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Soal Blok 7 PDU 07

1. Ditemukan anti-HIV dalam darah seseorang menandakana. sudah sembuh dari penyakit AIDS

b. pernah mendapat imunisasi HIVc. pembawa HIV virus, tapi tidak menular orang laind. pembawa HIV virus dan dapat menular orang laine. mengandung antibody terhadap virus HIV dan tidak menular orang lain

2. Pada masa akut suatu penyakit, imunoglobulin yang meningkat dalam darahnya berasal dari kelasa. IgA

b. IgGc. IgMd. IgDe. IgE

3. Cara untuk menunjukkan adanya reaksi imunologis dengan menggunakan aktivitas enzim sebagai

indikator merupakan prinsip kerja dari reaksi/ tesa. Imunoelektroforesis

b. RIAc. ELISAd. Imunofluoresensie. RPHA

4. Test Konfirmasi untuk penyakit sifilisa. RPR

b. VDRL screening testc. Wasseman

d. Kahne. TPHA

5. Antigen yang berbentuk partikel bila dicampur dengan antiserum yang spesifik termasuk reaksia. presipitasi antigen larutanb. aglutinasic. imunodifusid. Elisae. Imunoeletroforesis

6. Pemeriksaan seromarker untuk mengetahui adanya infeksi hepatitis A akut adalah

a. IgG HAVb. IgM HAVc. HBsAgd. Anti-HBce. Anti-HCV

7. HbsAg can be detected quickly bya. RPHA

b. PHAc. TPHAd. Coomb teste. VDRL

11. Grading of DHF patient with fever accompanied by unspesific symptoms tourniquet test (+)a. Grade 1

b. Grade 2c. Grade 3d. Grade 4

12. Diagnosis DHF >> 2 criteria klinis + trombositopenia + hemokonsentrasi


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13. Yang benar tentang DHFc. blood testd. membran plasma leakage

17. After a few days of Bacterimia, the baciili localize mainly in the lymphoid tissue of the smallintestine. The typical lesion is in

a. the GALT b. the payers patchc. MALTd. crypts of lieberkulin

19. The clinical feature of toxoplasmosis isa. asymptomatic in child

b. symptomatic in adultc. always symptomatic in kongenital infectiond. always symptomatic in kongenital infection and usually asymptomaticin adult

20. The causative agent of espundiaa. L. donovani

b. L. tropicac. L. braziliensisd. Toxoplasma gondii

24. Large kinetoplast is found ina. T. gambiense

b. T. rhodesiensec. T. cruzid. amastigote

25. The shape of C is found in the parasite of a. T. gambiense

b. T. rhodesiensec. T. cruzi d. Amastigote

26. The habitat of T.gambiense is ina. Connective tissue

b. Connective tissue and lymph nodesc. lymph nodes and blood streamd. connective tissue, lymph nodes, blood stream, CNS

27. Xeodiagnosis is used for the diagnosis of a. Leishmaniasis

b. African trypanosomiasisc. Chagas diseased. Malaria

28. Contoh Hipersensitivitas tipe 1 adalah >> asma bronkial

29. Contoh Hipersensitivitas tipe 2 adalah

30. Contoh Hipersensitivitas tipe 3 adalah >> SLE

31. Penyakit Hipersensitivitas tipe 4 adalah >> DM Tipe I

35. The pathogenesis of poststreptococcus glomerulonephritisa. Deposits in immune complex on the glomerular basal membrane

b. Direct infection of streptococcus


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c. IgA involved this diseased. Type IV hipersensitivity

39. The following are spesific cellular immune systema. Complement

b. NK cell

c. IgAd. Th2

42. Contoh imunitas seluler pade interseluler bakteria. Th1

b. Th2

43. Mucosal layer secret >> IgA

45. Respon vaskuler untuk inflamasi akut >> neutrofil ke interstitial

48. Child with lymphadenopaty underwent biopsy histology granulomatous inflamasi

49. 52 tahun, male, massive ...

51. Anak umur 4 tahun kena paku berkarat, reaksi healing processa. formasi fibrin

b.c.d. demigrasi dan emigrasi

57. Healing process ada 3 : cell proliferation, extra cellular matrix dan xxx. Yang termasuk extracellular matrix

a. Fibrin b. Elastinc. Integrind. Laminin

59. Contoh antihistamin generasi 3a. Etilendiamine

b. piperizinec. phenodiazined. levocetirizine

60. Obat rinitis alergika kronik a. difenhidramine

b. levocabastinec. feksophenadined. chloropheniramine

65. The drug which highest capability for reducing gastric juicea. Cimetidine

b. Famotidinec. Ranitidined. Promethazine

68. Obat untuk malaria yang juga dapat digunakan untuk toxoplasmosis>> Pirimethamin

68. This drug is not only use for malaria, but also used for toplasmosisa. Chloroquineb. Pyrimethaminec. Atovaquone


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d. Mefloquine

70. This drug is contraindicated for psoriasis patienta. Primakuin

b. Klorokuinc. Pirimetamin

d. Artemisin71. Obat anti malaria yang menyebabkan QT interval

a. Atovaquone b. mefloquinec. primaquined. pirimethamine

75. The following antibiotic is safe for treating malaria in pregnant womana. Clyndamicin

b. Tetracyclinec. Sulfand. Artemisin

78. IgM receptor located in fetus surface cell when the fetus isa. 10 weeks

b. 10,5 weeksc. 12 weeksd. 20 weeks

79. Cytoplasmic IgM located ina. stem cell

b. pre B cellc. mature B celld. plasma cell

80. Primary antibody with high molecular weight (MW) in primitive vertebra isa. Analogous autoantibody with IgM n human

b. Analogous autoantibody with IgG n humanc. Analogous autoantibody with IgA n humand. Analogous autoantibody with IgD n human

81. Di bawah ini merupakan organ limfoid primer d. Bone marrow and Thymus

81. IgG serum concentrate reduce in stagea. Fetus

b. Neonatusc. Youngd. Adult

85. Organ u/ imun, thymus berperana. waktu puber, thymus membesar

b. precursor T sel matang ada di medulac. mayoritas precursor T sel mati di medulla karena apoptosisd.sel epitel timus, sel dendrite, dan secret makrofag soluble factor yang mempengaruhi

pematangan sel T

86. Lymph node has one following histological featuresa. is a round-shaped organ with the size of more than 3 cm

b. most of the free cell in the node are lymphoid blast cellc. in a stimulated node, a germinal center may develop within the primary nodulesd. Para cortex are the areas between the capsule and the cortex


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88. MALT has one following feature :a. Located beneath the mucosa epithelial

b. Immune response also targeted and gainst component of foodc. Product IgE, release onto epidermal surfaced. Immune

89. Characteristic tonsil98. Gram (+) cocci arrange in grape cluster

a. Streptococci b. Poststreptococcic. Staphylococcid. Gonococci

101. Bakteri gram (+) yang tidak menghasilkan Catalase

104. A kind of enzyme produced by group A streptococcus. Can be used for suffering from heart attack a. Hyaluronides

b. Streptococcusc. DNAsed. B-lactamase

105. Yang mw ke mekah dikasih vaksin a. N. meningitidis

106. Pelvic inflammatory disease (PID) is usually caused by a. S. typhi

b. N. gonorrhoeaisc. S. aureusd. S. pyogenes

108/111. This species is usually dikatakan sebagai bioterrorisma. Cl. Tetani

b. Cl. botullinumc. C. diphteriaed. B. anthracis

112. Bacteri anaeroba. E. coli

b. N. gonorrhoec. S. aureusd. Cl. tetani

112. This fungus is found in form of yeasta. M.

b. . floccosumc. H. capsulatumd. C. Albicans

117. Bakteri gr (+) perut yang menyebabkan keracunan makanan >> c. S. aureus

120. Fungus yang termasuk yeast >> a. Candida albicans

123. Perbedaan vivax and palcifarum di hepar, pada vivax ada >> Hipnozoit

128. Atopic Allergies such as asma and hay fever affect >25 million individuals in US. What is mosteffective method of treating these Allergies.

a. Hyposensitization b. environmental controlc. adm of modified allergen


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d. adm of antihistaminee. adm of corticosteroid

129. Contoh preformed di sel mast >> Histamine

One of histological findings of spleen is

a. white pulp is the small, oval/ rounded grayish areas within the splenic cords b. most of parenchyma of the spleen is red pulpc. lymphocyts are the main resident cell population of splenic cordsd. the aged erythrocytes are rounded the lymphocyts

Obat malaria yang g bisa untuk kemoprofilaksis >> Kina/ Quinine Non spesifik humoral Non spesifik seluler Spesifik humoralSpesifik seluler

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

FAKULTAS KEDOKTERANUNIVERSITAS SRIWIJAYA

REMEDIAL MCQ AGUSTUS 2008

1. The disease based on Type II Hypersensitivity A. UrticariaB. GranulomaC. ITPD. Myasthenia Gravis

2. The disease based on Type III Hypersensitivity A. SLEB. ITPC. Anaphylaxis Shock D. Anemia Perniciosa

3. The disease based on Type IV Hypersensitivity A. Atopic DermatitisB. Graves DiseaseC. Good Pasteur SyndromeD. Type I Diabetes Mellitus

4. Immunoglobuline involved in Type I Hypersensitivity reaction A. IgEB. IgMC. IgGD. IgA

5. Immunoglobuline involved in Autoimmune Hemolytic Anemia A. IgG and IgMB. IgAC. IgED. IgD


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6. Early phase of Type I Hypesensitivity occurred A. Less than 2 hoursB. 2 24 hoursC. 48 hoursD. More than 6 days

7. The pathogenesis of Post Streptococcal Glomerulonephritis A. Deposits of immune complex on the glomerular basal membraneB. Direct infection of StreptococcusC. IgA involved this diseaseD. Type IV Hypersensitivity

8. Preformed mediator in the granules of mast cell A. LeucotrienB. HistamineC. ThromboxanesD. Prostaglandine

Question No. 9A woman, 21 years old, come to the hospital with the complain of redness on the face, especially after contact with the sun rays, she also have arthralgia on the knee and finger, and oral ulcer. Laboratoryfindings reveal: Hb 7,0 mg/dl, leukocyte 3000/mm 3, thrombocyte 65000/mm 3, proteinuria ++ (Esbach1000 mg), anti ds DNA +.

9. The possible diagnosis of this patient was A. Aplastic anemiaB. Acute glomerulonephritisC. Systemic Lupus ErythematosusD. Autoimmune Thrombocytopenic Purpura

10. Non specific Humoral Immune System A. Complement, Interferon, CRPB. Interferon, CRPC. CRP, ComplementD. Complement, Interferon

11. Specific Cellular Immune System A. ComplementB. NK cellC. IgAD. TH-2

12. Spesific Humoral Immune System A. IgA, Ig M, Ig GB. IgM, Ig GC. IgG, Ig AD. Ig G, TH 2

13. Specific Cellular Immune System A. BasophilB. Mast cellC. NK cellD. Cytotoxic T cell


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14. The functions of Complement A. LysisB. ChemotaxisC. OpsonisationD. a+b+c

15. The functions of Interferon A. Activation of NK cellB. Induction of resistanceC. Inhibitions of viral growthD. a+b+c

16. Plasma protein mediator role as chemotactic factor for neutrophil is A. SerotoninB. KallikreinC. Complement factor (C5a)D. Prostaglandin

17. A child with lymphadenopathy of neck underwent biopsy. Histopathologic feature showedgranulomatous inflammation. The most characteristic feature of granolomatous inflammation is ..A. Aggregation of ephiteloid macrophagesB. NecrosisC. Multinucleated giant cellsD. Eosinophils

18. A 59 year old man suffer a massive heart attack and expires 24 hours later due to ventricular arrhythmia. Histology examination of the effected heart muscle at autopsy would show anabundance of which of the following inflammatory cells A. FibroblastB. LymphocytesC. MacrophagesD. Neutrophil

19. Healing process of the human body is depending on type of the cell whos getting injury. Rapidlyregeneration cells are A. Stables cellsB. Labile cellsC. Permanent cellsD. Neurons

20. A 25 year old woman develops a sore, red, hot, swollen left knee. She has no history of traumaand no familial history of joint disease. Fluid aspirated from the joint space shows an abundanceof segmented neutrophils. Transendothelial migration of acute inflammatory cells into the

patients joint space was mediated primarily by which of the following families of proteinsA. EntactinsB. FibronectinsC. IntegrinsD. Fibrillins

21. A 4 year old boy fall on a rusty nail and punctures is skin. The wound is cleaned and coveredwith sterile gauze. Which of following is the initial event in the healing processA. Formation of a fibrin clotB. Accumulation of acute inflammatory cellsC. Deposition of proteogycans and collagenD. Differentiation and immigration of myofibroblasts

22. A 41 year old woman complains of excessive menstrual bleeding and pelvic pain of 4 months induration. She uses an intraiterin device (IUD) for contraception. Endometrial biopsy shows anexcess of plasma cells and macrophages within the uterine stroma and scattered lymphoid


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follicles. The presence of these cells within the stroma and scaterred lymphoid follicles. The presence of these cells within the stroma is evidence of which of the following conditions A. Acute inflammationB. Chronic inflammationC. Granulation tissueD. Granulomatous inflammations

23. The acute phase response consist of several clinical sign likes fever, fatique, anorexia, atc. A veryimportant mediator of the systemic effects inflammation is A. Gamma interferonB. Interleukin-2C. Interleukin-1D. Beta tumor necrosis factor

24. During early inflamation following margination of leukocytes, an important adhesive surface protein on leukocytes is A. Complement factor 5a (C5a)B. Endothelial leukocyte adhesion molecule (ELAM-1)C. Tumor necrosis factor (TNT)D. Leukocyte function antigent-1 (LFA-1)

25. The cells of the body are divided into 3 groups; labile cells, stable cells, permanent cells, whereare the stable cells have only low level replicate capacity. Which one the following examples arestable cells A. Hepatocytes and endothelialB. Hepatocytes and hematopoietic cellsC. Lens and neurons cellsD. Mucosal and endocrine cells

26. A 30 year old fire fighter suffers extensive third degree burn over his arm and hands. This patients is at high risk for developing which of following complication of wound healing A. DehiscenceB. ContractureC. KeloidD. Traumatic neuroma

27. The basic processes of healing have 3 key cellular mechanism; cell proliferation, extra cellular matrix, and cellular migration. Which one of the following example is extra cellular matrix A. FibrinB. ElastinC. IntegrinD. Laminin

28. Long term consequence of post-streptococcal diseaseA. NephrolithiasisB. CystitisC. TonsillopharyngitisD. Acute Rheumatic Fever

29. Streptococcus that Positive for QUELLUNG test isA. S.pneumoniaeB. S.bovisC. S.pyogenesD. S.agalactiae


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30. A kind of enzyme produced by Group A Streptococci can be used to treat patients suffering fromHeart Attack. The enzyme name is A. HyaluronidaseB. StreptokinaseC. DNAseD. Beta lactamase

31. Pilgrimage to Mecca (Mekah) must be vaccinated against bacteriaA. N.meningitidisB. S.aureusC. EnterococcusD. Gonococcus

32. Pelvic Inflammatory Disease (PID) is usually caused by A. S.typhiB. N.gonorrhoeaeC. S.aureusD. S.pyogenes

33. Gram positive rods that cause Food PoisoningA. B.subtilisB. B.anthracisC. B.cereusD. L.monocytogenes

34. This species is usually connected to bioterrorism A. Cl. tetaniB. Cl. BotulinumC. C. diphtheriaeD. B. anthracis

35. Pseudomembranous colitis is caused by A. Cl. tetaniB. Cl. difficileC. Cl. perfringensD. Cl. botulinum

36. The one of clinical manifestation of Neisseria gonorrhoeae infection isA. CellulitisB. BronchitisC. UrethritisD. Meningitis

37. Component of S.aureus cells wall which can bind to Fc-IgG isA. Teichoic acidB. PeptidoglycanC. LPSD. Protein A

38. Phagocytosis can be avoided by the function of this component.A. Polysaccharide capsuleB. FlagellaC. SporesD. LPS

39. Gram positive cocci arranged in grapelike clustersA. StreptococciB. PeptostreptococciC. Staphylococci


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D. Gonococci

40. Gram positive Cocci that do not produce CatalaseA. S.aureusB. S.epidermidisC. S.saphrophyticus

D. S.pyogenes41. Group of toxin in S.aureus that caused Food Poisoning is

A. EnterotoxinB. Toxic Shock Syndrome ToxinC. ExfoliatinD. Leukocidin

42. Urinary Tract Infection in catheterized patients is usually caused by A. S.aureusB. S.epidermidisC. S.saphrophyticusD. S.pneumoniae

43. Streptococcus thats included in Lancefield Group A A. E.faecalisB. S.bovisC. S.agalactiaeD. S.pyogenes

44. Non Sporeforming Gram (+) Rods that produced Exotoxin A. L. monocytogenesB. C. diphtheriaeC. Cl. tetaniD. B. anthracis

45. This species do not produced any toxin A. C. diphtheriaeB. L. monocytogenesC. Cl. tetaniD. B. anthracis

46. Anaerobic bacteria in this list isA. E. coliB. S. aureusC. N. gonorrhoeaeD. Cl. tetani

47. Intracellular Gram Negative Diplococci is a characteristic of A. PeptostreptococcusB. S. agalactiaeC. N. gonorrhoeaeD. S. epidermidis

48. Gram Positive Rod that grow Intracellular is A. C.diphtheriaeB. L.monocytogenesC. B.cereusD. Cl.difficile

49. The following infection is Predisposing Factor for Mycoses..A. HIV-AIDSB. SalmonellosisC. Shigellosis


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D. Brucellosis

50. The following mycoses is transmitted by Geophylic A. C.albicansB. E.floccosumC. H.capsulatum

D. M.canis51. This fungus is found in the form of Yeast

A. M.canisB. E.floccosumC. H.capsulatumD. C.albicans

52. This fungus is yeast with capsule A. C.albicansB. C.neoformansC. B.dermatitidisD. P.brasiliensis

53. The species is included in the group of Dimorphic Fungi A. C. immitisB. C. albicansC. T. rubrumD. M. canis

54. The most common medium to grow fungi isA. Blood agar B. MacConkey agar C. Sabouraud agar D. Nutrient

55. Direct preparation for fungi laboratory diagnosis A. Gram stainB. Ziehl NeelsenC. Neisser stainD. KOH 10% + glycerine

56. What is the characteristic of Plasmodium falcifarum A. Enlarged infected RBC with double chromatin dotsB. No enlargement of the infected RBC but with double chromatin dotsC. Fimbrae of the infected RBCD. Amoeboid appearance of the cytoplasm

57. The distinct difference between the life cycle Plasmodium vivax and Plasmodium falcifarum isthe the existence of..in the liver cells of vivax malariaA. MerozoiteB. HypnozoyteC. Crescent gametocytesD. Delicate ring

58. The average incubation period of Plasmodium falciparum isA. 3-4 daysB. 10-12 daysC. 10-12 weeksD. 1-4 months

59. Mode of infection of leismaniasis is by the A. Bite of tzetze flyB. Bite of mosquitoC. Bite of sandfly


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D. Bite of treatoma

60. Coned nose fly is the vector of A. Trypanosoma gambiese

B. Trypanosoma cruziC. Trypanosoma rhodesiense

D. Leismania donovani61. Transmission of disease through anteriostation development

A. Chagass diseaseB. Trypanosomiasis rhodesienseC. Trypanosomiasis gambienseD. Trypanosomiasis rodensiense and gambiense

62. Large kinetoplast is found in A. T. b. gambiense B. T. b. rhodesiesnseC. T. cruzi

D. Toxoplasma gondidi

63. The shape of C is found in the parasite of A. T. b. gambiense

B. T. b. rhodesienseC. T. cruziD. Amastigote

64. The habitat of Trypanosoma gambiense is in A. Connective tissuesB. Connective tissues and lymph nodesC. Lymph nodes and blood streamD. Connective tissues, lymph nodes, blood stream and central nervous system

65. Xenodiagnosis is used for the diagnosis of A. LeishmaniasisB. African trypanosomiasisC. Chagass diseaseD. Malaria

66. The disease based on Type I Hypersensitivity A. Autoimmune Hemolytic AnemiaB. Bronchial AsthmaC. SLED. Contact Dermatitis

67. Complications of typhoid fever, exception A. PerforationB. MeningitisC. CholecystitisD. Conjuntivitis

68. Several antibiotics are effective in enteric fever, exception A. PenicillinB. ChloramphenicolC. co-trimoxazoleD. Fluoroquinolones

69. The prevention living condition improve reduce the incidence of typhoid A. Sterilization of instrumentB. Routine AntibioticC. Herbal MedicineD. Sanitation


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70. Travelers to countries where enteric fever infections are endemic should be A. Sterilization of instrumentB. Routine AntibioticC. Herbal MedicineD. Typhoid vaccines

71. Routine Laboratory Findings have significantly the role out of diagnosis typhoid A. Relative lymphocytosisB. Widal testC. Salmonella IgMD. PCR

72. Human toxoplasmosis can be contracted by the A. Ingestion of underdone meat containing tissue cyst.B. Ingestion of underdone meat containing tissue cyst or swallowing of oocystC. Ingestion of isosporaD. Bitten of cat.

73. The clinical feature of toxoplasmosis is A. Asymptomatic in childB. Symptomatic in adultC. Always symptomatic in congenital infectionD. Always symptomatic in congenital infection and usually asymptomatic in adult

74. The causative agent of espundia A. Leishmania donovani B. Leishmania tropicaC. Leishmania brasislsiensis

D. Toxoplasma gondii

75. The cardinal sign on acute and active chronic inflammation are rubor, dolor, calor, and tumor.The cardinal sign of inflammation called rubor is mainly the result of A. Vasolidation of arteriolesB. Decreased interstitial hydrostatic pressureC. Increased vascular permeability of venulesD. Vasoconstriction of muscular arteries

76. Activation of receptor H 2 can cause A. Immune reactionB. BronchodilationC. Vasoconstriction of A. Coroner and A. Basiler D. Itching

77. An example of the third generation of antihistamines is A. EthilendiaminesB. PiperazinesC. PhenotiazinesD. Levocitirizines

78. Drug of choice for treating Rhinitis allergica chronic is B. DiphenhidramineC. ChlorpheniraminesD. FeksophenadineE. Levocabastine

79. In high doses, this antihistamine can be used as an anesthetic local A. PromethazinesB. TerphenadineC. Ethanolamines


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D. Scopolamines

80. Side effect of this second generation of antihistamines is cardiovascular disturbance A. DoxylaminesB. AztemizolC. Levocetirizine

D. Meclizine81. Muscarinic effect due to antihistamines utilization is

A. Tremor B. Dry mouthC. DizzinessD. Insomnia

82. Its action by inhibiting the contraction of gastric muscle A. RanitidineB. CimetidineC. FamotidineD. Nizatidine

83. The most capability in reducing gastric juice is A. CimetidineB. FamotidineC. RanitidineD. Promethazine

84. This drug is a drug of choice for conjunctivitis allergica A. AntazolineB. TerphenadineC. DyphenhidraminesD. Cetirizines

85. Glaucoma is contraindicated to A. TerphenadineB. LevocetirizineC. LoratadineD. Promethazine

86. For radical treatment is better using A. QuinineB. PrimaquineC. MefloquineD. Pyrimethamine

87. This drug is not only used for malaria, but also is used for toxoplasmosis A. ChloroquineB. PyrimethamineC. AtovaquoneD. Mefloquine

88. This antimalaria drug could not be used for chemoprophylaxis A. MefloquineB. QuinineC. ChloroquineD. Pyrimethamine

89. This drug is contraindicated for psoriasis A. PrimaquinineB. ChloroquineC. Pyrimethamine


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D. Artemisin 90. Side effect of this antimalaria can cause QT interval elevation

A. AtovaquoneB. ArtemisineC. Mefloquine

D. Primaquine91. Metochlopropamide reduces its concentration in plasma

A. AtovaquoneB. ClindamycinesC. SulfonamideD. Chloroquine

92. Its action by inhibiting of dehydrofolate reductase enzyme and tymidilate synthetase A. ChloroguanieB. ChloroquineC. ArtemisineD. Aztemisol

93. This antimalaria could not be used together with quinine A. MefloquineB. PrimaquineC. ClyndamicinesD. Doxylamine

94. This antibiotic is safe for treating malaria in pregnant woman A. ClyndamicineB. TetracyclinesC. SulfonD. Artemisin

95. Haemolytic anaemia occurred if this drug is taken by G6PD patient A. PrimaquineB. MefloquineC. AtovaquoneD. Pyrimethamine

96. The development of immunology system begins when the fetus is

B. 2 3 monthsC. 4 6 monthsD. 7 8 monthsE. Over 8 months

97. IgM receptor located in fetus surface cell when the fetus isA. 10 weeksB. 10.5 weeksC. 12 weeksD. 20 weeks

98. Cytoplasmic IgM located in....A. Stem cellB. Pre B cellC. Mature B cellD. Plasma cell

99. Humoral specific immune responds for bacteria in the mucosal layer A. IgGB. IgMC. IgED. IgA


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100. Cardinal sign on acute inflammation there are rubor, dolor, calor, and tumor. Dolor is mediated by A. BradykininB. HistamineC. Prostaglandin

D. Leukotrienes

SOAL Perkembangan Sistem Imunologi

1. Perkembangan Sistem Imunologi mulai pada janin Umur (A)A. 2 3 BulanB. 4 6 bulanC. 7 8 bulanD. lebih dari 8 bulan

2. Reseptor IgM terdapat pada permukaan sel janin umur : (B)A. 10 mingguB. 10.5 mingguC. 12 minguD. 20 minggu

3. IgM sitoplasmik terdapat pada sel : (B)A. Sel Induk B. Pre sel BC. Sel B matur D. Sel plasma

4. Antibodi utama dengan BM tinggi pada vertebrata primitifadalah: (A)

A. Antibodi analog dengan IgM pada manusiaB. Antibodi analog dengan IgG pada manusiaC. Antibodi analog dengan IgA pada manusiaD. Antibodi analog dengan IgD pada manusia

5. Coproantibodi adalah antibodi (B)A. IgGB. IgAC. IgMD. IgE

6. Sel induk limfosit akan berdiferensiasi menjadi : (A)A. sel limfosit B

B. Sel granulositC. Sel trombositD. Sel Monosit

7. Kadar serum IgG turun drastis pada saat kehidupan (B)A. JaninB. NeonatusC. Dewasa mudaD. Dewasa tua

8. Imunoglobulin sekretoris adalah : (A)A. IgG

B. IgAC. IgMD. IgD

9. Sel memori adalah sel berada dalam pengaruh lingkungan : (D)A. MakroB. MikroC. Makro dan mikroD. Molekuler


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10. Titer IgG mulai positif pada usia janin: (C)A. 10 mingguB. 10.5 mingguC. 12 mingguD. 20 minggu

ANTIMALARIA (dr. Theodorus, MmedSc)

1. Bekerja pada bentuk jaringan laten P. Ovalen dan P. Vivaks yang tersisa, setelah bentuk hepaticdilepaskan ke dalam sirkulasi :A. Pencegahan kausalB. Pengobatan supresiC. GametosidD. Pencegahan relaps (radikal)

2. Bekerja dengan mencegah terbentuknya stadium seksual eritrositik sehingga trasmisi kenyamuk dihindari :A. Pencegahan kausalB. Pengobatan supresiC. GametosidD. Pencegahan relaps (radikal)

3. Obat ini termasuk Skizontosid darah kerja lambat :A. AntifolatB. KlorokuinC. KinaD. Meflokuin

4. Obat ini tidak efektif digunakan sebagai kemoprofilaktik :A AntifolatB KlorokuinC KinaD Meflokuin

5. Salah satu ciri Atovakuon yaitu :A. Merupakan suatu devirate 4-aminokuinolinB. Kolaps membrane mitokondria meningkat bila diberi bersama proguanilC. Bentuk suspensi ketersediaan hayatinya separuh (1/2) X bentuk tabletD. Dapat di berikan pada wanita hamil dan menyusui

6. Salah satu ciri klorokuin :A. Larut dalam lipidB. Distribusinya cepat karena banyaknya obat ini di jaringanC. Tidak menimbulkan retinofatiD. Mengantagonis kerja anti konvulsan

7. Salah satu ciri Primakuin :A. Bersifat gametosidal hanya untuk P. FalciparumB. Larut dalam air dan metabolismenya cepatC. Obat alternatif untuk penyakit autoimunD. Aman untuk wanita hamil

8. Salah satu ciri Meflokuin :A. Tidak dapat diberikan pada penderita gangguan kunduksi jantungB. Berupa bubuk putih dan berasa pahitC. Artesunat menurunkan efeknyaD. Absorpsinya di saluran cerna jelek bila ada makanan


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9. Salah satu ciri Artemisin :A. Artemen larut dalam air B. Bermanfaat untuk kemoprofilaksisC. Lumefantrin meningkat efektifitasnyaD. Aman di berikan untuk penderita gangguan neurologik

10. Antimikroba ini sering digunakan oleh pelancong untuk profilaksis jangka pendek :A. TetrasiklinB. SulfonamidC. KlindamisinD. Kotrimoksasol

Kunci Jawaban Antimalaria :

1. D2. C3. A4. C5. B6. D7. B8. A9. C10. A

TUBERKULOSTATIKA (dr. Theodorus, MmedSc)

1. Obat ini termasuk tuberkulostatika golongan ke dua :A. TiosetasonB. EtionamidC. IsoniazidD. Pirazinamid

2. Obat ini mempunyai aktivitas steriliosasi di intrasel :A. RifampisinB. PirazinamidC. IsoniazidD. Sikloserin

3. Obat ini bersifat bakteriostatika di ekstraseluler :A. EtambutolB. StreptomisinC. Para amino salisilatD. Etionamid

4. Salah satu ciri Rifampisin :A. Bersifat bakterisidal di intraseluler B. Ekskresi terutama melalui urinC. Asam amino salisilat menurunkan absorpsinyaD. Meningkatkan kadar serum sulfonil urea

5. Salah satu ciri Isoniazid :A. Alkohol menurunkan efek obat iniB. Konsentrasi INH pada asetilator cepat lebih besar dari aselitator lambatC. Bekerja dengan menghambat sintesa protein


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D. Aman untuk penderita apilepsi

6. Salah satu ciri Etambutol :A. Bakteriostatik di intra dan ekstraseluler B. Aman diberikan untuk anak < 5 tahunC. Tidak menumbulkan drug fever

D. Tidak larut dalam air 7. Salah satu ciri :

A. Diabsorpsi dengan baik di intestinumB. Tidak dapat menembus plasentaC. Aman untuk penderita miastenia gravisD. Dapat di berikan untuk tularemia

8. Allopurinol digunakan untuk mengatasi efek samping obat ini berupa poliartralgiaA. Para amino salisilatB. RifampisinC. EtionamidD. Pirazinamid

9. Salah satu ciri Etionamid :A. Bekerja menghambat sintesa RNAB. Aman untuk wanita hamil dan menyusuiC. Bersifat renotoksik D. Dianjurkan diberikan bersama-sama pridoksin

10. Salah sau ciri sikloserin :A. Bekerja menghambat sintesa protein pada ribosom mikrobakteriumB. Distribusinya tidak mencapai cairan sereprospinalisC. Aman diberikan bersama-sama INHD. Kontraindikasi untuk penderita dengan gangguan gunjal

Kunci Jawaban Tuberkulostatika :1. B2. B3. C4. C5. A6. A7. D8. D9. D10. D

ORGANS OF THE IMMUNE SYSTEM (BLOCK 7)SOAL dr. JUSUF FANTONI, SpPA

1. Primary lymphoid organs in human beings are :

A. Mucosa associated lymphoid tissue (malt) & peyers patchesB. Buesa of fabricius & appendixC. Tonsil and spleenD. Bone marrow and thymus

2. Bone marrow has one the following features :A. Stromal cells survive even given dose radiationB. 90% of the pre-B cells die if they fail to from function Ig moleculesC. Bone marrow serves as a site of maturation of T-Lymphocytes


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

3. Thymes has one of the following characteristics :A. Situated above the lungs and below the thyroidB. Is the site of production of T-LymphocyteC. The cortical layer is covered with macrophages

D. Thymocytes are ;ess in the medulla4. As an organ of the immune system, thymus plays one of the following roles :

A. Following puberty, the thymus begins to enlargeB. Most precursor T-cells mature in the medullaC. Majority of the precursor T-cells die in the medulla due to apoptosisD. Thymic epithelial cells, interdigitating dendritic cells and macrophages secrete soluble

factors which influence T-cell maturation

5. Lymph node has one the following histological features :A. Is a round-shaped organ with the size of more than 3 CMSB. Most of the free cells in the node are lymphoid blast cellsC. In a stimulated node, a germinal centre may develop within the primary nodulesD. Paracortex are the areas between the capsule and the cortes

6. One of the histological findings of spleen is :A. White pulp is the small, oval/rounded grayish areas within the spenic cordB. Most of the parenchyme of the spleen is red pilpC. Lymphoctes are the main resident cell population of the splenic cordsD. The aged erythrocytes are removed by T-lymphocytes

7. Mucosa-associated lymphoid tissue (malt) has one of the following features :A. Malt is located beneath the mucosa epitheliaB. The immune response of malt also targeted against components of the foodC. Malt plasma cells produce IgG, releases onto the epithrlial surfaceD. Immune cell activation is the same as other lymphoid tissues

8. Tonsils are lymphoid organs which have one of the features mentioned below :

A. Pharyngeal tonsil (adenoid) has deep crypt which facilitate the contact of antigens with theimmune cells

B. Tonsils lymphoid nodules consist mainly of T-lymphocytesC. Tonsils share histological features with lymph nodes i.e ;. With afferent and efferent lymph

vessels and reticular fibresD. Exposure to antigens relies on the contact of antigens with cells of the immune system of

the epithelia which cover the tonsils.

9. Gut-Associated lymphoid tissue (galt) has one of the characteristics below :A. Are found only in the ileum and appendixB. Peyers patches located beneath the epithelium extend to the submucosaC. The epithelia appears squamous which allows contact of antigens with cells of the immune

systemD. T-Lymphocytes are predominant in galt.

10. To your understanding of the immune system, one of the following statements is correct :A. B and T-Lymphocytes originate from pluripotent stem cells in the bone marrows.B. T-Lymphocyte mainly developed and differentiated in thymusC. Lymph nodes are bean shapes organs which are found mainly in the neck, axilla and

inguinal areaD. When spleen is taken out of human body, that person will suffer reduced immune response

and toxicity.


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SOAL GRAM NEGATIVE

1. A patient begain to receive intravenous antibiotics dissolved in sterile saline solution developedfever within an hour. (The solution in which antibiotics were dissolved had been sterilized byautoclaving.) The IV infusion was stopped and the fluid cultured, but cultures on a variety of mediawere sterile.

Which of the following bacterial components would have been most effective in producing the patient's fever?

A. SporesB. Lipopolysaccharide.C. Capsule polysaccharide.D. Outer membrane proteins.E. Siderophores.

2. Three days after an appendectomy, a patient develops high fever. The patient's vital signs include adangerously low blood pressure. The patient's erythrocyte sedimentation rate (ESR) is above-normal. Which of the cytokines below most directly contributed to development of thesesymptoms?

A. IL-4B. IFN-gammaC. IL-8D. IL-10E. TNF-alpha

3. A hospitalized patient spikes a fever. Lactose-fermenting Gram-negative rods are isolated from a blood culture. Which of the following, produced in response to infection, played the largest role in producing the fever?

A. C3bB. IL-1C. IL-2D. IL-8E. Interferon-alpha

4. Toxin of Vibrio cholerae is:A. LOSB. Cholera toxin - activates adenylate cyclaseC. Toxin A - enterotoxinD. LPSE. ShET 1

5. The following statement are true of typhoid fever:A. The incubation period for enteric fever is 3-60 days, but symptoms typically occur in 3-5

weeksB. Patients who continue to shed bacteria for more than 1 month are considered chronic

carriersC. Detection of persistently high H antibody offers an additional way of screening for long-

term carriersD. Widal's test shows cross-reactivity with some other Salmonella speciesE. Blood culture culture is more sensitive than bone marrow

6. Drug of choice for enteric fever in children is:A. cotrimoxazoleB. ceftriaxonC. chloramphenicol

D. ampicillinE. quinolone

7. Oxygen requirements of Salmonella spp. is:A. MicroaerophilicB. AerobicC. Facultative anaerobeD. Obligate anaerobeE. Obligate aerobe

8. Morbidity of Bordetella pertussis is:
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A. FolliculitisB. Urinary tract infectionsC. Neonatal meningitisD. ConjunctivitisE. Whooping cough

9. This specimen can give the highest positivity for Salmonella typhi culture

A. bloodB. urineC. faecesD. bone marrow aspirateE. bile aspirate

10. Prolonged fever with neutropenia can be seen inA. dengue fever B. measlesC. typhoid fever D. diphtheriaE. varicella

11. Toxin of Shigella spp. is:A. Yst IIB. EnterotoxinsC. Cholera toxin - activates adenylate cyclaseD. LeukocidinE. LPS

SOAL IMUNISASI

1. The final goal of immunization is:a. to change disease epidemiology

b. to reduces disease prevalencec. eradication of diseased. to reduces disease incidencee. to protect individu from speficif disease

2. The immediate goal of immunization is:a. eradication of disease

b. to reduce disease prevalencec. to change disease epidemiologyd. to protect individu from specific diseasee. to get herd immunity

3. Ahmad is a healthy-two-months-old boy. He received the first dose of hepatitis B at 24 hours of age and BCG at 1 month of age. What vaccination are indicated (choose the best answer)?

a. Second dose of Hepatitis B b. First dose of DPT and OPVc. First dose of DPTd. First dose of DPT and Hibe. Second dose of Hepatitis B, first dose of OPV, DPT and Hib

4. Which of the following vaccines are inactivated bacterial vaccine?a. Diphtheriae, pertusis, tetanus, meningococcus

b. BCG, typhoidc. Measles, mumps, rubellad. OPV, yellow fever e. IPV, rabies

5. The following vaccine is a life attenuated viral vaccine:a. IPV, yellow fever, varicellab. Measles, mumps, rubellac. Hepatitis A, Hepatitis Bd. OPV, rabiese. Hib, cholera
http://www.med.jhu.edu/medcenter/quiz/objQuery.cgi?actionField=query&dbfield=micro&queryTypeFld=contains&queryFld=Shigella+spp.http://www.med.jhu.edu/medcenter/quiz/objQuery.cgi?actionField=query&dbfield=micro&queryTypeFld=contains&queryFld=Shigella+spp.


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6. These vaccines are included in Extended Programme of Immunization in Indonesia:a. BCG, Measles, DTP, IPV

b. BCG, Measles, DTP, MMR, Polioc. BCG, Measles, DTP, Polio, Hepatitis Bd. BCG, Measles, DTP, Polio, Hepatitis B, MMR e. BCG, Measles, DTP, Polio, Hepatitis B, MMR, Tetanus toxoid

7. A 6-month-old girl is brought to Primary Care to get BCG vaccination. The health care provider should:a. give BCG directly after doing physical examination and history taking

b. explain that its too late to give BCGc. make history taking, physical examination and doing tuberculine testd. make history taking, physical examination to check wether there is contraindicatione. give BCG directly

8. Contraindication of Measles vaccine is:a. Recent blood products

b. Close contact with immunodeficient person(s)c. Anaphylactic reaction to eggsd. Anaphylactic reaction to 2-phenoxyethanole. Anaphylactic reaction to the vaccine

9. Which administration route is incorrect?a. Measles vaccine subcutaneously in the deltoid region of an infant.

b. Hepatitis B intramuscularly in the anterolateral thigh of an infantc. BCG intracutaneously in the deltoid region of a childd. DTP intramuscularly in the upper outer quadrant of the buttock of a child.e. IPV administered subcutaneously.

10. Which vaccine listed below is most likely to produce adverse affects in animmunocompromised host?

a. Bacille Calmette-Guerin (BCG). b. Pneumococcal vaccine.c. Tetanus toxoid.d. Typhoid fever (killed-organism vaccine).e. Acellular Pertussis vaccine.

11. Which statement about the routine schedule is false?a. The first dose of hepatitis B vaccine is recommended from birth to 2 months of age.

b. The first dose of measles is ideally given at 9 months of age.c. The first dose of DTP is ideally given from birth to 2 months of age.d. The second dose of Hib vaccine is ideally given at 4 months of age.e. The fourth dose of DTaP is ideally given at 15 to 18 months of age.

12. Indication of diphtheria vaccine is:a. dirty wounds

b. travelers to areas where the disease is endemicc. chronic cardiopulmonary diseased. everyonee. inmates

13. Active microorganism suspension, or inactivated, or the fraction to evoke an immunologicresponse is called as:

a. Live attenuated vaccine b. Toxoidc. Immune serrad. Vaccinee. Inactivated vaccine

14. Freeze-sensitive vaccines :a. DTP, TT, hepB, DTP-hepB, Hib vaccines

b. DTP-hepB, OPV, Hib vaccinesc. Measles, BCG, DTP-hepB, Hib vaccinesd. DTP, TT, Measles, hepB, DTP-hepBe. TT, hepB, DTP-hepB, OPV
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SOAL INFEKSI TROPIS

1. The following statement are true of Diphtheria:a. "bull neck" is diagnostic

b. it is caused by Gram negative bacillic. toxin absorption is greatest in laryngeal diseased. Of the three strains, mitis produce more severe infection, and gravis and intermedius milder

infection.e. complete heart block is a manifestation of toxin-induced myocarditis

2. Plasma leakage in dengue infection can be manifest as:a. thrombocytopenia

b. haemoconcentrationc. leukopeniad. hypotensione. severe bleeding

3. The main defference between dengue haemorrhagic fever and dengue fever is:a. thrombocytopenia

b. haemorrhagec. plasma leakaged. hepatomegalye. positive rumple leede test

4. Kopliks spot in measles patient can be seen ata. the end of incubation period

b. the beginning of prodromal stagec. the beginning of convalescent staged. the end of eruption stagee. the beginning of eruption stage

5. The management of measles consist of:a. Vitamin A supplementation

b. Giving acyclovir c. Giving corticosteroidd. Giving profilactive antibiotice. Giving acetyl salycilat

6. A child was hospitalized with 4 days fever, myalgia, retro orbital pain, no source of infection.Physical finding reveal hepatomegaly, pleural effusion and ptechie. Laboratory result: RBC 13.5g/dL, WBC 3000/uL, hematocryte 45 vol%, platelet 80,000/uL. This patient diagnosis is:a. DHF grade I

b. DHF grade IIc. DHF grade III

d. DHF grade IVe. Dengue fever

7. The following management of diphtheria is incorrect:a. Bacteria eradication with Penicillin procaine and ADS

b. Toxin neutralizing with ADSc. Bacteria eradication with Penicillin procained. Corticosteroid is controversye. Patient isolation

8. The following statement are true of varicella zoser virus:a. Causing maculopapular rash

b. Acyclovir is usefull if given before 72 hours after onset of the rash

c. Incubation period 3 5 weeksd. Patient with shingles is not infectiouse. Remain latent in sensory ganglion after primary infection

9. Reactivation of latent varicella zoster infection manifest as:a. Varicella

b. Herpes zoster c. Eczema herpeticumd. Roseola infantume. Exanthema subitum


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10. The following characteristic of eruption in varicella is false:a. Skin lesions appear in scatter that generally involve the trunk, scalp, face, and extremities.

b. presence of lesions in many stages in any one general anatomic areac. central distribution of lesions that appear in cropsd. intense itchinge. a rapid evolution of macule to papule to vesicle to pustule to crust

SOAL SEPSIS

1. The systemic inflammation response syndrome includes which one of the following?A. Decreased level of consciousness.B. Decreased urine output.C. Evidence of bone marrow failure.D. Hypotension.E. Increased respiratory rate.

2. This pro-inflammatory mediator is produced early in the onset of sepsis and reflect the overactive

status of inflammatory:A. TNF-B. GM-CSFC. IL-10D. IL-4E. IL-13

3. Which one of the following sepsis therapeutic strategies is not targeted to inflammatory mediatorsor immune response?

A. GlukokortikoidB. Intravenous immune globulinC. Soluble TNF receptor

D. Anti-endotoxin antibodyE. Drotrecogin Alfa

4. Which one of the following is least likely to be helpful in the initial management of a child who presents with evidence of septic shock?

A. Blood glucose.B. Cerebrospinal fluid culture.C. Renal function studies.D. Serum electrolytes.E. Serum ionized calcium level.

Question 4 6 refer to the following case

A 10-year-old boy was admitted to the hospital with combustio (burned trauma). Patient is using urinecatheter. The patients vital signs are as follows: temperature 39 oC, heart rate 135 bpm, respiratory rate42 breaths/min, blood pressure 60/40 mmHg, and oxygen saturation 98% without oxygensupplementation. A chest radiograph is normal. White blood cell count is 20 x 10 3/uL and urine show35-40 white cells/hpf. No other sources of infection are identified.

5. This patients condition can best be defined asA. multiple dysfunction syndromeB. sepsisC. bacteremia

D. severe sepsisE. systemic inflammatory response syndrome6. After ensuring adequate airway and oxygenation, what is the next step in the management of this

patient?A. Antibiotic therapyB. -Blocker therapy to control heart rateC. Intravenous fluid resuscitationD. Surgical consult for gall bladder surgeryE. Vasopressor therapy with dopamine


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7. The most possible source of infection in this patient is:A. urinary tract infectionB. secondary infection of burned lesionC. pulmonary infectionD. occult bacteremiaE. gastrointestinal infection

8. Which one of the following is least likely to be associated with sepsis in a youngchild?A. Delayed capillary refill.B. Lactic acidosis.C. Normal blood pressure.D. Normal temperature.E. Tachycardia.

9. If we find this clinical change (alone) in septic patient, we can diagnose him as severe sepsis.A. Acute respiratory distress syndromeB. Renal dysfunctionC. Hematologic dysfunctionD. Neurological dysfunctionE. Respiratory dysfunction

10. The true statement about sepsis:A. During the onset of sepsis, the inflammatory system becomes hyporeactiveB. Lipopolysaccharide may contribute to Gram-negative sepsisC. Nosocomial sepsis should be treated with a second-generation cephalosporinD. Sepsis caused by H. influenzae may be associated with intravenous catheters or surgical

woundsE. Sepsis without a focus has a much better prognosis than urosepsis.

11. Which of the following statements refers to sepsis?A. Infection must be provenB. IL-1 and IL-6 activation can lead to pulmonary dysfunction through activation of

neutrophils that are attracted to lung tissue.C. The sepsis response to a gram-negative organism begins with the release of peptidoglycanD. The classic and alternate pathways of the complement system are activated by

antinflammatory cytokinesE. Release of TNF-, IL-1, and IL-6 stimulates the extrinsic coagulation cascade and produces

fibrin.

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