1.

Seorang penderita laki 55 thn dtng k rh sakit dengan keluhan sesak napas dan
cepat lelah . pada pemfis tkn drah 110/70 mmhg, denyut jantung 110
mmHg/menit, napas 30/menit CXR : kardiomegali dan tanda2 edem
intersisial . Echo : pembesaran ventrikel kiri tap tebal dinding dalam batas
normal hanya ges rakannya hipokinetik menyeluruh.

Pertanyaan : apa diagnosis yg paling mungkin penderita ini

a. Ischemic cardiomyopathy
b. Cor pulmonale chronicum
c. Congestive cardiomyopathy
d. Asymetri Septal hypertrophy
e. Idioatic hypertrophic subaortic stenosis

2. A patient with new omset syncope has a blood pleasure 110/95 dan a harsh
systolic ejection murmur at the base radiating to both carotid

Question : auscultation of the S2 at the base might reveal which of the

following findings

a. It is diminished
b. It is assentuated
c. It shoes fixed splitting
d. It’s normal in character
e. It’s widely split due to delayed ventricel ejection

3. Seorang perempuan 38thn dtg ke poli tdk prnah mengalami sakit sebelumnya.
Dyspeneu, sering lelah, TD 90/60 DJ 95 EKG irama irreguler S1 mengeras,
S2 diikuti bunyi opening snap

a. Friction rub
b. defisit pulse
c. Alternating pulse
d. Holosistolik …,..
e. Systolik ejection click

4. A asymptomatic 18 yo student dgn murmur ditemukan mitral regurgitasi pada

echo. Pemfis yg mungkin didptkan adalah

a. Early and mitsytolic murmur

b. Bunyi jantung 1 hilang
c. Lowpitched holosystolic murmur
d. Dimished forward stroke volume
e. Rapid decompensation with pulmonary edema

5. A 60 yo man with an acute myocardial infartc develops a new murmur . echo

reveals acute mitral regurgitation . the findings might includes
 a. Increased forward stroke volume
b. Rapid acute pulmonary edema
c. Increase the 1 heart sound
d. Harsh holosystolic murmur
e. Late systolic ejection murmur

6. Seorang lelaki umur 78 thn dtng ke t4 praktek anda dgn keluhan 5 bln
merasakan sesak napas yg makin berat, sesak waktu berrgiat , orthopneu dan
edema tungkai bwah . dia menyatakan adanya rasa dada tertekan sewaktu
berjalan dan berkurang saat istirahat pd pemeriksaan DVj =r+4 pd posisi
baring. Terdengar bsisng ejeksi sitolik drajat 4 pd daerah basis jantung yg
menjalar ke arteri karotis . ekg : hypertropi ventrikel kiri . echo : katup aorta
stenotik dan berkapur dgn perkiraan area katup 0,7 cm2 . fraksi ejeksi 40%
Pertanyaan : tindakan apa yg anda anjurkann untuk memperbaiki kelanjutam
hidup jangka panjang

a. Surgical valvulotomy
b. ACE-I + HCT
c. Digoxin + furosemide
d. Ballon valvulopaty
e. Aortic valve replacement

7. You are asked to supervise an exercise strees test on a 65 yo man he saw

doctor just a week for exertional chest pain n mild dyspnea. He has chest pain
when walks more than …. and jika dilanjutkan sesak napas . he never has
chest pain or dyspnea . on examination BP 120/85 . HR 80/min dan reguler
JVP 8 cmh20 dan lungs are …. has normal s1 dan sigle s2 . heh has soft
cressendo decresendo systolic murmur . best heard at the upper RSB . you can
cancel teh stress test.

Question : what is diagnosis

a. Atrial septal defect

b. Severe aortic stenosis
c. Moderate mitral stenosis
d. Hypertrophy cardiomyopathy
e. Moderate pulmonary stenosis

8. A 18 yo boy residing with his parents on a military base present with a fever
of 38,6c and complain of lower back , knee and wrist join . the arthritis is
nnot localised to any single joint . he gives a history of a severe sore throat
several weeks earlier . pemfis : kulit bengkak sekitar siku dan pergelangan
tangan . lab: kultur darah negatif , LED 100 dan titer asto naik. Apa terapinya

a. parenteral penisilin
b. supportive care alone
c. parenteral penicilin dan aspirin
d. parenteral penicilin dan glucocorticoid
 e. parenteral penicilin , aspirin dan diazepam

9. A 35 years old woman presents to the hospital because of palpitations. There

is a history of shortness of breath and cough. On examination her BP is
110/75 mmHg, HR is 110/min irregular, RR is 28/min and temperature is 37
C. It’s heard presystolic murmur with accentuated S1 in LSB IV,V. The ECG
recording reveals atrial fibrillation with rapid ventricular response. This
patient is easy to have ischemic stroke as a complication.

Question: What is your diagnosis ?

a. Mitral stenosis
b. Aortic stenosis
c. Pulmonic stenosis
d. Tricuspid stenosis
e. Mitral valve prolapse

10. A 35 years old,previously asymptomatic woman with the physical signs of

severe mitral stenosis abruptly develope dyspnea on ordinary effort.
Question: what event best explains the abrupt appearance of symptoms?

a. Pregnancy
b. Pneumonia
c. anxiety state
d. atrial fibrillation
e. pulmonary embolism