COMPILE ICM 2 – POOPS

1. Ada motorcycle accident trus orgnya langsung unconscious. Left hemiparesis, matanya anisokor.

Trus ditnya kenapa dia unconscious?

a. Gr2 concussion

b. Hematoma menekan brainstem  depresi respiratory

c. Hemorrhage

d. Skeletal fracture

e. Lupa

2. ditnya gmn status spinothalamicnya?  of pain, temperature, and crude touch

a. intact

b. ga intact

c. gabsa di cek

d. lupa

e. lupa

3. ditnya kenapa left hemiparesis. Kernohan phenomenon intinya  ipsilateral dengan lesi.

4. trus mau diapain firstnya? Pasang cervical collar

5. dia ceritanya metabolic acidosis trus mau alkalisasi urine. Kira2 zat apa yg bkin dia begini?

Aspirin, salicylate acid overdose

6. organophosphate poisoning  insektisida  sludge bbb, creased saliva and tear production,

diarrhea, vomiting, small pupils, sweating, muscle tremors, and confusion.

7. klo stemi anterior itu siapa yg memperdarahi? LAD

8. trus ada org chest pain substernal to the neck and left arm trus di ecg ga ada deviasi. Kira2

orgnya mau diapain?

a. Suruh plg

b. Observasi smbil nunggu enzim jantung

c. Telpon buat urgent pci

d. Telpon buat angiographu

9. Psychopath

10. Ada cowo lakuin verbal sma physical abuse ke istrinya krna dissatisfaction. Dia jarang kasih uang

bulanan ke istrinya , kasih kalau diminta. Kenapa dia??

a. Verbal abuse

b. Physical abuse

c. Emotional abuse

d. Economical abuse

e. Lupa
11. Ceritanya dia app akut trus peritonitis diffuse

Kenapa dia dari epigastric dlu sakitnya? Berdasarkan embryonic + saraf otonom visceral

apa yang harus dilakukan? Emergency laparotomy

12. Itung gcs dewasa

13. Itung degree shock hemorrhagic (2 soal)

14. Tentuin burn brp persen trus itung parklandnya??? 4 ml / kgbb/ % TBSA
15. Anak kecil febrile seizure 3x dalam staun. Perlu maintenance ato ga? Kalau iya kasih apa, dosisnya

brp???

- Valproic acid 15 – 40 mg/kg/day  hepatotoxic < 2 years

- Phenobarbital 3-4 mg / kg / day

Dengan duration therapy until 1 year with no seizure.--> should consider in infant < 12 bulan,

complex FS, neurodeficit after / before seizure.

16. Dosis max misoprostol 1200 MICROGRAM

17. Febrile seizure dibawah 10 bulan lakuin LP

Febrile seizure boleh di LP kalo :

- Infant < 12 bulan dengan prolonged complex febrile seizure / febrile status epilepticus

- 12 – 18 bulan

18. N-acetylsistein antidote nya acetaminofen  UPPER SYMPATHOMIMETIC

19. spinal cord injury klo dibilang ada grjala di biceps dan lateral arm itu brarti kena di C5 kayak

soal neuro 2014

bicep : C5 – C6

tricep : C7 – C8

cremaster : L1 – L2

patella : L3 – L4

Achilles : S1-S2
20. status epilepticus obat pilihannya LORAZEPAM

21. valium itu sama kayak Diazepam  VALIUM = DIAZEPAM TABLET

22. suicide gesture bikin mati, tapi bisa diobatin. mau diapain (psychotherapy aja)

23. ada ketusuk pisau di right upper quadrant. Mau diapain? Yg pasti jgn pilih yg cabut pisaunya

24. trus kan di resus tp ttp unstable  emergency laparotomy

25. ada gmbar xray yg air fluid level. Orgnya ada distensi abdomen, poop berdarah, ampulla recti

prolapse, trus ada metallic sound di usus, gabsa poop dan kentut  total obstruction et causa

right colon cancer

26. trus mau diapain? NPO, NGT , kateter buat dekompresi (ini dijadiin 2 nomer)

27. ada cewe ceritanya dia minum pil kb estrogen trus dia long flight dari Europe ke Singapore non

stop, trus SOB (PE) intinya. Definitive treatmentnya apa ? LMWH (DVT  PE)

28. trus ada stroke , pas ekg ada afib , di carotid ada bruit . what next ? lakuin usg carotid (lupa

nama kerennya)  USG CAROTID DOPPLER

29. ada bayi dia seizure trus GCS 3/15  mau diapain? Rectal diazepam, ato intubasi dulu

30. ada vt  DC shock

31. ada soal pneumothorax (PF jelas bngt)  what first ? O2 ato xray ato needle decomp

32. trus ceritnya di xray bneran pneumothorax  lakuin needle decomp buat acute tension

pneumothoraxnya

33. ada org dia mulutnya penuh darah, mandibular fracture, gabsa nafas lah intinya soalnya

saturation o2 nya turun jadinya gmn? Suction dl ato ett ato mau tracheostomy?

34. Ada soal dikasih tau , org kalau seizure 1x 2 hari yg lalu, skrg jg seizure?

Ini epilepsy ato acute symptomatic seizure (ada 2 nomer soal begini tipenya)
 EPILEPSI : 2 UNPROVOKED SEIZURE DALAM 24 JAM

35. Ceritanya dia status epilepticus trus dikasih fenitoin, seizure berenti. Trus mau diapain? Ttp kasih

IV fenitoin, maintenance fenitoin/ fenobarbital (apalin dosisnya soalnya ada dosisnya yg salah

ada yg bner)

MAINTENANCE ADULT 

- IV phenytoin 18 mg/kg

- Phenytoin oral 3 x 100 mg  control 1 minggu

36. Head tilt test buat syncope yang mana  ATYPICAL SYNCOPE (VASOVAGAL /

NEUROCARDIOGENIC)

37. Trus ada orang berdiri lamaaa bngt trus akhirnya pingsan. Ini syncope apa  ORTHOSTATIC

38. Trus ada org pneumoni, mau diapain (mucolitik sma reliever)  ini dijadiin 2 nomer 

ANTIBIOTIC ( 1ST : GENTAMICIN, - CIN LAINNYA, imipenem, macrolide, beta lactam, vancomycin

 MRSA) DAN MUCOLITIC (acetylsistein)

39. Anaphylactic shock dikasih apa ? adrenaline / EPINEPHRINE  1 : 1000

40. Ada orang main petasan trus meletus kena tangan leher sma muka  watch out buat inhalation

burn  intubasi

41. PPH gr2 dia kembar trus lama persalinannya  uterine atony

42. Septic abortion  infeksi  antibiotic : imipemem (single) / combination : ampicillin + genta +

clinda

43. Threatened abortion  OUE ketutup (liat Williams)

44. Kalau PPH pertama2 lakuin dulu yg namanya resus. Trus nextnya massage uterine smbil mikir ini

penyebab pph nya kenapa HAEMOSTASIS

45. Uterine atony mau dikasih apa ? oxytocin

46. Blighted ovum (nanti dikasih USG dia ada gestasional sac tp ga ada isinya)  MOLA

47. Trus ada org shock mau diapain

Gua bngung antara resus 20 ml/ kg atau kasih 2000ml dengan large IV (gua pilih yg kedua)
 48. Ada orang motorcycle accident dia paresis trus lama2 jadi hyperreflexia  spinal shock  lmn 

umn

49. Trus kenapa ada unstable angina? Plaque rupture

50. Lucid interval itu epidural hematoma

51. Trus kalau ada hematoma gede mau diapain  diangkat hematomanya trus prognosisnya bagus

(DNGERIN PAS DOKTER YESAYA NGAJAR). APA YG DIOMONGIN BNERAN KELUAR

SEKIAN GUYS GUA CMN APAL SEGINI

SOAL ICM KO GIL

Laki-laki 45 y.o sesak.

Diperburuk berbaring, no cough. PF : GCS 7, BP 100/80, HR 120, RR 45, Temp 36

a. O2 Nasal canul 35/ per menit

b. Upright position + diuretics

c. RL 500 mL

d. Consul SpJP SpP

e. Secure airway  Prinsip A-B-C-D-E

Intubasi  GCS < 8

 Airway : Suction, Head tilt chin lift, Oropharyngeal Airway (kalo ga bisa intubasi/ pasien

ngorok ‘snoring’)

 Breathing : Check ventilation, IPPA, RR, Suara Napas, Pengembangan dada

o Intervention  O2 (Nasal Canul)

o 1 Liter O2 , increace O2 fraction 4% (FiO2)

 Nasal Canul = max. 3 - 5L (>5L may cause iritasi mukosa hidung)

 Face mask = 5 – 10 L

 NRM , RM = 7 – 10 L

 Circulation : HR, BP, Skin perfusion (Check CRT)

 o Intervention  IV line 2000 2 line (in multiple trauma patient)

 Disability : GCS, Pupil, Lateralisasi

o No intervention except GCS <8 back to airway, breathing, circulation

 Exposure : Prevent hypothermia, Head to toe examination.

o Log roll

Setelah initial treatment, BP 120/80, HR 90, RR 25, O2 sat 98.

Secondary survey : Pitting edema grade 3 in all extremities.

Next management ?

a. O2 Nasal canul 35/ per menit

b. Upright position + diuretics

c. RL 500 mL

d. Consul SpJP SpP

e. Secure airway

HAEMORRAGIC SHOCK CLASS 1-4  Treatment  Respond (3)

Respond :
Full  Monitor + maintain fluid (Colloid)

Partial  Consider blood product

No respond  Colloid + Blood product

Algorithm :

 SEIZURE
 OBSGYN
o Indikasi SC

o Eclampsia, Preeclampsia
 CARDIO  ACLS
o Rhythm Shockable (VT, VF), Non Shockable (PEA, Asystole)
 ANAPHYLACTIC SHOCK
o Epinephrine 1:1000 dose 0,1-0,2
Laki – laki 27tahun, Nyeri perut kanan bawah 2 days prior. Sehari sebelumnya nyeri di ulu hati. PF : Mc

burney +. GCS 15, BP 120/80, HR 95, HR 16, Temp 37. First treatment?

a. Antipyretic

b. Antiemetic

c. Analgesic

d. IV fluid

After intitial Tx, membaik tapi masi nyeri perut kanan bawah. Next Management?

a. Antibiotic  karena ga demam

b. Consul SpB untuk operasi

c. Observation

d. Dipulangkan
Laki-laki 37 yo, Post KLL Motor dengan mobil. Pasien ga pake helm, terpental dari motor. PF : BP 80/40,

HR 140, RR 21, Temp 38, O2 Sat 85. Initial Management?

Airway : Check GCS, and O2 Saturation.

Intervention :

 Cervical Colar (indication : Jejas diatas clavicula, mekanisme trauma unknown, multiple trauma)

 Face mask

O2 sat jadi 97. 2ndary survey : Hematoma di femur dextra + deformitas, active hemorrhage at tibia

sinistra. Next Management?

a. Bolus 2L 2 line

b. Stop bleeding

c. X-ray cito

d. Consul SpOT untuk operasi segera

After treatment, BP 100/80, 30 mins later BP 70/50. Next management?

a. Bolus 2L 2 line

b. Mengganti crytaloid  colloid

c. Consul

d. Mencari pendarahan aktif lainnya

e. Menggunakan colloid + prepare blood transfusion  partial responder

After 6 hrs monitoring, BP stabil 120/ 80. Next management?

a. Sampel darah untuk check lab

b. Consul SpOT

c. Pembidaian

d. Obsevation
 e. X-Ray  baru consul

Sebelum X-Ray patient complains kebas di kaki. Pasien mengelukan kakinya terasa dingin. Next

Management? Compartment syndrome

a. Emergency fasciotomy

b. CT Scan

c. Operasi untuk ORIF (Open Reduction Internal Fixation) segera

d. Obat neurotropic

ANAPHYLACTIC SHOCK – DR IRMA

1. Seorang laki-laki berumur 47 tahun datang ke IGD dalam keadaan lemah, pucat, kulit dingin,

mukosa kering, mata cekung dan bernafas cepat. Dari anamnesa diketahui bahwa pasien

mengalami luka tembak pada paha kanan yang menyebabkan perdarahan hebat dalam 2 jam

terakhir. Tidak ada riwayat penyakit darah tinggi, jantung, diabetes, alergi obat maupun makanan

sebelum kejadian.

PF : GCS E2V5M4, TD 70/45 mmHg, Nadi 120x/mnt, RR 25-30x/mnt, Saturasi 95%RA

Pertanyaan:
Most likely diagnosis?

Jawaban:

a. Syok hipovolemia

b. Syok anafilaksis

c. Syok sepsis

d. Syok kardiogenik

e. Syok neurogenic

2. Seorang laki-laki berumur 47 tahun datang ke IGD dalam keadaan lemah, pucat, kulit dingin,

mukosa kering, keringat dingin dengan keluhan berat pada dada dan sesak nafas. Dari anamnesa
 diketahui bahwa pasien sempat lari jam 9 sekitar 45 menit sebelum hal ini terjadi. Keluhan tidak

hilang dengan istirahat dan sesak terlihat semakin berat. Pasien mempunyai riwayat merokok 55

pack years dan diabetes tanpa pengobatan rutin.

PF : GCS E2V2M4, TD 70/45 mmHg, Nadi 120x/mnt, RR 25-30x/mnt, Saturasi 95%RA

Pertanyaan:
Most likely diagnosis?
Jawaban:

a. Syok hipovolemia

b. Syok anafilaksis

c. Syok sepsis

d. Syok kardiogenik

e. Syok neurogenic

3. Seorang laki-laki berumur 47 tahun datang ke IGD dalam keadaan lemah, pucat, kulit dingin,

mukosa kering, keringat dingin dengan keluhan sesak nafas. Dari anamnesa diketahui bahwa

pasien mempunyai riwayat luka pada kaki kanan yang tidak kunjung sembuh selama 3 bulan

terakhir. Luka dari kaki menjalar ke tungkai atas disertai bau berbusuk. Pasien mengalami demam

tinggi sekitar 39C sejak 1 minggu yang lalu.

PF : GCS E2V2M4, TD 70/45 mmHg, Nadi 120x/mnt, RR 25-30x/mnt, Saturasi 95%RA

Pertanyaan:
Most likely diagnosis?
Jawaban:

a. Syok hipovolemia

b. Syok anafilaksis

c. Syok sepsis

d. Syok kardiogenik

e. Syok neurogenic
4. Seorang laki-laki berumur 47 tahun datang ke IGD dalam keadaan pucat, kulit dingin dan

mengeluh kerongkongannya kering dan terasa penuh. Dari anamnesa diketahui bahwa pasien

mengeluh gatal-gatal pada bagian muka dan seluruh tubuh sejak 3 jam yang lalu setelah makan

kacang mede. 10 menit SMRS, suara pasien berubah menjadi serak. Tidak ada riwayat seperti ini

sebelumnya. Pasien tidak mempunyai rwyt asthma, jantung, diabetes maupun darah tinggi.

PF : GCS E2V2M2, TD 60/30 mmHg, Nadi 150x/mnt, RR 40/mnt, Saturasi 92%RA

Pertanyaan:
Most likely diagnosis?

Jawaban:

a. Syok hipovolemia

b. Syok anafilaksis

c. Syok sepsis

d. Syok kardiogenik

e. Syok neurogenic

5. Seorang laki-laki berumur 47 tahun datang ke IGD dalam keadaan pucat, kulit dingin dan

mengeluh kerongkongannya kering dan terasa penuh. Dari anamnesa diketahui bahwa pasien

mengeluh gatal-gatal pada bagian muka dan seluruh tubuh sejak 3 jam yang lalu setelah makan

kacang mede. 10 menit SMRS, suara pasien berubah menjadi serak dan pasien mulai mengeluh

sesak nafas. Tidak ada riwayat seperti ini sebelumnya. Pasien tidak mempunyai rwyt asthma,

jantung, diabetes maupun darah tinggi.

PF : GCS E2V2M2, TD 60/30 mmHg, Nadi 150x/mnt, RR 40x/mnt, Saturasi 92%RA

Pertanyaan:
Apa yang akan anda lakukan sebagai dokter IGD?
Jawaban:

a. Pasang infus
 b. Beri cairan IV bolus

c. Beri kortikosteroid IV

d. Intubasi dini

e. Epinephrine IM

f. Beri oxygen 100%

g. Skin Test

6. Pasien tidak sadarkan diri dan alat-alat advanced airway devices sudah datang.

PF : GCS E2V2M2, TD 60/30 mmHg, Nadi 150x/mnt, RR 40x/mnt, Saturasi 90%RA

Pertanyaan:
Apa yang akan anda lakukan berikutnya?
Jawaban:

a. Pasang infus

b. Beri cairan IV bolus

c. Beri kortikosteroid IV

d. Intubasi dini

e. Epinephrine IM

f. Beri oxygen 100%

g. Skin Test

7. Pasien sudah terintubasi dan masih tidak sadarkan diri.

PF : GCS E2V2M2, TD 80/60 mmHg, Nadi 120x/mnt, RR 30x/mnt, Saturasi 92%RA

Pertanyaan:
Apa yang akan anda lakukan berikutnya?

Jawaban:

a. Pasang infus

b. Beri cairan IV bolus

 c. Beri kortikosteroid IV

d. Intubasi dini

e. Epinephrine IM

f. Beri Oxygen 100%

g. Skin test

ICM SOAL SIAP PRINT

1. A 25 years old woman comes to emergency department, complaint with abdominal pain and

vomiting since 1 day. At the physical examination shows the patient looks irritable, apatis, BP 80/50

mmHg, HR 130 x/m, RR 24 X/M, S 38.5o C. At abdominal examination, defance muscular (+) ->

(peritonitis) perut papan, tenderness at all field of abdomen, bowel sound (-). What is the

condition in this patient? Grade 3

a. Shock obstruction : poor perfusion, HR n RR naik, SOB, chest discomfort

b. Shock cardiogenic : chest discomfort, SOB, hampir syncope, bradikardi, excessive takikardi,

dysrhythmia. Di kasi inotropic (dobutamine)

c. Shock neurogenic : flaccid paralysis distal, loss of simpatetik NS (bradikardi, hipotensi,

vasodilatasi, loss of bladder control). Di kasi chronotropic (dopamine)

d. Shock hypovolemic : diare, vomiting, exernal ato internal bleeding, dizziness,
orthostatic changes in vital sign. Takikardi grade 2, Hipotensi grade 3, transfuse
berhenti klo uda lebih dr 10 Hb na.
e. Shock anaphylactic (masuk distributive) : HR n RR naik, bronchoconstric, warm, flushed skin

2. As the diagnosis above, the first step you must do as the emergency doctor is:

a. Antibiotic infusion

b. Strong analgesic i.v

c. Abdominal plain X-Ray

d. Crystalloid rapid infusion

 e. Adrenalin s.c

3. After doing that treatment, the hemodynamic of this patient is still unstable. The Patient still have

in shock condition. What is the next step you must do?

a. Change infusion fluid with Dextrose (cystaloid tapi isinya gula) 5%.
b. Give vasoactive dopamine drug : untuk vasoconstric pembuluh darah
c. Antipiretic drug i.v : obat demam

d. Immediately Laparotomy : klo di ksi resusitasi, transfuse darah, obat tidak berhasil bru ini 

karena no response (tapi laparotomy kalo pasien udah stable)

e. Antiemetic drug i.v : obat antimuntah

4. A 25 years old male presents to emergency with suspected closed left femur fracture after

motorcycle accident. He looks confused with blood pressure 80/60 mmHg and pulse 110 /min.

The doctor splints the fracture and gives large bores rapid crystalloid and colloid infusion but

unsuccessful in stabilizing the hemodynamic. What is the most likely cause of the failure?

a. Inadequate splinting
b. Major artery injury of the left femur : luka di femur bisa sampe 1500ml darah keluar
c. Underlying heart disease : harusnya ada tanda2 sakit jantung

d. Ongoing bleeding in other parts of the body : ini bisa tp biasanya di femur itu mengeluarkan

darahnya banyak klo ud perdarahan. Trus dia gk bisa ada sakit lgi di tmpt lain

e. No blood transfusion

5. A 35 years old female fall from 5 meters height. She presents with acute abdomen and multiple
open fractures on thigh and leg. Emergency laparotomy and temporary external fixation is
performed. After 6 days, the doctor wants to perform definitive stabilization of the fracture. The

reasons to wait until 6 days is to…

a. Achieve early healing of intraabdominal wound

 b. Stabilize hemodynamic

c. Control infection

d. Avoid immunosuppression period

e. Reduce inflammatory reaction

6. A 45 years old male presents with multiple injury and unstable hemodynamic after motorcycle

accident. The doctor found that the lung is clear, no abdominal defans muscular, stable pelvic

(pelvic buat retriperitoneal darah ngumpul d sana) and intact extremity. Where is the likely

source of the bleeding?

a. Thorax : lungnya clear

b. Intra peritoneal : perut papan

c. Retroperitoneal : urine output menurun (ginjal)

d. Intracranial
e. Pelvic cavity : pelvicnya stabil

7. A-17-year old woman comes to your private practice with pain on the left knee in which the pain

become worse at night for 2 months. Pain is aggravating by activity. There was a history of injury

at that knee. Sometime she feels fever and night sweat. The physical examination shows a palpable

mass, tender, warm. Range of motion of the left knee is decrease. The radiographic finding shows

a “sunray appearance (khas osteosarcoma)” on the proximal tibia. Which of the following is the

most rational step?

a. Establish osteosarcoma as diagnosis

b. Give a broad spectrum antibiotic

c. Prepare for immediate surgery

d. Pain relieve after 2 weeks of treatment as an endpoint

e. Communicate with the patient, risk and benefit of treatment option

8. A-24-year old woman consulted to you that since 3 weeks ago she felt of constant tiredness after

delivery of her second child 15 months ago. She is slightly pale, but has normal hemoglobin.

Every day she works as a secretary from 8 am to 4 pm, her first child now 3 years old. She has

now returned because the tiredness persists and a friend told her that a vitamin injection would

do her good. That is what she wants. What would be your treatment objective in this patient?

a. Advise her not to worry, it can resolve soon

b. Advise her to reduce physical/emotional overload

c. Doing a vitamin injection as she wants

d. Gives her the other option of drugs

e. Ask her to do other laboratory examination

9. A 37 year old man came to Emergency & Accident Unit with feeling of apprehension, fear and

palpitation, even mounting to feeling of impending death. After being examined by doctor, the

results showed that nothing was wrong. After 3 weeks, he got the same feelings, and he had to go to

the hospital again. But this time the Emergency staffs were busy, and he was kept to wait. Until about

15-20 minutes he had not been attended to, but his fear and palpitation subsided and became

calm by it. What would you think about the suffering that this person had?

a. Somatization disorder : dia tidak sakit tapi merasa sakit. Gastrointestinal, pain, sexual,

pseudoneurological symptoms. Harus ada 4 symptoms yang dia ga punya tp dia blg ada

Hipokondriak itu lebay about penyakitnya.

b. Generalized Anxiety Disorder (GAD) : Panic attack at least 6 bulan of persistent and excessive

worry and anxiety

c. Phobic anxiety disorder : Suatu keadaan yang buat dia takut jadi muncul serangan
d. Panic disorder : recurrent, unexpected Panic Attacks followed by at least 1 month of
persistent concern about having another Panic Attack
e. Neurotic disorder : anxiety, phobia, panic, sleep disorder
10. According to the above case, what would you do to help him?

a. Give some explanation as to the nature of his illness

b. Prescribe drug for this distress
c. Plan for psychoanalytical psychotherapy

d. Advise him to go for Yoga exercise

e. Advise him to go for refreshing

11. Again considering the above case, which of the following medication would suit him well:

a. Diazepam : obat anti convulsant

b. Chlorpromazine : biasanya di pke buat mood disorder ato mental disorder

c. Luminal : phenobarbital drugs untuk epilepsi

d. Alprazolam : anti anxietas
e. Perphenazine : obat schizophrenia tp bisa buat nausea and vomiting

12. A 45 year old man is having the custom of drinking of beer. After some months, his habit increase

into heavier drinks such as wine and then even Whiskey and Vodka. Few more months, he was

admitted to a hospital because of an accident where he banged his head when crossing a wooden

bar where he fell unconscious for few minutes. He was advised to be hospitalized. On the third day,

he began to shake in his hands and tremble the whole body. After being put on some drugs his

shaking subsided and he was discharged after being pronounced as recovered from his ailments. What

was the reason for his shaking?

a. Dementia : lebih ke fungsi kognitifnya kyk sering lupa

b. Brain contusion : karena brain injury. Pasien bisa loss of consciousness, headaches, tiredness,

insomnia, loss of memory, difficulty concentrating and trouble speaking, personality

changes.
 c. Delirium tremens : kondisi psikotik akibat alkohol toxic yang gejala na muncul 3-10
hari setelah minum, orangnya biasanya confusion. Shaking na itu adalah withdrawal
seizure (rum fits) yang muncul dalam 6-48 hours of alcohol cessation

d. Blackouts : syncope

e. Stroke

13. After his discharge from the hospital and returned to work he began to resume his habitual drinking,

his wife and family were against this habit of drinking, but he went on disregarding the advice.

Even he became irritable and shouted with abusive words against anybody at home even he

could beat his wife if she is nagging on. Some time he would throw things and hit his children.

What would you call this episode of hitting family members?

a. Wife battering as a result of alcoholism

b. Alcohol intoxication : loss of consciousness, impaired balance, dll

c. Marital discord : masalah pernikahan

d. Personality disorder : anankarstik, histrionik

e. Psychotic disorder : schizophrenia, brief psychotic disorder

14. If in this family the children who used to be very dutiful at school works and compliant to family

discipline, observing father did a very bad example. The eldest son who is rather big boy and
physically robust (kuat) became acting like a big boss against his schoolmates who are smaller

and weaker than him. Some time asking them to bring him candies, some time he extorted money

from them, otherwise he would threaten to hit them or refusing to be his friends. What is the

classification of this behavior Personality disorder

a. A bully
b. Bossy : tukang nyuruh

c. Delinquency : kenakalan remaja didasari masalah keluarga

d. Genetic inheritance
 e. ADHD (Attention Deficit Hyperactive Disorder) : risiko jadi delinquency gede pas remaja.

15. A 55 year old man came to emergency with suddenly being unconscious 2 hours before admission

after complaining of severe headache and vomit. His GCS was E3M5V3, blood pressure was

190/100 mmHg, HR 90 x/min, RR 16 x/min, temperature 36,7 oC. Which of the following

examination is the most appropriate to exclude intracranial bleeding?

a. Brain MRI : untuk seizure ato iskemik

b. Angiography : untuk kelainan pembuluh darah

c. Brain CT scan

d. Carotid Ultrasound

e. Electroencephalography

16. A 56 year old man was suddenly being confused and unable to move his left extremities 7 hours

ago. On examination his blood pressure was 200/100 mmHg, HR 74 x/min irregular. He was
disoriented, left hemiplegia with increased tone on left side, and babinsky sign on left side. Lab
exam: WBC 12.000/mm3, RBG 190 g/dl. His CT scan showed a large hypointense (darah) lesion

in the right frontotemporoparietal lobe with significant edema and midline shift. Which of the

following is an appropriate treatment? Ini CT tp laporannya MRI

a. r-TPA

b. Corticosteroids
c. Mannitol

d. Antihypertension

e. Antibiotic
Klo perdarahan ksi manitol trus klo BP sistolik na >=180 bru ksi antihipertensi. Klo iskemik kasih
rTPA klo <3jam klo ud lebih ksi aspirin ato gk heparin trus klo BP sistolik na >=220 ksi
antihipertensi
Ct hyperdense  darah  putih
 Ct hypondense  infarct  hitam

17. For case above, if the ECG showed atrial fibrillation, which of the following examination would be

most appropriate for the next step? Mo liat adanya penyumbatan/emboli

a. Brain MRI : Tumor, stroke ischemic

b. Brain PET scan : Diagnose cancer, Help diagnose dementia if other tests and exams do not

provide enough information, Tell the difference between Parkinson disease and other

movement disorders

c. Echocardiography : karena ada kelainan jantung, ada suara jantung tambahan

d. Transcranial Doppler : untuk help diagnose emboli ato gk

e. Electroencephalography : untuk evaluasi electrical activity in the brain

Pulmo emboli  ekg = Sinus takikardi, S1 Q3 T3, Atrial fibrillation

Cardioversion  untuk aritmia pada orang yang sadar

18. A 17 year old boy is brought to emergency following fall from 4 meters height one hour before

admission. On examination he is alert, weakness of his left leg and loss of fine touch on the left

with loss of pain and temperature sensation on the right leg at level Th-12 below. This clinical

picture is most consistent with which of the following?

a. A posterior cord syndrome (dorsal column) : impaired position (proprioceptive), vibration

turun, Romberg sign positif, gait ataxia, discrimination, stereognosis.

b. An anterior cord syndrome : pain and tempt turun (spinothalamic), motor loss (corticospinal)

c. A complete cord syndrome : weakness, complete sensory loss, loss of bowel bladder and

sexual function

d. A central cord syndrome : corticospinal n spinothalamic bisa kena dikit tp dorsal colum gk

kena
 e. A hemisection syndrome : ipsilateral weakness, ipsilateral proprioceptive n vibration,
contralateral pain n temp, ipsilateral tactile discrimination sense, trauma, HNP

19. Which of the following management is the most appropriate to prevent further damage of spinal

cord?  obat SCI : methyprednisonone

a. Give high dose corticosteroid : kn untuk mengobatin

b. Trendelenberg position : untuk meningkatkan peredaran darah ke kepala

c. Give mannitol : untuk menurunkan ICP

d. Neuroprotector agent (citicholine) : diberikan pada pasien strok tp setelah kena dan diksi

aspirin
e. Lumbar corcet

20. A 52 year old man was sent to ER caused by seizure. His wife watched that he suddenly stop his
activity, starred, got involuntary movement on his right hand and then spread to lower and
upper right arm and finally became convulsion bilaterally. He has infarct in left capsula

interna with risk factor diabetes mellitus 3 months before and never gets seizure. In the ER,

the result of blood examination in normal limit, except blood glucose was 58 mg/dl. Which of the

following is most likely diagnosis at that time?

a. Symptomatic epilepsy : tau penyebabnya tp kejangnya harus berulang

b. Pseudo seizures : klo org na pnya kelainan psikiatri, khasnya ada seizure na ada pelvic thrust
c. Acute symptomatic seizures : kejang yang ada penyebabnya
d. Idiopathic epilepsy : gk tau penyebab na apa tp ada masalah dan harus ber

e. Secondary epilepsy : udah tau penyebabnya

Epilepsi : kebangkitan serangan kejang tapi harus berulang tp lebih dari 24 jam

21. According to the case above, what is the type of his attack?

a. Partial seizure : masih sadar Cuma 1 anggota gerak yang kena

 b. Primary generalized seizure : kena seluruh tubuh

c. Absence seizure : non convulsion

d. Simple partial secondarily generalized seizures : masih sadar tp seluruh tibuh

e. Complex partial secondarily generalized seizures : tidak sadar

22. A 23 year old man was hospitalized after got head injury. His brain CT Scan showed subdural

hematoma and brain contusion in the right temporal region. On the second days before

underwent craniectomy, he suffered repeated left partial seizures. What is your working

diagnosis?

a. Symptomatic epilepsy : sifatnya chronic

b. Provoked seizures : sifatnya akut

c. Reflex seizures : condition in which seizures can be provoked habitually by an external

stimulus or, less commonly, internal mental processes

d. Cryptogenic epilepsy : mirip idiopathic epilepsy

e. Pseudoseizure : kelainan psikiatri

23. A –PWE(patient with epilepsy)-42 year-old-man was treated with Phenobarbital 150 mg once

daily but had bad compliance. During under psychological stress in his office, he get

repeated seizures. He brought to nearest hospital and during transportation for 20 minutes

he never gain his consciousness and still convulsive. What is your working diagnosis?
a. Status epilepticus : >5menit ato >1 trus diantara serangan tidak ada kesadaran

b. Early phase status epilepticus : monitor 0-30 menit setelah status epilepsi

c. Acute symptomatic seizures

d. Panic attack : palpitation, sweating, nausea, dll

e. Psychological episodic attack : kelainan psikiatri

24. A 39 year old woman suffering from breast cancer since a year ago. She has main complaint of

headache that sometimes is accompanied with vomit for three weeks. According to her husband,

she gets tonic-clonic convulsion this morning. Which is the priority diagnostic procedure you will

perform?

a. Brain CT Scan with contrast : biasanya buat perdarahan klo kontras klo penyumbatan
b. Brain MRI with contrast : curiga ada metastatic ke otak dan klo tumor pke contrast,
tumor lebih bagus pke MRI  kalo ada PET scan lebih ok shay

c. EEG : untuk evaluasi electrical activity in the brain

d. Blood examination

e. Mammography : untuk pemeriksaan payudara

For Number 25-27

A 4 years old boy presents with burn wound on his stomach, hand, tight, and buttocks after

her mother accidentally spilled boiled water one hour before. Wound is felt pain, bullae(-). He cried

very loud, seems no dyspneu. Fever (-). History of immunization was unknown. The patient never get

this accident before. Alergy (-).

At physical examination, patient looks compos mentis, moderate ill. Vital sign is normal.

Weight is 12 kg. At thorax examination, chest retraction (-), syanosis at extremity (-),
and good perifer perfusion. Localis status of this patient show pink on the wound
base, tepi tidak rata, necrotic tissue (+), bullae (-), pus (-), brown/black patchy (-),

abses (-). dengan luas 21%.

Laboratory examination shows anemia and mild leucocytosis.

25. What is the degree of that burn trauma on this patient?

a. 1 (epidermis) : kemerahan, pain, tidak perlu IV replacement

b. 2 (dermis) : pain, wetty appearance, klo yg B ada blister

c. 3a
 d. 3b

e. 3c

Grade 3 : painless, kehitaman, dry kulitnya, leathery

26. What is the best thing you must do for this patient before bring him to the hospital?

a. Give tooth pasta

b. Close with sterile dressing : klo ada luka

c. Shower with water for 15 minutes

d. Compress with ice for 15 minutes : gk boleh pake ice

e. Give topical antibiotic : gk boleh di kasi antibiotic klo fase akut

27. What is the initial step you must give at hospital?

a. Fluid Infusion Maintenance : setelah resusitasi

b. Give topical antiseptic : klo luka bakar jgn ksi antiseptic

c. Antibiotic : tidak boleh klo fase akut bisa meningkatkan resiko infeksi jamur
d. Parlkland resuscitation infusion
e. Bulectomy : operasi untuk remove bula tp ini kn gk ada bula

For Number 28-29

A 34-year-old woman just delivered a 4100 g boy after a 15-hour labor, including a 2,5 hour second

stage. During the repair of a midline episiotomy, there is a marked increase in the amount of vaginal

bleeding.

28. Which of the following is the most common cause of immediate postpartum hemorrhage?

a. Retained placental fragments

b. Uterine atony
c. Cervical laceration
 d. Vaginal laceration

e. Disseminated intravascular coagulation

29. Which of the following is the best immediate management of the probable cause of this postpartum

hemorrhage?
a. Massage and compression of the uterine fundus
b. Intravenous administration of 20 units of oxytocin : setelah na baru oxytocin

c. Abdominal hysterectomy : klo uda gk bisa berhenti lagi setelah dilakukan massage, trus di

ksi obat

d. Uterine artery embolization

e. Hypogastric artery ligation : Hypogastric artery aneurysms, Spontaneous hemorrhage due

to advanced pelvic cancer, Postprostatectomy bleeding

30. Dedy, 13 year old man brought to Emergency by his mother with seizures and altered consciousness.

His mother said that his seizures happen continuously since 45 minutes ago. Two days ago, he also

suffers seizure about 40 minute. Physical examination: Temp 39.5⁰C, He was lethargic, BP 120/80

mm Hg, Heart Rate 110 X/minute. Pupils were reactive and no obvious focal deficits. Babinsky sign

present bilaterally. Lab examination: Hb 14 mg/dL, Leukocyte 11.000 /mm3, Random glucose: 70

mg/dL, Liver Function Test, Renal function, Electrolyte: in normal limit. According to your examination

which of the following is the most likely diagnosis?

a. Febrile seizure : setiap kejang harus di sertai dengan demam. 6 BULAN - 5 TAHUN
b. Status epilepticus
c. Cryptogenic seizure : gk tau penyebab na

d. Refractory epilepsy : obat gk mempan untuk ngobatin kejangnya (uncontrolled, intractable,

or drug-resistant epilepsy)

e. Hypoglycemic seizure : Glukosa < 70 mg/dL

31. A 40 years old man presented in Emergency unit (ER) with unconsciousness. His wife finds him in

the bath room 2 hours ago and brings him to the hospital. Physical examination:

Unconsciousness, no trauma, BP 160/95 mm Hg. What kind of laboratory examination is the most

appropriate to find non structural causes of unconsciousness?

ELECTROLYTE IMBALANCE  Hipernatremia, hipercalcemia, hyperglikemia , ureum

a. Na , K , Ureum

b. Na, K, Glucose
c. Na, Glucose, Ureum

d. Na, Cl , Glucose

e. K, Cl, Glucose

32. A 7 years old boy, have injury falls from bicycle and had wound and bleeding at the lower

extremity. What is the most appropriate sequent to stop bleeding :

a. Vascular spasm – Blood coagulation – Platelet plug formation

b. Vascular spasm - Platelet plug formation - Blood coagulation
c. Platelet plug formation - Blood coagulation – Vascular spasm

d. Blood coagulation - Vascular spasm - Platelet plug formation

e. Blood coagulation – Platelet plug formation – Vascular spasm

33. A 60 year old man came to emergency unit with history of chest pain 9 days ago. Which is the most

appropriate laboratory examination do you need for this patient?

a. CPK serum

b. CK MB serum : 2-4 jam meningkat, puncaknya 12-24 jam, stelah 24 jam turun
c. Troponin I and T : stelah 6 jam meningkat, bertahan 1-2 minggu
d. SGOT/AST : klo orangnya jaundice

e. Myoglobin : 1-4 jam, puncak 6-7 jam, durasi na 24 jam

34. A 31 year old man came to emergency depart with complaint severe pain in abdominal area and

frequent vomit since 24 hours ago. In physical examination looks severe pain, pain pressure

abdomen (+) in all area. Radio imaging: not find sign of perforation. What’s the most important

laboratory examination do you need for make diagnosis?

a. Urinalysis : klo ada gangguan di ginjal atau saluran kemih

b. Amylase serum : buat pacreastitis akut (6-12 jam 3-5 hari)

c. Lipase serum : buat pancratitis akut lebih spesifik (12 hari)

d. Widal serology : untuk tifoid

e. Liver function test : klo ada tanda2 hepar membesar ato kuning

Cholesistitis  ke scapula
Pankreatitis  epigastric ke punggung

35. A 22-year-old female college student is brought into the emergency room by the police, who found

her walking back and forth across a busy street, talking to herself. The young woman appears

to be oriented with respect to person, place, and time. Her first hospital admission was two

months ago for a similar condition. During a psychiatric interview, she has difficulty concentrating,

and seems to hear voices. A phone call to her sister provides the additional information that the girl

dropped out of school three months ago and has been living on the street. Urine toxicology is

negative. What is the most likely disorder?

a. Schizoaffective : tidak ada masalah medis umum ato medikasi, bisa kembali ke baseline 

gangguan schizophrenia + mood

b. Halusination : biasa na udah schizophrenia

c. Bipolar delusion

d. Schizophreniform : 1-6 bulan, bisa kembali ke baseline

e. Panic
Brief psychotic (1 hari – 1 bulan)  schizophreniform (1-6 bulan)  schizophrenia (>6bulan)

36. A 45 year old man fell down after complaining severe headache. Vital sign was normal. He was

vomits several times after and had meningeal signs. What is the most appropriate investigation

needed? Meningeal Sign positif : Mengitis ato perdarahan (SAH)

a. Transcranial doppler

b. Laboratory
c. CT scan : gold standart untuk kelainan di kepala

d. Cranial X ray

e. Electroencephalography

37. A 20-year female presents with abdominal pain which was initially felt in the centre of abdomen

but now felt in the right iliac fossa. She denies any other symptom. Her last menstrual period was

5 days ago. Examination reveals low fever (37.9°C) and tender right iliac fossa. Digital rectal

examination shows tenderness on 9-12 Clock direction. What is the most likely diagnosis?

a. Acute appendicitis : khas banget sakitnya awalnya dari epigastrik turun ke perut
kanan bawah dan ada demam (37-38celcius/99-102 fahrenheit), sakit dan biasanya
ada perut papan, gabisa kentut, mual /muntah sesudah abdominal painnya mulai ada
b. Mid-cycle pain (Mittelschmerz) : abdominal pain/ cramping waktu lagi ovulasi pas mau

menstuasi

c. Urinary tract infection : burning feeling waktu pipis, pain/pressure in your back/lower

abdomen, urinenya : cloudy, dark, bloddy atau strange-smelling, tired/shaky, rasanya

pengen pipis banget tapi waktu keluar cuman dikit

d. Mesenteric lymphadenitis : inflamasi lymph nodes yang attaches intestine ke abdominal

wall. MK : diare, nausea and vomiting, malaise

 e. Intestinal obstruction : mechanical/functional obstruction of the intestine. MK : abdominal

pain, vomiting, bloating and not passing gas, swelling of the abdomen, crampy tapi ga

terus-terusan

38. An unconscious patient with sepsis in the intensive care unit undergoes a 2-hour period of severe

hypotension. Blood chemistries taken during the following 48 hours show rising creatine kinase

MB fraction (CK-MB), peaking at 5 times the upper limit of normal. ECG findings are equivocal;
with some degree of flat S-T segment

depression over several leads. Which of the following is the most likely diagnosis?

a. Prinzmetal angina (rare): The pain from variant angina is caused by a spasm in the coronary

arteries (which supply blood to the heart muscle). Gejala : pain discomfort severe, biasa na

muncul pas mlm dan pagi2, klo minum obat mendingan.  EKG : ST elevasi, sakit pas tidur

/ rest, kalo pake nitrat enakan

b. Stable angina : Non stemi

c. Subendochondral infarction : transmural tanda stemi  subendocardial = NSTEMI
d. Transmural infarction / STEMI

e. Unstable angina : iskemik tapi belum infark

39. A 74-year-old woman, in otherwise good health, tripped and injured her right leg  DVT 2 days

previously and has been bedridden since the accident. Two hours ago, she suddenly had shortness

of breath and became delirious. On physical examination, her blood pressure is 120/70 mm Hg,

heart rate is 110, and respiratory rate is 32 x/min. Pulse oximetry shows an oxygen saturation of

80%. Which of the following is the most likely diagnosis?

a. Pneumonia : akibat bakteri/virus biasanya pilek dulu. MK : batuk ada sputum, demam,

mengigil, dada sakit dan makin parah kalo lg batuk atau tarik nafas

b. Acute cerebral infarction : iskemik stroke, bagian otak yang necrosis karna kurang oksgen.
 c. Myocardial infarction : coronary arterynya ke block. MK : SOB, keringet dingin, fatigue, chest

pain : pressure, tightness trs spread ke neck, jaw or back, nausea, pusing

d. Pulmonary infarction : akibat dari pulmonary embolism jadi karna oksigen ganyampe 

tissuenya die.

e. Pulmonary thromboembolism : karna ada darah yang block salah satu dari pulmonary
arteries, biasanya karna ada blood clots yang travel ke paru dari legs dan jarang
banget dari bagian tubuh yang lain

40. A 60 year old woman comes to emergency room, complaining about dyspnea, dizziness, fatigue,

lightheadedness and palpitation. After a few second, the patient collapse. ECG shows on Lead II
Ventricular Fibrilation

What is the initial management for this patient?

a. Nitroglycerin sublingual : angina

b. Echocardiograph

c. Heart surgery : biasanya 3 jam sesudah eart attack  CABG

d. Dopamin : hemodynamic imbalances : MI,trauma, endotoxic septicemia, open-heart

surgery, renal failure, chronic cardiac decompensation as in congestive failure

e. Defibrilator : Atau CPR
41. A 61 years old man comes with vomitting, dispepsia and sweating. He feels cool when he plays

tennis and fainting for a few minute. He has hypertension and diabetes, no smoking and no

hypercholesterolemia.

What is the most likely location of AMI?

a. Inferior : II, III, aVf

b. Posterior : posterior lead V2-V5

c. Anterior : V3, V4

d. Lateral : I, aVL, V5,V6

e. Anteroseptal : V1, V2

For Number 42-45

A 60 year-old man, is brought by his friend to ED because of unconsciousness. According to his friend,

the patient is a heavy smoker and often to be hospitalized due to shortness of breath. On physical
examination, RR: 42x/m, BP: 100/80, Heart rate 120x/m. Blood gas analysis showed pH: 7,20 ( 7,35-

7,45); pO2: 50 (>80); pCO2: 82,5 (35-45); HCO3: 28 (22-26); BE +3 ( 2); SpO2: 88% (>95). Routine

blood examination: Hb: 17.8; Ht: 51; WBC: 11.000; Platelet 420.000, Natrium: 130 (135-145); Kalium

5 (3.5-4.5). The chest X-ray showed lung hyperinflation. PCO2 > 70 trus COPD biasanya CO2 nya
narcosis

42. According to those data, what is the most possible cause of the unconsciousness?

a. Severe hypoxemia : partial pressure <60% atau hemoglobin oxygen saturation <90% MK

: inability to communicate, confusion, possible coma/death.

b. CO2 narcosis : bisa ampe respiratory arrest kalo naik trus.  COPD

c. Sepsis : ada 2 atau lebih gejala temp >38/<36, HR >90, RR >20 atau PaCo2 <32, WBC

>12000 atau <4000 atau <10% bands

d. Hypokalemia : kaliumnya aja 5 masa hipo WKWKWK tp kalo kalium 2,5-3 muscle

weakness,myalgia,tremor, muscle cramps

e. Hyponatremia : 130-134:mild, 125-129 moderate, <125 profound. Kalo mild gejalanya

masih nausea dan malaise. <115 baru bikin neurologic symptoms : seizure,coma

43. What is the lung function test might be showed?

a. FEV1/FVC < 70  normal : 80

b. FEV1/FVC > 70 : ditemukan pada orang yang restriksi atau normal

c. FEV1/FVC normal

d. FEV1 > 75

e. FVC > 80
44. If we measure the lung static volume, what is the most possibility result?

a. increased tidal volume

b. increased expiratory respiratory volume

c. increased residual volume : pada orang COPD dan total lung capacity naik

d. decreased functional residual capacity : masi bisa dikeluarkan pada saat expiratory

e. decreased total lung capacity

45. What is the most inflammation cell that plays a role?

a. Macrophage :

b. Eosinophil + CD 4 : reaksi alergi (asma)

c. Neutrophil + CD 8 : neutrophil untuk fagosit bakteri
d. Mast cell : alergi

e. Basophil : alergi

For Number 46-47

A 32 year old man brought by his wife to mental hospital. The wife complained that since 3 days ago,

her husband had disorganized behaviour and speech. In this case, the doctor gives Haloperidol 3 x 5

mg a day. After 2 days, his wife come again and reported that he showed shaking his hand and feet.
Haloperidol paling sering bikin extrapiramidal

46. What does he suffered from?

 a. Acute Dystonia Reaction : 1-2 hari stlh pengobatan. MK : spasme atau kontraksi involunter

timbul dalam beberapa menit tortikolis(gerakan yang bikin jd condong ke satu sisi),

disastria bicara, krisis okulogirik dan sikap badan yang tidak biasa. Tx : benztropine 1-2 mg

IV/IM, diphenhydramine 25-50mg IV/IM

b. Akathisia : perasaan yang gelisah, gugup atau keinginan untuk terus bergerak jadi susah

tidur dan anxietas. tx : beta blocker (propranolol 30-60mg/day), anticholinergic (benztropine

1 mg 2-4x/hari)

c. Torticolis : leher sengklek (gejala dari acute dystonia reaction)

d. Parkinsonism : mulainya berjam-jam setelah dosis pertama dan secara berangsur-

angsur selama bertahun-tahun, MK : akinesia,tremor,jalan bungkuk,kekakuan otot.
Tx : antiparkinson : levodopa

e. Tardive Diskinesia : gerakan otot abnormal, involunter, menghentak, gejalanya ilang kalo

udah tidur,harus 6 bulan tx : benzodiazepine

47. According to the case above, what medicine should be given to the patient to reduce the symptoms?

a. Metilphenidate (psychostimulant : ADHD)

b. Triheksiphenidil (anticolinergic) : buat side effect extrapyramidal (antiparkinson). Bisa
juga Levodopa, antidepressant = SSRI : fluoxetine
c. Risperidone : atipical

d. Chlorpromazine : tipical

e. Carbamazepine : tipical

For Number 48-50

A 17 year old girl attempted to suicide by drinking one cup of “Baygon”. Her mother found her diary

saying that she really wants to be dead because her boyfriend has another girl and leaved her.

48. What is the most probably diagnosis?

 a. Anxiety Disorder : perasaan yang difus, yang sangat tidak menyenangkan, agak tidak

menentu dan kabur tentang sesuatu yang akan terjadi. MK : sakit kepala, berkeringat,

muscle spasm, palpitasi, dan hipertensi, yang dapat menyebabkan kelelahan umum dan

kelelahan.

b. Panic Disorder : periode kecemasan atau ketakutan yang kuat dan relative singkat (biasanya

kurang dari satu tahun), yang disertai oleh gejala somatik tertentu seperti palpitasi dan

takipnea berlangsung selama 20-30menit

c. PTSD : post traumatic gejala bertahan selama 3 bulan atau baru muncul pas 6 trakhir da

nada flash back!) Acute stress disorder : langsung muncul gejalanya dan symptoms ga

nyampe dalam 3 bulan

d. Schizophrenic : menunjukkan dua gejala yang terdaftar sebagai gejala 3 sampai 5 pada

kriteria A (waham,Halusinasi, bicara kacau, Perilaku yang sangat kacau/katatonik, Gejala

negatif: afek medatar, alogia, atau anhedonia) selama min 6 bulan.

e. Depression : kehilangan minat atau kesenangan dalam aktifitas yang menyenangkan,

penurunan energy atau kelelahan meningkat, gangguan tidur penurunan nafsu
makan, gabisa konsentrasi, niat bunuh diri, penurunan percaya diri, gejala minimal 2
minggu

49. According to the cases above, which type of the suicide she has?
a. Suicide Attempt : usaha bunuh diri
b. Suicide Gesture : melakukan usaha bunuh diri (gerak-gerik) tapi sebenernya gk mau bunuh

diri

c. Suicide Gamble : perilaku yang berpotensi fatal tapi masih bisa diselamatkan

d. Suicide Equivalent

e. Suicide Attack : kekerasan dimana orang yang menyerang berharap mati dalam perang. Ex

: terosis jihad
50. What is the classification of suicide for the case above?

a. Euthanasia : suntik mati

b. Murder Suicide : bunuh orang lain dulu seblm bunuh dirinya sendiri
c. Self Injury : nyakitin diri sendiri
d. Attack Suicide : kyk bunuh diri dan orang lain termasuk

e. Mass Suicide : bareng2 pengen bunuh diri

Soal ujian Dermatology(IMS)

A 45 years old man come to DV clinic, because he complained dysuria since 4 days ago. He felt

burning sensation when he urinated. He excreated purulent uretral discharge 2 days ago. His

wife had same problem with him. He had contact sexual with prostitute women 1 week ago.

Physical examination shows purulent uretral discharge, no ulcer. The external genitalia were

normal. Laboratorium test, gram stain show polymorphonuclear leukocytes(+), erythrocite (-),

gram negative intracellular diplococci. KOH10% examination shows spora (+), pseudohipha (-

), hipha (-).

What is the best treatment for this patient:

a. Doxycylclin 2 x 100 mg, 5 days (untuk gram negative)

b. Ofloxaxin 400 mg SD

c. Itraconazole 2X400 mg one day

d. Metronidazole 2 x 500 mg, 7 days

e. Benzatin Penisilin G 2,4 million unit SD

2. What is the complication for his wife, if she untreated :

a. Pelvic inflamatory disease

b. Ca Cervix
 c. Ovarium Cyst

d. No complication

e. Skin iritation

SOAL ICM 2

- Rumus parkland ada 2 soal (4 *kg*TSBA) ,cek uo

- 2nd degree burn yang preserved apa? (Lapisan kulit yang ada apanya) Vibration neuron/UV

protection/immune system/melanin/fluid loss barrier?

- Soal unconsciousness banyak BANGET belajar deh tentang lesi2 dimana, komplikasi nya apa

Seizure Lesi kanan  gejala di kiri

- Keluar soal yang jawabannya septic abortus  infection & abortus

- Itung %burn: pokoknya jawabannya 36% (soal angkatan ku sih jawabannya ini haahaa)

- Overdose obat yang bikin jaundice: aspirin

- Orang PTX, mau xray dulu/chest tube dulu?

- Antidote nya acetaminophen: NAC  n – acetyl sistein

- Orang ada gejala sludge bbb + trauma kepala belakang, kenapa dia? OP poisoning

- Keluar soal acute mania  heboh, mood disorder (2 weeks)

- Domestic Abuse tersering: physical abuse

- Keluar gejala psychopath  sadar atas perbuatannya dengan planning, pembohong, egosentris,

tidak ada rasa bersalah, impulsive, aggressive, hidup sebagai parasite. Sociopath  tidak plan,

mau liat orang lain suffer.

- Orang stress karena dulu sexual abuse: PTSD

- Ada soal aborsi OUE ketutup: abortus threatened/imminens inevitable / insipiens

- (ada gest sac gaada yolk sac dan fetus nya) blighted ovum, mola hidatidosa.  beta HCG naik

tinggi, perdarahan dini

- Belajar obat kejang (SE, febrile seizure)

- Dosis max misoprostol: 1200 microgram  1000mg

- Orang chemical burn first management: irigasi? Analgesic?

- Sesek pas jalan jauh dan naik tangga, NYHA berapa: NYHA grade 2

- Soal derajat shock 2 biji: both jawabannya derajat 3 (pas angkatan ku hehe)  BP TURUN,

AKRAL DINGIN, U/O MASIH ADA