SOAL UTS OGES Pak Anton 2013 – Esai 1 soal dan 70 PG

Esai : Jelaskan bagaimana mekanisme banyaknya glukosa dapat meningkatkan sekresi insulin.
Pilihan Ganda
1. ( ) disekresikan oleh ( ) 7. Hormon yang diekskresikan oleh ( ) mirip
dan merangsang kelenjar tiroid secara dengan yang diekskresikan oleh sistem saraf
langsung. simpatis.
a. Thyrotropin releasing hormone, a. Adrenal medula
hypothalamus b. Adrenal korteks
b. Thyrotropin releasing hormone, anterior c. Pineal
pituitary d. Parathyroids
c. Thyrotropin stimulating hormone, e. Thyroid
hypothalamus 8. Hormon utama yang berperan pada reseptor
d. Thyroid stimulating hormone, anterior flight-or-flight adalah...
pituitary a. Thyroxine
e. Semua pernyataan salah b. Cortisol
2. Meningkatnya kadar kalsium darah akan ( ) c. Epinephrine
sekresi kalsitonin dan ( ) sekresi parathyroid d. Aldosterone
hormon. e. Insulin
a. Meningkatkan, meningkatkan 9. Hormon pria dikenal dengan nama ( ) dan
b. Menurunkan, menurunkan secara struktur diklasifikasikan sebagai ( )
c. Meningkatkan, menurunkan hormon.
d. Menurunkan, meningkatkan a. Gonadotropin, peptide/protein
e. Semua salah b. Androgens, steroid
3. Aldosterone, adalah salah satu hormon c. Estrogens, peptide/protein
mineralokortikoid.... d. Androgens, peptide/protein
a. Meningkatkan tekanan darah e. Gonadotropin, steroids
b. Meningkatkan retensi air 10. Peran utama sistem endokrin adalah untuk
c. Merangsang reabsorpsi air menjaga homeostasis pada tubuh sebagai...
d. Merangsang ekskresi kalium a. Effector organs
e. Semua benar b. Communication pathways and
4. Renin adalah enzim yang berperan pada coordination
regulasi sekresi.... c. Integration centers
a. Thyroid hormone d. Sensory receptors
b. Glukokortikoid e. Requirements for glucose and oxygen
c. Parathyroid hormone 11. Berikut ini pasangan hormon yang bekerja
d. Aldosterone antagonis adalah...
e. Kalsitonin a. Insulin/glukagon
5. Kortisol adalah... b. Testosterone/estrogen
a. Gonadotropin c. Aldosterone/cortisol
b. Mineralokortikoid d. Parathyroid hormone/calcitonin
c. Adrenal medullary hormone e. A dan D
d. Androgen 12. Sel sperma diproduksi oleh...
e. Glukokortikoid a. Seminiferous tubules
6. Berikut ini yang bukan termasuk hormon b. Seminal vesicles
steroid adalah... c. Interstitial cells
a. Mineralokortikoid d. Tunica albuginea
b. Androgen e. Rete testis
c. Glukokortikoid 13. Berikut ini yang menggambarkan urutan yang
d. Thyroid hormone dilalui sperma saat keluar dari tubuh...
e. Active vitamin D a. Rete testis  efferent ductules  head of
epididymis  tail of epididymis 
 ejaculatory duct  ductus deferens  19. Bagian yang paling dalam dari dinding uterus,
urethra yang mengandung epitel kolumnar dan kaya
b. Efferent ductules  rete testis  tail of akan jaringan konektif adalah...
epididymis  head of epididymis  a. Medulla
ejaculatory duct  ductus deferens  b. Endometrium
urethra c. Cortex
c. Rete testis  efferent ductules  head of d. Perimetrium
epididymis  tail of epididymis  ductus e. Myometrium
deferens ejaculatory duct  urethra 20. Pada alat reproduksi wanita, yang equal
d. Rete testis  efferent ductules  tail of dengan skrotum pada reproduksi pria adalah...
epididymis  head of epididymis  a. Vestibule
seminal vesicles  ejaculatory duct  b. Clitoris
ductus deferens  urethra c. Labia majora
14. Struktur yang mana yang menambahkan cairan d. Labia minora
seperti susu yang bersifat alkali pada semen 21. Oogenesis berbeda dari spermatogenesis
untuk menetralisasi sifat asam pada saluran dalam hal...
reproduksi wanita. a. Semua langkah
a. Seminal vesicles b. Undifferentiated female germ cells tidak
b. Seminiferous tubules dapat menjalani mitosis setelah lahir
c. Prostate gland c. Sel-sel yang dibentuk meiosis pada
d. Interstitial cells wanita tidak equal dalam jumlah
e. Bulbourethral glands sebagaimana pada pria
15. Sperma yang matang mempunyai ( ) yang d. Oogenesis terjadi sebelum pubertas;
mengandung enzim-enzim yang penting untuk spermatogenesis terjadi setelah pubertas
penetrasi ke ovum saat fertilisasi. e. Meiosis pada oogenesis tidak lengkap
a. Head sampai adanya penetrasi sperma
b. Tail 22. Hormon utama yang mentriger ovulasi
c. Acrosome adalah...
d. Midpiece a. Kadar estrogen yang tinggi
e. Flagellum b. Kadar GnRH yang rendah
16. Pada pria, luteinizing hormone disekresikan c. Lonjakan LH
oleh ( ) dan distimulasi oleh ( ) d. Lonjakan FSH
a. Hypothalamus, interstitial cells e. Kadar progesteron yang tinggi
b. Hypothalamus, sertoli cells 23. Corpus luteum mensekresikan sejumlah besar
c. Anterior pituitary, interstitial cells ( ) dan sejumlah kecil ( )
d. Anterior pituitary, sertoli cells a. FSH, estrogen
e. Semua pernyataan salah b. Progesteron, estrogens
17. ( ) mengandung oosit, beebrapa lapis sel c. LH, FSH
granulosa dan antrum. d. Inhibin, progesterone
a. Corpus albicans e. Estrogens, inhibin
b. Primary follicle 24. Berikut ini yang tidak terjadi selama fase
c. Corpus luteum folikular adalah...
d. Graafian follicle a. Fase proliferasi uterus
e. Secondary follicle b. Perkembangan korpus luteum
18. Fimbriae adalah finger-like projections di... c. Kadar progesterone rendah
a. Ovary d. Kadar estrogen meningkat pada akhir fase
b. Uterus e. Kadar FSH menurun
c. Vagina 25. Pada fase sekretori, siklus uterus terutama
d. Uterine tubes dipengaruhi langsung oleh...
e. Bukan salah satu jawaban di atas a. Progesterone
b. FSH
c. LH
 d. Estrogen e. Struma difus non toksik
e. Inhibin 32. Pasien sedang menjalani terapi TB terdapat
26. Pada ovulasi, ovum meninggalkan folikel bercak kehitaman pada siku. Apa
menuju... diagnosisnya.
a. Ovary a. Paget disease
b. Abdominal cavity b. Cushing syndrome
c. Oviduct c. Addison disease
d. Uterus d. Efek samping OAT
e. Vagina e. Bukan salah satu dari jawaban di atas
27. Fertilisasi normalnya terjadi pada 1/3 jalan
turun di... Untuk soal nomor 33-37
a. Oviduct pada uterine tube Seorang perempuan 45 tahun mengeluh cepat lelah,
b. Uterus banyak kencing, BB menurun 8 kg, riwayat ibunya
c. Cervix menderita kencing manis, pernah melahirkan anak
d. Vagina lebih dari 4 kg, pemeriksaan fisik BB 51 kg, TB 160
e. Abdominal cavity cm, TD 150/90 mmHg.
28. 7-8 hari setelah fertilisasi maka terjadi 33. Kemungkinan hasil pemeriksaan darah yang
implantasi pada daerah... ditemukan pada pasien ini adalah...
a. Oviducts a. GDS 120 mg/dL
b. Uterine wall b. GDP 154 mg/dL
c. Cervix c. Kadar glukosa darah setelah makan 128
d. Vagina mg/dL
e. Fimbriae d. HbA1c 6,3
29. Metode kontrasepsi paling populer untuk e. TTGO 198 mg/dL
mencegah kehamilan yang tidak diinginkan 34. Patofisiologi terjadinya peningkatan kadar
adalah... glukosa darah pada kasus ini adalah...
a. Condom a. Penurunan sekresi glukagon
b. Diaphragm b. Kerusakan sel alfa pankreas
c. Birth control (oral) pill c. Peningkatan resistensi insulin
d. Contraceptive sponges d. Penurunan sekresi adrenalin
e. Intrauterine device e. Kenaikan sensitivitas insulin
30. Metode vasektomi pada pria adalah... 35. Riwayat pernah melahirkan anak di atas 4 kg
a. Menyebabkan impotensi menandakan bahwa pada saat hamil ibu ini
b. Mempengaruhi ejakulasi mengalami...
c. Menghambat sintesis testosteron a. DM tipe 1
d. Metode sterilisasi dengan pembedahan b. DM tipe 2
e. Menghasilkan spermatozoa c. DM gestasional
31. Seorang wanita 31 tahun datang dengan kelhan d. DM tipe lain
utama penurunan kesadaran dan panas tinggi e. DM insipidus
yang timbul setelah kecelakaan 1 hari SMRS. 36. Komplikasi mikrovaskular secara dini dapat
Penderita punya penyakit graves disease sejak ditemukan pada pasien ini jika pada
2 bulan yang lalu. PF: kesadaran menurun, pemeriksaan penunjang ditemukan...
sangat gelisah, N= 132x, TD= 110/60, S= 39,9 a. Peningkatan kreatinin
C. Keringat banyak, tiroid membersar difus, b. Ureum meningkat
bruit + di atas A. Karotis interna, takikardi, c. Mikroalbuminuria
murmur, hiperfleksi, dan tremor, Hb dan d. Proteinuria
leukosit DBN. T3 dan T4 meningkat, TSH e. Ukuran ginjal menurun
rendah. Apa diagnosisnya. 37. Komplikasi yang memiliki patogenesis yang
a. Hipertiroid mirip dengan retinopati proliferatif adalah...
b. Tirotoksikosis a. Stroke
c. Krisis tiroid b. Infark miokardium
d. Tiroiditis c. Ketoasidosis
 d. Nefropati b. ADH
e. Penyakit jantung koroner c. TSH
38. Di bawah ini, mana yang disebabkan oleh over d. Oxytocin
sekresi growth hormon. e. GnRH
a. Panhypopituitarism 45. Obat ini bekerja sebagai sintetik hormon T4...
b. Addison’s a. Levothyroxine
c. Acromegaly b. Pegvisomant
d. Diabetes c. Metformin
e. Bukan salah satu di atas d. PTU
39. Di bawah ini, yang mana yang dapat digunakan e. Iodine
untuk mengatasi hipotiroid... 46. Obat ini digunakan untuk mengatasi hipertiroid
a. Pegvisomant dengan menghambat T3 dan T4 pada kelenjar
b. Insulin tiroid, dan mencegah konversi T3 ke T4 di
c. Desmopressin jaringan...
d. Levothyroxine a. Mineralokortikoid
e. Semua benar b. Propylthiouracil
40. G protein coupled receptor yang bekerja c. Sodium iodide 131
dengan menurunkan konsentrasi cAMP d. Insulin
intrasel yaitu... e. Glukokortikoid
a. Gs protein coupled receptor 47. Kekurangan glukokortikoid menyebabkan...
b. Gi protein coupled receptor a. Cushing’s
c. Gq protein coupled receptor b. Hashimoto’s
d. Gh protein coupled receptor c. Addison’s
e. Salah semua d. Hyperthyroidism
41. Aktivitas protein G coupled receptor yang e. Hidrosefalus
menghasilkan second messengers IP3 dan 48. Obat berikut yang dapat meningkatkan
DAG adalah... sensitivitas insulin dengan mengaktivasi AMP-
a. Gs protein coupled receptor activated protein kinases yang berperan dalam
b. Gi protein coupled receptor signaling insulin adalah...
c. Gq protein coupled receptor a. Alpha glucosidase inhibitors
d. Gh protein coupled receptor b. Orlistat
e. Salah semua c. Metformin
42. Kekurangan ADH menyebabkan diabetes d. Dopamine agonist
insipidus. Obat di bawah ini yang bisa e. Bukan salah satu di atas
digunakan untuk mengatasi penyakit tersebut 49. Obat berikut ynag menghambat atau
adalah... memperlambat dicernanya glukosa di saluran
a. Insulin cerna adalah..
b. Metformin a. Biguanides
c. Desomopressin b. Bile acid sequesterants
d. Octreotide c. Alpha glucosidase inhibitor
e. Sulfonilurea d. Orlistat
43. Obat ini bekerja untuk mengatasi akromegali e. Bukan salah satu di atas
dengan bekerja sebagai somatostatin, a growth 50. Anti obesitas dari orlistat adalah dengan..
hormone release inhibit factor, yaitu.. a. Inhibiting lipase
a. Octreotide b. Stimulating lipase
b. Pegvisornant c. Inhibiting glucagon
c. Sodium iodide 131 d. Stimulating glucagon
d. Desmopressin e. Bukan salah satu di atas
e. Povidone iodine 51. Berikut ini yang termasuk dalam insulin
44. Di bawah ini adalah hormon yang dilepaskan secretagogues adalah...
oleh hipofisis anterior... a. TZD
a. Prolaktin b. Sulfonilurea
 c. Meglitinides b. Ligand-gated K+ channel
d. GLP-1 c. Glucose transporter
e. Bukan salah satu di atas d. Sodium-glucose cotransporter
52. Berikut ini adalah senyawa yang disintesis e. PPAR gamma receptor
pada rough endoplasmic reticulum, kecuali... 56. Berikut ini adalah sensor yang terlibat dalam
a. Tiroglobulin regulasi sekresi PTH..
b. Insulin a. G-protein coupled G2+ binding receptor
c. ACTH b. Calmodulin
d. GLP-1 c. Voltage-gated Ca2+ channel
e. Cortisol d. Ligand-gated K+ channel
53. Berikut ini adalah hormon yang berikatan e. Glucose transporter
dengan reseptor intrasel... 57. Dimana anda dapat menemukan sel endokrin
a. Cholecalciferol yang mensekresikan GLP-1...
b. Dopamin a. Pancreatic islet
c. Norepinefrin b. Adrenal medulla
d. ACTH c. Hipotalamus
e. PTH d. Epitel usus halus
54. Berikut ini adalah contoh dari congenital e. Hipofisis anterior
hormone resistance... 58. Berikut ini adalah hal yang terjadi saat
a. DM itpe 2 exercise...
b. Penyakit addison a. Menurunnya sekresi insulin
c. Mutasi reseptor hormon pertumbuhan b. Teraktivasinya saraf simpatis yang
d. Cretinism menginput sel beta pankreas
e. Hiphipofisis adrenal c. Uptake glukosa oleh otot rangka meningkat
55. Berikut ini protein mana yang berikatan d. Semua pernyataan benar
dengan sulfonilurea... e. Semua pernyataan salah
a. Voltage-gated Ca2+ channel

SOAL OGES PAK ANTON

1. Sel Sertoli menghasilkan riwayat diabet, wkt periksa kadar gula darah >126
a. Mukus b. Androgen Binding (klo gk salah) Tindakan yg tepat dilakukan..
Protein c. … d. FSH e. LH a. Cek ulang gula darah puasa dilain hari
2. Sperma dimatangkan dengan suhu b. Pantau gula darah selama 1 tahun
a. lebih rendah dari suhu tubuh c.
b. lebih tinggi dari suhu tubuh c. …. d
d…. e. …. e.
3. Diabetes tipe 2 disebut 6. Setelah melakukan tes lagi, gula darah nya
a. Insulin dependent diabetes b. ternyata makin naik. (> besar dry g td no 5).
Non- Insulin dependent diabetes c. Berikut tes yang nggak penting dilakukan
diabetes gestational d. juvenile a. EKG
diabetes e. ….. b. Gly….(blablabla)
4. Diabetes tipe 1 disebut (c dan d jg kayaknya c. ……
salah) d. …….
a. Juvenile diabetes b. Non-insulin e. ……
dependent diabetes c. .. d….. e. 7. Pasien didiagnosis positif DM 2, hasil tes
…Salah Semua blablabla, kemudian stlh di tes, ia berhasil merubah
5. Kasus (u/ no 5-6) (11:12 ya hhe) lifestyle, tp brt bdn gk bs turum, gula darah 210,
Tn X, umur 50 th, gk pernah konsumsi alcohol, tp Terapi yang perlu dilakukan
merokok, minum obat hipertensi, kolesterol tinggi, a. Melanjutkan diet tanpa minum obat
mengeluh sering berkemih. Kakaknya punya b. Olahraga
 c. Mulai minum / diberi resep metformin
d. Dipantau kadar gula darahnya
e. …..
7. Myxedema terjadi pada ……
8. Pelajari hirsusitisme apa, virilisme apa
9. Yang bukan merupakan hormone hopofisis
anterior
a. ADH b. FSH c. LH d. ACRH
e. TSH
10. Hipoglikemi dpt disebabkan kecuali….
a. Krg Olahraga b. Diabetes c.
Lapar d. …. e. Alkohol abuse
11. Diagnosis DM tipe 1 gimana, ada antibody
ditemukan
12. Cari tahu onset insulin
13. Sperma disimpan dimana……..
14. Diabetes saat hamil namanya apa……..
15. Progesteron dihasilkan dimana……..
16. Hormon yang mempengaruhi pertumbuhan
alami
17. Pada sperma yg punya enzim lisis (akrosom)
18. Kalo hiperaldosteron gmn (apakah hipertensi,
hipokalemia, penekanan rennin, pelajari aja)
19. Diabetes nefropati gmn…
20. Sel beta pulau langerhans selain insulin
menghasilkan apa…..
21. Hipertiroidisme, manifestasi klinik nya gmn
a. goiter b. penyakit Grave c. …. d. ….
e. …..
22. Sindroma Cushing tp bukan cushing disease
ditandai dengan apa….
23. Penghasil Sel sperma (sel leydig)

LATIHAN SOAL OGES - DIABETES

1. The risk factors for type 1 diabetes include all 6. Prediabetes is associated with all of the
of the following except: following except:
a. Diet a. Increased risk of developing type 2 diabetes
b. Genetic b. Impaired glucose tolerance
c. Autoimmune c. Increased risk of heart disease and stroke
d. Environmental d. Increased risk of developing type 1 diabetes
2. Type 2 diabetes accounts for approximately 7. Diabetics are at increased risk of heart disease
what percentage of all cases of diabetes in if they also:
adults? a. Smoke
a. 55%-60% b. Have high HDL cholesterol levels
b. 35%-40% c. Take aspirin
c. 90-95% d. Consume a high-fiber diet
d. 25-30% 8. Blood sugar is well controlled when
3. Risk factors for type 2 diabetes include all of Hemoglobin A1C is:
the following except: a. Below 7%
a. Advanced age b. Between 12%-15%
b. Obesity c. Less than 180 mg/dL
c. Smoking d. Between 90 and 130 mg/dL
d. Physical inactivity 9. Excessive thirst and volume of very dilute
4. What percentage of women with gestational urine may be symptoms of:
diabetes is diagnosed with type 2 diabetes a. Urinary tract infection
following pregnancy? b. Diabetes insipidus
a. 25%-30% c. Viral gastroenteritis
b. 5%-10% d. Hypoglycemia
c. <5% 10. Among female children and adolescents, the
d. 20%-25% first sign of type 1 diabetes may be:
5. Untreated diabetes may result in all of the a. Rapid weight gain
following except: b. Constipation
a. Blindness c. Genital candidiasis
b. Cardiovascular disease d. Insomnia
c. Kidney disease 11. Untreated hyperglycemia may lead to all of
d. Tinnitus the following complications except:
a. Hyperosmolar syndrome 19. Which of the following regimens offers the
b Vitiligo best blood glucose control for persons with type
c. Diabetic ketoacidosis 1 diabetes?
d. Coma a. A single anti-diabetes drugs
12. Hyperinsulinemia may be caused by all of b. Once daily insulin injections
the following except: c. A combination of oral anti-diabetic medications
a. An insulinoma d. Three or four injections per day of different
b. Nesidioblastosis types of insulin.
c. Insulin resistance 20. Diabetic neuropathies are diagnosed using
d. Type 1 diabetes all of the following except:
13. Which statement about diabetes is false? a. Nerve conduction studies or electromyography
a. The U.S. prevalence of diabetes is decreasing b. Ultrasound
b. Diabetes is the seventh leading cause of death in c. Foot examinations
the United States d. Minnesota Mutiphasic Personality inventory
c. Diabetes is the leading cause of blindness among (MMPI)
persons age 20 to 74
d. Diabetes is the leading cause of kidney failure Answers and Explanations
14. The lifetime risk of developing diabetes for a 1. A: Type 1 diabetes is a primary failure of
male born in 2000 is: pancreatic beta cells to produce insulin. It primarily
a. 1 in 5 affects children and young adults and is unrelated to
b. 1 in 3 diet.
c. 2 in 5 2. C: Type 2 diabetes accounts for the
d. 1 in 2 overwhelming majority of cases diagnosed in adults.
15. Which of the following measures does not It develops gradually, beginning with insulin
help to prevent diabetes complications? resistance and as the requirement for insulin
a. Controlling blood glucose increases, the pancreas becomes progressively less
b. Controlling blood pressure and blood lipids able to produce it.
c. Eliminating all carbohydrates from the diet 3. C: Additional risk factors for type 2 diabetes are
d. Prompt detection of diabetic eye and kidney a family history of diabetes, impaired glucose
disease metabolism, history of gestational diabetes, and
16. Proliferative retinopathy is often treated race/ethnicity. African-Americans,
using: Hispanics/Latinos, Asian Americans, Native
a. Tonometry Hawaiians, Pacific Islanders, and Native Americans
b. Fluorescein angiogram are at greater risk of developing diabetes than
c. Antibiotics whites.
d. Laser surgery 4. B: African-American, Hispanic/Latina and
17. Which of the following diabetes drugs acts Native American women are at greater risk of
by decreasing the amount of glucose produced developing gestational diabetes than are white
by the liver? women. Women who experience gestational
a. Sulfonylureas diabetes are at increased risk of developing diabetes
b. Meglitinides during the decade following pregnancy.
c. Biguanides 5. D: Untreated diabetes also may result in loss of
d. Alpha-glucosidase inhibitors lower limbs to amputation and death.
18. The benefits of using an insulin pump 6. D: Persons with elevated glucose levels that do
include all of the following except: not yet meet the criteria for diabetes are considered
a. By continuously providing insulin they eliminate to have prediabetes and are at increased risk of
the need for injections of insulin developing type 2 diabetes. Weight loss and
b. They simplify management of blood sugar and increasing physical activity can help people with
often improve A1C prediabetes prevent or postpone the onset of type 2
c. They enable exercise without compensatory diabetes.
carbohydrate consumption 7. A: Diabetics who smoke are at greater risk of
d. They help with weight loss developing heart disease because both diabetes and
smoking act to narrow blood vessels. Smoking also
is associated with increased risk of eye problems and
may compromise circulation to the legs.
8. A: A1c measures the percentage of hemoglobin
that is glycated and determines average blood
glucose during the two to three months prior to
testing. Used as a diagnostic tool, A1C levels of
6.5% or higher on two tests indicate diabetes. A1C
of 6% to 6.5% is considered prediabetes.
9. B: Diabetes insipidus is a condition in which the
kidneys are unable to conserve water, often because
there is insufficient antidiuretic hormone (ADH) or
the kidneys are unable to respond to ADH. Although
diabetes mellitus may present with similar
symptoms, the disorders are different. Diabetes
insipidus does not involve hyperglycemia.
10. C: The signs and symptoms that suggest type 1
diabetes include excessive thirst, hunger, urination,
weight loss, fatigue, irritability, blurred vision, and
infection with candida albicans (also known as yeast
infections).
11. B: Excessively high blood sugar or prolonged
hyperglycemia can cause diabetic ketoacidosis, the
condition in which the body breaks down fat for
energy and ketones spill into the urine. Diabetic
hyperosmolar syndrome occurs when blood sugar is
excessively high and available insulin is ineffective.
In this case, the body cannot use glucose or fat for
energy and glucose is excreted in the urine. Without
immediate medical attention, both conditions may
result in coma or death.
12. D: Hyperinsulinemia indicates a difficulty in
blood sugar regulation; the pancreas is working to
produce enough insulin to regulate blood sugar.
Hyperinsulinemia may be cause by a tumor of
insulin-producing cells (an insulinoma), excessive
numbers of insulin producing cells
(nesidioblastosis), or insulin resistance.
13. A: The prevalence of diabetes is increasing
dramatically. The CDC reports an increase of more
than three million cases in the two years from 2006
to 2008. By 2008, an estimated 8% of the U.S.
population had diabetes.
14. B: The CDC reports that adults in the U.S. are at
high risk of developing diabetes. Females are at
higher risk than males and Hispanics/Latinos are at
the greatest risk.
15. C: There is no evidence that eliminating all
sugar from the diet benefits people with diabetes. It
is more important for diabetics to manage and
control total carbohydrate intake so that their blood
glucose levels remain on target. Controlling blood
glucose, blood pressure, and blood lipid levels can
aid in the prevention of complications associated
with diabetes.
16. D: Scatter laser treatment is used to shrink
abnormal blood vessels in an effort to preserve
vision. When there is significant bleeding in the eye,
it is removed in a procedure known as vitrectomy.
Tonometry is a diagnostic test that measures
pressure inside the eye. A fluorescein angiogram is
a diagnostic test that traces the flow of dye through
the blood vessels in the retina; it is used to detect
macular edema.
17. C: Biguanides, such as metformin, lower blood
glucose by reducing the amount of glucose produced
by the liver. Sulfonylureas and Meglitinides
stimulate the beta cells of the pancreas to produce
more insulin. Alpha-glucosidase inhibitors block the
breakdown of starches and some sugars, which helps
to reduce blood glucose levels
18. D: Using an insulin pump has many advantages,
including fewer dramatic swings in blood glucose
levels, increased flexibility about diet, and improved
accuracy of insulin doses and delivery; however, the
use of an insulin pump has been associated with
weight gain.
19. D: Because persons with type 1 diabetes do not
produce insulin, they require insulin and cannot be
treated with oral anti-diabetic drugs. Several
injections of insulin per day, calibrated to respond to
measured blood glucose levels, offer the best blood
glucose control and may prevent or postpone the
retinal, renal, and neurological complications of
diabetes.
20. D: Nerve conduction studies assess transmission
of electrical signals through nerves and
electromyography evaluates nerve transmission to
muscles. Ultrasound can assess the responsivity and
function of internal organs that may be
compromised by neurological damage. Foot exams
help to assess peripheral neuropathy and to ensure
the integrity of skin. The MMPI is a psychological
test and is not used to assess diabetic neuropathy.
 Practice Questions on the Reproductive System

1. The main hormone released by the corpus d. Graafian follicle

luteum is progesteron 16. An antrum is characteristic of
1. The hormone that acts on Leydig cells is _____________ follicles.
LH a. Secondary
2. estrogen is the main hormone produced by b. Graafian
granulosa cells. c. Primary
3. True or False: The cremaster muscles d. Primary, secondary, and Graafian
actively regulate the number of sperm e. Secondary and Graafian
made on a daily basis. 17. True or False: An ectopic pregnancy
4. Human egg and sperm are similar in that: occurs when a secondary oocyte is
a. About the same number are fertilized in and implants in the uterine
produced per month tube.
b. They have the same degree of 18. The rounded region of the uterus superior
motility to the entrance of the uterine tubes is the:
c. They have the same number of a. Ampulla
chromosomes b. Fundus
d. They are about the same size c. Corpus
5. The testosterone-producing cells of the d. Isthmus
testes are called: e. Superior flexure
a. Sertoli cells 19. Primary oocytes are:
b. Granulosa cells a. Haploid
c. Spermatogonia b. Diploid
d. Leydig cells c. Polyploid
6. The testicular cells most involved with the d. Aneuploid
construction of the blood-testes barrier are 20. Consider the following 3 tubes. Which is
the: the correct order sperm travels through
a. Sertoli cells them.
b. Granulosa cells 1. Epididymis
c. Spermatogonia 2. Oviduct
d. Leydig cells 3. Ejaculatory Duct
7. The soft mucosal lining of the uterus is the Answer....
endometrium a. 1,3,2
8. The anterior pituitary hormone that b. 3,1,2
triggers ovulation is: LH c. 2,1,3
9. The fetus develops and grows in the uterus d. 2,3,1
10. The external sac enclosing the testes is the
skrotum 2. During menstruation, the stratum
11. ovulation is the release of the secondary Functionalis of endometrium is sloughed
oocyte from the ovary. off.
12. The corpora cavernosa are(n): male 3. True or False: Days 1-5 of the menstrual
erectile tissue cycle is the proliferative phase.
13. The female homologue of the scrotum is 4. The corpus luteum secretes progesterone
the labia majora which negatively feeds back and inhibits
14. Ejaculation is a simpatik response whereas the release of:
erection is a parasimpatik response. a. ABP and ICSH
15. An oocyte surrounded by one layer of b. LH and ICSH
squamous follicle-like cells is most likely.. c. LH and FSH
a. Primordial follicle d. FSH and TSH
b. Primary follicle 5. Which of the following is correct relative
c. Secondary follicle to the female anatomy?
 a. The vaginal orifice is the most
dorsal of the 3 openings in the
perineum
b. The urethra is between the
vaginal orifice and the anus
c. The anus is between vaginal
orifice and the urethra
d. The urethra is the more ventral of
the 2 openings in the vulva
6. The normal diploid number of human
chromosomes is 46
7. Sertoli cells produce:
a. Mucus
b. Androgen-binding protein
(inhibin)
c. Testosterone
d. FSH
e. LH
8. Spermatogenesis BEGINS in the:
a. Epididymis
b. Uterine horn
c. Rete testes
d. Seminiferous tubules
9. The site of oogenesis is the:
a. Ovary
b. Ovum
c. Oocyte
d. Oviduct
e. Ovarian lacunae
10. In the 1st phase of the menstrual cycle:
a. Oogonia differentiate into
primary oocytes
1. jelaskan mekanisme kerja hingga target tinggak molekuler dan seluler dari obat berikut ini beserta
indikasi DM tipe 1 ataukah DM tipe 2 : alfa glukose inhibitor, biguanida, insulin, thiazolidindion
Questions 1 and 2 refer to the following case
study.
A 54-year-old man who is new to the area presents
for a routine medical evaluation. He reports a
history of hypertension for which he takes long-
acting diltiazem. He also reports mild fatigue and
notes that he has experienced nocturnal voiding
approximately twice per week for the past 18
months. He denies drinking alcohol but has a 30
pack-year history of smoking. He has a 48-year-old
brother with type 2 diabetes, and his father died of
a myocardial infarction at age 53 years. On
physical examination, the patient is obese and his
blood pressure is 140/90 mm Hg and pulse is 60
bpm. Other results of physical examination are
b. The thickness of the stratum
basalis decreases dramatically
c. The Graafian follicle ruptures
d. The dominant follicle is
opsonized
e. None of the above
11. During ovulation, all of the following
occur EXCEPT:
a. Rupture of the Graafian follicle
b. Estrogen production reaches its
lowest point (estrogen tinggi saat
ovulasi)
c. FSH and LH plasma levels surge
d. Corpus luteum is formed
12. Which of the following would be the most
likely site of fertilization?
a. Ovary
b. Uterine tube
c. Fundus of uterus
d. Cervix
e. Vagina
13. Human chorionic gonadotropin:
a. Begins to be produced 4 months
after fertilization
b. Is produced by the prostate gland
c. Is produced by the corpus luteum
d. Is present ONLY if a successful
fertilization has occurred
e. Signals that endometriosis has
begun
normal. A fasting plasma glucose level is 138
mg/dL.
1. What is the most appropriate management of
the patient’s glucose level?
A) Repeat the fasting blood glucose measurement
on another day
B) Order a glycosylated hemoglobin level
C) Perform an oral glucose tolerance test
D) Follow up with a fasting blood glucose
measurement in 1 year
2. A second fasting glucose measurement for this
patient is 157 mg/dL. All of the following studies
would be helpful at this time EXCEPT:
A) Electrocardiography
B) Fasting lipid panel
C) 24-Hour urine cortisol level
D) Glycosylated hemoglobin level
Questions 3 and 4 refer to the following
laboratory studies.
The patient’s total cholesterol level is 290 mg/dL,
and his low-density lipoprotein and triglyceride
levels are increased. His high-density lipoprotein
level is 31 mg/dL. Based on his laboratory results,
the patient is diagnosed with type 2 diabetes. He
receives diabetes education and dietary counseling.
At this time, his ophthalmoscopic examination and
urinalysis are normal, and no microalbuminuria is
present. Results from an exercise stress test are
normal.
The patient returns for follow-up testing 4 months
later. He continues to smoke but claims he has been
compliant with his diet; however, his weight is
unchanged. His glycosylated hemoglobin level has
increased from 7.2 mg/dL at baseline to 7.5 mg/dL.
He returns again for follow-up 7 months later. His
blood pressure is now 150/80 mmHg. Repeated
laboratory testing reveals a fasting blood glucose
level of 210 mg/dL. His glycosylated hemoglobin
level has increased to 8.2 mg/dL.
3. Which therapeutic measure would be most
appropriate at this time?
A) Begin therapy with insulin
B) Begin therapy with metformin
C) Begin therapy with acarbose
D) Try 6 more months of behavior modification
4. Which of the following statements is TRUE?
A) A standardized diet is essential for all patients
with diabetes
B) Poorly controlled diabetic patients should be
encouraged to exercise vigorously to improve
glucose control
C) Meticulous glucose control with multiple insulin
injections per day based on the Diabetes Control
and Complications Trial results should be
universally prescribed
D) None of the above
EXPLANATION OF ANSWERS
1. (A) Repeat the fasting blood glucose
measurement on another day. The patient’s
fasting plasma glucose level is 126 mg/dL or more.
Repeating the test to confirm the level would
establish the diagnosis of diabetes. This patient’s
symptoms suggest that he may have had
hyperglycemia for many months.
Potential answer C (ie, perform an oral glucose
tolerance test) is not necessarily incorrect, but oral
glucose testing is no longer routinely ordered.
2. (C) 24-Hour urine cortisol level. This patient’s
diagnosis is type 2 diabetes. A baseline glycosylated
hemoglobin (HbA1C) level would be helpful now in
monitoring therapy. In addition, the patient has
serious risk factors for coronary artery disease.
Baseline electrocardiography and perhaps an
exercise stress test would be useful. There is no
reason to evaluate the patient for Cushing’s
syndrome or to look for secondary causes of
hypertension at this time.
3. (B) Begin therapy with metformin. The patient
is failing diet and lifestyle modifications. His
HbA1C level has increased. At this time,
pharmacotherapy is indicated. He is obese and has
hypertension and hyperlipidemia, all of which
strongly suggest insulin resistance; thus, metformin
is a logical therapeutic choice. Medication therapy
should be directed at improving his insulin
resistance at this time. A response to metformin may
demonstrate some improvement of the other
abnormalities associated with insulin resistance.
Acarbose is appropriate for persons with mild
fasting hyperglycemia and postprandial
hyperglycemia.
4. (D) None of the above. None of these statements
(ie, “A standardized diet is essential for all patients
with diabetes;” “Poorly controlled diabetic patients
should be encouraged to exercise vigorously to
improve
glucose control;” and “Meticulous glucose control
with multiple insulin injections per day based on the
Diabetes Control and Complications Trial results
should be universally prescribed”) is true. Care of
the diabetic patient must be individualized based on
management goals. Medical, social, and
psychological factors influence the management of
diabetic patients. It is inappropriate for physicians to
encourage vigorous exercise to improve glucose
control. Meticulous glucose control should be
considered only in selected, highly motivated
patients with realistic treatment goals.
1. Acromegaly is most frequently diagnosed in:
a. Middle-aged adults
b. Newborns
c. Children ages 2 to 5
d. Adults age 65 and older
2. Grave's disease is:
a. The most common cause of hypothyroidism
b. The most common cause of hyperparathyroidism
c. The most common cause of hyperthyroidism
d. The most common cause of adrenal insufficiency
3. Symptoms of Grave's ophthalmopathy
include all of the following except:
a. Bulging eyeballs
b. Dry, irritated eyes and puffy eyelids
c. Cataracts
d. Light sensitivity
c. A form of hyperthyroidism
d. A rare form of hypothyroidism
9. Persons at increased risk of developing
Hashimoto's disease include all of the following
except:
a. Persons with vitiligo
b. Asian-Americans
c. Persons with rheumatoid arthritis
d. Persons with Addison's disease
10. All of the following statements about
Hashimoto's disease are true except:
a. Many patients are entirely asymptomatic
b. Not all patients become hypothyroid
c. Most cases of obesity are attributable to
Hashimoto's disease
d. Hypothyroidism may be subclinical

4. An ACTH stimulation test is commonly used 11. The most common benign tumor of the
to diagnose: pituitary gland is a:
a. Grave's disease a. Glioma
b. Adrenal insufficiency and Addison's disease b Prolactinoma
c. Cystic fibrosis c. Carcinoid tumor
d. Hashimoto's disease d. Islet cell tumor

5. All of the following are symptoms of 12. Symptoms of polycystic ovarian syndrome
Cushing's syndrome except: (PCOS) may include all of the following except:
a. Severe fatigue and weakness a. Pelvic pain
b. Hypertension and elevated blood glucose b. Acne, oily skin, and dandruff
c. A protruding hump between the shoulders c. Infertility
d. Hair loss d. Weight Loss

6. Which of the following conditions is caused by 13. Women with PCOS are at increased risk for
long-term exposure to high levels of cortisol? all of the following except:
a. Addison's disease a. Pregnancy
b. Crohn's disease b. Diabetes
c. Adrenal insufficiency c. Cardiovascular disease
d. Cushing's syndrome d. Metabolic syndrome

7. A "sweat test" or newborn screening may be 14. All of the following organs may be affected
used to detect: by multiple endocrine neoplasia type 1 except:
a. Cystic fibrosis a. Parathyroid glands
b. Adrenal insufficiency b. Kidneys
c. Grave's disease c. Pancreas and Duodenum
d. Hypothyroidism d. Pituitary gland

8. Hashimoto's disease is: 15. What is the treatment for

a. Chronic inflammation of the thyroid gland hyperparathyroidism?
b. Diagnosed most frequently in Asian-Americans a. Synthetic thyroid hormone
and Pacific Islanders b. Desiccated thyroid hormone
c. Surgical removal of the glands
d. Calcium and phosphate
16. The most common causes of death in people
with cystic fibrosis is:
a. Dehydration
b. Opportunistic infection
c. Lung cancer
d. Respiratory failure
17. Untreated hyperthyroidism during
pregnancy may result in all of the following
except:
a. Premature birth and miscarriage
b. Low birthweight
c. Autism
d. Preeclampsia
18. Short stature and undeveloped ovaries
suggest which of the following disorders:
a. Polycystic ovarian syndrome
b. Prolactinoma
c. Grave's disease
d. Turner syndrome
19. Endocrine disorders may be triggered by all
of the following except:
a. Stress
b. Infection
c. Chemicals in the food chain and environment
d. Cell phone use
20. An analysis of data from the Women's
Health Initiative questioned the use of which
therapy to prevent heart disease?
a. Synthetic thyroid hormone
b. Oral contraceptives
c. Weight-loss drugs
d. Postmenopausal hormone replacement therapy
Answers and Explanations
1. A: Acromegaly results from benign tumors on the
pituitary gland that produce excessive amounts of
growth hormone. Although symptoms may present
at any age, the diagnosis generally occurs in middle-
aged persons. Untreated, the consequences of
acromegaly include type 2 diabetes, hypertension
and increased risk of cardiovascular disease, arthritis
and colon polyps.
2. C: Grave's disease is an autoimmune disorder
characterized by an enlarged thyroid gland and
overproduction of thyroid hormones producing
symptoms of hyperthyroidism such as rapid
heartbeat, heat intolerance, agitation or irritability,
weight loss, and trouble sleeping. It usually presents
in persons age 20 to 40 and it is much more common
in women than in men.
3. C: Grave's ophthalmopathy is an inflammation of
tissue behind the eye causing the eyeballs to bulge.
In addition to the above-mentioned symptoms,
Grave's ophthalmopathy may cause pressure or pain
in the eyes, double vision, and trouble moving the
eyes. About one-quarter of persons with Grave's
disease develop Grave's ophthalmopathy. The
condition is frequently self-limiting, resolving
without treatment over the course of a year or two.
4. B: The ACTH stimulation test measures blood
and urine cortisol before and after injection of
ACTH. Persons with chronic adrenal insufficiency
or Addison's disease generally do not respond with
the expected increase in cortisol levels. An abnormal
ACTH stimulation test may be followed with a CRH
stimulation test to pinpoint the cause of adrenal
insufficiency.
5. D: Cushing's syndrome also may cause fragile,
thin skin prone to bruises and stretch marks on the
abdomen and thighs as well as excessive thirst and
urination and mood changes such as depression and
anxiety. Women who suffer from high levels of
cortisol often have irregular menstrual cycles or
amenorrhea and present with hair on their faces,
necks, chests, abdomens, and thighs.
6. D: Cushing's syndrome is a form of
hypercortisolism. Risk factors for Cushing's
syndrome are obesity, diabetes, and hypertension.
Cushing's syndrome is most frequently diagnosed in
persons ages 20 to 50 who have characteristic round
faces, upper body obesity, large necks, and relatively
thin limbs.
7. A: Cystic fibrosis is the most common inherited
fatal disease of children and young adults in the
United States. Cystic fibrosis is usually diagnosed
by the time an affected child is three years old.
Often, the only signs are a persistent cough, a large
appetite but poor weight gain, an extremely salty
taste to the skin, and large, foul-smelling bowel
movements. A simple sweat test is currently the
standard diagnostic test. The test measures the
amount of salt in the sweat; abnormally high levels
are the hallmark of the disorder.
8. A: Hashimoto's disease is the most common cause
of hypothyroidism. It is an autoimmune disease that
produces chronic inflammation of the thyroid gland.
More women are affected than men and it is
generally diagnosed in persons ages 40 to 60. When
treatment is indicated, synthetic T4 is administered.
9. B: Along with the above-mentioned groups,
persons with type 1 diabetes and persons suffering
from pernicious anemia (insufficient vitamin b12)
are at increased risk of developing Hashimoto's
disease. Because it tends to run in families, there is
likely a genetic susceptibility as well.
Environmental factors such as excessive iodine
consumption and selected drugs also have been
implicated as potential risk factors.
10. C: Although weight gain may be a symptom of
Hashimoto's disease, the majority of obese people
have normal thyroid function; rarely is thyroid
disorder the sole cause of obesity. Other symptoms
of Hashimoto's disease include fatigue, cold
intolerance, joint pain, myalgias, constipation, dry
hair, skin and nails, impaired fertility, slow heart
rate, and depression.
11. B: Prolactinomas can cause symptoms by
releasing excessive amounts of prolactin into the
blood or mechanically by pressing on surrounding
tissues. In women, symptoms may include menstrual
irregularities and infertility; in men erectile
dysfunction and libido may be impaired.
12. D: In addition to the above-mentioned
symptoms, PCOS may cause menstrual
irregularities, thinning hair or male-pattern baldness,
thick skin or dark patches of skin and excessive hair
growth on the face, chest, abdomen, thumbs and
toes.
13. A: Women with PCOS produce excessive
amounts of androgens and do not release ova during
ovulation, which seriously compromises their ability
to conceive. Although women with PCOS can
become pregnant, often by using assistive
reproductive technology, they are at increased risk
for miscarriage.
14. B: Multiple endocrine neoplasia type 1, also
known as Werner's syndrome, is a heritable disorder
that causes tumors in endocrine glands and the
duodenum. Although the tumors associated with
multiple endocrine neoplasia type 1 are generally
benign, they can produce symptoms chemically by
releasing excessive amounts of hormones or
mechanically by pressing on adjacent tissue.
15. C: When hyperparathyroidism requires
treatment, surgery is the treatment of choice and is
considered curative for 95% of cases. Because
untreated hyperparathyroidism may elevate blood
and urine levels of calcium and deplete phosphorus,
bones and teeth may lose the minerals needed to
remain strong.
16. D: Declining pulmonary function is a hallmark
of cystic fibrosis. Drugs such as Pulmozyme
(dornase alfa) and Zithromax (azithromycin) can
slow the progression of lung disease and mechanical
physical therapy devices help CF patients to breathe
more easily by loosening and dislodging mucus. For
some patients with severe lung damage, lung
transplantation is a treatment option.
17. C: In addition to the above-mentioned
complications of uncontrolled hyperthyroidism in
pregnancy, expectant mothers may suffer congestive
heart failure and thyroid storm, which is life-
threatening thyrotoxicosis with symptoms that
include agitation, confusion, tachycardia, shaking,
sweating, diarrhea, fever, and restlessness.
18. D: Turner syndrome results from a chromosomal
abnormality and occurs in an estimated 1 in 2,500
female births. It occurs more frequently in preterm
pregnancies. Affected women are shorter than
average and are infertile because they lack ovarian
function. They also may have webbed necks, broad
chests, arms that turn out from the elbow,
lymphedema of the hands and feet and skeletal,
cardiac, and renal problems.
19. D: Endocrine function may be influenced by
myriad factors. In addition to the above-mentioned,
there is evidence that exposure to naturally
occurring and man-made endocrine disruptors such
as tributyltin, certain bioaccumulating chlorinated
compounds, and phytoestrogens is widespread and
in susceptible individuals, may trigger endocrine
disorders.
20. D: The results of the Women's Health Initiative
study prompted the U.S. Food and Drug
Administration (FDA) to advise against using
hormone therapy (estrogen-alone or estrogen-plus-
progestin) to prevent heart disease. When hormone
replacement therapy is used to treat moderate to
severe hot flashes and symptoms of vulvar and
vaginal atrophy it should used at the lowest doses for
the shortest duration needed to achieve treatment
objectives.