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  • 1/12 Pertanyaan

    Tn. Christ, 68 tahun datang ke IGD dengan keluhan kaki kanannya lemah dan bicara sulit. Pasien mengaku mempunyai riwayat hipertensi. Berdasarkan pemeriksaan fisik didapatkan tekanan darah 175/110 mmHg. Dalam waktu 12 jam keluhan pasien menghilang. Apakah diagnosa pada kasus di atas?

    • A. Stroke iskemik
    • B. Stroke hemoragic
    • C. Serangan iskemik transien
    • D. Reversible Ischemic Neurologic Defisit (RIND)
    • E. Stroke in evolution
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  • 2. 

    Nn. Lena, 26 tahun mengeluh sulit berbicara pada saat presentasi. Pemahaman baik. Apa diagnosis pada pasien di atas?

    • A. Aphasia wernick

    • B. Aphasia broca

    • C. Global aphasia

    • D. Amnesic aphasia

    • E. Anomic aphasia

    Correct Answer
    A. B. Aphasia broca
    Explanation
    The given information suggests that Lena, a 26-year-old, has difficulty speaking during presentations but has good comprehension. This symptom is characteristic of Broca's aphasia, which is a type of aphasia that affects the ability to produce speech while comprehension remains relatively intact. Therefore, the correct diagnosis for the patient in this case is Aphasia Broca.

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  • 3. 

    Wanita 40 tahun mengeluh sesak sejak 3 bulan terakhir jari-jari dan pergelangan kedua tangan nyeri, sendi bengkak, dan terasa kaku. Dirasakan pagi saat bangun tidur kurang lebih 1 jam. Sudah berobat tidak ada perubahan. Pemeriksaan fisik dalam batas normal. Ekstremitas dalam batas normal, riwayat trauma (-), dan deformitas (-). Pada PIP II-IV dan MCP II-IV hangat, PIP I-V dan MCP I-V nyeri tekan. Laboratorium LED 60, asam urat 5 mg/dl. Diagnosis pada pasien adalah ….

    • A. Pseudogout Arthritis

    • B. Rheumatoid Arthritis

    • C. Osteoarthritis

    • D. Gout Arthritis

    • E. Osteoporosis

    • Option 6

    Correct Answer
    A. B. Rheumatoid Arthritis
    Explanation
    The patient is a 40-year-old woman who has been experiencing shortness of breath for the past 3 months, as well as pain, swelling, and stiffness in the fingers and wrists. These symptoms are most likely indicative of rheumatoid arthritis. The fact that the symptoms are worse in the morning upon waking up, last for about an hour, and there is no improvement with treatment suggests an inflammatory condition. The laboratory results, specifically the elevated erythrocyte sedimentation rate (LED), further support the diagnosis of rheumatoid arthritis.

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  • 4. 

    Laki-laki 40 tahun mengeluh bengkak dan nyeri hebat pada ibu jari kaki kiri. Pasien 1 hari sebelumnya berekreasi di daerah pegunungan tanpa menggunakan alas kaki. Dari pemeriksaan fisik tanda vital normal, artritis pada metatarsophalangeal 1 kaki kiri. Gold standart untuk diagnosis pasien adalah ....

    • A. Kadar asam urat serum tinggi

    • B. Kadar kolesterol tinggi

    • C. Cairan sendi mengandung kristal monosodium urat

    • D. Cairan sendi mengandung nanah

    • E. Kadar asam urat urine tinggi

    Correct Answer
    A. C. Cairan sendi mengandung kristal monosodium urat
    Explanation
    The patient is presenting with symptoms of swelling and severe pain in the left big toe, which is consistent with gout. Gout is a form of arthritis caused by the deposition of monosodium urate crystals in the joints. The gold standard for diagnosing gout is the identification of these crystals in the synovial fluid of the affected joint. Therefore, option C, which states that the synovial fluid contains monosodium urate crystals, is the correct answer. Options A, B, D, and E are not specific to the diagnosis of gout and do not provide the gold standard for its diagnosis.

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  • 5. 

    Seorang laki-laki 20 tahun datang ke RS dengan keluhan kedua tungkai sulit digerakkan setelah ditabrak motor dari samping. Dari pemeriksaan fisik didapatkan TD 110/70, N 88x/m, RR 20x/m. GCS 14. Luka (-), anestesi (+) setinggi umbilikus ke bawah, kedua tungkai sulit digerakkan. Pemeriksaan penunjang yang paling tepat adalah ….

    • A. Pemeriksaan elektrolit lengkap

    • B. EMG ekstremitas inferior

    • C. Rontgen vertebra lumbosakral AP lateral

    • D. Aspirasi sumsum tulang

    • E. MRI vertebra lumbosakral

    Correct Answer
    A. E. MRI vertebra lumbosakral
    Explanation
    The correct answer is E. MRI vertebra lumbosakral. Given the patient's complaints of difficulty moving both legs after being hit by a motorcycle, along with the physical examination findings of difficulty moving both legs and anesthesia below the umbilicus, it suggests a possible spinal cord injury. The most appropriate diagnostic test to evaluate the spinal cord is an MRI of the lumbosacral spine. This imaging modality can provide detailed information about the spinal cord and surrounding structures, helping to identify any potential injuries or abnormalities.

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  • 6. 

    By. Usia 11 bulan datang dengan riwayat kejang 1 jam sebelumnya. Keluhan disertai dengan demam sejak 3 hari yang lalu. Anak menangis saat kejang dan tertidur beberapa saat setelah kejang. Pemeriksaan fisik dilakukan didapatkan anak lemah, temperatur 39C. Tiba-tiba anak kejang lagi sesaat setelah infus terpasang. Obat apakah yang dokter berikan?

    • A. Diazepam 5mg rectal

    • B. Diazepam 10mg rectal

    • C. Diazepam 5mg bolus

    • D. Diazepam 10mg bolus

    • E. Diazepam 5mg oral

    Correct Answer
    A. C. Diazepam 5mg bolus
    Explanation
    The correct answer is C. Diazepam 5mg bolus. This is because the patient is presenting with febrile seizures, which are seizures that occur in young children during a fever. Diazepam is a commonly used medication to treat seizures, and a bolus dose is given to quickly stop the seizure activity. The dose of 5mg is appropriate for a child of this age. Rectal administration is preferred in this situation as it is easier and faster to administer in a child who may be agitated or uncooperative.

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  • 7. 

    Tn. Adi, 70 tahun mengalami penurunan kesadaran dan kelemahan anggota gerak kiri dibawa keluarganya ke UGD. Riwayat hipertensi (+), saat diukur TD 190/100 mmHg. Penanganan paling awal yang harus dilakukan?

    • A. Turunkan tensi

    • B. Pasang oksigen

    • C. Elevasi kepala

    • D. Pasang iv line

    • E. Obat neuroprotektif

    Correct Answer
    A. B. Pasang oksigen
    Explanation
    The correct answer is B. Pasang oksigen (Administer oxygen). The patient is experiencing a decrease in consciousness and weakness in the left limb, which could indicate a possible stroke or other neurological condition. The elevated blood pressure (190/100 mmHg) suggests hypertensive urgency or emergency. Administering oxygen is the most immediate and important intervention to ensure adequate oxygenation to the brain and other vital organs. This can help stabilize the patient's condition while further evaluation and management are carried out.

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  • 8. 

    An. Rizky berusia 12 tahun dibawa ke UGD RS dengan keluhan mulut sulit dibuka dan kejang, setelah kejang pasien sadar. Dari anamnesis diketahui 1 minggu sebelumnya kaki sang anak tertusuk duri saat bermain. Pada pemeriksaan fisik diperoleh kesadaran baik, suhu 37.3C, BB 35kg, HR 80x/m, RR 26x/m, dan ditemukan spasmus pada otot-otot muka. Apakah uji yang dapat digunakan sebagai bed side diagnostic test untuk kasus ini?

    • A. Tes reflex

    • B. Tes spatula

    • C. Tes muscular

    • D. Tes neuromotorik

    • E. Tes neurosensorik

    Correct Answer
    A. B. Tes spatula
    Explanation
    The correct answer is B. Tes spatula. In this case, the patient presented with difficulty in opening the mouth and muscle spasms in the face. The history of a foot injury and the symptoms suggest the possibility of tetanus, a bacterial infection that affects the nervous system. The spatula test, also known as the "trismus test," is used to assess the severity of trismus, which is a common symptom of tetanus. By gently trying to open the patient's mouth with a spatula, the healthcare provider can determine the degree of muscle stiffness and assess the need for further treatment.

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  • 9. 

    Ny. Yang, 45 tahun mengeluh lutut kanan bengkak, nyeri, dan teraba agak panas sejak 3 hari yang lalu. Riwayat trauma atau sakit sebelumnya yang sama disangkal. Tidak terdapat keluhan pada sendi yang lain. Diketahui menderita DM sejak 10 tahun yang lalu. Hasil pemeriksaan fisik didapatkan BB 80kg, TB 150cm, dan terdapat kesan adanya cairan sendi lutut kanan. Pemeriksaan lab asam urat 7.1 mg/dL, titer ASTO <200 IU/mL. Jumlah sel dalam cairan sendi 100.000/mm3 dengan PMN 85%. Rontgen lutut kesan dalam batas normal. Diagnosis yang tepat adalah .... 

    • A. Arthritis reumathoid

    • B. Arthritis gout

    • C. Osteoarthritis

    • D. Arthritis septic

    • E. Pseudogout

    Correct Answer
    A. D. Arthritis septic
    Explanation
    The correct answer is Arthritis septic. This is because the patient presents with a swollen, painful, and warm right knee joint, along with a history of diabetes mellitus. The physical examination reveals the presence of joint fluid and laboratory findings indicate an elevated neutrophil count in the joint fluid. These findings suggest an infection in the knee joint, which is consistent with septic arthritis. The absence of trauma or previous similar symptoms helps to rule out other causes such as rheumatoid arthritis or gout.

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  • 10. 

    Tn. Broke 32 tahun dibawa ke UGD dengan keluhan penurunan kesadaran sejak 2 jam yang lalu. Satu minggu sebelumnya mengeluh demam disertai sakit kepala dan mual. Riwayat penggunaan narkoba suntik sejak 2 tahun yang lalu, 3 bulan terakhir berat badan menurun. Pada pemeriksaan fisik tampak keluar cairan dari telinga kiri. GCS E2M5V3, kaku kuduk (+). Analisis cairan serebrospinal warna jernih, jumlah sel 150/uL dominan limfosit, glukosa 40mg/dL, protein meningkat, India ink (+). Apakah diagnosis pada pasien?

    • A. Meningitis TB

    • B. Meningitis bakterial

    • C. Meningitis kriptokokus

    • D. Ensefalitis toksoplasma

    • E. Meningoensefalitis viral

    Correct Answer
    A. C. Meningitis kriptokokus
    Explanation
    The patient's symptoms and physical examination findings, such as decreased consciousness, fever, headache, nausea, weight loss, and fluid leakage from the ear, suggest a possible diagnosis of meningitis. The clear cerebrospinal fluid analysis with increased lymphocyte count, low glucose level, and positive India ink stain indicate a fungal infection. Among the options given, the most likely diagnosis is cryptococcal meningitis, which is caused by Cryptococcus neoformans.

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  • 11. 

    Tn. Brock, 59 tahun datang dengan keluhan batuk dan sesak 1 minggu yang lalu. Pasien mendapat kemoterapi atas indikasi ca kolorektal 2 bulan yang lalu. Pada pemeriksaan foto thoraks didapatkan infiltrat interstitial difus bilateral. Tes sputum (-) dan pasien tidak respon terhadap antibiotika. Pada biopsi paru didapatkan tanda pneumonisitis interstitial akut dan kronik disertai sel yang besar mengandung inklusi nuklear berwarna biru gelap. Apa kemungkinan penyebabnya?

    • A. CMV

    • B. EBV

    • C. Herpes simplex virus

    • D. Mycoplasma

    • E. Pneumocystis jiroveci

    Correct Answer
    A. A. CMV
    Explanation
    The presence of interstitial infiltrates on chest X-ray, negative sputum test, and lack of response to antibiotics suggests an infectious etiology. The biopsy findings of acute and chronic interstitial pneumonitis with large cells containing dark blue nuclear inclusions are consistent with cytomegalovirus (CMV) infection. CMV is a common opportunistic infection in immunocompromised individuals, such as those undergoing chemotherapy for colorectal cancer. CMV can cause interstitial pneumonitis, and the characteristic nuclear inclusions can be seen on histopathological examination. Therefore, CMV is the likely cause of the patient's symptoms.

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  • 12. 

    An. laki-laki 10 tahun, ke praktik dokter umum dengan keluhan kejang menyentak-nyentak pada seluruh tubuh sejak 10 menit yang lalu selama 10 menit. Pasien tidak sadar, keluar busa dari mulut. Ini merupakan serangan ke-3 dalam satu tahun terakhir. Orang tua menyangkal trauma kepala, demam sebelum serangan, dan nyeri kepala pada saat ini. Pemeriksaan fisik tidak ditemukan kelainan. Dimanakah lokasi yang paling sering terjadi pada keadaan ini?

    • A. Lobus frontal

    • B. Lobus temporalis

    • C. Lobus parietalis

    • D. Lobus oksipital

    • E. Semua lobus

    Correct Answer
    A. E. Semua lobus

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  • Mar 22, 2023
    Quiz Edited by
    ProProfs Editorial Team
  • Jun 27, 2020
    Quiz Created by
    Medlirez
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