitidine d. Promethazine 68. Obat untuk malaria yang juga dapat digunakan untuk toxoplasmosis >> Pirimethamin 68. This drug is not only use for malaria, but also used for toplasmosis a. Chloroquine b. Pyrimethamine c. Atovaquone

d. Mefloquine 70. This drug is contraindicated for psoriasis patient a. Primakuin b. Klorokuin c. Pirimetamin d. Artemisin 71. Obat anti malaria yang menyebabkan QT interval a. Atovaquone b. mefloquine c. primaquine d. pirimethamine 75. The following antibiotic is safe for treating malaria in pregnant woman a. Clyndamicin b. Tetracycline c. Sulfan d. Artemisin 78. IgM receptor located in fetus surface cell when the fetus is a. 10 weeks b. 10,5 weeks c. 12 weeks d. 20 weeks 79. Cytoplasmic IgM located in a. stem cell b. pre B cell c. mature B cell d. plasma cell 80. Primary antibody with high molecular weight (MW) in primitive vertebra is a. Analogous autoantibody with IgM n human b. Analogous autoantibody with IgG n human c. Analogous autoantibody with IgA n human d. Analogous autoantibody with IgD n human 81. Di bawah ini merupakan organ limfoid primer d. Bone marrow and Thymus 81. IgG serum concentrate reduce in stage a. Fetus b. Neonatus c. Young d. Adult 85. Organ u/ imun, thymus berperan a. waktu puber, thymus membesar b. precursor T sel matang ada di medula c. mayoritas precursor T sel mati di medulla karena apoptosis d.sel epitel timus, sel dendrite, dan secret makrofag soluble factor yang mempengaruhi pematangan sel T 86. Lymph node has one following histological features a. is a round-shaped organ with the size of more than 3 cm b. most of the free cell in the node are lymphoid blast cell c. in a stimulated node, a germinal center may develop within the primary nodules d. Para cortex are the areas between the capsule and the cortex

88. MALT has one following feature : a. Located beneath the mucosa epithelial b. Immune response also targeted and gainst component of food c. Product IgE, release onto epidermal surface d. Immune 89. Characteristic tonsil 98. Gram (+) cocci arrange in grape cluster a. Streptococci b. Poststreptococci c. Staphylococci d. Gonococci 101. Bakteri gram (+) yang tidak menghasilkan Catalase 104. A kind of enzyme produced by group A streptococcus. Can be used for suffering from heart attack a. Hyaluronides b. Streptococcus c. DNAse d. B-lactamase 105. Yang mw ke mekah dikasih vaksin a. N. meningitidis 106. Pelvic inflammatory disease (PID) is usually caused by a. S. typhi b. N. gonorrhoeais c. S. aureus d. S. pyogenes 108/111. This species is usually dikatakan sebagai bioterrorism a. Cl. Tetani b. Cl. botullinum c. C. diphteriae d. B. anthracis 112. Bacteri anaerob a. E. coli b. N. gonorrhoe c. S. aureus d. Cl. tetani 112. This fungus is found in form of yeast a. M. b. . floccosum c. H. capsulatum d. C. Albicans 117. Bakteri gr (+) perut yang menyebabkan keracunan makanan >> c. S. aureus 120. Fungus yang termasuk yeast >> a. Candida albicans 123. Perbedaan vivax and palcifarum di hepar, pada vivax ada >> Hipnozoit 128. Atopic Allergies such as asma and hay fever affect >25 million individuals in US. What is most effective method of treating these Allergies. a. Hyposensitization b. environmental control c. adm of modified allergen

d. adm of antihistamine e. adm of corticosteroid 129. Contoh preformed di sel mast >> Histamine One of histological findings of spleen is a. white pulp is the small, oval/ rounded grayish areas within the splenic cords b. most of parenchyma of the spleen is red pulp c. lymphocyts are the main resident cell population of splenic cords d. the aged erythrocytes are rounded the lymphocyts Obat malaria yang g bisa untuk kemoprofilaksis >> Kina/ Quinine Non spesifik humoral Non spesifik seluler Spesifik humoral Spesifik seluler

Soal Dr. Wisman, penyakit hipersensitivitas, malaria, obat malaria, mycology, parasit, DBD, sepsis, salmonella, imun dasar, bakteri gr (+), gr (-)basil coccus, akut kronik inflamasi, heling process, histology, antibiotik, perkembangan sist imun.

FAKULTAS KEDOKTERAN UNIVERSITAS SRIWIJAYA REMEDIAL MCQ AGUSTUS 2008


1. The disease based on Type II Hypersensitivity A. Urticaria B. Granuloma C. ITP D. Myasthenia Gravis The disease based on Type III Hypersensitivity A. SLE B. ITP C. Anaphylaxis Shock D. Anemia Perniciosa The disease based on Type IV Hypersensitivity A. Atopic Dermatitis B. Graves Disease C. Good Pasteur Syndrome D. Type I Diabetes Mellitus Immunoglobuline involved in Type I Hypersensitivity reaction A. IgE B. IgM C. IgG D. IgA Immunoglobuline involved in Autoimmune Hemolytic Anemia A. IgG and IgM B. IgA C. IgE D. IgD

2.

3.

4.

5.

6.

Early phase of Type I Hypesensitivity occurred A. Less than 2 hours B. 2 24 hours C. 48 hours D. More than 6 days The pathogenesis of Post Streptococcal Glomerulonephritis A. Deposits of immune complex on the glomerular basal membrane B. Direct infection of Streptococcus C. IgA involved this disease D. Type IV Hypersensitivity Preformed mediator in the granules of mast cell A. Leucotrien B. Histamine C. Thromboxanes D. Prostaglandine

7.

8.

Question No. 9 A woman, 21 years old, come to the hospital with the complain of redness on the face, especially after contact with the sun rays, she also have arthralgia on the knee and finger, and oral ulcer. Laboratory findings reveal: Hb 7,0 mg/dl, leukocyte 3000/mm3, thrombocyte 65000/mm3, proteinuria ++ (Esbach 1000 mg), anti ds DNA +. 9. The possible diagnosis of this patient was A. Aplastic anemia B. Acute glomerulonephritis C. Systemic Lupus Erythematosus D. Autoimmune Thrombocytopenic Purpura Non specific Humoral Immune System A. Complement, Interferon, CRP B. Interferon, CRP C. CRP, Complement D. Complement, Interferon Specific Cellular Immune System A. Complement B. NK cell C. IgA D. TH-2 Spesific Humoral Immune System A. IgA, Ig M, Ig G B. IgM, Ig G C. IgG, Ig A D. Ig G, TH 2 Specific Cellular Immune System A. Basophil B. Mast cell C. NK cell D. Cytotoxic T cell

10.

11.

12.

13.

14.

The functions of Complement A. Lysis B. Chemotaxis C. Opsonisation D. a+b+c The functions of Interferon A. Activation of NK cell B. Induction of resistance C. Inhibitions of viral growth D. a+b+c Plasma protein mediator role as chemotactic factor for neutrophil is A. Serotonin B. Kallikrein C. Complement factor (C5a) D. Prostaglandin A child with lymphadenopathy of neck underwent biopsy. Histopathologic feature showed granulomatous inflammation. The most characteristic feature of granolomatous inflammation is .. A. Aggregation of ephiteloid macrophages B. Necrosis C. Multinucleated giant cells D. Eosinophils A 59 year old man suffer a massive heart attack and expires 24 hours later due to ventricular arrhythmia. Histology examination of the effected heart muscle at autopsy would show an abundance of which of the following inflammatory cells A. Fibroblast B. Lymphocytes C. Macrophages D. Neutrophil Healing process of the human body is depending on type of the cell whos getting injury. Rapidly regeneration cells are A. Stables cells B. Labile cells C. Permanent cells D. Neurons A 25 year old woman develops a sore, red, hot, swollen left knee. She has no history of trauma and no familial history of joint disease. Fluid aspirated from the joint space shows an abundance of segmented neutrophils. Transendothelial migration of acute inflammatory cells into the patients joint space was mediated primarily by which of the following families of proteins A. Entactins B. Fibronectins C. Integrins D. Fibrillins A 4 year old boy fall on a rusty nail and punctures is skin. The wound is cleaned and covered with sterile gauze. Which of following is the initial event in the healing process A. Formation of a fibrin clot B. Accumulation of acute inflammatory cells C. Deposition of proteogycans and collagen D. Differentiation and immigration of myofibroblasts A 41 year old woman complains of excessive menstrual bleeding and pelvic pain of 4 months in duration. She uses an intraiterin device (IUD) for contraception. Endometrial biopsy shows an excess of plasma cells and macrophages within the uterine stroma and scattered lymphoid

15.

16.

17.

18.

19.

20.

21.

22.

follicles. The presence of these cells within the stroma and scaterred lymphoid follicles. The presence of these cells within the stroma is evidence of which of the following conditions A. Acute inflammation B. Chronic inflammation C. Granulation tissue D. Granulomatous inflammations 23. The acute phase response consist of several clinical sign likes fever, fatique, anorexia, atc. A very important mediator of the systemic effects inflammation is A. Gamma interferon B. Interleukin-2 C. Interleukin-1 D. Beta tumor necrosis factor During early inflamation following margination of leukocytes, an important adhesive surface protein on leukocytes is A. Complement factor 5a (C5a) B. Endothelial leukocyte adhesion molecule (ELAM-1) C. Tumor necrosis factor (TNT) D. Leukocyte function antigent-1 (LFA-1)

24.

25.

The cells of the body are divided into 3 groups; labile cells, stable cells, permanent cells, where are the stable cells have only low level replicate capacity. Which one the following examples are stable cells A. Hepatocytes and endothelial B. Hepatocytes and hematopoietic cells C. Lens and neurons cells D. Mucosal and endocrine cells A 30 year old fire fighter suffers extensive third degree burn over his arm and hands. This patients is at high risk for developing which of following complication of wound healing A. Dehiscence B. Contracture C. Keloid D. Traumatic neuroma The basic processes of healing have 3 key cellular mechanism; cell proliferation, extra cellular matrix, and cellular migration. Which one of the following example is extra cellular matrix A. Fibrin B. Elastin C. Integrin D. Laminin Long term consequence of post-streptococcal disease A. Nephrolithiasis B. Cystitis C. Tonsillopharyngitis D. Acute Rheumatic Fever Streptococcus that Positive for QUELLUNG test is A. S.pneumoniae B. S.bovis C. S.pyogenes D. S.agalactiae

26.

27.

28.

29.

30.

A kind of enzyme produced by Group A Streptococci can be used to treat patients suffering from Heart Attack. The enzyme name is A. Hyaluronidase B. Streptokinase C. DNAse D. Beta lactamase Pilgrimage to Mecca (Mekah) must be vaccinated against bacteria A. N.meningitidis B. S.aureus C. Enterococcus D. Gonococcus Pelvic Inflammatory Disease (PID) is usually caused by A. S.typhi B. N.gonorrhoeae C. S.aureus D. S.pyogenes Gram positive rods that cause Food Poisoning A. B.subtilis B. B.anthracis C. B.cereus D. L.monocytogenes This species is usually connected to bioterrorism A. Cl. tetani B. Cl. Botulinum C. C. diphtheriae D. B. anthracis Pseudomembranous colitis is caused by A. Cl. tetani B. Cl. difficile C. Cl. perfringens D. Cl. botulinum The one of clinical manifestation of Neisseria gonorrhoeae infection is A. Cellulitis B. Bronchitis C. Urethritis D. Meningitis Component of S.aureus cells wall which can bind to Fc-IgG is A. Teichoic acid B. Peptidoglycan C. LPS D. Protein A Phagocytosis can be avoided by the function of this component. A. Polysaccharide capsule B. Flagella C. Spores D. LPS Gram positive cocci arranged in grapelike clusters A. Streptococci B. Peptostreptococci C. Staphylococci

31.

32.

33.

34.

35.

36.

37.

38.

39.

D. 40.

Gonococci

Gram positive Cocci that do not produce Catalase A. S.aureus B. S.epidermidis C. S.saphrophyticus D. S.pyogenes Group of toxin in S.aureus that caused Food Poisoning is A. Enterotoxin B. Toxic Shock Syndrome Toxin C. Exfoliatin D. Leukocidin Urinary Tract Infection in catheterized patients is usually caused by A. S.aureus B. S.epidermidis C. S.saphrophyticus D. S.pneumoniae Streptococcus thats included in Lancefield Group A A. E.faecalis B. S.bovis C. S.agalactiae D. S.pyogenes Non Sporeforming Gram (+) Rods that produced Exotoxin A. L. monocytogenes B. C. diphtheriae C. Cl. tetani D. B. anthracis This species do not produced any toxin A. C. diphtheriae B. L. monocytogenes C. Cl. tetani D. B. anthracis Anaerobic bacteria in this list is A. E. coli B. S. aureus C. N. gonorrhoeae D. Cl. tetani Intracellular Gram Negative Diplococci is a characteristic of A. Peptostreptococcus B. S. agalactiae C. N. gonorrhoeae D. S. epidermidis Gram Positive Rod that grow Intracellular is A. C.diphtheriae B. L.monocytogenes C. B.cereus D. Cl.difficile The following infection is Predisposing Factor for Mycoses.. A. HIV-AIDS B. Salmonellosis C. Shigellosis

41.

42.

43.

44.

45.

46.

47.

48.

49.

D. 50.

Brucellosis

The following mycoses is transmitted by Geophylic A. C.albicans B. E.floccosum C. H.capsulatum D. M.canis This fungus is found in the form of Yeast A. M.canis B. E.floccosum C. H.capsulatum D. C.albicans This fungus is yeast with capsule A. C.albicans B. C.neoformans C. B.dermatitidis D. P.brasiliensis The species is included in the group of Dimorphic Fungi A. C. immitis B. C. albicans C. T. rubrum D. M. canis The most common medium to grow fungi is A. Blood agar B. MacConkey agar C. Sabouraud agar D. Nutrient Direct preparation for fungi laboratory diagnosis A. Gram stain B. Ziehl Neelsen C. Neisser stain D. KOH 10% + glycerine What is the characteristic of Plasmodium falcifarum A. Enlarged infected RBC with double chromatin dots B. No enlargement of the infected RBC but with double chromatin dots C. Fimbrae of the infected RBC D. Amoeboid appearance of the cytoplasm The distinct difference between the life cycle Plasmodium vivax and Plasmodium falcifarum is the the existence of..in the liver cells of vivax malaria A. Merozoite B. Hypnozoyte C. Crescent gametocytes D. Delicate ring The average incubation period of Plasmodium falciparum is A. 3-4 days B. 10-12 days C. 10-12 weeks D. 1-4 months Mode of infection of leismaniasis is by the A. Bite of tzetze fly B. Bite of mosquito C. Bite of sandfly

51.

52.

53.

54.

55.

56.

57.

58.

59.

D. 60.

Bite of treatoma

Coned nose fly is the vector of A. Trypanosoma gambiese B. Trypanosoma cruzi C. Trypanosoma rhodesiense D. Leismania donovani Transmission of disease through anteriostation development A. Chagass disease B. Trypanosomiasis rhodesiense C. Trypanosomiasis gambiense D. Trypanosomiasis rodensiense and gambiense Large kinetoplast is found in A. T. b. gambiense B. T. b. rhodesiesnse C. T. cruzi D. Toxoplasma gondidi The shape of C is found in the parasite of A. T. b. gambiense B. T. b. rhodesiense C. T. cruzi D. Amastigote The habitat of Trypanosoma gambiense is in A. Connective tissues B. Connective tissues and lymph nodes C. Lymph nodes and blood stream D. Connective tissues, lymph nodes, blood stream and central nervous system Xenodiagnosis is used for the diagnosis of A. Leishmaniasis B. African trypanosomiasis C. Chagass disease D. Malaria The disease based on Type I Hypersensitivity A. Autoimmune Hemolytic Anemia B. Bronchial Asthma C. SLE D. Contact Dermatitis Complications of typhoid fever, exception A. Perforation B. Meningitis C. Cholecystitis D. Conjuntivitis Several antibiotics are effective in enteric fever, exception A. Penicillin B. Chloramphenicol C. co-trimoxazole D. Fluoroquinolones The prevention living condition improve reduce the incidence of typhoid A. Sterilization of instrument B. Routine Antibiotic C. Herbal Medicine D. Sanitation

61.

62.

63.

64.

65.

66.

67.

68.

69.

70.

Travelers to countries where enteric fever infections are endemic should be A. Sterilization of instrument B. Routine Antibiotic C. Herbal Medicine D. Typhoid vaccines Routine Laboratory Findings have significantly the role out of diagnosis typhoid A. Relative lymphocytosis B. Widal test C. Salmonella IgM D. PCR Human toxoplasmosis can be contracted by the A. Ingestion of underdone meat containing tissue cyst. B. Ingestion of underdone meat containing tissue cyst or swallowing C. Ingestion of isospora D. Bitten of cat.

71.

72.

of oocyst

73.

The clinical feature of toxoplasmosis is A. Asymptomatic in child B. Symptomatic in adult C. Always symptomatic in congenital infection D. Always symptomatic in congenital infection and usually asymptomatic in The causative agent of espundia A. Leishmania donovani B. Leishmania tropica C. Leishmania brasislsiensis D. Toxoplasma gondii

adult

74.

75.

The cardinal sign on acute and active chronic inflammation are rubor, dolor, calor, and tumor. The cardinal sign of inflammation called rubor is mainly the result of A. Vasolidation of arterioles B. Decreased interstitial hydrostatic pressure C. Increased vascular permeability of venules D. Vasoconstriction of muscular arteries Activation of receptor H2 can cause A. Immune reaction B. Bronchodilation C. Vasoconstriction of A. Coroner and A. Basiler D. Itching An example of the third generation of antihistamines is A. Ethilendiamines B. Piperazines C. Phenotiazines D. Levocitirizines Drug of choice for treating Rhinitis allergica chronic is B. Diphenhidramine C. Chlorpheniramines D. Feksophenadine E. Levocabastine In high doses, this antihistamine can be used as an anesthetic local A. Promethazines B. Terphenadine C. Ethanolamines

76.

77.

78.

79.

D. 80.

Scopolamines

Side effect of this second generation of antihistamines is cardiovascular disturbance A. Doxylamines B. Aztemizol C. Levocetirizine D. Meclizine Muscarinic effect due to antihistamines utilization is A. Tremor B. Dry mouth C. Dizziness D. Insomnia Its action by inhibiting the contraction of gastric muscle A. Ranitidine B. Cimetidine C. Famotidine D. Nizatidine The most capability in reducing gastric juice is A. Cimetidine B. Famotidine C. Ranitidine D. Promethazine This drug is a drug of choice for conjunctivitis allergica A. Antazoline B. Terphenadine C. Dyphenhidramines D. Cetirizines Glaucoma is contraindicated to A. Terphenadine B. Levocetirizine C. Loratadine D. Promethazine For radical treatment is better using A. Quinine B. Primaquine C. Mefloquine D. Pyrimethamine This drug is not only used for malaria, but also is used for toxoplasmosis A. Chloroquine B. Pyrimethamine C. Atovaquone D. Mefloquine This antimalaria drug could not be used for chemoprophylaxis A. Mefloquine B. Quinine C. Chloroquine D. Pyrimethamine This drug is contraindicated for psoriasis A. Primaquinine B. Chloroquine C. Pyrimethamine

81.

82.

83.

84.

85.

86.

87.

88.

89.

D. 90.

Artemisin

Side effect of this antimalaria can cause QT interval elevation A. Atovaquone B. Artemisine C. Mefloquine D. Primaquine Metochlopropamide reduces its concentration in plasma A. Atovaquone B. Clindamycines C. Sulfonamide D. Chloroquine Its action by inhibiting of dehydrofolate reductase enzyme and tymidilate synthetase A. Chloroguanie B. Chloroquine C. Artemisine D. Aztemisol This antimalaria could not be used together with quinine A. Mefloquine B. Primaquine C. Clyndamicines D. Doxylamine This antibiotic is safe for treating malaria in pregnant woman A. Clyndamicine B. Tetracyclines C. Sulfon D. Artemisin Haemolytic anaemia occurred if this drug is taken by G6PD patient A. Primaquine B. Mefloquine C. Atovaquone D. Pyrimethamine The development of immunology system begins when the fetus is B. 2 3 months C. 4 6 months D. 7 8 months E. Over 8 months IgM receptor located in fetus surface cell when the fetus is A. 10 weeks B. 10.5 weeks C. 12 weeks D. 20 weeks Cytoplasmic IgM located in.... A. Stem cell B. Pre B cell C. Mature B cell D. Plasma cell Humoral specific immune responds for bacteria in the mucosal layer A. IgG B. IgM C. IgE D. IgA

91.

92.

93.

94.

95.

96.

97.

98.

99.

100. Cardinal sign on acute inflammation there are rubor, dolor, calor, and tumor. Dolor is mediated by A. Bradykinin B. Histamine C. Prostaglandin D. Leukotrienes

SOAL Perkembangan Sistem Imunologi


1. Perkembangan Sistem Imunologi mulai pada janin Umur (A) A. 2 3 Bulan B. 4 6 bulan C. 7 8 bulan D. lebih dari 8 bulan 2. Reseptor IgM terdapat pada permukaan sel janin umur : (B) A. 10 minggu B. 10.5 minggu C. 12 mingu D. 20 minggu 3. IgM sitoplasmik terdapat pada sel : (B) A. Sel Induk B. Pre sel B C. Sel B matur D. Sel plasma 4. Antibodi utama dengan BM tinggi pada vertebrata primitifadalah: (A) A. Antibodi analog dengan IgM pada manusia B. Antibodi analog dengan IgG pada manusia C. Antibodi analog dengan IgA pada manusia D. Antibodi analog dengan IgD pada manusia 5. Coproantibodi adalah antibodi (B) A. IgG B. IgA C. IgM D. IgE 6. Sel induk limfosit akan berdiferensiasi menjadi : (A) A. sel limfosit B B. Sel granulosit C. Sel trombosit D. Sel Monosit 7. Kadar serum IgG turun drastis pada saat kehidupan (B) A. Janin B. Neonatus C. Dewasa muda D. Dewasa tua 8. Imunoglobulin sekretoris adalah : (A) A. IgG B. IgA C. IgM D. IgD 9. Sel memori adalah sel berada dalam pengaruh lingkungan : (D) A. Makro B. Mikro C. Makro dan mikro D. Molekuler

10. Titer IgG mulai positif pada usia janin: (C) A. 10 minggu B. 10.5 minggu C. 12 minggu D. 20 minggu

ANTIMALARIA (dr. Theodorus, MmedSc)


1. Bekerja pada bentuk jaringan laten P. Ovalen dan P. Vivaks yang tersisa, setelah bentuk hepatic dilepaskan ke dalam sirkulasi : A. Pencegahan kausal B. Pengobatan supresi C. Gametosid D. Pencegahan relaps (radikal) 2. Bekerja dengan mencegah terbentuknya stadium seksual eritrositik sehingga trasmisi kenyamuk dihindari : A. Pencegahan kausal B. Pengobatan supresi C. Gametosid D. Pencegahan relaps (radikal) 3. Obat ini termasuk Skizontosid darah kerja lambat : A. Antifolat B. Klorokuin C. Kina D. Meflokuin 4. Obat ini tidak efektif digunakan sebagai kemoprofilaktik : A Antifolat B Klorokuin C Kina D Meflokuin 5. Salah satu ciri Atovakuon yaitu : A. Merupakan suatu devirate 4-aminokuinolin B. Kolaps membrane mitokondria meningkat bila diberi bersama proguanil C. Bentuk suspensi ketersediaan hayatinya separuh (1/2) X bentuk tablet D. Dapat di berikan pada wanita hamil dan menyusui 6. Salah satu ciri klorokuin : A. Larut dalam lipid B. Distribusinya cepat karena banyaknya obat ini di jaringan C. Tidak menimbulkan retinofati D. Mengantagonis kerja anti konvulsan 7. Salah satu ciri Primakuin : A. Bersifat gametosidal hanya untuk P. Falciparum B. Larut dalam air dan metabolismenya cepat C. Obat alternatif untuk penyakit autoimun D. Aman untuk wanita hamil 8. Salah satu ciri Meflokuin : A. Tidak dapat diberikan pada penderita gangguan kunduksi jantung B. Berupa bubuk putih dan berasa pahit C. Artesunat menurunkan efeknya D. Absorpsinya di saluran cerna jelek bila ada makanan

9. Salah satu ciri Artemisin : A. Artemen larut dalam air B. Bermanfaat untuk kemoprofilaksis C. Lumefantrin meningkat efektifitasnya D. Aman di berikan untuk penderita gangguan neurologik 10. Antimikroba ini sering digunakan oleh pelancong untuk profilaksis jangka pendek : A. Tetrasiklin B. Sulfonamid C. Klindamisin D. Kotrimoksasol Kunci Jawaban Antimalaria : 1. D 2. C 3. A 4. C 5. B 6. D 7. B 8. A 9. C 10. A

TUBERKULOSTATIKA (dr. Theodorus, MmedSc)


1. Obat ini termasuk tuberkulostatika golongan ke dua : A. Tiosetason B. Etionamid C. Isoniazid D. Pirazinamid 2. Obat ini mempunyai aktivitas steriliosasi di intrasel : A. Rifampisin B. Pirazinamid C. Isoniazid D. Sikloserin 3. Obat ini bersifat bakteriostatika di ekstraseluler : A. Etambutol B. Streptomisin C. Para amino salisilat D. Etionamid 4. Salah satu ciri Rifampisin : A. Bersifat bakterisidal di intraseluler B. Ekskresi terutama melalui urin C. Asam amino salisilat menurunkan absorpsinya D. Meningkatkan kadar serum sulfonil urea 5. Salah satu ciri Isoniazid : A. Alkohol menurunkan efek obat ini B. Konsentrasi INH pada asetilator cepat lebih besar dari aselitator lambat C. Bekerja dengan menghambat sintesa protein

D. Aman untuk penderita apilepsi 6. Salah satu ciri Etambutol : A. Bakteriostatik di intra dan ekstraseluler B. Aman diberikan untuk anak < 5 tahun C. Tidak menumbulkan drug fever D. Tidak larut dalam air 7. Salah satu ciri : A. Diabsorpsi dengan baik di intestinum B. Tidak dapat menembus plasenta C. Aman untuk penderita miastenia gravis D. Dapat di berikan untuk tularemia 8. Allopurinol digunakan untuk mengatasi efek samping obat ini berupa poliartralgia A. Para amino salisilat B. Rifampisin C. Etionamid D. Pirazinamid 9. Salah satu ciri Etionamid : A. Bekerja menghambat sintesa RNA B. Aman untuk wanita hamil dan menyusui C. Bersifat renotoksik D. Dianjurkan diberikan bersama-sama pridoksin 10. Salah sau ciri sikloserin : A. Bekerja menghambat sintesa protein pada ribosom mikrobakterium B. Distribusinya tidak mencapai cairan sereprospinalis C. Aman diberikan bersama-sama INH D. Kontraindikasi untuk penderita dengan gangguan gunjal Kunci Jawaban Tuberkulostatika : 1. B 2. B 3. C 4. C 5. A 6. A 7. D 8. D 9. D 10. D

ORGANS OF THE IMMUNE SYSTEM (BLOCK 7) SOAL dr. JUSUF FANTONI, SpPA
1. Primary lymphoid organs in human beings are : A. Mucosa associated lymphoid tissue (malt) & peyers patches B. Buesa of fabricius & appendix C. Tonsil and spleen D. Bone marrow and thymus Bone marrow has one the following features : A. Stromal cells survive even given dose radiation B. 90% of the pre-B cells die if they fail to from function Ig molecules C. Bone marrow serves as a site of maturation of T-Lymphocytes

2.

D. 3.

Vertebrate including humans will survive even all the stem cells are destroyed

Thymes has one of the following characteristics : A. Situated above the lungs and below the thyroid B. Is the site of production of T-Lymphocyte C. The cortical layer is covered with macrophages D. Thymocytes are ;ess in the medulla As an organ of the immune system, thymus plays one of the following roles : A. Following puberty, the thymus begins to enlarge B. Most precursor T-cells mature in the medulla C. Majority of the precursor T-cells die in the medulla due to apoptosis D. Thymic epithelial cells, interdigitating dendritic cells and macrophages secrete soluble factors which influence T-cell maturation Lymph node has one the following histological features : A. Is a round-shaped organ with the size of more than 3 CMS B. Most of the free cells in the node are lymphoid blast cells C. In a stimulated node, a germinal centre may develop within the primary nodules D. Paracortex are the areas between the capsule and the cortes One of the histological findings of spleen is : A. White pulp is the small, oval/rounded grayish areas within the spenic cord B. Most of the parenchyme of the spleen is red pilp C. Lymphoctes are the main resident cell population of the splenic cords D. The aged erythrocytes are removed by T-lymphocytes Mucosa-associated lymphoid tissue (malt) has one of the following features : A. Malt is located beneath the mucosa epithelia B. The immune response of malt also targeted against components of the food C. Malt plasma cells produce IgG, releases onto the epithrlial surface D. Immune cell activation is the same as other lymphoid tissues Tonsils are lymphoid organs which have one of the features mentioned below : A. Pharyngeal tonsil (adenoid) has deep crypt which facilitate the contact of antigens with the immune cells B. Tonsils lymphoid nodules consist mainly of T-lymphocytes C. Tonsils share histological features with lymph nodes i.e ;. With afferent and efferent lymph vessels and reticular fibres D. Exposure to antigens relies on the contact of antigens with cells of the immune system of the epithelia which cover the tonsils. Gut-Associated lymphoid tissue (galt) has one of the characteristics below : A. Are found only in the ileum and appendix B. Peyers patches located beneath the epithelium extend to the submucosa C. The epithelia appears squamous which allows contact of antigens with cells of the immune system D. T-Lymphocytes are predominant in galt. To your understanding of the immune system, one of the following statements is correct : A. B and T-Lymphocytes originate from pluripotent stem cells in the bone marrows. B. T-Lymphocyte mainly developed and differentiated in thymus C. Lymph nodes are bean shapes organs which are found mainly in the neck, axilla and inguinal area D. When spleen is taken out of human body, that person will suffer reduced immune response and toxicity.

4.

5.

6.

7.

8.

9.

10.

SOAL GRAM NEGATIVE


1. A patient begain to receive intravenous antibiotics dissolved in sterile saline solution developed fever within an hour. (The solution in which antibiotics were dissolved had been sterilized by autoclaving.) The IV infusion was stopped and the fluid cultured, but cultures on a variety of media were sterile. Which of the following bacterial components would have been most effective in producing the patient's fever? A. Spores B. Lipopolysaccharide. C. Capsule polysaccharide. D. Outer membrane proteins. E. Siderophores. Three days after an appendectomy, a patient develops high fever. The patient's vital signs include a dangerously low blood pressure. The patient's erythrocyte sedimentation rate (ESR) is abovenormal. Which of the cytokines below most directly contributed to development of these symptoms? A. IL-4 B. IFN-gamma C. IL-8 D. IL-10 E. TNF-alpha A hospitalized patient spikes a fever. Lactose-fermenting Gram-negative rods are isolated from a blood culture. Which of the following, produced in response to infection, played the largest role in producing the fever? A. C3b B. IL-1 C. IL-2 D. IL-8 E. Interferon-alpha Toxin of Vibrio cholerae is: A. LOS B. Cholera toxin - activates adenylate cyclase C. Toxin A - enterotoxin D. LPS E. ShET 1 The following statement are true of typhoid fever: A. The incubation period for enteric fever is 3-60 days, but symptoms typically occur in 3-5 weeks B. Patients who continue to shed bacteria for more than 1 month are considered chronic carriers C. Detection of persistently high H antibody offers an additional way of screening for longterm carriers D. Widal's test shows cross-reactivity with some other Salmonella species E. Blood culture culture is more sensitive than bone marrow Drug of choice for enteric fever in children is: A. cotrimoxazole B. ceftriaxon C. chloramphenicol D. ampicillin E. quinolone Oxygen requirements of Salmonella spp. is: A. Microaerophilic B. Aerobic C. Facultative anaerobe D. Obligate anaerobe E. Obligate aerobe Morbidity of Bordetella pertussis is:

2.

3.

4.

5.

6.

7.

8.

A. Folliculitis B. Urinary tract infections C. Neonatal meningitis D. Conjunctivitis E. Whooping cough 9. This specimen can give the highest positivity for Salmonella typhi culture A. blood B. urine C. faeces D. bone marrow aspirate E. bile aspirate 10. Prolonged fever with neutropenia can be seen in A. dengue fever B. measles C. typhoid fever D. diphtheria E. varicella 11. Toxin of Shigella spp. is: A. Yst II B. Enterotoxins C. Cholera toxin - activates adenylate cyclase D. Leukocidin E. LPS

SOAL IMUNISASI
1. The final goal of immunization is: a. to change disease epidemiology b. to reduces disease prevalence c. eradication of disease d. to reduces disease incidence e. to protect individu from speficif disease 2. The immediate goal of immunization is: a. eradication of disease b. to reduce disease prevalence c. to change disease epidemiology d. to protect individu from specific disease e. to get herd immunity 3. Ahmad is a healthy-two-months-old boy. He received the first dose of hepatitis B at 24 hours of age and BCG at 1 month of age. What vaccination are indicated (choose the best answer)? a. Second dose of Hepatitis B b. First dose of DPT and OPV c. First dose of DPT d. First dose of DPT and Hib e. Second dose of Hepatitis B, first dose of OPV, DPT and Hib 4. Which of the following vaccines are inactivated bacterial vaccine? a. Diphtheriae, pertusis, tetanus, meningococcus b. BCG, typhoid c. Measles, mumps, rubella d. OPV, yellow fever e. IPV, rabies 5. The following vaccine is a life attenuated viral vaccine: a. IPV, yellow fever, varicella b. Measles, mumps, rubella c. Hepatitis A, Hepatitis B d. OPV, rabies e. Hib, cholera

6. These vaccines are included in Extended Programme of Immunization in Indonesia: a. BCG, Measles, DTP, IPV b. BCG, Measles, DTP, MMR, Polio c. BCG, Measles, DTP, Polio, Hepatitis B d. BCG, Measles, DTP, Polio, Hepatitis B, MMR e. BCG, Measles, DTP, Polio, Hepatitis B, MMR, Tetanus toxoid 7. A 6-month-old girl is brought to Primary Care to get BCG vaccination. The health care provider should: a. give BCG directly after doing physical examination and history taking b. explain that its too late to give BCG c. make history taking, physical examination and doing tuberculine test d. make history taking, physical examination to check wether there is contraindication e. give BCG directly 8. Contraindication of Measles vaccine is: a. Recent blood products b. Close contact with immunodeficient person(s) c. Anaphylactic reaction to eggs d. Anaphylactic reaction to 2-phenoxyethanol e. Anaphylactic reaction to the vaccine 9. Which administration route is incorrect? a. Measles vaccine subcutaneously in the deltoid region of an infant. b. Hepatitis B intramuscularly in the anterolateral thigh of an infant c. BCG intracutaneously in the deltoid region of a child d. DTP intramuscularly in the upper outer quadrant of the buttock of a child. e. IPV administered subcutaneously. 10. Which vaccine listed below is most likely to produce adverse affects in an immunocompromised host? a. Bacille Calmette-Guerin (BCG). b. Pneumococcal vaccine. c. Tetanus toxoid. d. Typhoid fever (killed-organism vaccine). e. Acellular Pertussis vaccine. 11. Which statement about the routine schedule is false? a. The first dose of hepatitis B vaccine is recommended from birth to 2 months of age. b. The first dose of measles is ideally given at 9 months of age. c. The first dose of DTP is ideally given from birth to 2 months of age. d. The second dose of Hib vaccine is ideally given at 4 months of age. e. The fourth dose of DTaP is ideally given at 15 to 18 months of age. 12. Indication of diphtheria vaccine is: a. dirty wounds b. travelers to areas where the disease is endemic c. chronic cardiopulmonary disease d. everyone e. inmates 13. Active microorganism suspension, or inactivated, or the fraction to evoke an immunologic response is called as: a. Live attenuated vaccine b. Toxoid c. Immune serra d. Vaccine e. Inactivated vaccine 14. Freeze-sensitive vaccines : a. DTP, TT, hepB, DTP-hepB, Hib vaccines b. DTP-hepB, OPV, Hib vaccines c. Measles, BCG, DTP-hepB, Hib vaccines d. DTP, TT, Measles, hepB, DTP-hepB e. TT, hepB, DTP-hepB, OPV

SOAL INFEKSI TROPIS


1. The following statement are true of Diphtheria: a. "bull neck" is diagnostic b. it is caused by Gram negative bacilli c. toxin absorption is greatest in laryngeal disease d. Of the three strains, mitis produce more severe infection, and gravis and intermedius milder infection. e. complete heart block is a manifestation of toxin-induced myocarditis 2. Plasma leakage in dengue infection can be manifest as: a. thrombocytopenia b. haemoconcentration c. leukopenia d. hypotension e. severe bleeding 3. The main defference between dengue haemorrhagic fever and dengue fever is: a. thrombocytopenia b. haemorrhage c. plasma leakage d. hepatomegaly e. positive rumple leede test 4. Kopliks spot in measles patient can be seen at a. the end of incubation period b. the beginning of prodromal stage c. the beginning of convalescent stage d. the end of eruption stage e. the beginning of eruption stage 5. The management of measles consist of: a. Vitamin A supplementation b. Giving acyclovir c. Giving corticosteroid d. Giving profilactive antibiotic e. Giving acetyl salycilat 6. A child was hospitalized with 4 days fever, myalgia, retro orbital pain, no source of infection. Physical finding reveal hepatomegaly, pleural effusion and ptechie. Laboratory result: RBC 13.5 g/dL, WBC 3000/uL, hematocryte 45 vol%, platelet 80,000/uL. This patient diagnosis is: a. DHF grade I b. DHF grade II c. DHF grade III d. DHF grade IV e. Dengue fever 7. The following management of diphtheria is incorrect: a. Bacteria eradication with Penicillin procaine and ADS b. Toxin neutralizing with ADS c. Bacteria eradication with Penicillin procaine d. Corticosteroid is controversy e. Patient isolation 8. The following statement are true of varicella zoser virus: a. Causing maculopapular rash b. Acyclovir is usefull if given before 72 hours after onset of the rash c. Incubation period 3 5 weeks d. Patient with shingles is not infectious e. Remain latent in sensory ganglion after primary infection 9. Reactivation of latent varicella zoster infection manifest as: a. Varicella b. Herpes zoster c. Eczema herpeticum d. Roseola infantum e. Exanthema subitum

10. The following characteristic of eruption in varicella is false: a. Skin lesions appear in scatter that generally involve the trunk, scalp, face, and extremities. b. presence of lesions in many stages in any one general anatomic area c. central distribution of lesions that appear in crops d. intense itching e. a rapid evolution of macule to papule to vesicle to pustule to crust

SOAL SEPSIS
1. The systemic inflammation response syndrome includes which one of the following? A. Decreased level of consciousness. B. Decreased urine output. C. Evidence of bone marrow failure. D. Hypotension. E. Increased respiratory rate. 2. This pro-inflammatory mediator is produced early in the onset of sepsis and reflect the overactive status of inflammatory: A. TNF- B. GM-CSF C. IL-10 D. IL-4 E. IL-13 3. Which one of the following sepsis therapeutic strategies is not targeted to inflammatory mediators or immune response? A. Glukokortikoid B. Intravenous immune globulin C. Soluble TNF receptor D. Anti-endotoxin antibody E. Drotrecogin Alfa 4. Which one of the following is least likely to be helpful in the initial management of a child who presents with evidence of septic shock? A. Blood glucose. B. Cerebrospinal fluid culture. C. Renal function studies. D. Serum electrolytes. E. Serum ionized calcium level. Question 4 6 refer to the following case A 10-year-old boy was admitted to the hospital with combustio (burned trauma). Patient is using urine catheter. The patients vital signs are as follows: temperature 39oC, heart rate 135 bpm, respiratory rate 42 breaths/min, blood pressure 60/40 mmHg, and oxygen saturation 98% without oxygen supplementation. A chest radiograph is normal. White blood cell count is 20 x 103/uL and urine show 35-40 white cells/hpf. No other sources of infection are identified. 5. This patients condition can best be defined as A. multiple dysfunction syndrome B. sepsis C. bacteremia D. severe sepsis E. systemic inflammatory response syndrome 6. After ensuring adequate airway and oxygenation, what is the next step in the management of this patient? A. Antibiotic therapy B. -Blocker therapy to control heart rate C. Intravenous fluid resuscitation D. Surgical consult for gall bladder surgery E. Vasopressor therapy with dopamine

7. The most possible source of infection in this patient is: A. urinary tract infection B. secondary infection of burned lesion C. pulmonary infection D. occult bacteremia E. gastrointestinal infection 8. Which one of the following is least likely to be associated with sepsis in a young child? A. Delayed capillary refill. B. Lactic acidosis. C. Normal blood pressure. D. Normal temperature. E. Tachycardia. 9. If we find this clinical change (alone) in septic patient, we can diagnose him as severe sepsis. A. Acute respiratory distress syndrome B. Renal dysfunction C. Hematologic dysfunction D. Neurological dysfunction E. Respiratory dysfunction 10. The true statement about sepsis: A. During the onset of sepsis, the inflammatory system becomes hyporeactive B. Lipopolysaccharide may contribute to Gram-negative sepsis C. Nosocomial sepsis should be treated with a second-generation cephalosporin D. Sepsis caused by H. influenzae may be associated with intravenous catheters or surgical wounds E. Sepsis without a focus has a much better prognosis than urosepsis. 11. Which of the following statements refers to sepsis? A. Infection must be proven B. IL-1 and IL-6 activation can lead to pulmonary dysfunction through activation of neutrophils that are attracted to lung tissue. C. The sepsis response to a gram-negative organism begins with the release of peptidoglycan D. The classic and alternate pathways of the complement system are activated by antinflammatory cytokines E. Release of TNF-, IL-1, and IL-6 stimulates the extrinsic coagulation cascade and produces fibrin.